The component model of treatment in child and adolescent psychiatry: theoretical concept and empirical results.

Abstract

The paper describes the theoretical concept and practical realization of the component model of treatment in child and adolescent psychiatry. Treatment procedures in a university department of child and adolescent psychiatry are analyzed based on a sample of 4545 patients in different settings (inpatient, day patient, and outpatient settings) and applying five different treatment components (individual psychotherapy with the patient, functional therapies, parent- and family-oriented interventions, other environmental interventions and psychotropic medication). These five treatment components were applied in variable combination to different disorders and in various settings. Treatment success based on therapists' ratings is described regarding a variety of ICD-9 diagnoses. Effect sizes were calculated for outpatient treatments (total sample 1682) and for inpatient treatments (total sample 1490). The effect size in the outpatient setting was 1.01 for normal completers vs. drop-outs, 1.27 for normal completers vs. non-beginners, and 0.34 for non-beginners vs. drop-outs. The corresponding effect sizes for inpatients were 0.74 for normal completers vs. drop-outs 1.27 for normal completers vs. non-beginners, and 0.84 for non-beginners vs. drop-outs. In spite of some methodological restrictions, the results of this naturalistic study can be used to improve empirically based treatment procedures under realistic clinical conditions.