Abstract
Outcomes are reported for youths with serious emotional disturbance receiving customary services from community mental health service providers who receive state mental health funds. Various outcome indicators for the Child and Adolescent Functional Assessment Scale (CAFAS) are described, as well as a procedure for categorizing youths into client types based on the CAFAS subscale scores. The youth's intake assessment was compared to the last CAFAS evaluation that the youth received. A statistically significant reduction in mean CAFAS total score was observed for the entire sample and for each client type. In addition, the mean number of subscales on which the youth was rated as severely impaired significantly decreased for the total sample and for each client type. The proportion of youths who experienced a clinically meaningful improvement in functioning was 58.6%. For the subset of youths who were rated as severely impaired on one or more subscales at intake, 53.1% left services without any severe impairments. The pattern of outcome results differed for subgroups based on type and extent of impairment. Implications of these findings and suggestions for using outcome monitoring to improve services in the public mental health sector are discussed.
Similar content being viewed by others
REFERENCES
Achenbach, T. M. (1991). Manual for the Child Behavior Checklist/4-18 and 1991 Profile. Burlington: University of Vermont Department of Psychiatry.
Carpinello, S. E., Rosenberg, L., Stone, J., Schwager, M., & Felton, C. J. (2002). New York state's campaign to implement evidence-based practices for people with serious mental disorders. Psychiatric Services, 53, 153-155.
Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: Lawrence Erlbaum.
Duchnowski, A., Hall, K., Kutash, K., & Friedman, R. (1998). The alternatives to residential treatment study. In M. Epstein, K. Kutash, & A. Duchnowski (Eds.), Outcomes for children and youth with behavioral and emotional disorders and their families: Programs and evaluation best practices (pp. 55-80). Austin, TX: Pro-ed.
Greenbaum, P. E., Dedrick, R. F., Friedman, R. M., Kutash, K., Brown, E. C., Lardieri, S. P., et al. (1998). National Adolescent and Child Treatment Study (NACTS): Outcomes for children with serious emotional and behavioral disturbance. In M. H. Epstein, K. Kutash, & A. Duchnowski. (Eds.), Outcomes for children and youth with behavioral and emotional disorders and their families: Programs and evaluation best practices (pp. 21-54). Austin, TX: Pro-ed.
Henggeler, S. W., Rowland, M. D., Randall, J., Ward, D. M., Pickrel, S. G., Cunningham, P. B., et al. (1999). Home-based multisystemic therapy as an alternative to the hospitalization of youths in psychiatric crisis: Clinical outcomes. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 1331-1339.
Hodges, K. (2000a). Child and Adolescent Functional Assessment Scale (2nd Rev.). Ypsilanti: Eastern Michigan University.
Hodges, K. (2000b). Child and Adolescent Functional Assessment Scale Self-Training Manual (2nd Rev.). Ypsilanti: Eastern Michigan University.
Hodges, K. (2003). CAFAS Manual for Training Coordinators, Clinical Administrators, and Data Managers (2nd ed.). Ypsilanti: Eastern Michigan University.
Hodges, K., Doucette-Gates, A., & Kim, C. S. (2000). Predicting service utilization with the Child and Adolescent Functional Assessment Scale in a sample of youths with serious emotional disturbance served by Center for Mental Health Services-funded demonstrations. The Journal of Behavioral Health Services and Research, 27, 47-59.
Hodges, K.,Doucette-Gates, A., & Liao, Q. (1999). The relationship between the Child and Adolescent Functional Assessment Scale (CAFAS) and indicators of functioning. Journal of Child and Family Studies, 8, 109-122.
Hodges, K., & Kim, C. S. (2000). Psychometric study of the Child and Adolescent Functional Assessment Scale: Prediction of contact with the law and poor school attendance. Journal of Abnormal Child Psychology, 28, 287-297.
Hodges, K., & Wong, M. M. (1996). Psychometric characteristics of a multidimensional measure to assess impairment: The Child and Adolescent Functional Assessment Scale. Journal of Child and Family Studies, 5, 445-467.
Hodges, K., & Wong, M. M. (1997). Use of the Child and Adolescent Functional Assessment Scale to predict service utilization and cost. The Journal of Mental Health Administration, 24, 278-290.
Hodges, K., Wong, M. M., & Latessa, M. (1998). Use of the Child and Adolescent Functional Assessment Scale (CAFAS) as an outcome measure in clinical settings. The Journal of Behavioral Health Services and Research, 25, 325-336.
Hodges, K., & Wotring, J. (2000). Client typology based on functioning across domains using the CAFAS: Implications for service planning. The Journal of Behavioral Health Services and Research, 27, 257-270.
Hodges, K., & Xue, Y. (2003). Presence of multiple problems as a prognostic indicator of outcome for youth with SED. Unpublished manuscript. Eastern Michigan University.
Kazdin, A. E., Bass, D., Siegel, T., & Thomas, C. (1989). Cognitive-behavioral therapy and relationship therapy in the treatment of children referred for antisocial behavior. Journal of Consulting and Clinical Psychology, 57, 522-535.
Koch, J. R., Lewis, A., & McCall, D. (1998). A multistakeholder-driven model for developing an outcome management system. The Journal of Behavioral Health Services and Research, 25, 151-162.
Liao, Q., Manteuffel, B., Paulic, C., & Sondheimer, D. (2001). Describing the population of adolescents served in systems of care. Journal of Emotional and Behavioral Disorder, 9, 13-29.
Luborsky, L., Diguer, L., Luborsky, E., McLellan, A. T., Woody, G., & Alexander, L. (1993). Psychological Health-Sickness (PHS) as a predictor of outcomes in dynamic and other psychotherapies. Journal of Consulting and Clinical Psychology, 61, 542-548.
Manteuffel, B., Stephens, R., & Santiago, R. (2002). Overview of the national evaluation of the Comprehensive Community Mental Health Services for Children and Their Families Program and summary of current findings. Children's Services: Social Policy, Research, and Practice, 5, 3-20.
Mowbray, C. T., Grazier, K. L., & Holter, M. (2002). Managed behavioral health care in the public sector: Will it become the third shame of the states? Psychiatric Services, 53, 157-170.
Quist, R., & Matshazi, D. (2000). The Child and Adolescent Functional Assessment Scale (CAFAS): A dynamic predictor of juvenile recidivism. Adolescence, 35, 181-192.
Resendez, M., Quist, R., & Matshazi, D. (2000). A longitudinal analysis of family empowerment and client outcomes. Journal of Child and Family Studies, 9, 449-460.
Rosenblatt, J., & Furlong, M. (1998). Outcomes in a system of care for youths with emotional and behavioral disorders: An examination of differential change across clinical profiles. Journal of Child and Family Studies, 7, 217-232.
Rouse, L. W., Toprac, M. G., & MacCabe, N. A. (1998). The development of a statewide continuous evaluation system for the Texas Children's Mental Health Plan: A total quality management approach. The Journal of Behavioral Health Services and Research, 25, 194-207.
Walrath, C., Mandell, D., & Leaf, P. (2001). Responses of children with different intake profiles to mental health treatment. Psychiatric Services, 52, 196-201.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Hodges, K., Xue, Y. & Wotring, J. Use of the CAFAS to Evaluate Outcome for Youths with Severe Emotional Disturbance Served by Public Mental Health. Journal of Child and Family Studies 13, 325–339 (2004). https://doi.org/10.1023/B:JCFS.0000022038.62940.a3
Issue Date:
DOI: https://doi.org/10.1023/B:JCFS.0000022038.62940.a3