Inpatient Treatment of Children and Adolescents

Abstract

The report reviews the literature from 1975 to 2001. Conclusions from the report indicate that parental involvement is highly correlated with successful outcomes. Length of stay is not correlated with successful outcomes. Generally, extended hospitalizations provide little added benefit over shorter inpatient programs. Follow-up with community mental health is highly correlated with successful outcomes and is an integral part of maintaining goals. The therapeutic alliance is positively correlated with successful outcomes. Placement may exacerbate the sense of failure and anger, and create a sense of loss of connectedness to the family. Inpatient and residential treatment does not seem any more effective than day treatment, multi-systemic treatment, or community mental health services and is more costly. Inpatient care is generally thought of as a part of a comprehensive treatment program that includes continued treatment as an outpatient following discharge from the inpatient facility. Programs should include a focus on family involvement and establishing good therapeutic alliances. Extended hospitalization should be avoided in favor of intense community-based support and treatment, supported by brief inpatient hospitalizations with coordinated aftercare.