Does engagement with an intensive outreach service predict better treatment outcomes in ‘high-risk’ youth?
Article first published online: 24 JAN 2012
© 2012 Blackwell Publishing Asia Pty Ltd
Early Intervention in Psychiatry
Volume 6, Issue 2, pages 176–184, May 2012
How to Cite
Schley, C., Yuen, K., Fletcher, K. and Radovini, A. (2012), Does engagement with an intensive outreach service predict better treatment outcomes in ‘high-risk’ youth?. Early Intervention in Psychiatry, 6: 176–184. doi: 10.1111/j.1751-7893.2011.00338.x
- Issue published online: 17 APR 2012
- Article first published online: 24 JAN 2012
- Received 25 March 2011; accepted 2 December 2011
- assertive community treatment;
- assertive outreach;
- early intervention;
- intensive case management
Aim: Engagement is critical in ensuring that the most ‘at risk’ clients receive care from psychiatric services, but the relationship between engagement and treatment outcomes remains unclear. This study investigated possible improvements in client engagement and the relationship between engagement and treatment outcomes in a group of difficult-to-engage, ‘high-risk’ young people seen by the Intensive Mobile Youth Outreach Service (IMYOS) in Western Metropolitan Melbourne, Australia.
Methods: Data from standardized outcome measures on client engagement, suicidality, hostility, well-being and functioning obtained at referral, after initial assessment and at discharge, were analysed retrospectively.
Results: Improved engagement was achieved after initial assessment and remained steady at discharge. All outcome measures showed significant improvement at discharge. Higher overall engagement following assessment was associated with decreased hostility risk and greater well-being and functioning at discharge. The engagement dimensions ‘collaboration’, ‘perceived usefulness’ and ‘client-therapist interaction’ were most consistently associated with better treatment outcomes.
Conclusion: Engagement at an early stage of treatment can be a useful predictor for later hostility risk, well-being and functioning. To promote better outcomes for difficult-to-engage youth, service delivery needs to focus on collaborative client involvement, the development of a ‘strong’ therapeutic alliance and individualization of treatment in regard to client needs.