Symposia
Assessment
Angela Chiu, Ph.D.
Assistant Professor
Weill Cornell Medicine / New York Presbyterian Hospital
New York, New York
Payal Desai, M.P.H.
Director of Program Data at the Youth Anxiety Center
Columbia University/New York State Psychiatric Institute
New York, New York
Laura Skriner, PhD
Founding Member, Co-Director
The Center for Stress, Anxiety, and Mood
Summit, New Jersey
Corinne Catarozoli, PhD
Assistant Professor of Psychology in Clinical Psychiatry
Weill Cornell Medicine
New York, New York
Paul Sullivan, Ph.D.
Clinical Assistant Professor/Adolescent Inpatient Psychologist
NYU Langone Medical Center/Bellevue Hospital Center
New York, NY
Shannon M. Bennett, Ph.D.
Assistant Professor
Weill Cornell Medical School
Delmar, NY
Background: Given the wide range of diagnostic presentations treated in hospital-based acute care settings, finding efficient ways to identify and measure progress on the chief concerns of consumers in these settings is important. The current study uses a self-administered version of the Top Problems Assessment to describe treatment targets identified by youth and their caregivers presenting for care at an adolescent partial hospital setting. Caregiver-youth agreement on these chief concerns upon admission and predictors of agreement were explored.
Method: Participants were 122 youth (age range 13-19 years; Mage = 15.58, SD = 1.50), and their caregivers who were admitted to an adolescent partial hospitalization program. Youth and their caregivers completed the Screen for Child Anxiety Related Disorders (SCARED-C/P) and Patient Health Questionnaire-9 (PHQ-9) at intake along with a modified version of the Top Problems Assessment, where they were prompted nominate up to three top problems they would like addressed in treatment and supply severity ratings for these problems. All written responses for top problems were double coded by two blinded independent coders using a coding manual that categorized top problems into 25 qualitative categories representing diagnostic, symptom, and functional impairment domains.
Results: Although Diffuse Anxiety (caregivers: 49.5%; youth: 36.89%) and Depression (caregivers: 38.61%; youth: 42.62%) were the problems nominated with highest frequency, low rates of caregiver-youth agreement were found for these two codes (Diffuse Anxiety k = .03, p = .78; Depression k = .19, p = .06). These data suggest that although youth and caregivers in our sample frequently identified Diffuse Anxiety and Depression as chief concerns, these caregivers and youth rarely came from the same family. Additionally, about one-third (34.65%) of caregiver-youth pairs did not match on any target problems. No associations emerged between caregiver-youth matching and demographic factors, symptom severity or type of diagnosis.
Conclusion: Although anxiety and depression appear to be the most commonly cited top problems, disagreement on these domains as top treatment goals exist in a high acuity population seeking services through a partial hospital program. Treatment teams in acute care settings such as a partial hospital program can benefit from careful assessment surrounding the initial goals of treatment as youth and their caregivers may not agree on the referral problems upon entering a program.