Youth Mental and Behavioral Health and Placement Assessment Tools Examined in Ground-breaking New Study

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Assessment tools to help determine the best interventions, treatment, and levels of care for youth at risk is perhaps one of the most important professional tasks we can provide for these young people. Choosing the right tool for the job can be an overwhelming job. Dr. Seifert has summarized the key factors of some of the most popular tools, placed them in charts, and made them available on the web. Additionally, these charts will be updated frequently. The charts are very useful tools for professionals working with youth. Also reported in the charts are preliminary data on a (6) six-year follow up study of the CARE: Child and Adolescent Risk Evaluation and the CARE subscale for youth with Sexual Behavior Problems.

It is important to assess behavioral, mental health and placement issues when determining a treatment or case management plan for a client. Many tools have been created and are in varying stages of research and standardization. Additionally, there are risk, mental health, behavior rating scales, level of placement, and case management tools. Consequently, it is sometimes an overwhelming task to determine the right tool for a particular task.

RISK TOOLS

Determination of future risk of violence is an important forensic task. It can contribute to decisions about the appropriate level of care or structure that a youth needs. Research has demonstrated repeatedly that clinical judgment about the risk of future violence or sexual offending is no better than chance. Tools to determine this risk affect a youth's life significantly and should be reliable and valid. Youth violence risk tools developed to date include the SAVRY, PCL-YV, YLS-CMI, and the CARE.

ASSESSMENT OF PLACEMENT NEEDS

It is important to determine the appropriate level and type of services needed for all clients, so that they may be successful in their treatment, safety, and development to be the best they can be. There is a portion of the client population that have one or two minor problems that only need minimal services in one system and can bed treated i9n the community. There are also clients that are served by multiple public agencies (i.e. DSS, DJS/criminal justice, Mental Health, Education/Vocational system, Developmental Disabilities), have problems in more than one domain (i.e. psychiatric, legal, school, job, interpersonal), and need multiple services. Their families also may have numerous difficulties (i.e. abuse, violence, psychiatric problems, substance abuse) that need treatment.

“There have been a number of previous attempts to use assessments as a method of determining level of care needs for children, adolescents, and adults. However there has been no clearly defined method for linking the assessment to the need for treatment, or the level of structure best suited to deliver this treatment.” (American Academy of Child and Adolescent Psychiatry American Association of Community Psychiatrists) Consequently, it is important to look at what assessment tools and intervention models are supported by research. Developing an effective range of services is based on the use of validated assessments of multiple areas of functioning. A cost effective system of care should be based on a validated tool to determine the level and intensity of services needed. A reliable and valid case management tool is also needed to determine the type of services needed.

Several instruments have been developed in an attempt to help determine placement needs. The CAFAS, CALOCUS, YLS/CMI, CARE, and the CASII are instruments that have been developed to attempt to determine youth placement and treatment needs. The characteristics of these tools are listed in the placement chart (follow link below to the placement chart). It can be used to select the tool with the properties that are needed for a particular purpose or system. All tools have acceptable reliability, a manual and peer review.

MENTAL HEALTH ASSESSMENT

There are several tried and true instruments in the field and some newer ones. Each has its own particular strength and weakness. Again, you are looking for the best tool for the job. These mental health charts are in the very beginning stages, so look for lots of future updates.

COMPARISON CHARTS

The website link below takes you to several pages of charts that categorize and compare the various tools on several (certainly not all) criteria. This can be a beginning place to narrow down your search for the best tool for a particular job, situation, or population. It is a work in progress and will be updated frequently. The charts that are posted as of this date (6/4/05) pertain to youth risk, mental and behavioral health, placement and case management issues. As soon as they are ready, I will be posting information about adult and female assessment tools. So, check back often. I hope you find this site helpful.

CARE UPDATE

The CARE was developed by Dr. Seifert and was published by Research Press in 2003. Dr. Seifert is presently analyzing 6 years of data on violence, behavior problems, and sexual behavior problems committed by 650 study participants after the administration of the CARE. Preliminary data uphold the validity of the CARE and the CARE subscale for youth with sexual behavior problems as a valid tool to assess the risk of future youthful offending behaviors, if appropriate treatment is not provided. Correlations between CARE scores and later assaults by youth is .63 with and ROC of .91 (n = 137). Correlations between CARE subscale scores and later sexual behavior problems by Youth is .64 (ROC = .88, n = 43). This can prove to be a valuable tool for clinicians, Courts and Department of Juvenile Services.

Contact:

Kathryn Seifert, Ph.D.

410-334-6961

drkathy2@peoplepc.com

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Kathryn Seifert, Ph.D.
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410-334-6961
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