Predictors of functional improvement in children and adolescents at a publicly funded specialist outpatient treatment clinic in a Canadian Prairie City

Psychiatry Res. 2019 Mar;273:613-623. doi: 10.1016/j.psychres.2019.01.093. Epub 2019 Jan 30.


Children's mental health problems substantially impact their functioning. For clinically treated children and adolescents, we explored the impact of mental health treatment on functioning and identified predictors of functional improvement. Outpatient clinical data from a regional publicly funded specialist outpatient treatment clinic were analyzed. The Child and Adolescent Functional Assessment Scale (CAFAS) was used to assess outcomes. Non-parametric tests were used to compare baseline and exit scores. Logistic regression analysis was used separately for children and adolescents to examine predictors of improvement. Total CAFAS scores at exit showed a significant decrease from initial scores for both age groups, indicating improvements in clients' functioning. Children and adolescents had shared predictors for initial level of dysfunction, length of treatment and the presence of pervasive behavioral impairment (PBI). Primary presenting problem, caregiver support and area of residence were only associated with outcome among children. Clients with higher initial levels of dysfunction and PBI require longer treatment cycles to reach an acceptable outcome. Shortening the length of treatment cycles may improve the efficiency of resource use but can be detrimental to some clients. Personalized treatment should be tailored to the clients with specific characteristics and needs.

Keywords: Adolescent; CAFAS; Child; Functional improvement.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Ambulatory Care / methods*
  • Ambulatory Care / psychology
  • Ambulatory Care Facilities*
  • Child
  • Cohort Studies
  • Community Mental Health Services / methods*
  • Female
  • Forecasting
  • Humans
  • Male
  • Neurodevelopmental Disorders / epidemiology
  • Neurodevelopmental Disorders / psychology
  • Neurodevelopmental Disorders / therapy*
  • Outpatients / psychology
  • Prospective Studies
  • Psychotherapy / methods
  • Recovery of Function* / physiology
  • Saskatchewan / epidemiology