Investigating family-based alternatives to institution-based mental health services for youth: lessons learned from the pilot study of a randomized field trial

J Clin Child Psychol. 1997 Sep;26(3):226-33. doi: 10.1207/s15374424jccp2603_1.


The development and validation of family-based alternatives to out-of-home placements for children is an important goal in the mental health services field. The rigorous evaluation of such alternatives, however, can be difficult to accomplish. The purpose of this article is to describe initial barriers experienced during the pilot study of a randomized trial, funded by the National Institute of Mental Health, conducted in a field setting, and the strategies that were used to overcome these barriers. The randomized trial is examining home-based multisystemic therapy as an alternative to the psychiatric hospitalization of youths presenting psychiatric emergencies. The pilot study illuminated the interface of treatment and services research issues, prompting significant changes in the project's clinical procedures, organization, and supervisory processes, as well as in the project's interface with existing community resources for serving youths with serious emotional disturbances.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Affective Symptoms / diagnosis
  • Affective Symptoms / psychology
  • Affective Symptoms / therapy*
  • Combined Modality Therapy
  • Community Mental Health Services*
  • Dangerous Behavior*
  • Family Therapy*
  • Female
  • Homicide / prevention & control
  • Homicide / psychology
  • Hospitalization*
  • Hospitals, Psychiatric
  • Humans
  • Male
  • Outcome and Process Assessment, Health Care
  • Patient Care Team
  • Pilot Projects
  • Psychotic Disorders / diagnosis
  • Psychotic Disorders / psychology
  • Psychotic Disorders / therapy*
  • South Carolina
  • Suicide / prevention & control
  • Suicide / psychology