Dose-effect of children's psychosocial rehabilitation on the daily functioning of youth with serious emotional disturbance

Children's psychosocial rehabilitation (CPSR) is a promising but under-evaluated home- and community-based treatment for children with serious emotional disturbance (SED). CPSR addresses the functional impairments of children with SED through an asset-based, skill-building approach that involves multiple systems in the child's life. The present study evaluated the effectiveness of CPSR by examining the relationship between the number of hours of CPSR received (dose) and changes in children's daily functioning (effect). Data came from a retrospective review of medical charts at a site with a well-specified CPSR model. Trained raters assessed children's functioning at intake and 4 months post-intake using the Child and Adolescent Functional Assessment Scale or the Preschool and Early Childhood Functional Assessment Scale. After controlling for initial severity of impairment and receipt of concurrent psychotherapy and medication, regression analyses revealed children receiving larger doses of CPSR exhibited better daily functioning and had better odds of achieving clinically significant improvement than children receiving lower doses of CPSR. Findings suggest CPSR is a beneficial treatment for children with SED. Further study of this innovative treatment is warranted.