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We examined the differential outcomes in residential treatment for youths with conduct disorder (CD)--with special attention paid to interactions with age and gender--in a sample of children and adolescents in 50 residential treatment centers and group homes across Illinois. Multi-disciplinary teams rated youths ages 6-20 (N = 457) on measures of mental health and other factors within 30 days of admission, about 7 months after admission, and at discharge. While both groups initially responded similarly to treatment, the CD group performed better relative to the non-CD group over the full course of treatment, showing healthier relative change on five outcomes variables and more significant improvement. Age range moderated the relationship between CD group membership and change in work/ school performance. There were significant between groups differences within the youngest age group (6-11 years) in which the CD group worsened relative to the non-CD group. Keywords Conduct disorder * Residential treatment * Outcomes * Children * Adolescents

We describe cases from the clinical records in the Intensive Mental Health Program to illustrate the diverse presenting problems, intervention strategies, therapeutic process, and outcomes for children receiving services in this schoolbased, community-oriented treatment model. Cases reflect varying degrees of treatment response and potential factors that influence the fluctuating levels of emotional disturbance and impaired functioning in the home, school, and community. Keywords Serious emotional disturbance * School-based programs * Intensive mental health program * Case descriptions

We provide information about consumer and provider perceptions using a mixed-model pilot study within the Intensive Mental Health Project (IMHP), a school-based treatment service for children with SED and their families. Caregiver, youth, and provider questionnaires developed for this project elicited quantitative and qualitative information on treatment satisfaction, therapeutic alliance, and active involvement in treatment. Caregivers and children overall had positive perceptions of the services they received through IMHP. Providers reported very good working relationships with most children and families. Consumers also provided constructive comments about how to improve services. Our results add support to the importance of therapeutic alliance and collaboration, which are guiding principles of the IMHP. Keywords Consumer satisfaction * Serious emotional disturbance * Therapist perceptions

We examined behavioral markers of caregiver involvement and the ways in which family participation was related to treatment outcomes in 47 elementary school children with SED enrolled in a school-based intensive mental health program. Measures of caregiver involvement included therapeutic home visits, attendance at therapeutic meetings, completion of ratings on the daily point sheet, and extra communications with the therapeutic team on the point sheet. Greater initial impairment was associated with greater caregiver involvement. Greater caregiver involvement was linked to improvement in child thought processes, increased ability to provide emotional and social supports for the child, and greater overall child functioning at discharge. Our findings also reflected increased therapists' attempts to provide additional in-home services in cases where caregivers demonstrated a decline in their ability to provide for their children's physical and material needs, or in which therapists discovered that the family functioning was more impaired than what was initially assessed. We provide a case study that exemplifies many of these findings. Keywords Caregivers * Serious emotional disturbance * Clinical outcomes * Program evaluation

We investigated the use of a popular measure, the Children and Adolescent Functional Assessment Scale (CAFAS), in treatment outcome research. The sample included 70 children who had been discharged from an elementary therapeutic classroom (Intensive Mental Health Program). Significant relationships were found between decreases in CAFAS scores and optimal educational placement, contributing to evidence of the scale's discriminant validity. Clinically significant change in CAFAS scores was also investigated, with a 30 point change in score most accurately discriminating between placements after discharge. Further investigations of real world outcomes versus changes in score on this measure are warranted. Keywords CAFAS * Discriminant validity * Clinical significance * Outcomes * School-based intervention

We describe changes in adaptive functioning for children enrolled in the Intensive Mental Health Program (IMHP), an innovative model for serving children with the most severe forms of SED. Most children show marked improvements in multiple indicators of role performance and symptomatology. Although a high risk, high need group, most children attended school regularly and lived with a stable caregiver at discharge. Keywords Serious emotional disturbance * Treatment outcome * Program evaluation * School-based interventions