Psychotherapy outcome in public and private settings: Comparing children and adults

Melinda Mueller (2000)

Researchers have recently emphasized the importance of assessing psychotherapy's impact for children and adolescents in actual practice settings (Weisz, 1992). The relatively small amount of such research available has precluded extensive outcome comparisons among client subgroups, but there has been some suggestion that standard treatment of children might be ineffective. Weisz and his colleagues, in a series of studies and reviews, have concluded that treated children fare no better than quasi (no treatment) control groups (Weisz & Weiss, 1993; Weisz, Weiss, Han, Granger, & Morton, 1995b). No published study has directly compared outcome for children and adults the same settings using the same or similar measures. The purpose of the this study was to do such comparisons at two research consortia, one of public clinics and another of private practices. Children and adults were compared directly using identical measures of satisfaction, client rating and therapist ratings and similar symptom-oriented measures (BSI and CBCL) pre- and post-treatment. Improvement was assessed using Jacobson and Truax's Reliable Change (1992). Information gathered from public and private settings was analyzed separately. Findings revealed that in the public setting children demonstrated poorer adjustment (on symptom measures) prior to and post treatment in comparison to adults. In addition, fewer children demonstrated improvement and parents were more dissatisfied with services. In the private setting, the results were inconsistent, with adults demonstrating poorer adjustment at intake only (on Client and Therapist Ratings). Implication and future directions were suggested.