- Email: [email protected]
46.5 SPARC Program: Impact on the Trainees
CLINICAL PERSPECTIVES 46.1 — 47.0
Conclusions: Findings of this project suggest that the SPARC program was effective in improving adherence to follow-up treatment and reducing future suicide attempts among high-risk suicidal youth by providing evidence-based care that was widely accepted by patients and families.
EBP, PRE, S http://dx.doi.org/10.1016/j.jaac.2017.07.264
46.1 SPARC PROGRAM: BACKGROUND AND DEVELOPMENT Betsy D. Kennard, PsyD, University of Texas Southwestern Medical Center, [email protected] Objectives: The presentation will provide information on current evidencebased treatment approaches for suicidal youth and the development of an intensive outpatient program. Methods: Outcome data on adolescent treatment programs will be discussed, along with the development and implementation methods used to develop an intensive outpatient program. Results: Outcomes suggest that an intensive outpatient program for adolescents with suicidal behaviors is acceptable and feasible to implement with positive patient and parent satisfaction outcomes. Conclusions: Suicide-focused intensive outpatient programs providing specialized care fill an important gap in the treatment of suicidal youth and families.
EBP, PRE, S http://dx.doi.org/10.1016/j.jaac.2017.07.265
46.2 SPARC PROGRAM: IMPLEMENTATION Brooke Castillo, MA, Children’s Health System of Texas, [email protected] Objectives: This segment will discuss the implementation of the program and various modules used during the treatment. Methods: Treatment includes an initial assessment and three hours of group therapy sessions twice weekly for four to six weeks. Individual and family therapy sessions are provided as needed. Parents and teenagers attend a three-hour multifamily group therapy once a week during the first two weeks of treatment. Consultation to a child and adolescent psychiatrist is provided as needed. After discharge from the program, families are contacted at one and six months by phone to assess subsequent suicidal behaviors, service utilization, and adherence to ongoing psychiatric and psychosocial treatment recommendations. Results: The intervention approach primarily consists of 11 modules that uses several skills of CBT, DBT, mindfulness CBT, and relapse prevention CBT. The effectiveness of the modules will also be discussed during this section. Conclusions: The program was successfully implemented to 427 youth over the span of three years.
EBP, PRE, S http://dx.doi.org/10.1016/j.jaac.2017.07.266
46.3 SPARC PROGRAM: OUTCOMES Graham J. Emslie, MD, University of Texas Southwestern Medical Center, [email protected] Objectives: This presentation will present data on changes in depression, suicidality, and patient satisfaction before and after treatment and at one and six months after treatment. Methods: Patients and families completed measures of depression [Quick Inventory of Depressive SymptomatologyAdolescents (QIDS-A)], Suicidality [Concise Health Risk Tracking (CHRT)], and client satisfaction [Client Satisfaction Questionnaire (CSQ-8)] at beginning and end of treatment. Clinicians completed the Columbia Suicide Severity Rating Scales for suicidality. At one and six months, patients were interviewed for reattempt, readmission, and ongoing treatment. Results: Between 2014 and 2016, 474 youth were evaluated and 427 completed at least one session. The majority were female (79.4%), and the
S68
www.jaacap.org
mean age was 14.9 + 1.4 years. Of the participants, 81.5 percent completed the program. There was a significant improvement in depression (QIDS-A 14.1–7.2) and suicide propensity (CHRT 26.2–15.1). More than 80 percent of patients were contactable at six months, and more than 90 percent were receiving outpatient treatment. Data on reattempt and readmission rates will be presented. Conclusions: The program was effective in reducing symptoms and improving continuity of care between inpatient and outpatient treatment.
EBP, PRE, S http://dx.doi.org/10.1016/j.jaac.2017.07.267
46.4 SPARC PROGRAM: DISSEMINATION Alexandra Moorehead, BS, Children’s Health System of Texas, [email protected] Objectives: This presentation will discuss various challenges and dissemination strategies to implement Suicide Prevention and Resilience at Children’s (SPARC) program to serve underserved and low-income culturally diverse population. Methods: Qualitative interviews were conducted with suicidal teenagers (n ¼ 6), their parents (n ¼ 6), and community clinicians (n ¼ 8) to perform needs assessment. Results: Findings of the qualitative interviews will be discussed. This information is being used to make specific changes in the structure and implementation of the program to cater to the needs of such communities. Conclusions: This discussion shows the ways in which the outreach of the SPARC program will be expanded to target culturally diverse populations. This will further help in expanding the program to other groups that currently lack such treatment.
EBP, PRE, S Supported by the University of Texas Southwestern Medical Center http://dx.doi.org/10.1016/j.jaac.2017.07.268
46.5 SPARC PROGRAM: IMPACT ON THE TRAINEES Ankit Parmar, MD, University of Texas Southwestern Medical Center, [email protected] Objectives: The goal of this session is to discuss psychiatry and psychology trainees’ perspectives while they rotated through the program. Methods: Personal experience and findings of an anonymous survey will be discussed here. Results: Approximately five to seven psychiatry and psychology trainees are involved with the Suicide Prevention and Resilience at Children’s (SPARC) program each year. The survey (n ¼ 10) suggested that more than 90 percent of the trainees “agreed” or “strongly agreed” that the program made them feel more comfortable in working with suicidal patients and performing safety planning. Almost all the trainees felt that this was a valuable experience during their training and that they would recommend it to the incoming trainees. Several trainees also conducted research projects during this rotation. Conclusions: In addition to helping suicidal adolescents, the SPARC program helped train future care providers in learning different aspects of psychotherapeutic techniques and safety planning and potentially motivated them to work with this population in the future.
EBP, PRE, S http://dx.doi.org/10.1016/j.jaac.2017.07.269
CLINICAL PERSPECTIVES 47 DEVELOPING A COMMUNITY-BASED CONTINUUM OF CARE FOR CHILDREN WITH DEVELOPMENTAL DISABILITIES Robert L. Klaehn, MD, Anthem Insurance Companies, Inc., [email protected]; Kathleen Koth, DO, Medical College of Wisconsin and Children’s Hospital of Wisconsin, kkoth@chw.
J OURNAL
OF THE
AMERICAN A CADEMY OF CHILD & ADOLESCENT P SYCHIATRY VOLUME 56 NUMBER 10S OCTOBER 2017
Conclusions: Findings of this project suggest that the SPARC program was effective in improving adherence to follow-up treatment and reducing future suicide attempts among high-risk suicidal youth by providing evidence-based care that was widely accepted by patients and families.
EBP, PRE, S http://dx.doi.org/10.1016/j.jaac.2017.07.264
46.1 SPARC PROGRAM: BACKGROUND AND DEVELOPMENT Betsy D. Kennard, PsyD, University of Texas Southwestern Medical Center, [email protected] Objectives: The presentation will provide information on current evidencebased treatment approaches for suicidal youth and the development of an intensive outpatient program. Methods: Outcome data on adolescent treatment programs will be discussed, along with the development and implementation methods used to develop an intensive outpatient program. Results: Outcomes suggest that an intensive outpatient program for adolescents with suicidal behaviors is acceptable and feasible to implement with positive patient and parent satisfaction outcomes. Conclusions: Suicide-focused intensive outpatient programs providing specialized care fill an important gap in the treatment of suicidal youth and families.
EBP, PRE, S http://dx.doi.org/10.1016/j.jaac.2017.07.265
46.2 SPARC PROGRAM: IMPLEMENTATION Brooke Castillo, MA, Children’s Health System of Texas, [email protected] Objectives: This segment will discuss the implementation of the program and various modules used during the treatment. Methods: Treatment includes an initial assessment and three hours of group therapy sessions twice weekly for four to six weeks. Individual and family therapy sessions are provided as needed. Parents and teenagers attend a three-hour multifamily group therapy once a week during the first two weeks of treatment. Consultation to a child and adolescent psychiatrist is provided as needed. After discharge from the program, families are contacted at one and six months by phone to assess subsequent suicidal behaviors, service utilization, and adherence to ongoing psychiatric and psychosocial treatment recommendations. Results: The intervention approach primarily consists of 11 modules that uses several skills of CBT, DBT, mindfulness CBT, and relapse prevention CBT. The effectiveness of the modules will also be discussed during this section. Conclusions: The program was successfully implemented to 427 youth over the span of three years.
EBP, PRE, S http://dx.doi.org/10.1016/j.jaac.2017.07.266
46.3 SPARC PROGRAM: OUTCOMES Graham J. Emslie, MD, University of Texas Southwestern Medical Center, [email protected] Objectives: This presentation will present data on changes in depression, suicidality, and patient satisfaction before and after treatment and at one and six months after treatment. Methods: Patients and families completed measures of depression [Quick Inventory of Depressive SymptomatologyAdolescents (QIDS-A)], Suicidality [Concise Health Risk Tracking (CHRT)], and client satisfaction [Client Satisfaction Questionnaire (CSQ-8)] at beginning and end of treatment. Clinicians completed the Columbia Suicide Severity Rating Scales for suicidality. At one and six months, patients were interviewed for reattempt, readmission, and ongoing treatment. Results: Between 2014 and 2016, 474 youth were evaluated and 427 completed at least one session. The majority were female (79.4%), and the
S68
www.jaacap.org
mean age was 14.9 + 1.4 years. Of the participants, 81.5 percent completed the program. There was a significant improvement in depression (QIDS-A 14.1–7.2) and suicide propensity (CHRT 26.2–15.1). More than 80 percent of patients were contactable at six months, and more than 90 percent were receiving outpatient treatment. Data on reattempt and readmission rates will be presented. Conclusions: The program was effective in reducing symptoms and improving continuity of care between inpatient and outpatient treatment.
EBP, PRE, S http://dx.doi.org/10.1016/j.jaac.2017.07.267
46.4 SPARC PROGRAM: DISSEMINATION Alexandra Moorehead, BS, Children’s Health System of Texas, [email protected] Objectives: This presentation will discuss various challenges and dissemination strategies to implement Suicide Prevention and Resilience at Children’s (SPARC) program to serve underserved and low-income culturally diverse population. Methods: Qualitative interviews were conducted with suicidal teenagers (n ¼ 6), their parents (n ¼ 6), and community clinicians (n ¼ 8) to perform needs assessment. Results: Findings of the qualitative interviews will be discussed. This information is being used to make specific changes in the structure and implementation of the program to cater to the needs of such communities. Conclusions: This discussion shows the ways in which the outreach of the SPARC program will be expanded to target culturally diverse populations. This will further help in expanding the program to other groups that currently lack such treatment.
EBP, PRE, S Supported by the University of Texas Southwestern Medical Center http://dx.doi.org/10.1016/j.jaac.2017.07.268
46.5 SPARC PROGRAM: IMPACT ON THE TRAINEES Ankit Parmar, MD, University of Texas Southwestern Medical Center, [email protected] Objectives: The goal of this session is to discuss psychiatry and psychology trainees’ perspectives while they rotated through the program. Methods: Personal experience and findings of an anonymous survey will be discussed here. Results: Approximately five to seven psychiatry and psychology trainees are involved with the Suicide Prevention and Resilience at Children’s (SPARC) program each year. The survey (n ¼ 10) suggested that more than 90 percent of the trainees “agreed” or “strongly agreed” that the program made them feel more comfortable in working with suicidal patients and performing safety planning. Almost all the trainees felt that this was a valuable experience during their training and that they would recommend it to the incoming trainees. Several trainees also conducted research projects during this rotation. Conclusions: In addition to helping suicidal adolescents, the SPARC program helped train future care providers in learning different aspects of psychotherapeutic techniques and safety planning and potentially motivated them to work with this population in the future.
EBP, PRE, S http://dx.doi.org/10.1016/j.jaac.2017.07.269
CLINICAL PERSPECTIVES 47 DEVELOPING A COMMUNITY-BASED CONTINUUM OF CARE FOR CHILDREN WITH DEVELOPMENTAL DISABILITIES Robert L. Klaehn, MD, Anthem Insurance Companies, Inc., [email protected]; Kathleen Koth, DO, Medical College of Wisconsin and Children’s Hospital of Wisconsin, kkoth@chw.
J OURNAL
OF THE
AMERICAN A CADEMY OF CHILD & ADOLESCENT P SYCHIATRY VOLUME 56 NUMBER 10S OCTOBER 2017