Reinterpreting the Fort Bragg Evaluation findings: the message does not change.

Vanderbilt Institute for Public Policy Studies, Vanderbilt University, Nashville, TN 37212, USA.
The Journal of Mental Health Administration 02/1996; 23(1):137-45.
Source: PubMed
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    ABSTRACT: Examination of the evaluation sample and the outcome data from the Fort Bragg Demonstration Project suggests that the children served were mildly disturbed, were atypical of those served in most public mental health clinics, spent less than optimal time in the new services developed, and were judged as making considerable progress with minimal treatment regardless of age or level of judged psychopathology. The use of normative outcome measures in a pre-post design was considered a major reason for failure to find any significant differences between differently treated children.
    Child Psychiatry and Human Development 02/1997; 27(4):241-54. DOI:10.1007/BF02353353 · 1.93 Impact Factor
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    ABSTRACT: This article examines research on systems of care, which are acknowledged as the current dominant paradigm in the delivery of children's mental health services. The authors conclude that systems of care produce important system-level changes. Early results suggest that these systems changes do not impact clinical outcomes, however. One plausible explanation for this finding is that system interventions are too far removed from the actual delivered services, thereby limiting their potential impact. Moreover, numerous assumptions underlying the purported effectiveness of systems of care remain unvalidated. The authors propose that the primary direction to improving children's mental health services should be through effectiveness research, in contrast to continued large-scale investments in systems research and development. Recommendations are made for addressing methodological problems that researchers will confront and for developing policies encouraging future research on the effectiveness of children's mental health services.
    Applied and Preventive Psychology 12/1997; 6(1-6). DOI:10.1016/S0962-1849(05)80062-9 · 2.27 Impact Factor
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    ABSTRACT: This study evaluates an exemplary system of care designed to provide comprehensive mental health services to children and adolescents. It was believed that the system would lead to more improvement in the functioning and symptoms of clients compared to those receiving care as usual. The project employed a randomized experimental five-wave longitudinal design with 350 families. While access to care, type of care, and the amount of care were better in the system of care, there were no differences in clinical outcomes compared to care received outside the system. In addition, children who did not receive any services, regardless of experimental condition, improved at the same rate as treated children. Similar to the Fort Bragg results, the effects of systems of care are primarily limited to system-level outcomes but do not appear to affect individual outcomes such as functioning and symptomatology.
    The Journal of Behavioral Health Services & Research 06/1999; 26(2):185-202. DOI:10.1007/BF02287490 · 1.37 Impact Factor
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