Lessons learned: Analyzing Pediatric Symptom Checklist 35 outcome data to determine optimal length of stay in Short-term Residential Therapeutic Programs (STRTP)
In 2020, approximately 9,307 youth in California were in a Short-Term Residential Therapeutic Program (STRTP). On average, these youth received services for 176 days (5.8 months) 1. Recent studies conducted on residential treatment programs show a broad range of episode lengths, with evidence that both longer and shorter stays can be associated with positive educational, employment, and permanency outcomes2. Researchers have historically used the Child and Adolescent Functional Assessment Scale (CAFAS), a 200-item scale that measures a youth’s level of functional impairment, to estimate the number of months it took for a youth to show improvement (30 or more points). However, according to the UCLA Center for Health Policy and Research, the CAFAS has significant limitations in measuring change in outcomes. Alternatively, the UCLA Center for Health Policy and Research suggests that the Pediatric Symptom Checklist 35 (PSC-35) screening assessment is best suited for monitoring the effectiveness of publicly funded child mental health care3. However, there is little to no research that examines PSC-35 outcome data to determine when improvement occurs in residential therapeutic programs.
Sycamores is a multi-service organization that provides integrated programs of specialized and intensive care and supervision serving children, youth, young adults, and families throughout the Los Angeles County as well as out of county. Sycamores’ STRTP serves 60 youth on a yearly basis and is designed to treat hard-to-place, males ages 11-18 with behavior disorders. The program aims to improve their level of functioning in the areas of education, emancipation preparation, health, behavior, and social and emotional well-being.
To assess youth’s level of functioning and comply with the Los Angeles County mandate, Sycamores STRTP established the PSC-35 tool as an agency required measure. Clinicians assess regularly and use this data to determine their course of action and create/update the youth’s treatment plan. In addition, Sycamores’ Research and Continuous Improvement (RCI) department supports to monitor PSC compliancy and uses this data to establish agency goals and demonstrate the effectiveness of the STRTP program. Historically, the RCI Department has analyzed intake and discharge data to show improvement, however this year the RCI department is analyzing PSC-35 data to determine when on average a positive/negative change occurs.
It is our hope that by sharing our experience and lessons learned from conducting an internal analysis of PSC-35 data that we can stimulate discussions on how data can be analyzed and used to inform treatment goals specifically for youth placed in STRTP. For example, information about the average time it takes youth to experience improvement can be shared with caregivers as part of a strategy to manage expectations at the beginning of treatment. Through our experience, participants will have the opportunity to learn how they can collect and analyze data and implement strategies that will help youth receive the care that they need.
1 Department of Social Services. (2022, Jan). Continuum of Care Reform(CCR) Dashboard. Retrieved from https://www.cdss.ca.gov/inforesources/data-portal/research-and-data/ccr-data-dashboard
2Huefner, J. C., Ringle, J. L., Thompson, R. W., & Wilson, F. A. (2018). Economic evaluation of residential length of stay and long-term outcomes. Residential Treatment for Children & Youth, 35(3), 192-208.
3 UCLA Center for Health Policy Research. (2017, Sept). California Child Mental Health Performance Outcomes System: Recommendation Report. Retrieved from http://healthpolicy.ucla.edu/publications/Documents/PDF/2017/California_Child_Mental_Health_Performance_Outcomes_System_Recommendation_Report.pdf