Functional outcomes of maltreated children and adolescents in a community-based rehabilitation program in Brazil: six-month improvement and baseline predictors

Child Abuse Negl. 2014 Jul;38(7):1231-7. doi: 10.1016/j.chiabu.2013.10.025. Epub 2013 Dec 2.

Abstract

This study sought to implement outcomes monitoring and to review outcome data from a community-based rehabilitation program for maltreated children and adolescents in São Paulo, Brazil. Maltreated children and adolescents (N=452) were enrolled in The Equilibrium Program (TEP), a multidisciplinary community-based rehabilitation program. About half (n=230) of the participants were successfully evaluated using the Children's Global Assessment Scale (C-GAS) at entry, 3, and/or 6 months later. Analysis of outcomes used hierarchical linear modeling of functional change from baseline. With a baseline C-GAS score of 51.7 (SD=14.22), average improvement was 2.8 and 5.5 points at 3 and 6 months, respectively (reflecting small to moderate effect sizes=0.20 and 0.39). Improvement was associated with Problems related to upbringing (p<.02) at entry and absence of Physical abuse (p<.05) and Negative life events in childhood (p<.05) but was not associated with sociodemographics or any specific psychiatric diagnosis. This study showed that outcomes monitoring is feasible in a community-based program in a developing country. Although there was no untreated control group for comparison and specific evidence-based treatments were not used, it is notable that significant improvement, with small to moderate effect size, was observed.

Keywords: Maltreated children; Mental health; Program evaluation system care.

MeSH terms

  • Adolescent
  • Brazil
  • Child
  • Child Abuse / psychology
  • Child Abuse / rehabilitation*
  • Community Mental Health Services / methods*
  • Feasibility Studies
  • Female
  • Humans
  • Male
  • Mental Disorders / psychology
  • Mental Disorders / rehabilitation*
  • Treatment Outcome