The relationship between the experience and success of inpatient psychotherapy treatment among children and adolescents

Objective: Examined here is the degree to which particular aspects of treatment experience in the inpatient psychotherapy of children and adolescents correlate significantly with the actual success of treatment. Methodology: Data of 95 patients hospitalised between 2002 and 2006 in the Department of Child and Adolescent Clinical Psychotherapy at the NLKH Tiefenbrunn were analysed. To assess the relationships multiple regression analyses were carried out, whereby the dependent variable was on the one hand, the retrospective estimate of treatment success by the patients by means of the Questionnaire to Assess Treatment (Fragebogen zur Beurteilung der Behandlung/FBB),and on the other, the difference on the General-Severity-Index (GSI) of the Symptom Checklist 90-R (SCL-90-R) between the time of admission and release from hospital. Patients' experience of treatment was assessed by means of the Ward Experience Questionnaire (Stationserfahrungsbogen/SEB) by Sammet and Schauenburg (1999). Results: The direct measurement of success (FBB-P-Scale Success of Treatment) correlated highly significantly with the SEB scales Expectation of Self-Efficacy, Individual Therapeutic Relationship, Atmosphere among Co-Patients, Group Cohesion, Relationship to Therapy Team, Intensity of Treatment, and with the Difference in the Estimate of Individual Therapeutic Relationship between Patient and Therapist. The indirect measure of success also correlated highly significantly with the Atmosphere among Co-Patients and the perceived Expectation of Self-Efficacy. The relationship between the Relationship to Therapy Team was also significant at the 5% level. In the subsequent regression analyses the SEB scales explained 51% of the variance between the retrospective estimates of success (FBB). The subscales Relationship to Therapy Team (beta = 0.47, t((df)) = 4.15((84)), P < .01) and Expectation of Self-Efficacy (beta = 0.32, t((df)) = 3.30((84)), P < .01) proved to be significant predictors of treatment success. Using the difference in the GSI values on the SCL-90-R as the dependent variable, the SEB scales explained 23% of the variance in treatment success, whereby Atmosphere among Co-Patients was the only significant individual subscale (beta = 0.35, t((df))= 2.63((84)), P < .01). Conclusions: The success of inpatient psychotherapy treatment among children and adolescents in the sample studied correlated significantly with particular aspects of treatment experience. In this connection, the reduction in symptoms apparent in the comparison of values at admission with those at release seems to be primarily related to the Atmosphere among Co-Patients, whereas the success of treatment as estimated directly by the patients correlates more strongly with Relationship to Therapy Team and Expectation of Self-Efficacy. Due to the correlative design of the study, the issue of causality could not be completely resolved.