ASEBA Research

Brigitte Manteuffel, Robert Stephens, and Rolando Santiago (2002) have published an overview of the National Evaluation of the Comprehensive Community Mental Health for Children and Their Families Program. This program has established systems of care for mental health services in 67 U.S. communities. The CBCL and YSR were used to assess children at intake and follow-up. Other measures included the Child and Adolescent Functional Assessment Scale (CAFAS) completed by trained raters and the Residential-Living Environments and Placement Stability Scale (ROLES). Initial CBCL scores for over 11,000 children and YSR scores for over 7,000 youths were significantly associated with a variety of child and family risk factors. Problem scores increased significantly as the number of risk factors increased. Follow-up assessments over 2-year periods showed declines in CBCL Internalizing, Externalizing, and Total Problems scores that were statistically significant and that were also clinically significant according to Jacobson and Truax's Reliable Change Index (RCI). Although the results indicated improvement for children who remained in the study over a 2-year period, the authors pointed out that their "evaluation was not intended to be a randomized controlled trial, limiting our understanding of the impact of system change and service delivery on children's outcomes" (p. 18). Nevertheless, coordination of assessment over so many programs serving so many children was a major advance in efforts to improve and demonstrate systems of care.