Gordon K. Farley

Day Treatment for Children in the United States

This paper describes the general philosophy and characteristics of day treatment settings and provides a summary of the research examining their efficacy. While there appear to be good reasons for the continuing interest in the utilization of day treatment for seriously troubled and troubling children, there is still much to be learned about this population, including the specific gains made and the effects of different kinds of interventions.

Behavior and Personality Changes in Emotionally Disturbed Children Enrolled in a Psychoeducational Day Treatment Center

Abstract Data describing personality and behavior characteristics of emotionally disturbed children during and following treatment in a psychoeducational day treatment center are presented. Positive changes in social interactions, academic performance, intellectual performance, and self-esteem were documented after approximately 2 years of day treatment. These gains were for the most part maintained at the time of the first follow-up at 3 to 6 months following discharge and the second follow-up at 18 to 24 months following discharge. The discussion focuses on the process of change over time and on the interrelationships of the changes that occurred.

Four Perspectives on the Competence and Self-Esteem of Emotionally Disturbed Children beginning Day Treatment

Competence and self-esteem ratings of 34 children beginning day treatment were compared with ratings by their parents, psychotherapists, and teachers. Childrens scores were the highest and teachers were the lowest. Adult raters scores showed a strong trend or a significant difference on almost all subscales. There were no differences between adult rater pairs. The adults views present a close approximation of the childrens reality; the childrens views represent a defense of this reality. The results are discussed in terms of the amount of communication among rater groups, the role each adult rater has with the child, and the implications regarding treatment.

How Do Emotionally Disturbed Children Report Their Competencies and Self-Worth?

Abstract Responses of 68 children starting day psychiatric treatment (DPT) on the Piers-Harris Childrens Self-concept Scale were compared with a similar group of 34 children on the Perceived Competence Scale for Children (PCSC), a measure designed to reduce a socially desirable response set. Comparisons also were made with the PCSCs normative sample. Surprisingly, both self-concept measures drew primarily positive answers from DPT children, who were impaired in many domains. They also saw themselves as significantly more skilled at athletics and as varying less across abilities than normal children. None of the demographic variables was related to self-concept ratings. Possible explanations for these findings and directions for future research are discussed.

The Psychological Effects of Moving and Living Overseas

Abstract This study attempts to define distinctive attitudes and character traits found in American teenagers who have lived overseas in different locations for a considerable period of their lives. Such adolescents offer an extreme example of the risks and stresses of geographic relocation. Through the use of the Semantic Differential Technique and a sentence completion questionnaire, we compared the overseas adolescents with a group of high school students in the United States, matched with the overseas group for age, sex, socioeconomic status, and marital status of parents. Our findings suggest that the extent of geographic mobility, overseas residence, and sex significantly affect adolescent attitudes and personality patterns. The mobile overseas group reported less positive self concepts, greater insecurity about the future, less comfort and reliance on the support of interpersonal relationships, and less positive affect states.

Home behaviors of children in three treatment settings: an outpatient clinic, a day hospital, and an inpatient hospital.

OBJECTIVEnTo compare parents ratings of home behaviors of three groups of children: those entering an outpatient clinic, a day hospital, and an inpatient hospital. It was hypothesized that the home behaviors of children starting day and inpatient hospital treatment would be rated as significantly more deviant than those of children beginning outpatient treatment, and there would be no significant differences in behavior ratings of children beginning day and inpatient hospital treatment.nnnMETHODnA standardized behavior checklist was completed by the primary parent at the time treatment was begun. Scores on four factor scales were obtained, and a multivariate analysis of covariance was carried out.nnnRESULTSnThe hypotheses were partially supported. Children beginning day and inpatient hospitalization were seen as more disordered, anxious, and aggressive than were those starting outpatient treatment; children starting day treatment were reported as more learning disabled than were those in both outpatient and inpatient settings; and children entering the inpatient setting were perceived as more aggressive than were those in day treatment.nnnCONCLUSIONnAggressive behavior and learning disability appear to be determinants of choice of treatment setting. The progression from least to most restrictive placement was demonstrated for aggressive behavior only.

Intellectual competence of children who are beginning inpatient and day psychiatric treatment

Intellectual abilities of 300 children with serious emotional disorders, referred to either psychiatric day- or inpatient-hospital treatment, were compared. Comparisons also were made to WISC-R standardization data. The findings indicated that children referred to inpatient settings were similar in intellectual competency to children in day treatment. Also, children with serious emotional disorders did not appear to differ strongly in clinically meaningful ways from the WISC-R standardization sample, a finding that replicates results of other investigators. Three distinct, clinically useful profiles emerged from a cluster analysis of the total group that may be practical in planning educational and therapeutic interventions in treatment settings for seriously disturbed children. The profiles underscored the wide range of intellectual abilities represented among these children.

The Self-concepts of Children Entering Day Psychiatric Treatment

Self-concepts of 68 school-aged children beginning day treatment were described and compared with groups of normal and clinic referred children studied by others. The expectation that day treatment children would have significantly lower self-concept scores than normal and clinic referred children was not met. In fact, a trend in the opposite direction emerged. 75 percent of children beginning day treatment expressed primarily positive views about how they valued themselves. Those with psychoneurotic disorders had significantly higher self-concept scores than did those with personality disorders and a modest but significant inverse relationship was found between self-concept and severity of disturbance. Social class was significantly related to ratings of self-worth and accounted for 42 percent of the variance. Sex, race and IQ did not influence self-concept ratings. Treatment implications, measurement issues and suggestions for future research are discussed.

Academic achievement of children with emotional disorders treated in a day hospital program: an outcome study

Reading, spelling, and arithmetic achievement of children treated in a day psychiatric hospital was examined over time. The results indicated that the majority of children fell in the average and above achievement group and progressed evenly over time. Almost none got worse and only a few made large gains. Organic impairment ratings appeared to distinguish the three performance groups within each subject area.

The Concept of Body Image and the Remediation of Body Image Disorders

This article is an introduction to the concept of body image. The development of body image is discussed and an operational definition of body image is provided. Methods of assessing body image are discussed and a case example demonstrating the treatment of distortions of body image is given. This case study also serves to illustrate the complexity of problems with body image.