Empirical Investigation of Efficacy in Home-Based Mental Health Care

• Main Author: Athorp, Ann
• Format: Others
• Published: DigitalCommons@USU 1997
• Subjects: poverty; mental illness; home-based therapy; Psychology
• Online Access: https://digitalcommons.usu.edu/etd/3633; https://digitalcommons.usu.edu/cgi/viewcontent.cgi?article=4641&context=etd

The current study consisted of two experiments to examine the impact of home-based therapy on mental illness in multiproblem families. Review of the literature focused on the interplay between poverty and mental illness in defining multiproblem families and the utilization of home-based therapy with this population and others. Experiment 1 focused on delineating the type and severity of psychological distress in families characterized as multiproblem. Subjects were 58 participants in the Community-Family Partnership, a Comprehensive Child Development Program located at Utah State University in Logan, Utah. In this sample, serious psychological distress was evident with depression in both women and men as a primary symptom. Female participants in Experiment 1 showed psychological distress across more subscales and higher standardized mean difference effect sizes on the global subscales of the Symptom Checklist-90-Revised than male participants. Significant distress was also evident on the Somatization and Obsessive-Compulsive subscales for female participants and on the Hostility subscale for male participants. In a corollary to Experiment 1, participants in this study also fit the description of multiproblem based on their demographic characteristics. Experiment 2 implemented a home-based therapy program based on Sherman's Action Counseling model and evaluated its effectiveness in terms of reduction of psychological distress. Six individuals drawn from the Experiment 1 sample participated in Experiment 2. At pretest, they were not demographically different from the Experiment 1 sample, and they exhibited severe psychological symptoms such that their score profiles on the Symptom Checklist 90-Revised met both definitions of caseness for that instrument. These subjects participated in nine weekly sessions of home-based therapy based on the Action Counseling model. Therapy was very successful for one subject, moderately successful for four subjects, and not successful for one subject using reduction of psychological distress as the measure of effectiveness. Additionally, Experiment 2 examined elements of the therapy that contributed to effectiveness. Mastery of and implementation of the 10 Action Counseling steps appeared to contribute to therapy success. Limitations were discussed with respect to internal and external validity in the current study. Recommendations for future work were provided.