Recovery and relapse in multi-problem families following community-based multidisciplinary treatment

In a comparative group outcome study of 47 multiproblem families which received treatment from multidisciplinary child and family mental health services teams and 47 waiting list controls, it was found that treated cases showed significant improvement over the course of three months during which they attended the service. Improvement occurred in children's behavioural adjustment and maternal psychological health. Waiting list controls did not improve significantly on either of these variables during the three month treatment period. However, mean scores of the treatment group at nine months follow-up were not significantly better than pretreatment scores, indicating that gains made during treatment were lost at follow-up. An analysis of the clinical significance of changes in children's adjustment showed that while 41% of children moved from the clinical to the normal range during the course of treatment, all had relapsed at six-month follow up. These results point to the importance of developing a chronic care rather than an acute care approach to service provision for multiproblem families.