Goal setting improves retention in youth mental health: a cross-sectional analysis

Cairns, Alice J., Kavanagh, David J., Dark, Frances, and McPhail, Steven M. (2019) Goal setting improves retention in youth mental health: a cross-sectional analysis. Child and Adolescent Psychiatry and Mental Health, 13. 31.

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Background: This study explored if a youth-specific mental health service routinely set goals with young people during initial intake/assessment and if goal setting and goal quality in this service was associated with patient retention.

Methods: Consecutive initial assessments (n = 283) and administrative service data from two youth-specific health services in Australia were audited for evidence of goal setting, content and quality of the goal and number of therapy services provided after the intake/assessment process. Logistic regression was used to determine if goal setting was associated with disengagement after the assessment session, controlling for drug use, unemployment, age, gender, mental health diagnosis and service site. A consecutive sub-sample of 166 goals (74 participants), was analysed for goal quality. Each goal was assessed against three components of the SMART (specific, measurable, acceptable/achievable, realistic and timed goals) criteria; specific, measurable and timed; and assigned a goal quality score 1–3. A multiple regression explored whether goal quality was predictive of the number of sessions attended, controlling for the same variables as the logistic regression.

Results: Goal setting was evident in the records of 187 participants (66%). Although most goals were for emotional management, 24% addressed improvements in function. Of the 166 goals analysed in depth, 95 were specific, 23 measurable, but none were timed. Not setting goals during initial assessments correlated with service disengagement (OR 0.30, p > 0.001). Goal setting was positively associated with more therapy sessions attended, regardless of goal quality rating.

Conclusions: Engagement and retention of young people within mental health services can be challenging. Clinical tools such as goal setting may keep young people engaged in services longer, potentially improving clinical outcomes. Further research exploring the effectiveness of current youth service models on client-specific goal based outcomes is recommended.

Item ID: 59077
Item Type: Article (Research - C1)
ISSN: 1753-2000
Copyright Information: © The Author(s) 2019. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Funders: Australian Postgraduate Award, National Health and Medical Research Council of Australia (NHMRC)
Projects and Grants: NHMRC Hot North Early Career Fellowship APP1131932, NHMRC Fellowship APP1090440
Date Deposited: 15 Aug 2019 02:05
FoR Codes: 52 PSYCHOLOGY > 5203 Clinical and health psychology > 520304 Health psychology @ 50%
42 HEALTH SCIENCES > 4206 Public health > 420601 Community child health @ 50%
SEO Codes: 92 HEALTH > 9202 Health and Support Services > 920209 Mental Health Services @ 50%
92 HEALTH > 9205 Specific Population Health (excl. Indigenous Health) > 920501 Child Health @ 50%
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