TREATMENT PROVIDED BY A UNIVERSITY DEPART MENT OF CHILD AND ADOLESCENT-PSYCHIATRY WITH REGIONAL CARE RESPONSIBILITY AND ITS ASSOCIATED FACILITIES, AND THE ISSUE OF QUALITY ASSURANCE

In a clinical population of more than 10 000 children and adolescents the therapies used were analyzed statistically. The sample consisted o f all children and adolescents referred to the Department of Child and Adolescent Psychiatry of the University of Marburg or one of its asso ciated facilities between 1983 and 1991. Usage at each facility (inpat ient wards, outpatient clinic, day treatment ward, mobile child psychi atric service and child guidance clinic) was analyzed separately. The facilities differed markedly regarding the age and sex distribution of the clients, diagnoses made, types of treatment used and overall dura tion of treatment. Furthermore, the duration and intensity of differen t types of treatment (psychotherapy, functional therapies, parent- and family-oriented interventions, other context-oriented interventions, pharmacological treatment) differed substantially at the different fac ilities. Overall a central component of treatment was work with the pa rents and other family members; in quantitative terms, drug treatment was of minor importance. With many patients and families a combination of two or more different types of treatment was used; therefore it is very important to integrate the different therapies into a treatment plan tailored to the individual and with consistent goals. The results are discussed in connection with quality assurance.