Parental satisfaction and outcome: a 4-year study in a child and adolescent mental health service

Objective: The aim of this paper is to examine the facets of parental satis faction and its relationship with clinician-rated outcome in a child and ad olescent mental health service. Method: Patients (n = 1278) consecutively assessed between 1992 and 1996 we re included in the study. When treatment ended, clinicians rated the outcom e of the intervention and parents were asked to complete a satisfaction que stionnaire. Results: Sixty-nine per cent of cases were rated by clinicians as having a positive outcome. Outpatients were more likely to be given a positive ratin g than inpatients. Satisfaction questionnaires were returned by 40% of pare nts; 76% of these were mostly or very satisfied, Satisfaction scores increa sed with the number of outpatient sessions attended but did not differ betw een inpatients and outpatients. There was a significant but small agreement (27% better than chance) between clinicians rating of outcome and parental satisfaction. Level of agreement varied according to service provided and the number of sessions attended, While rates of positive outcome increased over the study period, ratings of satisfaction were stable, Conclusions: Overall, ratings of satisfaction were comparable with those re ported in other studies. Variations in concordance between parents and clin icians show that outcome and satisfaction, although related, are different constructs influenced by different factors depending on the services provid ed. Focusing on specific aspects of satisfaction, as opposed to global meas ures, may be more useful for services, although such undertakings must be s upported with efforts to improve clinical outcomes.