INVESTIGATING FAMILY-BASED ALTERNATIVES TO INSTITUTION-BASED MENTAL-HEALTH-SERVICES FOR YOUTH - LESSONS LEARNED FROM THE PILOT-STUDY OF A RANDOMIZED FIELD TRIAL

The development and validation of family-based alternatives to out-of- home placements for children is an important goal in the mental health services field. The rigourous evaluation of such alternatives, howeve r, can be difficult to accomplish. The purpose of this article is to d escribe initial barriers experienced during the pilot study of a rando mized trial, funded by the National Institute of Mental Health, conduc ted in a field setting, and the strategies that were used to overcome these barriers. The randomized trial is examining home-based multisyst emic therapy as an alternative to the psychiatric hospitalization of y ouths presenting psychiatric emergencies. The pilot study illuminated the interface of treatment and services research issues, prompting sig nificant changes in the project's clinical procedures, organization, a nd supervisory processes, as well as in the project's interface with e xisting community resources for serving youths with serious emotional disturbances.