Telephone Support Services (TSS)

Telephone Support Services

OVERVIEW

Telephone Support Services (TSS) is a program designed to increase medical and mental health service use among youth exhibiting psychosocial problems through a series of phone calls. The telephone interventionists assist in helping the youth understand diagnoses and treatment, finding services, and provide empathy and nonjudgmental support. The treatment and control groups showed no significant differences in service use.

DESCRIPTION OF PROGRAM

Target population: Youth age 11 to 20 exhibiting psychosocial problems.

Telephone Support Services are a series of phone calls designed to assist youth in obtaining follow-up healthcare after a medical visit. The first phone call is made one to two weeks after the medical clinic visit, the second call is made a week before the first follow-up medical appointment, and the third call is made one to two weeks after the first follow-up appointment. The calls involve both case management and motivational interviewing. The telephone interventionists assess the youth’s understanding of and interest in the physician’s recommendations and viewpoints on their psychosocial problem. The interventionist can provide assistance in finding mental healthcare. Telephone interventionists are doctoral level clinicians that complete a two-day training on motivational interviewing. Calls are recorded and supervised by a clinical psychologist and checked for fidelity by a motivational interviewing expert.

EVALUATION(S) OF PROGRAM

Stevens, J., Klima, J., Chisolm, D., & Kelleher, K. J. (2009). A trial of telephone services to increase adolescent utilization of health care for psychosocial problems. Journal of Adolescent Health, 45, 564-570.

Evaluated population: The population in this study was 179 youth age 11 to 20 recruited from a hospital’s adolescent medicine clinic. The mean age of youth was 17.2 years and the majority of the youth were female (86.7 percent). Sixty-eight percent of the youth were African American, 29 percent were white, and 2 percent were Asian.

Approach: To be eligible for the study, the youth had a score greater than 35 on the Center for Epidemiological Studies Depression Scale for Children, suicidal ideation in the past 30 days, and/or self-reported alcohol use of more than two drinks or any illegal substance use in the past 30 days. Youth were randomly assigned to the experimental Telephone Support Services (TSS) intervention (n = 89) as described above or an Enhanced Usual Care (UC+) control condition (n = 90). Youth in the UC+ control group received three phone calls at one, four, and twelve weeks after the initial screening. The calls were only made to update contact information, and the telephone interventionists did not assess patient understanding, interest in receiving services, or offer assistance. In one of the twenty UC+ calls assessed for fidelity, a youth asked about making an appointment with the adolescent medicine clinic and the interventionist told the youth to call that clinic.

Youth were assessed on utilization of primary care, emergency room care, psychiatric services, family therapy, other forms of psychotherapy, and inpatient care during the four months after initial screening.

Results: TSS had no significant impacts on medical or mental health service utilization. An analysis of possible mediating factors showed that age and receipt of motivational interviewing had no significant impact on service utilization.

SOURCES FOR MORE INFORMATION

References:

Program categorized in this guide according to the following:

Evaluated participant ages: 11-20

Program components: Counseling/therapy

Measured outcomes: Mental Health

KEYWORDS: Children, Adolescents, Youth, Young Adults, Middle School, High School, Other, Black/African American, Home-based, Case Management, Counseling/Therapy, Depression/Mood Disorders, Marijuana/Illicit/Prescription Drugs, Alcohol Use

Program information last updated on 10/5/10