Program

Oct 05, 2010

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:

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.

KEYWORDS:
Children, Adolescents, Youth, Young Adults, Middle School, High School,
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

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