Patient and Family Treatment Outcomes
New Horizons measures its results by obtaining parent-rated scores both before and after treatment on the Youth Outcomes Questionnaire (YO-Q 2.1; a measure of symptoms and behavior) and the Child & Adolescent Family Functioning Inventory (CAFFI; a measure of how well families communicate, solve problems together,
feel close and connected, and more). We also collect data on how satisfied parents are with treatment.
Treatment Outcomes
Both the YO-Q 2.1 and the CAFFI produce a Total Score as well as individual subscale scores, all of which would be expected to improve (be reduced) between the start of treatment and the end.
We perform two statistical tests to determine if the average decrease in scores is more than what would be expected by chance (statistical significance using a paired-samples t - test) and how large the treatment effect is (as measured Cohen's d).
Here's the bottom line:
The kids who complete IFFT show substantial clinical improvement: Significant reductions in mental health symptoms and problem behaviors, and far better communication and closeness with family members.
Youth Outcomes Questionnaire
Version 2.1
The above graph shows for the 40 most recent families that completed treatment, the average patient (child) YO-Q Total Score at the start of treatment was 105, which is much higher than the average score for kids in outpatient programs (78.7). That’s not unexpected given that the kids we treat generally have long-standing, serious challenges. By the end of treatment, the average score dropped to only 41. Note the YO-Q has a clinical cutoff of 47, meaning that an average score of 41 is below the cutoff and indicates a lack of clinical distress. The Total Score was reduced on average to a high degree of statistical significance (p < .0001) and with an extremely large treatment effect (d = 2.28).
The YO-Q also has five subscales (Emotional Distress, Relationship Problems (with parents and peers), Social Problems, Behavioral Challenges, and Critical Items (e.g. self-harm, suicidal thoughts, substance abuse, psychosis, etc.). Each of these scores was also reduced on average to a high degree of statistical significance (p < .0001) and all with an extremely large treatment effects.
Child and Adolescent Family Functioning Inventory
For the 40 most recent families who completed treatment, the average CAFFI Total Score at the time treatment began was 90 (almost twice that of families who do not have a child with a mental health condition), and by the end of treatment the average score dropped to just 50. The Total Score was reduced on average to a point of high statistical significance (p < .0001) and with an extremely large treatment effect d = 2.7). Note the Total Score on the CAFFI for families that aren’t in clinical distress is 50.0 or less, so on average after IFFT most families were no longer experiencing clinical distress.
The CAFFI also has subscales (Ability to Solve Problems, Managing Stress and Conflict, Closeness and Connection, and Effective Communication). Each of these scores was also reduced on average to a high degree of statistical significance
(p < .0001) and all with a extremely large treatment effects.
A Note on Our Data
We want to be honest and transparent with you about what these numbers mean.
They reflect families who completed treatment, not everyone who started it. Some families don't finish for various reasons, such as moving out of the area or a change in insurance. Less often, we're unable to help some families despite giving it our all, but this doesn't happen very often.
We also don't have a comparison group of families who tried a different kind of treatment during the same time period. We feel we deliver results pretty quickly (for most families, noticeable improvement in just a few months), though there may be other approaches out there that work just as fast — we're just not aware of any. Last, the ratings also come from parents, who are right there in the therapy with their child. Their perspective matters quite a lot to them and to us, obviously, but there isn't an independent, outside measure
of the child's progress. The closest we come to this are reports of the child's behavior in school from teachers, a very important part of their treatment. .
None of this makes the progress these families made any less real — we just believe you deserve the full scientific picture, not just the encouraging parts.
One Family's Story:
Patient Y
The patient was a 16-year-old boy who had already received several years of individual therapy, numerous psychotropic medications, an IOP program, a residential treatment program, and two psychiatric hospitalizations. Every type of mental health care, yet he continued to struggle.
He was on the spectrum, in “autistic burnout,” and had an extreme demand avoidant (PDA) profile. He would not/could not go to in-person school, and although he was technically on independent study, he refused to log into his classes or do any schoolwork.
He would become highly emotionally dysregulated (meltdowns) multiple times per week, including screaming at his parents, threatening them, throwing things, threatening suicide, and becoming physically aggressive. He was also mostly homebound and would rarely leave the house due to anxiety.
All daily demands (expectations) had already been lowered by the parents. An essential part of IFFT is to restore age-typical family expectations (asking the child or teen to be kind, help out around the house, regulate their emotions, do schoolwork, etc.), which we began doing right from the start of treatment.
The graph below shows daily numerical ratings from 1-10 kept by the parents over six months of treatment. Notice the low scores at the start of treatment and the wide variability from one day to the next.
However, over time, these scores gradually improved and remained consistently high and in the nonclinical range during the latter half of treatment and beyond.
And it wasn’t just that his scores improved. He returned successfully to in-person school after about six weeks (and did his homework), came off all medications, and meltdowns, aggression, suicidal threats, and breaking things stopped altogether (you can see those early in treatment on days in which there was a score of 2, 3, and 4). He also would routinely leave the house again and got his driver’s license.
The result was the cessation of meltdowns, better cooperation, increased closeness and connection, a much happier teenager, and
a calmer home for everyone.
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Case Example:
Patient X
This is another example of a neurodivergent 9-year-old, also prone to severe emotional dysregulation and with a extreme
demand-avoidant (PDA-type), profile.
Dysregulation stopped altogether (the days with scores of 2, 3, and ) and his daily scores increased and remained consistently high by the
conclusion of treatment.
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Overall Family Satisfaction
New Horizons Child and Family Institute asks families to periodically evaluate our work in order for us to know if we are on the right track and meeting their needs.
The above graph shows responses to the statement, "Overall, I am satisfied with the services my family and I are receiving" (175 of the most recent responses in total). As can be seen, 97.6% of our families indicated that statement is either completely true (83.2%), or very true (14.4%).
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