Study of community-based services for children and adolescents who are severely emotionally disturbed.

This article presents the results of a descriptive study of community-based services for children and adolescents who are severely emotionally disturbed. The study was funded by the National Institute of Mental Health Child and Adolescent Service System Program (CASSP) and was designed to obtain state-of-the-art information about several promising and innovative treatment approaches emerging in the field--home-based services, crisis services, and therapeutic foster care. The methodology involved literature reviews, a survey to identify programs, detailed questionnaires to learn about identified programs, and site visits to a sample of programs in each category. Two of the service components explored in the study are described in this article. Home-based services include intensive counseling, support, and case management services provided on an outreach basis to troubled children and their families in their own home. Both crisis-oriented and longer-term home-based models are discussed. The crisis services described include a variety of innovative residential crisis services which have been highly successful as alternatives to more restrictive placements in crisis situations. The authors emphasize that these services should not be seen as panaceas but as essential components of a comprehensive, community-based system of care for emotionally disturbed youngsters and their families.