Integrated, Family‐based, Partial Hospital Treatment for Complex Pediatric Illness

• Author: Rebecca S. Laptook,Michelle L. Rickerby,Thomas A. Roesler,Jack H. Nassau,Pamela C. High,Diane DerMarderosian
• Date: 01 March 2019
• Published date: 01 March 2019
• DOI: http://doi.org/10.1111/famp.12350

Integrated, Family-based, Partial Hospital Treatment

for Complex Pediatric Illness

THOMAS A. ROESLER*

JACK H. NASSAU

†

MICHELLE L. RICKERBY

†

REBECCA S. LAPTOOK

†

DIANE DERMARDEROSIAN

‡

PAMELA C. HIGH

‡

This paper describes a unique treatment program for complex pediatric illness. The Has-

bro Children’s Partial Hospital Program uses a family systems orientation, integrated

care, and a partial hospital setting to treat children with a wide range of pediatric ill nesses

that have failed outpatient and inpatient treatments. We have treated more than 2000 chil-

dren with at least 80 different ICD-9 diagnoses. The multidisciplinary tr eatment team

functions as a meta-family for children and their families who present with illness and

family beliefs that impede successful outcomes with standard care. The three features: fam-

ily systems orientation, integrated care, and partial hospital setting, hopefully interact to

create an environment that helps families expand and modify their explanatory models

regarding participating in effective medical care. The goal of treatment is for both children

and their parents to feel empowered to take control of the illness. Parents completing stan-

dardized measures at intake describe their children and families as experiencing signifi-

cant emotional distress, low levels of general family functioning, and poor quality of life.

Although the children are described as having distinct behavioral differences, the families

are described as responding to the experience of a seriously ill child in similar ways. A

treatment program that addresses the noncategorical aspects of how families respond to ill-

ness while addressing the specific diseases of the children can allow children and their

families to respond favorably to treatment.

Keywords: Complex Pediatric Illness; Family Treatment; Day Treatment;

Interdisciplinary Treatment

Fam Proc 58:68–78, 2019

INTRODUCTION

In this paper, we describe a family-based, intensive intervention that takes a noncate-

gorical approach to the treatment of a wide range of chronic or otherwise difficult to

treat pediatric illnesses. In doing so, we reopen an old debate about whether a common

treatment approach can be effective with different illnesses (Stein & Jessop, 1982). We

*Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA.

†

Division of Child and Adolescent Psychiatry, Hasbro Children’s Partial Hospital Program, Rhode Island

Hospital, Providence, RI.

‡

Department of Pediatrics, Hasbro Children’s Partial Hospital Program, Rhode Island Hospital, Providence, RI.

Correspondence concerning this article should be addressed to Jack H. Nassau, Hasbro Children’s Par-

tial Hospital Program, Potter Building, Rhode Island Hospital, 593 Eddy St. Providence, RI 02903. E-mail:

jnassau@lifespan.org

68

Family Process, Vol. 58, No. 1, 2019 ©2018 Family Process Institute

doi: 10.1111/famp.12350