Graf, Daniel (2025). Bringing Therapy AT_HOME. On the Potential of Home Treatment as Alternative to Inpatient Treatment in Child and Adolescent Psychiatry. (Thesis). Universität Bern, Bern
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Abstract
In the current climate of global crises and strained mental health systems, home treatment (HT) in child and adolescent psychiatry offers an approach to meet the growing needs of young people experiencing mental disorders. Unlike traditional inpatient treatment (IT), where patients go to a clinic, in HT a multidisciplinary treatment team brings the clinic to the patient’s home. This approach is based on the premise that the young patient’s environment is often both part of the problem and part of a sustainable solution, emphasizing strong family and systemic involvement to prevent relapse. Despite broad interest in HT for the potential to facilitate access to mental healthcare and enhance the stability of treatment effects, evidence of its effectiveness in child and adolescent psychiatry remains limited. Accordingly, this thesis aimed at a comprehensive evaluation of HT as an alternative to IT, presented across three studies. The first study provides a systematic review and meta-analytic synthesis of previous clinical trials on the topic. Both superiority and non-inferiority meta-analyses found no significant differences between HT and IT in improving the primary outcomes of psychosocial functioning and psychopathology. Studies 2 and 3 evaluated the clinical outcomes of a HT program piloted at the University Hospital of Child and Adolescent Psychiatry and Psychotherapy in Bern, Switzerland, considering both immediate (Study 2) and long-term (Study 3) treatment outcomes. Regarding the direct treatment course, no significant differences in psychopathological improvement were observed between HT and IT. However, follow-up outcomes showed greater stability in treatment effects for the HT group, with significantly better functional and psychopathological outcomes 21 months after discharge. Overall, the three studies provide macro- and micro-level evidence suggesting that HT represents an equally effective and potentially more sustainable alternative to IT for children and adolescents with mental disorders. Current methodological limitations are discussed, and implications for future research are outlined.
| Item Type: | Thesis |
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| Dissertation Type: | Cumulative |
| Date of Defense: | 30 May 2025 |
| Subjects: | 600 Technology > 610 Medicine & health |
| Institute / Center: | 07 Faculty of Human Sciences |
| Depositing User: | Hammer Igor |
| Date Deposited: | 11 Sep 2025 14:09 |
| Last Modified: | 30 Sep 2025 21:16 |
| URI: | https://boristheses.unibe.ch/id/eprint/6681 |
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