Date of Award

2021

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

School Psychology

Abstract

The provision of pediatric mental health services has changed greatly over the last several decades with more children and adolescents requiring intensive mental health treatment. Despite this increase, systemic barriers continue to prevent youth from receiving appropriate treatment following psychiatric hospitalization. An important aspect of this treatment process includes a child’s return to school, one of the most common environments for a child or adolescent outside of their home. For many children, the hospital-to-school transition team may include regular and special education teachers, school psychologists, social workers or therapists, psychiatrists, medical doctors, case managers, and nurses. Because of this, it can be difficult for one group or individual to take the lead, and a diffusion of responsibility is likely to occur resulting in a transition process that is uncoordinated, disjointed, and invalidating to the child and their family. Currently, little is known about the communication and collaboration across transition service providers and how differing transition practices may impact the child’s transition. The objective of this mixed methods study was to better understand the hospital-to-school transition through the eyes of the school-based provider. Data collection was guided by the study’s core research questions which sought to gain insight into the communication and collaboration across ecological systems, employment of standardized practices and protocols, and perceived facilitators and barriers to this process. In addition, participants had the opportunity to report on their personal lived-experiences including level of satisfaction and recommendations associated with the hospital-to-school transition. In general, positive participant experiences often included structured reintegration plans, a re-entry team, and the formation of positive relationships with local hospital programs. In contrast, negative transition experiences were frequently associated with a lack of communication and collaboration across ecological systems including but not limited to hospital providers, outpatient therapists, and caregivers. Taken together, the study’s findings reveal many implications and recommendations for practice including standardized transition planning, designated roles and responsibilities, improved interdisciplinary relationships, increased communication and collaboration consistency, enhanced familial support, the implementation of preventative school-based mental health supports, and the mitigation of systemic and organizational barriers. These findings provide a contribution to the literature by delivering a more comprehensive understanding of the hospital-to-school transition from the lens of a school-based clinician. Further investigation of the hospital-to-school transition process and the effects of standardized practices and targeted interventions across key participant groups (i.e., hospital personnel, outpatient providers, families) is warranted.

Creative Commons License

Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.

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