Efficacy Study
Aspen Achievement Academy is one of the only wilderness programs to have monitored the treatment efficacy of their program with an outcome measure (with acceptable psychometric properties) over the last three and a half years (since 1996). In an effort to track progress made by adolescents who have attended Aspen, an outcome measure (the Youth-Outcome Questionnaire1 or Y-OQ) was used to assess adolescents as they came into the program, at graduation, and at 3, 6, and 12 months following graduation. The Y-OQ is rated by a parent and measures behavioral difficulties, depression, anxiety, interpersonal relations, and other psychological difficulties. It was thought to be appropriate in assessing progress with these teens since most of our students present with these types of difficulties.
Results indicate that clinically significant change was made by these adolescents while they were in the program. Clinically significant change is defined as change that is meaningful and noticeable. The Y-OQ defines clinically significant change as a drop of 13 points on the total score. The Y-OQ score dropped by 40 points over the course of the program. In other words, behavioral concerns, substance use, depressive symptoms, and a variety of other issues improved considerably over the course of the program.
Furthermore, symptoms continued to change after the program was done. Interestingly, at intervals of 3, 6, and 12 months following graduation, parents rated these teens as continuing to improve as demonstrated by a decrease in their Y-OQ scores. In other words, the effect of the program appears to have continued after the program is over. While these adolescents may have been attending additional treatment, it is clear that they continued to improve over time.
Finally, it is important to note that the Y-OQ suggests a range in which a score is thought to be within normal limits, or like the average teenager in the community. This range occurs with a score of 46 or below. By the 12 month follow-up, teens that attended the Aspen Achievement Academy scored a 51, which is almost in the range considered to be "normal" or like teens in the community. These adolescents had made enough progress over the course of that year, to be mostly similar to teens in the community.
By Mathew J. Hoag, Ph.D, Liscensed Clinical Psychologist
1 The Y-OQ is a 64-item outcome instrument designed to be sensitive to change (i.e., symptom reduction) in psychotherapy. It is used as both an assessment and session-to-session tracking device in psychotherapy with children age 4-17 and measures behavioral functioning in six different domains. Cutoff scores are provided (see graph) which differentiate community (a score between 0 and 46), outpatient (average score of 79), and inpatient populations (average score of 100). The Y-OQ demonstrates excellent psychometric properties.