Novel Interventions in Children's Health Care (NICH): Innovative treatment for youth with complex medical conditions

There is a well-known subgroup of children and adolescents with complex medical conditions who have many psychosocial challenges that put them at risk for repeated and, at times, avoidable hospitalizations. Intensive behavioral health interventions that address the multitude of problems associated with complex medical conditions have proven effective in improving adherence to treatment, improving overall psychosocial functioning, and reducing avoidable hospitalizations. Based largely on this research, we adapted and augmented a family-based problem-solving intervention for youth with complex medical conditions who have been repeatedly hospitalized. The intervention involves intensive family based problem solving augmented with care coordination and case management. The intervention is implemented in the family's home, in the hospital, in the clinic, over e-mail, via video teleconferencing, and by text. To our knowledge, this effort is a first in the application of intensive behavioral health care for youth with complex medical conditions who are repeatedly hospitalized. We describe the theoretical and empirical underpinnings of the intervention, provide a description of the intervention using a case example, and present "lessons learned" from our efforts toward reducing hospitalizations and utilization of services in a population of youth with complex medical conditions who have repeatedly experienced avoidable hospitalizations.