Social Class and Child Psychiatric Practice: The Clinician's Evaluation of the Outcome of Therapy
JOHN F. McDERMOTT M.D.1,
SAUL I. HARRISON M.D.2,
JULES SCHRAGER M.S.W.3,
ELIZABETH W. KILLINS M.S.W.4, , and
BARBARA DICKERSON 5
1 Professor and chairman, department of psychiatry, University of Hawaii School of Medicine
2 Professor and training director, Children's Psychiatric Hospital, University of Michigan Medical Center, Ann Arbor, Mich. 48104
3 Director, department of social work, Children's Psychiatric Hospital, University of Michigan Medical Center, Ann Arbor, Mich. 48104
4 Supervisor and coordinator of the outpatient treatment screening committee, Children's Psychiatric Hospital, University of Michigan Medical Center, Ann Arbor, Mich. 48104
5 Research assistant, project on social class and child psychiatric practice, University of Michigan Medical Center, Children's Psychiatric Hospital, University of Michigan Medical Center, Ann Arbor, Mich. 48104
Data from the evaluation and treatment of 364 lower-, lower middle-, and upper middle-class children were compared. There was no significant difference among the three groups as to perceived improvement at termination of treatment, but longer duration of treatment was associated with greater improvement in the upper middle-class group compared with the other two. While the findings did not indicate class-related differences in basic treatment approach, they did point up subtle difficulties in application of traditional therapeutic modes to lower middle-class and lower-class patients.
