week five discussion program

5

Psychology Week 4 Assignment

Barbara Maclure

Keiser University

Program Evaluation

11/23/2025

Method

The Program

The Tides Family Services (TFS) EOS program aims to provide home and community-based behavioral health services to children and adolescents aged 6–21 in Rhode Island, with the aim of reducing depressive symptoms while maintaining youth safety at different settings. The services are delivered to schools, homes, and other community settings with 24/7 availability. The program offers individual cognitive behavioral therapy (CBT), 24/7 crisis response, family-centered interventions, school-based support, and PHQ-A screenings (Tides Family Services, 2025). Clients receive at least one planned contact per week and phone support with additional sessions.

Definitions

The programs target all youth aged 6-21 and must be enrolled in the TFS program between 1st of January and June 30th, 2026, for issues such as depressive symptoms, risk of self-harming, family instability, or related psychosocial concerns. The primary outcome that will be evaluated is clinically meaningful improvement or change in depressive symptoms between intake and six months of participation in the program, measured by a reliable decrease in PHQ-A scores from throughout the six months. Clients are expected to participate in weekly individual sessions, as well as engage in school-based or alternative education support if crucial to their condition.

Design

The evaluation will employ a self-controlled pre-post design, which is appropriate for Tides Family Services, and will involve comparing each youth’s PHQ-A score at intake to their score at six months. This design evaluates and allows assessment of individual change in depressive symptoms over time without altering the program’s delivery. One limitation of this design is maturation, meaning some of the participants' symptoms might improve naturally over time without treatment, making it hard to determine which improvement is due to TFS services. All enrolled clients during the selected period will be included in the evaluation to provide a complete assessment of program effectiveness.

Setting

The assessment will be done in the naturalistic conditions of the Tides Family Services (TFS) EOS program currently being practiced. The program is composed of the family or private homes in the state of Rhode Island, public and alternative school environments, and community centers. The setting was chosen because it represents the real-life, actual environment of the home and community-based service model of the program. The chosen setting makes the evaluation results more ecologically valid. It helps in quantifying the outcomes of where the clients live and operate daily.

Participants

The sampling group to be used in this evaluation will include all the youth (aged between 6 and 21 years). The youths are newly enrolled in the Tides Family Services EOS program within the period of six months between January 1, 2026, and June 30, 2026. Eligibility will be conditioned by a new admission to the program within this period. The chosen youth must present with issues such as depressive symptoms, a risk of self-harm, family conflict, or other psychosocial instability. A census sampling method will be used, and this means all viable clients who have enrolled within this time frame will be contacted to take part. There will be removal of the selection bias, providing a detailed picture of the program's success with its standard client flow (Gao & Liu, 2024). This will be the best method of a practical program evaluation because it makes use of the already existing intake process without involving complicated randomization. The assessment schedule is planned to help in capturing change over time, with the primary measure taken at two key points in time. The first one is at the intake (during the first week of services to establish a baseline). The second one is at six months post-intake and it is focused on assisting in the evaluation of the progress and changes in symptoms. The procedure is conducted based on the intervention model of the program. An approximate sample size that is projected to be between 80 and 100 youth. The choice of the size of population is based on a review of the service capacity of the agency and the demographics of the region with respect to this six-month cohort. The basis of this estimation is that the program has a steady caseload and caters to a considerable number of the target population in the state.

Outcomes and Measures

The main consequence of the decrease in the intensity of depressive symptoms will be quantitatively assessed through application of the Patient Health -Adolescent version (PHQ-A). This tool was chosen with particular reference to the fact that it is the direct relationship or alignment with the program’s objective in the mitigation of depressive symptoms. PHQ-A is a self-reported instrument consisting of 9 items in which the adolescents are asked to rate the frequency of their depressive experience in the last two weeks. Its suitability to the TFS population tends to be complex. The first multifaceted aspect is that its validation was specifically carried out in adolescent groups (Mansour et al., 2020). The approach ensured that Questionnaire the questions are indeed pertinent, and the normative data can be used. Second, it has a simple structure with a Flesch-Kincaid reading level of about 4.5. Therefore, it is accessible to young people with different literacy levels and does not put a lot of administrative pressure on the individuals who are not researchers as their primary occupation. All nine items are each related to a DSM-5 criterion of major depressive disorder and are rated on a 4-item Likert scale, with 0 (not at all) to 3 (nearly every day). Each item is scored, and the resultant total summation of the scores is a consideration of the total severity (0-27) that has a clear and quantifiable measure. In terms of its psychometrics, the PHQ-A has exhibited excellent internal consistency reliability with a reported alpha of Cronbach's alpha. 89, which shows that the items are constantly measuring the same underlying construct of depression. The measure has demonstrated good convergent validity as the scores have a significant correlation with independent diagnoses of major depressive disorder and scores in other longer, well-established depression inventories. The successful program outcome of improvement will be defined as a statistically significant and clinically meaningful reduction in the sum of PHQ-A outcomes before and after the six-month follow-up period at the time of intake.

References

Gao, X., & Liu, Z. (2024). Analyzing the psychometric properties of the PHQ-9 using item response theory in a Chinese adolescent population. Annals of General Psychiatry, 23(1). https://doi.org/10.1186/s12991-024-00492-3

Mansour, M., Krishnaprasadh, D., Lichtenberger, J., & Teitelbaum, J. (2020). Implementing the Patient Health Questionnaire Modified for Adolescents to improve screening for depression among adolescents in a Federally Qualified Health Centre. BMJ Open Quality, 9(4), e000751. https://doi.org/10.1136/bmjoq-2019-000751

Tides Family Services. (2025). Home. https://www.tidesfs.org/