The CASI is the end product of many years of research conducted by Paul A. Sunseri, Psy.D. In addition to conducting research, Dr. Sunseri has over two decades of experience working in and consulting for a variety of residential treatment programs for mentally ill children and adolescents.

The CASI was developed in response to a significant problem that exists among children placed into residential treatment programs. Outcome research on residential treatment indicates that a substantial number of children are unstable in care and experience multiple placements.

Prior to the development of the CASI, there did not exist an objective, evidenced-based method to identify children at risk for multiple placements at the time they are first referred for care. Placement failure is common as higher risk children often go unrecognized when they are first placed into the residential care system. Consequently, they are often placed into settings that are ill-equipped to treat the severity of their problems (Sunseri, in review).

In order to produce relevant, useful, statistically-based information about children and adolescents referred to residential treatment programs, it was essential that the CASI have a substantial research foundation. Altogether, the CASI is based on findings from three of the largest and most comprehensive data sets ever collected on children in care. Each data set and its contribution to the CASI is briefly described here, and complete references are provided below. To obtain a copy of the User's Guide and Technical Manual for the Child and Adolescent Screening Inventory for Residential Care that describes its development and psychometric properties, please contact us and we will gladly provide it for your review.

The first data set consists of over 300 children and adolescents placed into residential care programs (Sunseri, 2001). Information collected on this sample was obtained directly from county agencies (social services, mental health, and probation) as children were being placed into residential treatment programs. Follow-up data on the outcome of placement, as well as behaviors exhibited during the course of treatment, were obtained one year from the date of placement. Many of the CASI narrative statements on serious treatment interfering behaviors (running away, requiring physical restraints or seclusions, and needing psychiatric hospitalization) are derived from this data set.

The second data set is larger, over 1,000 children and adolescents placed into a variety of residential treatment programs. In this sample, intake and follow-up discharge data were obtained directly from the residential treatment programs themselves. The CASI Behavioral Scales (Aggression, Noncompliance, Other Externalizing/Conduct Problems, Sexualized Behavior, Self-Harm, and Total Problems) are largely derived from this sample. These scales provide the user with quantitative information in the form of T-scores and percentiles that compares an individual child’s behavior referred for treatment relative to other children and adolescents in residential care. Unlike other commonly used ratings scales such as the CAFAS and the CBCL, the CASI behavioral scales allow for a direct, side-by-side comparison of the referred child's behavior to other children in residential treatment programs.

The third data set is larger still, a total of 8,933 children and adolescents who were placed into a full range of residential treatment programs. In fact, this is the largest sample of children in care collected and analyzed to date. Information on these clients was obtained at the time of intake and at discharge again by the residential treatment programs. The sections of the CASI that pertain to the Family Functioning Level and its corresponding relationship to placement stability are derived from this sample (Sunseri, 2004). Additional aspects of the predictive statements on running away are also based on this sample (Sunseri, 2003).

Finally, the CASI is based not only on these three data sets, but also on other relevant research findings culled from comprehensive literature reviews. Many of the treatment recommendations found in the CASI are based on evidenced-based treatments identified in the literature (e.g., Sunseri, 2004).

References

Sunseri, P.A. (2001). The prediction of unplanned discharge from residential treatment. Child & Youth Care Forum, 30(5), 281-301.

Sunseri, P.A. (2003). Predicting treatment termination due to running away among adolescents in residential care. Residential Treatment for Children & Youth, 21(2), 43-60.

Sunseri, P.A. (2004). Family functioning and residential treatment outcomes. Residential Treatment for Children & Youth, 21 (1), 33-53.

Sunseri, P.A. (2004). Preliminary outcomes on the use of dialectical behavior therapy to reduce hospitalization among adolescents in residential care. Residential Treatment for Children & Youth, 21 (4), 59-76.

Sunseri, P.A. (2005). User's Guide and Technical Manual for the Child and Adolescent Screening Inventory for Residential Care, 2nd Edition. Placerville, CA: Psychological Assessment Systems, Inc.

Sunseri, P.A. (in press). Reducing multiple placements, managing costs, and improving treatment outcomes among children referred to residential care facilities. Residential Treatment for Children & Youth.