BOAM: A Visual, Explanatory Diagnostic and Psychoeducation System Used in Collaboration with Families—Feasibility and Acceptability for Children Who Are Non-Responsive to Treatment as Usual

Abstract

Many children referred to mental health services have neurodevelopmental problems, which are not always recognized because the resulting emotional and behavioral problems dominate diagnosis and treatment. BOAM (Basic needs, Order, Autonomy and Meaning) is a new diagnostic system consisting of imaginative models that explain the complexity of symptoms and underlying neuropsychological problems in a simple way. It is designed to be used in a transparent, collaborative process with families, so that family members can better understand the nature of mental health problems, thus increasing self-knowledge and mutual understanding. In this study, the feasibility of the BOAM diagnostic trajectory and subsequent treatment informed by this trajectory are evaluated clinically in 34 children who have not responded to or relapsed after treatment as usual (TAU). Parents completed questionnaires pre-test, post-test and at a 3-month follow-up. The treatment drop-out rate was 2.9%. Post-test, parents rated the BOAM trajectory positively. The questionnaires (measuring child psychopathology, attention, executive functioning, family functioning, partner relationships and parenting stress) demonstrated sensitivity to change, and therefore, seems appropriate for a future effectiveness study. A limitation was the high percentage of missing measurements both post-test (41%) and at the follow-up (41%). The BOAM diagnostic trajectory and subsequent treatment may be a feasible alternative for children who do not respond to or relapse after TAU.