The cost of collaboration: Predictors of hours spent in collateral contacts

Collateral contacts, while at the heart of wraparound care, are time consuming and often non-reimbursable. This column presents data from a study of 1,639 child patients. It examined whether the amount of time that clinicians spent in collateral activities could be predicted by demographic variables, child diagnosis, parental psychopathology or family history of mental disorders, or staff variables. For every 60 minutes of direct patient contact, approximately 20 minutes of collateral activities were performed by the clinician. The best predictors of spending time in collateral activities were having parents who were not married, a mother with depression or anxiety, a child patient with a history of substance misuse or abuse, and a child patient with a history of maltreatment.