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Caregiver Participation in Community-Based Mental Health Services for Children Receiving Outpatient Care

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Caregiver participation in child mental health treatment has been associated with better youth outcomes, but little is known about the amount and type of caregiver participation in usual care services for children. This study examined 1,255 caregivers’ reports of their participation in the outpatient services their children received through a large, public mental health system in the Southwest. The majority of the caregivers reported that they participated in their child’s services. Extent of participation was associated with several factors including children’s physical health and caregivers’ primary language, satisfaction with the services, feelings of support, and perceptions of barriers to participation. The findings offer some encouragement for the contextual fit for many evidence-based interventions that focus on caregiver involvement, and highlight which caregivers may need greater encouragement to participate in their child’s care.

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  1. 1.

    Nock MK, Ferriter C. Parent management of attendance and adherence in child and adolescent therapy: A conceptual and empirical review. Clinical Child and Family Psychology Review. 2005;8:149–66.

  2. 2.

    Dowell KA, Ogles BM. The effects of parent participation on child psychotherapy outcome: A meta-analytic review. Journal of Clinical Child and Adolescent Psychology. 2010;39:151–62.

  3. 3.

    Karver MS, Handelsman JB, Fields S, et al. Meta-analysis of therapeutic relationship variables in youth and family therapy: The evidence for different relationship variables in the child and adolescent treatment outcome literature. Clinical Psychology Review. 2006;26:50–65.

  4. 4.

    Haine-Schlagel, R. Brookman-Frazee, L., Fettes, DL., et al. Therapist focus on parent involvement in community-based youth psychotherapy. Journal of Child and Family Studies (in press).

  5. 5.

    Kendall PC. Treating anxiety disorders in children: Results of a randomized clinical trial. Journal of Consulting and Clinical Psychology. 1994;62:100–10.

  6. 6.

    Noser K, Bickman L. Quality indicators of children’s mental health services: Do they predict improved client outcomes? Journal of Emotional and Behavioral Disorders. 2000;8:9–18.

  7. 7.

    Patterson GR, Chamberlain P. A functional analysis of resistance during parent training therapy. Clinical Psychology: Science and Practice. 1994;1(1):53–70.

  8. 8.

    Richards MM, Bowers MJ, Lazicki T, et al. Caregiver involvement in the Intensive Mental Health Program: Influence on changes in child functioning. Journal of Child and Family Studies. 2008;17:241–52.

  9. 9.

    Baydar N, Reid MJ, Webster-Stratton C. The role of mental health factors and program engagement in the effectiveness of a preventive parenting program for Head Start mothers. Child Development. 2003;74:1433–53.

  10. 10.

    Coatsworth JD, Duncan LG, Pantin H, et al. Retaining ethnic minority parents in a preventive intervention: The quality of group process. The Journal of Primary Prevention. 2006;27:367–89.

  11. 11.

    Dumas JE, Nissley-Tsiopinis J, Moreland AD. From intent to enrollment, attendance, and participation in preventive parenting groups. Journal of Child and Family Studies. 2007;16:1–26.

  12. 12.

    Garvey C, Julion W, Fogg L, Kratovil A, et al. Measuring participation in a prevention trial with parents of young children. Research in Nursing and Health. 2006;29:212–22.

  13. 13.

    Nye CL, Zucker RA, Fitzgerald HE. Early family-based intervention in the path to alcohol problems: Rationale and relationship between treatment process characteristics and child and parenting outcomes. Journal of Studies on Alcohol. 1999;Supplement No. 13:10–21.

  14. 14.

    Baker-Ericzén MJ, Hurlburt MS, Brookman-Frazee L, et al. Comparing child, parent, and family characteristics in usual care and empirically supported treatment research samples for children with disruptive behavior disorders. Journal of Emotional and Behavioral Disorders. 2010;18:82–99.

  15. 15.

    Eyberg SM, Nelson MM, Boggs SR. Evidence-based psychosocial treatments for children and adolescents with disruptive behavior. Journal of Clinical Child and Adolescent Psychology. 2008;37:215–37.

  16. 16.

    Kendall, PC, Furr, JM, Podell, J.L. Child-focused treatment of anxiety. In: AE Kazdin, JR Weisz (Eds). Evidence-based Psychotherapies For Children and Adolescents, Second Edition. New York: Guilford Press, 2010, pp. 45–60.

  17. 17.

    Garland AF, Bickman L, Chorpita BF. Change what? Identifying quality improvement targets by investigating usual mental health care. Administration and Policy in Mental Health. 2010;37:15–26.

  18. 18.

    Israel P, Thomsen PH, Langeveld JH, et al. Child factors associated with parent involvement in usual clinical care of children and adolescents: A national register study. Nordic Journal of Psychiatry. 2007;61:173–81.

  19. 19.

    Israel P, Thomsen PH, Langeveld JH, et al. Parent-youth discrepancy in the assessment and treatment of youth in usual clinical care setting: Consequences to parent involvement. European Child and Adolescent Psychiatry. 2007;16:138–48.

  20. 20.

    Garland AF, Brookman-Frazee L, Hurlburt M, et al. Mental health care for children with disruptive behavior problems: A view inside therapists’ offices. Psychiatric Services. 2010;61:788–95.

  21. 21.

    Brunk M. Guidelines for the YSS & the YSS-F. Available at: (2001). Accessed December 22, 2011.

  22. 22.

    Riley SE, Stromberg AJ, Clark JJ. Assessing parental satisfaction with children’s mental health services with the Youth Services Survey for Families. Journal of Child and Family Studies. 2005;14:87–9.

  23. 23.

    Brunk M. The childrens MHSIP consumer survey. Ready for primetime? Available at: (2003). Accessed August 17, 2012.

  24. 24.

    Chorpita BF, Daleiden EL, Weisz JR. Identifying and selecting the common elements of evidence based interventions: A distillation and matching model. Mental Health Services Research. 2005;7:5–20.

  25. 25.

    Garland AF, Hawley KM, Brookman-Frazee L, et al. Identifying common elements of evidence-based psychosocial treatments for children’s disruptive behavior problems. Journal of the American Academy of Child and Adolescent Psychiatry. 2008;47:505–14.

  26. 26.

    Cruz TH, Marshall SW, Bowling JM, et al. The validity of a proxy acculturation scale among U.S. Hispanics. Hispanic Journal of Behavioral Sciences. 2008;30:425–46.

  27. 27.

    Ho J, Yeh M, McCabe K, et al. Parental cultural affiliation and youth mental health service use. Journal of Youth and Adolescence. 2007;36:529–42.

  28. 28.

    Corrigan, PW, River LP, Lundin RK, et al. Stigmitizing attributions about mental illness. Journal of Community Psychology. 2000;28:91–102.

  29. 29.

    Pullman MD, VanHooser S, Hoffman C, et al. Barriers to and supports of family participation in a rural system of care for children with serious emotional problems. Community Mental Health Journal. 2010;46:211–220.

  30. 30.

    Harrison, ME, McKay, MM, Bannon WM. Inner-city child mental health service use: The real question is why youth and families do not use services. Community Mental Health Journal. 2004;40:119–129.

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This work was partially supported by a contract from the San Diego Department of Health and Human services and two grants from the National Institute of Mental Health (K23MH080149 and P30MH074678). The authors would like to thank Bill Ganger, Erica Gomez, Beth Janis, Kristen Honda, Nicole Sanchez, and Shellane Villarin for their contributions to this manuscript.

Conflict of Interest

The authors do not report any conflicts of interest.

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Correspondence to Kya Fawley-King PhD.

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Fawley-King, K., Haine-Schlagel, R., Trask, E.V. et al. Caregiver Participation in Community-Based Mental Health Services for Children Receiving Outpatient Care. J Behav Health Serv Res 40, 180–190 (2013).

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  • Mental Health Service
  • Usual Care
  • Mental Health System
  • Child Mental Health
  • Public Mental Health System