Child and Adolescent Social Work Journal

, Volume 28, Issue 1, pp 63–78 | Cite as

Using a Community Participatory Research Approach to Understand Satisfaction with Psychopharmacology Among Families of Children with Psychiatric Co-Morbidities

  • Karen Hacker
  • Elisa Friedman
  • Shalini A. Tendulkar
  • Patrice Melvin
  • Maureen Jerz
  • Lisa Lambert


How do parents of children with psychiatric co-morbidities perceive their children’s use of psychiatric medications? To learn more, the Parent/Professional Advocacy League of Massachusetts (PAL), representing families of children with mental health needs, collaborated with researchers on a community-based participatory research (CBPR) study. A questionnaire assessed satisfaction with psychiatric medication as it pertained to children with psychiatric co-morbidities (n = 212). Satisfied parents were likely to employ alternative therapies and feel that prescribers had informed them about medication use and side effects. Results reinforce the need for prescribers to discuss psychopharmacology with families. CBPR improved study relevance and supported PAL’s advocacy efforts.


Psychiatric co-morbidities Children Mental health Community-based participatory research Parental satisfaction 



We would like to thank the families who made this study possible and the staff at PAL who helped design the survey, recruit participants and interpret the findings. We would also like to thank Dr. Lise Fried for her consultation on the analysis. This study was supported by a grant from the Deborah Munroe Noonan Memorial Fund of Massachusetts.

Conflict of Interest

We have no conflict of interests to report.


  1. Allen, S. (2007, October 7). Massachusetts tracks children on psychiatric drugs. Prescriptions eyed after overdose. Boston Globe.Google Scholar
  2. Anderson, R., Barbara, A., & Feldman, S. (2007). What patients want: A content analysis of key qualities that influence patient satisfaction. Journal of Medical Practice Management, 22, 255–261.PubMedGoogle Scholar
  3. Angold, A., Costello, E. J., & Erkanli, A. (1999). Comorbidity. The Journal of Child Psychology and Psychiatry, 40(1), 57–87.CrossRefGoogle Scholar
  4. Atdjian, S., & Vega, W. A. (2005). Disparities in mental health treatment in U.S. racial and ethnic minority groups: implications for psychiatrists. Psychiatric Services, 56(12), 1600–1602.CrossRefPubMedGoogle Scholar
  5. Bauermeister, J. J., Shrout, P. E., Ramirez, R., Bravo, M., Alegria, M., Martinez-Taboas, A., et al. (2007). ADHD correlates, comorbidity, and impairment in community and treated samples of children and adolescents. Journal of Abnormal Child Psychology, 35(6), 883–898.CrossRefPubMedGoogle Scholar
  6. Buller, M., & Buller, D. (1987). Physicians’ communication style and patient satisfaction. Journal of Health and Social Behavior, 28(4), 375–388.CrossRefPubMedGoogle Scholar
  7. Concannon, P., & Tang, Y. (2005). Management of attention deficity hyperactivity disorder: a parental perspective. Journal of Paediatrics and Child Health, 41, 625–630.CrossRefPubMedGoogle Scholar
  8. Cruz, M., & Pincus, H. (2002). Research on the influence that communication in Psychiatric encounters has on treatment. Psychiatric Services, 53, 1253–1265.CrossRefPubMedGoogle Scholar
  9. Davis, M. P., & Darden, P. M. (2003). Use of complementary and alternative medicine by children in the United States. Archives of Pediatrics and Adolescent Medicine, 157(4), 393–396.CrossRefPubMedGoogle Scholar
  10. Dosreis, S., Zito, J. M., Safer, D. J., Soeken, K. L., Mitchell, J. W., Jr., & Ellwood, L. C. (2003). Parental perceptions and satisfaction with stimulant medication for attention-deficit hyperactivity disorder. Journal of Developmental and Behavioral Pediatrics, 24(3), 155–162.PubMedGoogle Scholar
  11. DosReis, S., Butz, A., Lipkin, P., Anixt, J., Weiner, C., & Chernoff, R. (2006). Attitudes about stimulant medication for attention-deficit/hyperactivity disorder among African American families in an inner city community. The Journal of Behavioral Health Services and Research, 423(33), 423–430.CrossRefGoogle Scholar
  12. Ernst, E. (1999). Prevalence of complementary/alternative medicine for children: a systematic review. European Journal of Pediatrics, 158(1), 7–11.CrossRefPubMedGoogle Scholar
  13. Gharabawi, G., Greenspan, A., Rupnow, M., Kosik-Gonzalez, C., Bossie, C., Zhu, Y., et al. (2006). Reduction in psychotic symptoms as a predictor of patients satisfaction with antipsychotic medication in schizophrenia: Data from a randomized double-blind trial. BMC Psychiatry, 6, 45.CrossRefPubMedGoogle Scholar
  14. Green, A. R., Ngo-Metzger, Q., Legedza, A. T., Massagli, M. P., Phillips, R. S., & Iezzoni, L. I. (2005). Interpreter services, language concordance, and health care quality. Experiences of Asian Americans with limited English proficiency. Journal of General Internal Medicine, 20(11), 1050–1056.CrossRefPubMedGoogle Scholar
  15. SAS Institute. (2003). SAS (version 9.2). Cary, NC: SAS Institute, Inc.Google Scholar
  16. Israel, B. A., Schulz, A. J., Parker, E. A., & Becker, A. B. (1998). Review of community-based research: assessing partnership approaches to improve public health. Annual Review of Public Health, 19, 173–202.CrossRefPubMedGoogle Scholar
  17. Jensen, P. S., Bhatara, V. S., Vitiello, B., Hoagwood, K., Feil, M., & Burke, L. B. (1999). Psychoactive medication prescribing practices for U.S. children: gaps between research and clinical practice. Journal of the American Academy of Child & Adolescent Psychiatry, 38(5), 557–565.CrossRefGoogle Scholar
  18. Johnston, C., Seipp, C., Hommersen, P., Hoza, B., & Fine, S. (2005). Treatment choices and experiences in attention deficit and hyperactivity disorder: relations to parents’ beliefs and attributions. Child: Care, Health and Development, 31(6), 669–677.CrossRefGoogle Scholar
  19. Kazdin, A. E., Holland, L., & Crowley, M. (1997). Family experience of barriers to treatment and premature termination from child therapy. Journal of Consulting and Clinical Psychology, 65(3), 453–463.CrossRefPubMedGoogle Scholar
  20. Korsch, B. M., Gozzi, E. K., & Francis, V. (1968). Gaps in doctor-patient communication. 1. Doctor-patient interaction and patient satisfaction. Pediatrics, 42(5), 855–871.PubMedGoogle Scholar
  21. Kuno, E., & Rothbard, A. B. (2002). Racial disparities in antipsychotic prescription patterns for patients with schizophrenia. The American Journal of Psychiatry, 159(4), 567–572.CrossRefPubMedGoogle Scholar
  22. Lambert, W., Salzer, M., & Bickman, L. (1998). Clinical outcome, consumer satisfaction, and ad hoc ratings of improvement in children’s mental health. Journal of Consulting and Clinical Psychology, 66(66), 270–279.CrossRefPubMedGoogle Scholar
  23. Lambert, L., Jerz, M., Friedman, E., & Hacker, K. (2006). Medications and choices. The perspectives of families and youth. Boston, MA: Parent/Professional Advocacy League.Google Scholar
  24. Lazaratou, H., Anagnostopoulos, D., Alevizos, E., Haviara, F., & Ploumpidis, D. (2007). Parents attitudes and opinions on the use of psychotropic medication in mental disorders of childhood. Annals of General Psychiatry, 6, 32.CrossRefPubMedGoogle Scholar
  25. Lochman, J. (1983). Factors related to patients’ satisfaction with their medical care. Journal of Community Health, 9, 91–109.CrossRefPubMedGoogle Scholar
  26. Martin, A., Van Hoof, T., Stubbe, D., Sherwin, T., & Scahill, L. (2003). Multiple psychotropic pharmacotherapy among child and adolescent enrollees in Connecticut Medicaid managed care. Psychiatric Services, 54, 72–77.CrossRefPubMedGoogle Scholar
  27. Minkler, M., & Wallerstein, N. (2003). Introduction to community based participatory research, in community-based participatory research for health. San Francisco, CA: Jossey-Bass.Google Scholar
  28. Olfson, M., Marcus, S. C., Weissman, M. M., & Jensen, P. S. (2002). National trends in the use of psychotropic medications by children. Journal of the American Academy of Child & Adolescent Psychiatry, 41(5), 514–521.CrossRefGoogle Scholar
  29. Olson, A. L., Kelleher, K. J., Kemper, K. J., Zuckerman, B. S., Hammond, C. S., & Dietrich, A. J. (2001). Primary care pediatricians’ roles and perceived responsibilities in the identification and management of depression in children and adolescents. Ambulatory Pediatrics, 1(2), 91–98.CrossRefPubMedGoogle Scholar
  30. Plunkett, J. (1984). Parents’ treatment expectation and attrition from child psychiatric services. Journal of Clinical Psychology, 40, 372–377.CrossRefPubMedGoogle Scholar
  31. Rappaport, N., & Chubinsky, P. (2000). The meaning of psychotropic medications for children, adolescents, and their families. Journal of the American Academy of Child & Adolescent Psychiatry, 39(9), 1198–1200.CrossRefGoogle Scholar
  32. Rappaport, N., Prince, J. B., & Bostic, J. Q. (2005). Lost in the black box: juvenile depression, suicide, and the FDA’s black box. Journal of Pediatrics, 147(6), 719–720.CrossRefPubMedGoogle Scholar
  33. Ritvo, R., Al-mateen, C., Ascherman, L., Beardslee, W., Hartmann, L., Lewis, O., et al. (1999). Report of the psychotherapy task force of the American Academy of Child and Adolescent Psychiatry. Journal of Psychotherapy Practice and Research, 8(2), 93–102.PubMedGoogle Scholar
  34. Roberts, R., Roberts, C., & Xing, Y. (2007). Rates of DSM-IV psychiatric disorders among adolescents in a large metropolitan area. Journal of Psychiatric Research, 41, 959–967.CrossRefPubMedGoogle Scholar
  35. Shtatland, E., Kleinman, K., & Cain, E. (2004, March 30–April 3). Stepwise methods in using SAS Proc Logistic and SAS Enterprise Miner for Prediction. Paper presented at the Proceedings of the 28th Annual SAS Users Group International Conference, Seattle, WA.Google Scholar
  36. Sinha, D., & Efron, D. (2005). Complementary and alternative medicine use in children with attention deficit hyperactivity disorder. Journal of Paediatrics and Child Health, 41(1–2), 23–26.CrossRefPubMedGoogle Scholar
  37. Stevens, J., Harman, J. S., & Kelleher, K. J. (2005). Sociodemographic and economic comparisons of children prescribed longer-acting versus short-acting stimulant medications for attention deficit hyperactivity disorder. The Journal of Behavioral Health Services and Research, 32(4), 430–437.CrossRefGoogle Scholar
  38. PAL Membership Survey (2009). Parent Professional Advocacy League. Accessed 22 Oct 2006.
  39. US Food and Drug Administration FDA News. (2004). FDA launches a multi-pronged strategy to strengthen safeguards for children treated with antidepressant medications. Accessed 3 Sept 2007.
  40. Warner, L. A., Pottick, K. J., & Mukherjee, A. (2004). Use of psychotropic medications by youths with psychiatric diagnoses in the U.S. mental health system. Psychiatric Services, 55(3), 309–311.CrossRefPubMedGoogle Scholar
  41. Wolraich, M. (2003). Annotation: The use of psychotropic medications in children: An American view. The Journal of Child Psychology and Psychiatry, 44, 159–168.CrossRefGoogle Scholar
  42. Zandbelt, L. C., Smets, E. M., Oort, F. J., Godfried, M. H., & de Haes, H. C. (2007). Medical specialists’ patient-centered communication and patient-reported outcomes. Medical Care, 45(4), 330–339.CrossRefPubMedGoogle Scholar
  43. Zito, J. M., Safer, D. J., DosReis, S., Gardner, J. F., Soeken, K., Boles, M., et al. (2002). Rising prevalence of antidepressants among US youths. Pediatrics, 109(5), 721–727.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Karen Hacker
    • 1
  • Elisa Friedman
    • 2
  • Shalini A. Tendulkar
    • 1
  • Patrice Melvin
    • 3
  • Maureen Jerz
    • 4
  • Lisa Lambert
    • 4
  1. 1.Institute for Community HealthHarvard Medical School and Cambridge Health AllianceCambridgeUSA
  2. 2.Institute for Community HealthCambridge Health AllianceCambridgeUSA
  3. 3.Program for Patient Safety and QualityChildren’s Hospital BostonBostonUSA
  4. 4.Professional Advocacy League of MassachusettsBostonUSA

Personalised recommendations