Parent engagement in child mental health (MH) services has received growing attention due to its significance in intervention outcomes and evidence-based care. In particular, parent participation engagement (PPE) reflects active and responsive contributions in and between sessions. Yet, limited research has examined factors associated with PPE, particularly within community-based MH services where PPE is low and highly diverse families are often served.
This study examined child, parent, and therapist factors associated with PPE in a sample of racially/ethnically diverse parent–child dyads receiving publicly-funded, community-based MH services.
This prospective study included 18 parent–child dyads receiving community-based MH services from 17 therapists in five outpatient clinics for child disruptive behaviors. PPE was measured using in-session observational assessment of therapy recordings. Child factors that were examined included age, first time child MH service use, and intensity of child behavior problems. Parent factors included ethnicity, education, depression symptoms, and parent motivation to participate in therapy. Therapist factors included therapist training in parent-mediation interventions, attitudes towards organizational functioning, and attitudes towards parent participation strategies.
Results from linear regression analyses indicated that first time child MH service use, intensity of child behavior problems, parent ethnicity and motivation to participate in therapy, as well as therapists’ training and attitudes about their practice were each significantly associated with PPE.
Results highlight specific child, parent, and therapist characteristics that may impact observed PPE in child MH therapy. These findings underscore the importance of considering the influence of family and provider factors on PPE in community-based child MH services.
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The term “parent” throughout this article represents any primary caregiver.
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This study was supported by the National Institute of Mental Health of the National Institutes of Health under Award Number K23MH080149 (PI: Haine-Schlagel). The authors would like to acknowledge Cristina Bustos, Ph.D., Amy Drahota, Ph.D., Scott Roesch, Ph.D., Ann Garland, Ph.D., Cortney Janicki, and Emily Ewing for their contributions to the project as well as the participating clinics, therapists, and families.
Conflict of interest
All authors have no conflict of interest to declare.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
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A. Stadnick, N., Haine-Schlagel, R. & I. Martinez, J. Using Observational Assessment to Help Identify Factors Associated with Parent Participation Engagement in Community-Based Child Mental Health Services. Child Youth Care Forum 45, 745–758 (2016). https://doi.org/10.1007/s10566-016-9356-z
- Child mental health treatment
- Disruptive behavior problems