Abstract
We examined variables associated with treatment engagement in a real-world therapeutic setting. The model of care examined involved school-linked mental health care for children and their families in a rural county. Service utilization characteristics, as well as child- and treatment-specific variables were examined in relation to their impact on therapy length, missed appointments, and treatment outcome. A total of 168 students and their families participated in therapeutic services over a period of approximately 4.5 years. Overall, children who had less psychopathology and a higher level of clinician-rated functioning (GAF) at the start of therapy were more likely to successfully complete treatment. Parental involvement in therapy was associated with a longer course of therapy, as well as more missed appointments. Barriers to treatment and treatment engagement, as well as future directions of study, are discussed.
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References
Achenbach, T. M., & Rescorla, L. A. (2004). The achenbach system of empirically based assessment (ASEBA) for ages 1.5–18 years. In Maruish (Ed.), The use of psychological testing for treatment planning and outcomes assessment: Volume 2: Instruments for children and adolescents (3rd ed, pp. 179–213). Mahwah, NJ: Lawrence Erlbaum Associates Publishers.
American Psychiatric Association (2000). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, D.C.: American Psychiatric Association, Text Revision (DSM-IV TR).
Armbruster, P., & Kazdin, A. E. (1994). Attrition in child psychotherapy. Advances in Clinical Child Psychology, 16, 81–108.
Balassone, M. L., Bell, M., & Peterfreund, N. (1991). A comparison of users and nonusers of a school-based health and mental health clinic. Journal of Adolescent Health, 12, 240–246.
Barmish, A., & Kendall, P. C. (2005). Should parents be co-clients in cognitive-behavioral therapy for anxious youth? Journal of Clinical Child and Adolescent Psychology, 34, 569–581.
Casat, C., Sobolewski, J., & Gordon, J. (1999). School-based mental health services (SBS): A pragmatic view of a program. Psychology in the Schools, 36, 403–413.
Costello, E. J., & Janiszewski, S. (1990). Who gets treated? Factors associated with referral in children with psychiatric disorders. Acta Psychiatrica Scandinavica, 81, 523–529.
Dumas, J., & Wahler, R. (1983). Predictors of treatment outcome in parent training: Mother insularity and socioeconomic disadvantage. Behavior Assessment, 5, 301–313.
Durlak, J. (1977). Description and evaluation of a behaviorally oriented school-based preventive mental health program. Journal of Consulting and Clinical Psychology, 45, 27–33.
Evans, G. D., & Rey, J. (2001). In the echoes of gunfire: Practicing psychologists’ responses to school violence. Professional Psychology: Research & Practice, 32, 157–164.
Everett B. C., & Sori, C. E. F. (2005). Involving parents in children’s therapy. In B. C. Everett (Eds.), Children in therapy: Using the family as a resource (pp. 475–501). New York: WW Norton & Co.
Ezpeleta, L., Keeler, G., Alaatin, E., Costello, E. J., & Angold, A. (2001). Epidemiology of psychiatric disability in childhood and adolescence. Journal of Child Psychology and Psychiatry, 42, 901–914.
Flaherty, L., & Weist, M. (1999). School-based mental health services: The Baltimore models. Psychology in the Schools, 36, 379–389.
Forehand, R., Middlebrook, J., Rogers, T., & Steffe, M. (1983). Dropping out of parent training. Behaviour Research & Therapy, 21, 663–668.
Greenberg, M. T., Domitrovich, C., & Bumbarger, B. (2001). The prevention of mental disorders in school-aged children: Current state of the field. Prevention and Treatment, 4, Article 1 (electronic journal).
Greeno, C. G., Anderson, C. M., Shear, M. K., & Mike, G. (1999). Initial treatment engagement in a rural community mental health center. Psychiatric Services, 50, 1634–1636.
Griffith, J. D., Knight, D. K., Joe, G. W., & Simpson, D. D. (1998). Implications of family and peer relations for treatment engagement and follow-up outcomes: An integrative model. Psychology of addictive behaviors, 12, 113–126.
Kazdin, A., Holland, L, & Crowley, M. (1997). Family experience of barriers to treatment and premature termination from child therapy. Journal of Consulting and Clinical Psychology, 65, 453–463.
Kazdin, A., Mazurick, J., & Bass, D. (1993). Risk for attrition in treatment of antisocial children and families. Journal of Clinical Child Psychology, 22, 2–16.
Lear, J. G., Gleicher, H. B., St. Germaine, A., & Porter, P. J. (1991). Reorganizing health care for adolescents: The experience of the school-based adolescent health care program. Journal of Adolescent Health, 12, 450–458.
Miller, G., & Prinz, R. (2003). Engagement of families in treatment for childhood conduct problems. Behavior Therapy, 34, 517–534.
Morrissey-Kane, E., & Prinz, E. J. (1999). Engagement in child and adolescent treatment: The role of parental cognitions and attributions. Clinical Child and Family Psychology Review, 2, 183–198.
Nock, M. K., & Ferriter, C. (2005). Parent management of attendance and adherence in child and adolescent therapy: A conceptual and empirical review. Clinical Child and Family Psychology Review, 8, 149–166.
Nock, M. K., & Kazdin, A. E. (2001). Parent expectancies for child therapy: Assessment and relation to participation in treatment. Journal of Child and Family Studies, 10, 155–180.
Santisteban, D. A., Szapocnik, J., Perez-Vidal, A., Kurtines, W. M., Murrary, E. J., & LaPerriere, A. (1996). Efficacy of intervention for engaging youth and families into treatment and some variables that may contribute to differential effectiveness. Journal of Family Psychology, 10, 35–44.
Southam-Gerow, M. A., Kendall, P. C., & Weersing, V. R. (2001). Examining outcome variability: Correlates of treatment response in a child and adolescent anxiety clinic. Journal of Clinical Child Psychology, 30, 422–436.
Suveg, C., Roblek, T. L., Robin, J., Krain, A., Aschenbrand, S., & Ginsburg, G. S. (2006). Parental involvement when conducting cognitive-behavioral therapy for children with anxiety disorders. Journal of Cognitive Psychotherapy: An International Quarterly, 20, 287–299.
United States Census Bureau (2004). State & County Quickfacts. Retrieved from the Internet August 27, 2006 from http://www.quickfacts.census.gov
Trivette, P., & Thompson-Drew, C. (2003). Implementing a school-based health center: The Winston-Salem/Forsyth County experience. Psychology in the Schools, 40, 289–296.
Valdez, C. R., Carlson, C., & Zanger, D. (2005). Evidence-based parent training and family interventions for school behavior change. School Psychology Quarterly, 20, 403–433.
Webster-Stratton, C., & Hammond, M. (1990). Predictors of treatment outcome in parent training for families with conduct problem children. Behavior Therapy, 21, 319–337.
Wren, F. J., Scholle, S. H., Heo, J., & Comer, D. M. (2003). Pediatric mood and anxiety syndromes in primary care: Who gets identified. International Journal of Psychiatry in Medicine, 33, 1–16.
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Evans, G.D., Radunovich, H.L., Cornette, M.M. et al. Implementation and Utilization Characteristics of a Rural, School-linked Mental Health Program. J Child Fam Stud 17, 84–97 (2008). https://doi.org/10.1007/s10826-007-9148-z
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DOI: https://doi.org/10.1007/s10826-007-9148-z