Parental engagement in the treatment process is influenced by parents' beliefs about the cause of their children's problems, perceptions about their ability to handle such problems, and expectations about the ability of therapy to help them. This paper examines the role of parental cognitions related to attributions and expectations in relation to engagement in child mental health treatment. Reviewed studies indicate that parental attributions and expectations influence three aspects of treatment: help seeking, engagement and retention, and outcome. This paper integrates findings from developmental and clinical research, highlights gaps in the literature, presents the beginnings of a model regarding the parental attributional process as it relates to engagement in treatment, recommends future research directions, and discusses clinical implications.
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Alexander, J. F., Waldron, H. B., Barton, C., & Mas, C. H. (1989). The minimizing of blaming attributions and behaviors in delinquent families. Journal of Consulting and Clinical, 57, 19-24.
Angold, A., Messer, S., Stangl, D., Farmer, E., Costello, E., & Burns, B. (1998). Perceived parental burden and service use for child and adolescent psychiatric disorders. American Journal of Public Health, 88, 75-80.
Armbruster, P., & Fallon, T. (1994). Clinical, sociodemographic, and systems risk factors for attrition in a children's mental health clinic. American Journal of Orthopsychiatry, 64, 577-585.
Armbruster, P., & Kazdin, A. (1994). Attrition in child psychotherapy. In T. H. Ollendick & R. J. Prinz, (Eds.), Advances in clinical child psychology (Vol. 16, pp. 81-108). New York: Plenum Press.
Baden, A. D., & Howe, G. W. (1992). Mothers' attributions and expectancies regarding their conduct-disordered children. Journal of Abnormal Child Psychology, 20, 467-486.
Barkley, R. A., & Cunningham, C. E. (1979). The effects of methylphenidate on the mother-child interactions of hyperactive children. Archives of General Psychiary, 36, 201-208.
Barlow, D. (1988). Anxiety and its disorders: The nature and treatment of anxiety and panic. New York: The Guilford Press.
Beck, J. S. Cognitive therapy: Basics and beyond. New York: Guilford.
Bloomquist, M. L. (1996). Skills training for children with behavior disorders: A parent and therapist guidebook. New York: The Guilford Press.
Bonner, B. L., & Everett, F. L. (1986). Influence of client preparation and problem severity on attitudes and expectations in child psychotherapy. Professional Psychology: Research and Practice, 17, 223-229.
Bowen, R., South, M., Fischer, D., & Looman, T. (1994). Depression, mastery and number of group sessions attended predict outcome of patients with panic and agoraphobia in a behavioral/medication program. Canadian Journal of Psychiatry, 39, 283-288.
Bugental, D. B., Blue, J., & Cruzcosa, M. (1989). Perceived control over caregiving outcomes: Implications for child abuse. Developmental Psychology, 22, 723-742.
Bugental, D. B., Johnston, C., New, M., & Silvester, J. (1998). Measuring parental attributions: Conceptual and methodological issues. Journal of Family Psychology, 12, 459-480.
Bugental, D. B., & Shennum, W. A. (1984). “Difficult” children as elicitors and targets of adult communication patterns: An attributional-behavioral transactional analysis. Monographs of the Society for Research in Child Development, 49(1, Serial No. 205).
Burck, C. (1975). A study of families' expectations and experiences of a child guidance clinic. British Journal of Social Work, 8, 145-158.
Burns, D. D. (1989). The feeling good handbook: Using the new mood therapy in everyday life. New York: Morrow.
Campis, L., Lyman, R., & Prentice-Dunn, S. (1986). The parental locus of control scale: Development and validation. Journal of Clinical Child Psychology, 15, 260-267.
Carr, A. (1990). Failure in family therapy: A catalogue of engagement mistakes. Journal of Family Therapy, 12, 371-386.
Carroll, J. S. (1978). Causal attributions in expert parole decisions. Journal of Peonality and Social Psychology, 36, 1501-1511.
Cialdini, R. B. (1993). Influence: Science and practice (3rd Ed.). New York: Harper Collins.
Clarke, G., Hops, H., Lewinsohn, P., Andrews, J., Steeley, J., & Williams, J. (1992). Cognitive-behavioral group treatment of adolescent depression: Prediction of outcome. Behavior Therapy, 23, 341-354.
Compas, B. E., Adelman, H., Freundl, P., Nelson, P., & Taylor, L. (1982). Parent and child causal attributions during clinical interviews. Journal of Abnormal child Psychology, 10, 77-84.
Costello, E. J., Costello, A. J., Edelbrock, C., Burns, B. J., Dulcan, M. K., Brent, D., & Janiszewski, S. (1988). Psychiatric disorders in pediatric primary care: Prevalence and risk factors. Archives of General Psychiatry, 45, 1107-1116.
Day, D. M., Factor, D. C., & Szkiba-Day, P. J. (1994). Relations among discipline style, child behavior problems, and perceived ineffectiveness as a caregiver among parents with conduct problem children. Canadian Journal of Behavioral Science, 26, 520-533.
Day, L., & Reznikoff, M. (1980). Preparation of children and parents for treatment at a children's psychiatric clinic through videotaped modeling. Journal of Consulting and Clinical, 48, 303-304.
Dix, T., & Grusec, J. E. (1985). Parent attribution processes in the socialization of children. In I. E. Sigel (Ed.), Parental belief systems (pp. 201-233). Hillsdale, NJ: Erlbaum.
Dix, T., Ruble, D., Grusec, J. E., & Nixon, S. (1986). Social cognition in parents: Inferential and affective reactions to children of three age levels. Child Development, 57, 879-894.
Dix, T., Ruble, D., & Zambarano, R. (1989). Mothers' implicit theories of discipline: Child effects, parent effects, and the attribution process. Child Development, 60, 1373-1391.
Dumas, J. (1984). Child, adult-interactional, and socioeconomic setting events as predictors of parent training outcome. Education and Treatment of Children, 7, 351-364.
Dumas, J. (1986). Parental perception of treatment outcome in families of aggressive children: A causal model. Behavior Therapy, 17, 420-432.
Erhardt, D., & Baker, B. L. (1990). The effects of behavioral parent training on families with young hyperactive children. Journal of Behavioral Therapy and Experimental Psychiatry, 21, 121-132.
Ewalt, P., Cohen, M., & Harmatz, J. (1972). Prediction of treatment acceptance by child guidance clinic applicants: An easily applied instrument. American Journal of Orthopsychiatry, 42, 857-864.
Fairhurst, S. (1996). Promoting change in families: Treatment matching in residential treatment centers. Residential Treatment for Children and Youth, 14, 21-32.
Fauber, R. L., & Long, N. (1991). Children in context: The role of the family in child psychotherapy. Journal of Consulting and Clinical Psychology, 59, 813-820.
Frankel, F., & Simmons, J. Q. (1992). Parent behavioral training: Why and when some parents drop out. Journal of Clinical Child Psychology, 21, 322-330.
Friestad, M., & Wright, P. (1999). Everyday persuasion knowledge. Psychology and Marketing, 16, 185-194.
Frieze, I. H. (1979). Perceptions of battered wives. In I. H. Frieze, D. Bar-Tal, & J. S. Carroll (Eds.), New approaches to social problems (pp. 79-108). San Francisco: Jossey-Bass.
Furey, W. M., & Basili, L. A. (1988). Predicting consumer satisfaction in parent training for noncompliant children. Behavior Therapy, 19, 555-564.
Gaines, T., & Stedman, J. M. (1981). Factors associated with dropping out of child and family treatment. The American Journal of Family Therapy, 9, 45-51.
Goodnow, J. J. (1984). Parents' ideas about parenting and development: A review of issues and recent work. In M. E. Lamb, A. L. Brown, & B. Rofogg (Eds.), Advances in developmental psychology (Vol. 3, pp. 193-242). Hillsdale, NJ: Erlbaum.
Goodnow, J. J. (1985). Change and variation in parents' ideas about childhood and parenting. In I. E. Sigel (Ed.), Parental belief systems (pp. 235-270). Hillsdale, NJ: Erlbaum.
Goodnow, J. J. (1988). Parents' ideas, actions, and feelings: Models and methods from developmental and social psychology. Child Development, 59, 286-320.
Goodnow, J. J., Knight, R., & Cashmore, J. (1985). Adult social cognition: Implications of parents' ideas for approaches to development. In M. Perlmutter (Ed.), Social cognition: Minnesota symposia on child development (Vol 18, pp. 287-324). Hillsdale, NJ: Erlbaum.
Gould, M. S., Shaffer, D., & Kaplan, D. (1985). The characteristics of dropouts from a child psychiatry clinic. Journal of the American Academy of Child and Adolescent Psychiatry, 24, 316-328.
Gretarsson, S. J., & Gelfand, D. M. (1988). Mothers' attributions regarding their children's social behavior and personality characteristics. Developmental Psychology, 24, 264-269.
Griest, D. L., Forehand, R., Wells, K. C., & McMahon, R. J. (1980). An examination of differences between nonclinic and behavior-problem clinic-referred children and their mothers. Journal of Abnormal Psychology, 89, 497-500.
Griest, D. L., & Wells, K. C. (1983). Behavioral family therapy with conduct disorder children. Behavior Therapy, 14, 37-53.
Griest, D. L., Wells, K. C., & Forehand, R. (1979). An examination of predictors of maternal perceptions of maladjustment in clinic-referred children. Journal of Abnormal Psychology, 88, 277-281.
Gustafson, K. E., McNamara, J. R., & Jensen, J. (1994). Parents' informed consent decisions regarding psychotherapy for their children: Consideration of therapeutic risks and benefits. Professional Psychology: Research and Practice, 25, 16-22.
Harvey, J. H., & Weary, G. (1981). Perspectives on attributional processes. Dubuqui, IA: Wm. C. Brown.
Heider, F. (1958). The psychology of interpersonal relationships. New York: Wiley.
Henggeler, S. (1994). A consensus: Conclusions of the APA task force report on innovative models of mental health services for children, adolescents, and their families. Journal of Clinical Child Psychology, 23, 3-6.
Himelstein, S., Graham, S., & Weiner, B. (1991). An attributional analysis of maternal beliefs about the importance of childrearing practices. Child Development, 62, 301-310.
Hinshaw, S. P., Henker, B., & Whalen, C. K. (1984). Cognitive-behavioral and pharmacologic interventions for hyperactive boys: Comparative and combined effects. Journal of Consulting and Clinical Psychology, 25, 739-749.
Hricik, D. A., & Phillips Keane, S. (1988). Referred and nonreferred children's predictions of their mothers' behavior evaluations. Journal of Clinical Child Psychology, 17, 8-13.
Janssens, J. (1994). Authoritarian child rearing, parental locus of control, and the children's behavior style. International Journal of Behavioral Development, 17, 485-501.
Johnston, C. (1996). Parent characteristics and parent-child interactions in families of nonproblem children and ADHD children with higher and lower levels of oppositional-defiant behavior. Journal of Abnormal Child Psychology, 24, 85-103.
Johnston, C., & Patenaude, R. (1994). Parent attributions for inattentive-overactive and oppositional-defiant child behaviors. Cognitive Therapy and Research, 18, 261-275.
Johnston, C., Reynolds, S., Freeman, W., & Geller, J. (1998). Assessing parental attributions for child behavior using open-ended questions. Journal of Clinical Child Psychology, 27, 87-97.
Kazdin, A. E., Esveldt-Dawson, K., Unis, A. S., & Rancurello, M. D. (1983). Child and parent evaluations of depression and agression in psychiatric inpatient children. Journal of Abnormal Child Psychology, 11, 401-413.
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, 453-463.
Kazdin, A. E., Holland, L., Crowley, M., & Breton, S. (1997). Barriers to Participation in Treatment Scale: Evaluation and validation in the context of child outpatient treatment. Journal of Child Psychology and Psychiatry, 38, 1051-1062.
Kazdin, A. E., & Mazurick, J. L. (1994). Dropping out of child psychotherapy: Distinguishing early and late dropouts over the course of treatment. Journal of Consulting and Clinical Psychology, 62, 1069-1074.
Kazdin, A. E., Mazurick, J. L., & Bass, D. (1993). Risk for attrition in treatment of antisocial children and families. Journal of Clinical Child Psychology, 22, 2-16.
Kazdin, A. E., Stolar, M. J., & Marciano, P. L. (1995). Risk factors for dropping out of treatment among white and black families. Journal of Family Psychology, 9, 402-417.
Kazdin, A. E., & Wassell, G. (1999). Barriers to treatment participation and therapeutic change among children referred for conduct disorder. Journal of Clinical Child Psychology, 28, 160-172.
Kelley, H. H. (1973). Causal schemata and the attribution process. American Psychologist, 28, 107-123.
Kourany, R. F., Garber, J., & Tornusciolo, G. (1990). Improving first appointment attendance rates in child psychiatry outpatient clinics. Journal of the American Accademy of Child and Adolescent Psychiatry, 29, 657-660.
Kovacs, M., & Lohr, W. D. (1995). Research on psychotherapy with children and adolescents: An overview of evolving trends and current issues. Journal of Abnormal Child Psychology, 23, 11-30.
Liddle, H. A. (1995). Conceptual and clinical dimensions of a multidemensional, multisystems engagement strategy in family-based adolescent treatment. Psychotherapy, 32, 39-58.
Lown, N., & Britton, B. (1991). Engaging families through the letter writing technique. Journal of Strategic and Systemic Therapies, 10, 43-48.
MacKinnon, C. E., Lamb, M. E., Belsky, J., & Baum, C. (1990). An affective-cognitive model of mother-child aggression. Development and Psychopathology, 2, 1-13.
Mash, E. J., & Johnston, C. (1983). Parental perceptions perceptions of child behavior problems, parenting self-esteem, and mothers' reported stress in younger and older hyperactive and normal children. Journal of Consulting and Clinical Psychology, 51, 86-99.
McHale, J. P., & Fivaz-Depeursinge, E. (1999). Understanding triadic and family group interactions during infancy and toddlerhood. Clinical Child and Family Psychology Review, 2, 107-127.
McHugh, M., Beckman, L., & Frieze, I. H. (1979). Analyzing alcoholism. In I. H. Frieze, D. Bar-Tal, & J. S. Carroll (Eds.), New approaches to social problems (pp. 168-208). San Francisco: Jossey-Bass.
McKay, M. M., McCadam, K., & Gonzales, J. J. (1996). Addressing the barriers to mental health services for inner city children and their caretakers. Community Mental Health Journal, 32, 353-361.
McMahon, R. J., Forehand, R., Griest, D. L., & Wells, K. C. (1981). Who drops out of treatment during parent behavioral training? Behavioral Counseling Quarterly, 1, 79-84.
Miller, S. A. (1988). Parents' beliefs about children's cognitive development. Child Development, 59, 259-285.
Miller, W. R. (1985). Motivation for treatment: A review with special emphasis on alcoholism. Psychological Bulletin, 98, 84-107.
Miller, W. R., & Rollnick, S. (1991). Motivational interviewing: Preparing people to change addictive behavior. New York: Guilford Press.
Mouton, P., & Tuma, J. (1988). Stress, locus of control, and satisfaction in clinic and control mothers. Journal of Clinical Psychology, 17, 217-224.
Page, M., Poertner, J., & Lindbloom, R. (1995). Promoting the preschooler's chances for success: A program efficacy review for behaviorally disordered or emotionally troubled children. Early Child Development and Care, 106, 167-176.
Patterson, G. R. (1982). Coercive family process. Eugene, OR: Castalia.
Pekarik, G., & Stephenson, L. (1988). Adult and child client differences in therapy dropout research. Journal of Clinical Child Psychology, 17, 316-321.
Pescosolido, B. A. (1996). Bringing the “community” into utilization models: How social networks link individuals to changing systems of care. Research in the Sociology of Health Care, 13, 171-197.
Plunkett, J. W. (1984). Parent's treatment expectations and attrition from a child psychiatric service. Journal of Clinical Psychology, 40, 372-377.
Prinz, R. J., & Miller, G. E. (1994). Family-based treatment for childhood antisocial behavior: Experimental influences on dropout and engagement. Journal of Clinical and Consulting Psychology, 62, 645-650.
Prinz, R. J., & Miller, G. E. (1996). Parental engagement in interventions for children at risk for conduct disorder. In R. D. Peters & R. J. McMahon (Eds.) Preventing childhood disorders, substance abuse, and delinquency. Thousand Oaks, CA: Sage.
Prochaska, J. O., DiClemente, C., & Norcross, J. C. (1992). In search of how people change: Applications to addictive behaviors. American Psychologist, 47, 1102-1114.
Raviv, A., Maddy-Weitzman, E., & Raviv, A. (1992). Parents of adolescents: Help-seeking intentions as a function of help sources and parenting issues. Journal of Adolescence, 15, 115-135.
Reimers, T., Wacker, D., Derby, K. M., & Cooper, L. (1995). Relationship between parental attributions and the acceptability of behavioral treatments for children's behavior problems. Behavioral Disorders, 20, 171-178.
Roberts, M., Joe, V., & Hallbert-Rowe, A. (1992). Oppositional child behavior and parental locus of control. Journal of Clinical Child Psychology, 21, 170-177.
Rodrigue, J. (1994). Beyond the individual child: Innovative systems approaches to service delivery in pediatric psychology. Journal of Clinical Child Psychology, 23, 32-39.
Rotter, J. (1966). Generalized expectancies for internal versus external control reinforcements. Psychological Monographs, 1, No. 609.
Santisteban, D. A., Szapocznik, J., Perez-Vidal, A., Kurtines, W., Murray, 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.
Sameroff, A. J., & Feil, L. A. (1985). Parental concepts of development. In I. E. Sigel (Ed.), Parental Belief Systems (pp. 83-105). Hillsdale, NJ: Erlbaum.
Selekman, M. D. (1997). Solution-focused therapy with children: Harnessing family strengths for systemic change. New York: The Guilford Press.
Singh, H., Janes, C. L., & Schechtman, J. M. (1982). Problem children's treatment attrition and parents' perception of the diagnostic evaluation. Journal of Psychiatric Treatment Evaluation, 4, 257-253.
Slep, A. M. S., & O'Leary, S. G. (1998). The effects of maternal attributions on parenting: An experimental analysis. Journal of Family Psychology, 12, 234-243.
Smith, A. M., & O'Leary, S. G. (1995). Attributions and arousal as predictors of maternal discipline. Cognitive Therapy and Research, 19, 459-471.
Sobol, M. P., Ashbourne, D. T., Earn, B. M., & Cunningham, C. E. (1989). Parents' attributions for achieving compliance from attention-deficit-disordered children. Journal of Abnormal Child Psychology, 17, 359-369.
Spitzer, A., Webster-Stratton, C., & Hollinsworth, T. (1991). Coping with conduct-problem children: Parents gaining knowledge and control. Journal of Clinical Child Psychology, 20, 413-427.
Spoth, R., Goldberg, C., & Redmond, C. (1999). Engaging families in longitudinal preventive intervention research: Discrete-time survival analysis of socioeconomic and social-emotional risk factors. Journal of Consulting and Clinical Psychology, 67, 157-163.
Stouthamer-Loeber, M., Loeber, R., & Thomas, C. (1992). Caretakers seeking help for boys with disruptive and delinquent behavior. Comprehensive Mental Health Care, 2, 159-178.
Viale-Val, G., Rosenthal, R. H., Curtiss, G., & Marohn, R. C. (1984). Dropout from adolescent psychotherapy: A preliminary study. Journal of the American Academy of Child Psychiatry, 23, 562-568.
Walitzer, K. S., Dermen, K. H., & Connors, G. J. (1999). Strategies for preparing clients for treatment: A review. Behavior Modification, 23, 129-151.
Watson, J. (1986). Parental attributions of emotional disturbance and their relation to outcome. Australian Psychologist, 21(2), 271-282.
Webster-Stratton, C. (1988). Mothers' and fathers' perceptions of child deviance: Roles of parent and child behaviors and parent adjustment. Journal of Consulting and Clinical Psychology, 56, 909-915.
Weiner, B. (1980). A cognitive (attribution)-emotion-action model of motivated behavior: An analysis of judgments of help-giving. Journal of Personality and Social Psychology, 39, 186-200.
Weiner, B. (1985). An attributional theory of achievement motivation and emotion. Psychological Review, 92, 548-573.
Weiner, B. (1986). An attributional theory of motivation and emotion. New York: Springer-Verlag.
Weisz, J. R., Weiss, B., & Donenberg, G. R. (1992). The lab versus the clinic: Effects of child and adolescent psychotherapy. American Psychologist, 47, 1578-1585.
Weisz, J. R., Weiss, B., & Langmeyer, D. B. (1987). Giving up on child psychotherapy: Who drops out? Journal of Consulting and Clinical Psychology, 55, 916-918.
Wenning, K., & King, S. (1995). Parent orientation meetings to improve attendance and access at a child psychiatric clinic. Psychiatric Services, 46, 831-833.
Yukl, G., Kim, H., & Chavez, C. (1999). Task importance, feasibility, and agent influence behavior as determinants of target commitment. Journal of Applied Psychology, 84, 137-143.
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Morrissey-Kane, E., Prinz, R.J. Engagement in Child and Adolescent Treatment: The Role of Parental Cognitions and Attributions. Clin Child Fam Psychol Rev 2, 183–198 (1999). https://doi.org/10.1023/A:1021807106455
- family intervention
- children and adolescents
- parental cognitions
- parental attributions