Why bother with beliefs? Examining relationships between race/ethnicity, parental beliefs about causes of child problems, and mental health service use.

Joint Doctoral Program in Clinical Psychology, San Diego State University, San Diego, CA 92123, USA.
Journal of Consulting and Clinical Psychology (Impact Factor: 4.85). 11/2005; 73(5):800-7. DOI: 10.1037/0022-006X.73.5.800
Source: PubMed

ABSTRACT In this study, the authors examined the role of parental beliefs about the causes of child problems in predicting later mental health service use in a large, diverse population of at-risk youths. Study hypotheses were that parental beliefs consistent with biopsychosocial causes would be associated with later mental health service use; sociological, spiritual, or nature disharmony etiologies would be negatively associated with service use; and beliefs would partially mediate the relationship between race/ethnicity and service use. Of the 5 biopsychosocial beliefs, 2 were positively related to later mental health service use. Unexpectedly, of the 6 parental beliefs related to sociological, spiritual, or nature disharmony etiologies, only 1 was negatively associated with later service use patterns. Parental endorsement of etiologies relating to physical causes, relational issues, trauma, and prejudice was found to partially mediate the relationship between race/ethnicity and service use for Asian/Pacific Islander American and Latino youths. ((c) 2005 APA, all rights reserved).

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    ABSTRACT: Race/ethnic disparities in utilization of children’s mental health care have been well documented and are particularly concerning given the long-term risks of untreated mental health problems (Institute of Medicine, 2003; Kessler et al. Am J Psychiatry 152:10026–1032, 1995). Research investigating the higher rates of unmet need among race/ethnic minority youths has focused primarily on policy, fiscal, and individual child or family factors that can influence service access and use. Alternatively, this study examines provider behavior as a potential influence on race/ethnic disparities in mental health care. The goal of the study was to examine whether patient (family) race/ethnicity influences physician diagnostic and treatment decision-making for childhood disruptive behavior problems. The study utilized an internet-based video vignette with corresponding survey of 371 randomly selected physicians from across the USA representing specialties likely to treat these patients (pediatricians, family physicians, general and child psychiatrists). Participants viewed a video vignette in which only race/ethnicity of the mother randomly varied (non-Hispanic White, Hispanic, and African American) and then responded to questions about diagnosis and recommended treatments. Physicians assigned diagnoses such as oppositional defiant disorder (48 %) and attention deficit disorder (63 %) to the child, but there were no differences in diagnosis based on race/ethnicity. The majority of respondents recommended psychosocial treatment (98 %) and/or psychoactive medication treatment (60 %), but there were no significant differences based on race/ethnicity. Thus, in this study using mock patient stimuli and controlling for other factors, such as insurance coverage, we did not find major differences in physician diagnostic or treatment decision-making based on patient race/ethnicity.
    12/2014; DOI:10.1007/s40615-014-0069-4
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    ABSTRACT: This article used an ecological model to identify relevant ethnocultural factors (ECFs) and to suggest intervention strategies targeting these factors within combined parent–child cognitive behavioral therapy, an evidence-based treatment (EBT) for families at risk for child physical abuse (CPA). Three case vignettes were presented of families of diverse ethnocultural backgrounds, including a multi-racial African American and European American family, an African American family, and an Arab American family, referred to a specialty clinic after an allegation of inappropriate physical discipline or substantiated physical abuse. The vignettes illustrate strategies to address ECFs, including race and ethnicity, immigration, acculturation, religious beliefs, and sociocultural context, related to parental beliefs and practices about child discipline. Intervention strategies presented provide practical guidance for clinicians working with diverse families. The ECFs identified in this paper can also guide future research in selecting relevant variables for empirical studies on the association between ECFs and the primary domains of intervention in EBT for families at risk for CPA.
    Journal of Child and Family Studies 01/2014; DOI:10.1007/s10826-014-9969-5 · 1.42 Impact Factor


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May 26, 2014