Article

Engaging families in child mental health services

Departments of Psychiatry and Community Medicine, Mount Sinai School of Medicine, 1425 Madison Avenue, New York, NY 10029, USA.
Child and Adolescent Psychiatric Clinics of North America (Impact Factor: 2.6). 11/2004; 13(4):905-21, vii. DOI: 10.1016/j.chc.2004.04.001
Source: PubMed

ABSTRACT

To increase the involvement of urban youth and families who need mental health services, child mental health agencies and providers might consider the following: (1) examining intake procedures and developing interventions to target specific barriers to service use; (2) providing training and supervision to providers to increase a focus on engagement in the first face-to-face meetings with youth and families; (3) providing service delivery options with input from consumers regarding types of services offered. Involvement of youth and their families is a primary goal that must receive as much attention as any other part of the service delivery process. One might argue that without youth and family participation, effective services never will be provided to youth and families in need.

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    • "Attendance involves the presence of the agreed-upon participants during a therapeutic contact (Nock & Ferriter, 2005) and is an easy-to-measure outcome with demonstrated associations with treatment outcome (e.g., Baydar, Reid, & Webster-Stratton, 2003). Multiple scholars have published qualitative reviews of engagement intervention studies presenting strategies for increasing initial attendance and ongoing retention in services, such as appointment reminders, discussion and resolution of barriers to treatment, incentives, and motivational interviewing (e.g., Ingoldsby, 2010; McKay & Bannon, 2004). Yet the overreliance on attendance as the primary outcome of interest has important implications for our conceptualization of evidence-based engagement interventions . "
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    ABSTRACT: Using the distillation component of the Distillation and Matching Model framework (Chorpita, Daleiden, & Weisz, 2005), we examined which engagement practices were associated with three domains of treatment engagement: attendance, adherence, and cognitive preparation (e.g., understanding of, readiness for treatment). Eighty-nine engagement interventions from 40 randomized controlled trials in children' s mental health services were coded according to their engagement practices and outcomes. Analyses examined whether the practices used in successful interventions differed according to engagement domain. Practice patterns differed somewhat depending on whether attendance, adherence, or cognitive preparation was the outcome of interest. For example, assessment of barriers to treatment frequently occurred in successful interventions targeting attendance, whereas homework assignment frequently occurred in successful interventions when adherence was the target outcome. Modeling and expectation setting were frequently used in successful interventions targeting cognitive preparation for treatment. Distillation provides a method for examining the practice patterns associated with different engagement outcomes. An example of the application of these findings to clinical practice includes using certain practices (e.g., assessment, psychoeducation about services, and accessibility promotion) with all youth and families to promote attendance, adherence, and cognitive preparation. Then, other practices (e.g., modeling, homework assignment) can be added on an as-needed basis to boost engagement or to address interference in a particular engagement domain. The use of a distillation framework promotes a common language around engagement and highlights practices that lend themselves well to training, thereby promoting the dissemination of engagement interventions.
    Full-text · Article · Jan 2015 · Journal of Clinical Child & Adolescent Psychology
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    • "One factor contributing to service-delivery gaps for children with behavioral problems is failure to effectively engage families in ways that are common in partnership models (McKay & Bannon, 2004). One parent partnership model with emerging empirical support from several experimental single case design studies (e.g., Colton & Sheridan, 1998; Sheridan , Kratochwill, & Elliott, 1990; Weiner, Sheridan, & Jenson, 1998) and at least one largescale randomized trial (Sheridan et al., 2012) is conjoint behavioral consultation (CBC; Sheridan & Kratochwill, 2008). "
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    ABSTRACT: The present study is a large-scale randomized trial testing the effects of a family-school partnership model (i.e., Conjoint Behavioral Consultation, CBC) for promoting behavioral competence and decreasing problem behaviors of children identified by their teachers as disruptive. CBC is a structured approach to problem-solving that involves consultants, parents, and teachers. The effects of CBC on family variables that are commonly associated with important outcomes among school-aged children (i.e., family involvement and parent competence in problem solving), as well as child outcomes at home, were evaluated. Participants were 207 children with disruptive behaviors from 91 classrooms in 21 schools in kindergarten through grade 3 and their parents and teachers. Results indicated that there were significantly different increases in home-school communication and parent competence in problem solving for participants in the CBC relative to control group. Likewise, compared to children in the control group, children in the CBC group showed significantly greater decreases in arguing, defiance, noncompliance, and tantrums. The degree of family risk moderated parents' competence in problem solving and children's total problem behaviors, teasing, and tantrums.
    Preview · Article · Dec 2013 · Journal of school psychology
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    • "Engagement is critical for implementing EBTs with high-stress families [74]. Counselors felt engagement required substantial attention as this type of “talk therapy” was mostly new to Zambia. "
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    ABSTRACT: The need to address the treatment gap in mental health services in low- and middle-income countries (LMIC) is well recognized and particularly neglected among children and adolescents. Recent literature with adult populations suggests that evidence-based mental health treatments are effective, feasible, and cross-culturally modifiable for use in LMIC. This paper addresses a gap in the literature documenting pre-trial processes. We describe the process of selecting an intervention to meet the needs of a particular population and the process of cross-cultural adaptation. Community-based participatory research principles were implemented for intervention selection, including joint meetings with stakeholders, review of qualitative research, and review of the literature. Trauma-focused Cognitive Behavioral Therapy (TF-CBT) was chosen as the evidence-based practice for modification and feasibility testing. The TF-CBT adaptation process, rooted within an apprenticeship model of training and supervision, is presented. Clinical case notes were reviewed to document modifications. Choosing an intervention can work as a collaborative process with community involvement. Results also show that modifications were focused primarily on implementation techniques rather than changes in TF-CBT core elements. Studies documenting implementation processes are critical to understanding why intervention choices are made and how the adaptations are generated in global mental health. More articles are needed on how to implement evidence-based treatments in LMIC.
    Full-text · Article · Oct 2013 · International Journal of Mental Health Systems
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