This article reports a systematic review of engagement measures for psychosocial therapy. MEDLINE, EMBASE, and PsycINFO databases were searched to identify English-language studies (published 1980 to February 2010) that reported on an instrument/rating scale to measure engagement in psychosocial treatment for mental health difficulties. Forty-seven studies were identified, reporting information on 40 measures of treatment engagement. Although our findings suggest that therapeutic engagement appears to be considered an important construct to assess, they also reveal that there is little consensus in the definition of engagement employed. Few measures are generalizable across treatment settings and clinical populations, and limited information is reported on the indices of reliability and validity. It is concluded that further work is required to develop adequate measures of therapeutic engagement.

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Clients with personality disorder (PD) can encounter difficulties engaging in psychosocial therapy. One way to address this is to identify the factors that contribute to their low engagement. The Multifactor Offender Readiness Model (MORM), a model developed to explain poor treatment engagement in offenders, might guide the identification of engagement difficulties in clients with PD. In this study, we sought to validate and extend the MORM for clients with PD by identifying the perceived barriers to and facilitators of their engagement. A two-round Delphi Survey was employed to identify clients' and clinicians' levels of agreement on the factors that impair and promote engagement. Seventy-six clients and 55 clinicians were recruited from English specialist forensic and non-forensic personality disorder services. Our findings reveal that the perceived barriers to engagement for those with PD are in the most part congruent with the impediments outlined in the MORM. However, we do find some additional barriers relevant specifically to people with PD. A Treatment Readiness Model for Personality Disorder (TReMoPeD), which is an augmented version of the MORM, is presented. This model provides guidance for ways of taking action to improve a client's chance of engaging with services. Copyright

Objective: This article systematically reviews studies of parental bonding in people with eating disorders. Method: MEDLINE, PsychINFO, EMBASE and CINAHL were searched to identify studies that compared parental bonding in people diagnosed with an eating disorder relative to non-clinical controls. Results: Twenty-four studies were identified. Women with eating disorders typically reported lower parental care and higher parental protection compared to non-clinical, but not psychiatric, controls.Interestingly, these relationships were mediated by avoidant problem solving style and several schemas from the Young Schema Questionnaire (YSQ 1 ). Discussion:While there are methodological limitations associated with the reviewed studies, they do offer some support for the proposal that difficulties in parent-child relationships predispose women to eating disorders and other psychiatric diagnoses. suggesting that difficult relationships between parents and children could be implicated in the onset of eating disorders. Using attachment theory 5 as an explanatory framework, it has been suggested that insecure attachments to caregivers are common in those with eating disorders. The symptoms of their eating disorder are assumed to represent an attempt to maintain physical and psychological proximity to a caregiver 6,7 . Likewise, psychodynamic theories suggest that parents of those who develop eating disorders are demanding/over-controlling and emotionally unresponsive. This is assumed to result in either; 1) a need for the adolescent to remain child-like to avoid abandonment, 2) a refusal to eat to subdue the internalised controlling parent, or 3) weight-control behaviours to maintain closeness to the parent 8,9 . Parental bonding and eating disorders 4It is important to assess the empirical support for the hypothesised link between early parent-child relationships and eating disorders. To date, four systematic literature reviews have sought to synthesise data on this empirical question 6,10,7,11 .Before considering their conclusions, it is important to note that they conceptualise existing empirical studies as either considering the "attachment construct" as defined by Bowlby 5,12 , or considering "parental bonding" as defined by Parker and colleagues 12 .Briefly, the "attachment construct" referred to in these reviews is defined by Bowlby's attachment theory 5 . This suggests that children respond to caregiver's behaviour in ways that most effectively achieve care and security.