Barriers and facilitators to treatment participation by adolescents in a community mental health clinic

Abstract

An estimated 40-60% of children in mental health treatment drop out before completing their treatment plans, resulting in increased risk for ongoing clinical symptoms and functional impairment, lower satisfaction with treatment, and other poor outcomes. Research has focused predominately on child, caregiver, and family factors that affect treatment participation in this population and relatively less on organizational factors. Findings are limited by focus on children between 3 and 14 years of age and included only caregivers' and/or therapists' perspectives. The purpose of this descriptive qualitative study was to identify organizational factors that influenced participation in treatment, with special attention to factors that contributed to dropout in adolescents. The sample included 12 adolescent-caregiver dyads drawn from two groups in a large public mental health provider database. Analysis of focus group interview data revealed several perceived facilitators and barriers to adolescent participation in treatment and provided several practical suggestions for improving treatment participation. Implications of the findings for psychiatric mental health nurses and other clinicians who provide services to families of adolescents with mental health concerns are discussed.

Parental Experiences of Supporting Children with Clinically Significant Post-Traumatic Distress: a Qualitative Study of Families Accessing Psychological Services

“…Recent research has extolled the importance of parental engagement in child psychological treatment post-trauma (Cobham et al 2016) and parent and child satisfaction with services is strongly associated with treatment completion and functional improvement (Garland et al 2007;Oruche et al 2014;Ronzoni and Dogra 2012). Therefore, clinical care and psychological interventions may be enhanced by the inclusion of targeted information and advice for families engaged with psychological services following child trauma exposure.…”

Enhancing Collaborative Treatment Planning with Young People in Mental Health Settings: A Narrative Scoping Review

“…Fundamentally, they emphasised the need for a respectful and collaborative relationship between the clinician and young person (Holum, 2012;Oruche, Downs, Holloway, Draucker, & Aalsma, 2014). When a young person feels secure they are better able to participate in formulating goals (Green, Wisdom, Wolfe, & Firemark, 2012;Holum, 2012).…”

“…When a young person feels secure they are better able to participate in formulating goals (Green, Wisdom, Wolfe, & Firemark, 2012;Holum, 2012). Eight articles emphasised the importance of clinicians developing trust, respecting and promoting client autonomy (Amodeo & Collins, 2007;Crais, 1993;Green et al, 2012;Holum, 2012;Oruche et al, 2014;Schauer et al, 2007;Song & Omar, 2009;Toivakka, 2012), and encouraging clients to make their own decisions regarding their treatment (Green et al, 2012;Holum, 2012;Walker et al, 2009). For this to occur, it was suggested that the process of treatment planning should focus on understanding the client's experience, independent of their ability to express their needs (Kjellberg et al, 2012).…”

“…• Offering a sense of calm (Holum, 2012), warmth, understanding, empathy, personal respect, honesty, authenticity and unconditional positive regard (Day, 2008;Green et al, 2012;Kjellberg et al, 2012;Oruche et al, 2014;Schauer et al, 2007).…”

“…• Listening and relating in an open and inclusive way to convey shared values with the young person (Day, 2008;Oruche et al, 2014;Schauer et al, 2007).…”