Factors Influencing Parental Engagement in a Community Child and Adolescent Mental Health Service: A Qualitative Comparison of Completers and Non-Completers

Abstract

A B S T R A C TAttrition is a significant problem in child mental health services. Research investigating the factors associated with attrition has produced conflicting results, and failed to consider clients' own decision to terminate treatment prematurely. This study investigated parental accounts of why they completed or discontinued treatment. Completers and non-completers were interviewed using an open-ended interview schedule. All completed the Strengths and Difficulties Questionnaire (SDQ) before beginning treatment, but the sample size was too small to yield meaningful results. Core differences were found in the accounts of parents who completed treatment and parents who discontinued treatment. Completers' accounts were more focused on the child's problem and identified more factors that facilitated the effectiveness of the intervention; whereas non-completers' accounts were more focused on family problems and identified more obstacles that interfered with the effectiveness of the intervention. The findings have implications for the way in which non-completers are conceptualized for understanding the process of engagement.K E Y W O R D S adolescent, attrition, child, drop-out, mental health, non-completion I T I S W I D E LY accepted that improvements are urgently needed in the provision of mental health services to children and adolescents (

Strengths and Difficulties Questionnaire: research and clinical applications

“…Although the latter indicated that generic standardized measures were useful in making decisions about priority, they should be selected to reflect specific service objectives or in combination with specific or tailor-developed instruments. Other interesting characteristics of these studies were the frequent combination of quantitative and qualitative measures [15,40,45], and the repeated completion of the SDQ at follow-up intervals, ranging from a few weeks to 3 years.…”

Perspectives on Engagement Barriers and Alternative Delivery Formats from Non-completers of a Community-Run Parenting Program

“…As federal and state dollars spent on researching parent training programs are being invested with the expectation that the programs will eventually be turned over to and used by community providers, it is imperative that community providers understand common participation barriers and are equipped with techniques that can be used to increase engagement. Unfortunately, while some barriers to participation in community-run interventions have been identified, there is still much unknown about the various obstacles faced by families that are preventing them from achieving optimal results (Attride-Stirling, Davis, Farrell, Groark, & Day, 2004; Baker-Ericzén, Jenkins, & Haine-Schlagel, 2013). More importantly, minimal research has been conducted on specific methods and alternatives to improve parental attendance and high quality participation (Ingoldsby, 2010; Nock & Ferriter, 2005; Nock & Kazdin, 2005).…”

Therapist, Parent, and Youth Perspectives of Treatment Barriers to Family-Focused Community Outpatient Mental Health Services

“…Completers also identified factors that facilitated their involvement in treatment (i.e. parenting differently) and, indicated fewer obstacles than non-completers (Attride-Stirling, Davis, Farrell, Groark, & Day, 2004). Evidence also suggests that compared to families who remain in treatment, parents who terminate services prematurely are more likely to report situational obstacles (e.g., additional life stressors, lack of resources) (Prinz & Miller, 1994).…”