The Role of Stigma in Parental Help-Seeking for Perceived Child Behavior Problems in Urban, Low-Income African American Parents

Dempster, Robert; Davis, Deborah Winders; Jones, V. Faye; Keating, Adam; Wildman, Beth G.

doi:10.1007/s10880-015-9433-8

Cited by 51 publications

(34 citation statements)

References 62 publications

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“…There were also a range of other barriers that were more frequently endorsed by fathers of children in the high externalising group than the low externalising group, including factors related to stigma (worry about being judged), maternal gatekeeping (my partner attended without me and did not encourage my participation), and help-seeking attitudes (problems with my child’s behaviour require treatment of the child, I don’t think programs are suitable for fathers). Stigma has been found to be predictive of lower levels of help-seeking in parents of children with behavioural problems [49] which indicates the importance of normalising attendance at parenting programs, both in promotional materials and by practitioners who are working with families. It is also important for promotional materials to provide information in order to address misconceptions that child behavioural problems require treatment of the child only rather than the parents, and that programs are not suitable for fathers.…”

Section: Discussionmentioning

confidence: 99%

Optimising child outcomes from parenting interventions: fathers’ experiences, preferences and barriers to participation

et al. 2017

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BackgroundEarly childhood interventions can have both immediate and long-term positive effects on cognitive, behavioural, health and education outcomes. Fathers are underrepresented in interventions focusing on the well-being of children. However, father participation may be critical for intervention effectiveness, especially for parenting interventions for child externalising problems. To date, there has been very little research conducted to understand the low rates of father participation and to facilitate the development of interventions to meet the needs of fathers. This study examined fathers’ experiences of, and preferences for, parenting interventions as well as perceptions of barriers to participation. It also examined how these factors were associated with child externalising behaviour problems, and explored the predictors of participation in parenting interventions.MethodsA community sample of 1001 fathers of children aged 2–16 years completed an online survey about experiences with parenting interventions, perceived barriers to participation, the importance of different factors in their decision to attend, and preferred content and delivery methods. They also completed ratings of their child’s behaviour using the Strengths and Difficulties Questionnaire.ResultsOverall, 15% of fathers had participated in a parenting intervention or treatment for child behaviour, with significantly higher rates of participation for fathers of children with high versus low levels of externalising problems. Fathers rated understanding what is involved in the program and knowing that the facilitator is trained as the two most important factors in their decision to participate. There were several barriers to participation that fathers of children with high-level externalising problems were more likely to endorse, across practical barriers and help-seeking attitudes, compared to fathers of children with low-level externalising problems. Almost two-thirds of fathers of children with high-level externalising behaviour had not participated in a parenting intervention or treatment. The only significant predictors of intervention participation were severity of child externalising behaviour problems and child age.ConclusionsThe findings have important implications for services seeking to increase father engagement and highlight a number of strategies to enhance the promotion and delivery of parenting interventions to fathers. These strategies include more public health messaging about parenting programs and the importance of father participation.

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Section: Discussionmentioning

confidence: 99%

Optimising child outcomes from parenting interventions: fathers’ experiences, preferences and barriers to participation

et al. 2017

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“…Culturally relevant care and communication can increase parents motivation and engagement in treatment, improve quality of care and positive treatment outcomes. Given that parents may feel that diagnostic labels such as attention deficit hyperactivity disorder and post- traumatic stress syndrome are stigmatizing (Dempster, Davis, Faye Jones, Keating, & Wildman, 2015; Dempster et al 2013), providing parent education about the benefits of early diagnosis and answering parent’s questions may help with treatment engagement and reduce attrition. Treatment screening questionnaires that are not culturally relevant may be inadequate for assessing cultural factors that influence the mental health of underserved ethnic families and children.…”

Section: Discussionmentioning

confidence: 99%

Understanding Barriers to Initial Treatment Engagement among Underserved Families Seeking Mental Health Services

et al. 2016

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This mixed method study examined factors associated with parents not attending their child’s mental health treatment after initially seeking help for their 2–5 year old child. It was part of a larger study comparing two evidence-based treatments among low-income racial/ethnic minority families seeking child mental health services. Of 123 parents who initiated mental health treatment (71% African American or multi-racial; 97.6% low-income), 36 (29.3%) never attended their child’s first treatment session. Socio-demographic characteristics, parenting stress, depression, severity of child behavior problems, and length of treatment delay from intake to first scheduled treatment session were compared for families who did and did not attend their first treatment session. Parents who never attended their child’s first treatment session were more likely to live with more than 4 adults and children (p=.007) and have more depressive symptoms (p=.003). Median length of treatment delay was 80 days (IQR =55) for those who attended and 85 days (IQR =67.5) for those who did not attend their child’s first treatment session (p=.142). Three themes emerged from caregiver interviews: (a) expectations about the treatment, (b) delays in getting help, and (c) ambivalence about research participation. Findings suggest the need to develop better strategies for addressing risk factors early in the treatment process and reducing the length of time families with adverse psychosocial circumstances must wait for child mental health treatment.

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“…Studies indicate that parents and family members struggle with the burden of courtesy stigma on interrelationships. For example, beliefs associated with the fear of avoidance by others, social rejection, and discrimination are reported among parents of children with mental health diagnoses (Corrigan and Miller 2004;Dempster et al 2015;Shibre et al 2001). Moreover, evidence suggests that family members engage in behavioral responses to the stigma by concealing the family members' mental illness from others (Stengler-Wenzke et al 2004), avoiding seeking treatment (Moses 2010), staying silent about their child (KoroLjungberg and Bussing 2009), and hiding or limiting the social contact of the family member with the illness (Lin et al 1981).…”

Section: Beliefs About Close Family Members or Associates Of Individumentioning

confidence: 99%

Conceptualizing Culturally Infused Engagement and Its Measurement for Ethnic Minority and Immigrant Children and Families

Yasui

Pottick

Chen

2017

Clin Child Fam Psychol Rev

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Despite the central role culture plays in racial and ethnic disparities in mental health among ethnic minority and immigrant children and families, existing measures of engagement in mental health services have failed to integrate culturally specific factors that shape these families' engagement with mental health services. To illustrate this gap, the authors systematically review 119 existing instruments that measure the multi-dimensional and developmental process of engagement for ethnic minority and immigrant children and families. The review is anchored in a new integrated conceptualization of engagement, the culturally infused engagement model. The review assesses culturally relevant cognitive, attitudinal, and behavioral mechanisms of engagement from the stages of problem recognition and help seeking to treatment participation that can help illuminate the gaps. Existing measures examined four central domains pertinent to the process of engagement for ethnic minority and immigrant children and families: (a) expressions of mental distress and illness, (b) causal explanations of mental distress and illness, (c) beliefs about mental distress and illness, and (d) beliefs and experiences of seeking help. The findings highlight the variety of tools that are used to measure behavioral and attitudinal dimensions of engagement, showing the limitations of their application for ethnic minority and immigrant children and families. The review proposes directions for promising research methodologies to help intervention scientists and clinicians improve engagement and service delivery and reduce disparities among ethnic minority and immigrant children and families at large, and recommends practical applications for training, program planning, and policymaking.

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The Role of Stigma in Parental Help-Seeking for Perceived Child Behavior Problems in Urban, Low-Income African American Parents

Cited by 51 publications

References 62 publications

Optimising child outcomes from parenting interventions: fathers’ experiences, preferences and barriers to participation

Optimising child outcomes from parenting interventions: fathers’ experiences, preferences and barriers to participation

Understanding Barriers to Initial Treatment Engagement among Underserved Families Seeking Mental Health Services

Conceptualizing Culturally Infused Engagement and Its Measurement for Ethnic Minority and Immigrant Children and Families

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