Therapeutic relationship and dropout in youth mental health care with ethnic minority children and adolescents

Haan, A.M. de; Boon, Albert; Jong, Joop T. V. M. de; Geluk, Charlotte; Vermeiren, Robert

doi:10.1111/cp.12030

Cited by 14 publications

(8 citation statements)

References 32 publications

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“…7,23 The current study also expands knowledge in that attrition rates were not discussed by the participants, although this is a frequent topic of concern in the literature, 4,9 especially with young people. 12 However, this was not a frequent issue experienced by the online practitioners within their narratives; only mentioned once within Part 3 within the larger context of risk. Managing risk was a significant challenge outlined by therapists within their narratives.…”

Section: Discussionmentioning

confidence: 99%

“…11 High attrition rates are particularly prevalent in young people, with rates of up to 69% reported. 12 O'Keeffe et al 13 added that adolescents are more likely to prematurely discontinue therapy if the therapeutic approach does not match their desired style. Importantly, a positive therapeutic relationship can be a protective factor against premature attrition within the therapeutic process.…”

Section: Introductionmentioning

confidence: 99%

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Exploring the development and maintenance of therapeutic relationships through e-Health support: A narrative analysis of therapist experiences

Wood

Wilson²,

Parry

2021

Medicine Access @ Point of Care

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Objective: Amid COVID-19 disruptions, e-therapy has become even more essential and has rapidly expanded across statutory, private and third sectors to meet growing demands for digital mental health support. A challenge in digital therapeutic care is how to develop and maintain a supportive, collaborative therapeutic relationship, built upon mutual trust and respect; intrinsic values of relationships that are often implied through complex non-verbal cues. Online practitioners are eager to learn how to adapt to online delivery, although platform-specific training is limited. The aim of the current study was to focus upon the therapist experience of online therapeutic relationships with young people, exploring a range of factors through their perspectives, including the impact of anonymity. Methods: Eight e-therapy practitioners were recruited from Kooth, an online mental health service. Narrative interviews undertaken via Skype facilitated reflective conversational one-to-one discussions, based upon the practitioners’ individual experiences, led by the interviewee. Following transcription and anonymisation, a narrative analysis was undertaken to explore participants’ experiences, perspectives and reflections. Results: Four analytic layers arose from the narratives, which explored the challenging learning experience of translating existing therapeutic skills to online working, rapidly building therapeutic relationships, managing risk in the online therapeutic relationship, and techniques for maintaining a digital therapeutic relationship. Conclusion: The study provides novel insights into the flexibility and adjustments therapists can make to improve online interventions and delivery through the development and maintenance of positive therapeutic relationships. Recommendations are also made in relation to platform-specific training, communicative adaptations, risk management and practitioner support.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Exploring the development and maintenance of therapeutic relationships through e-Health support: A narrative analysis of therapist experiences

Wood

Wilson²,

Parry

2021

Medicine Access @ Point of Care

View full text Add to dashboard Cite

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“…While the racial homogeneity of the sample limits the generalizability of the findings to other racial and ethnic groups, it is worth noting that the racial breakdown of this study reflects general mental health trends in the United States. Minority adolescents utilize mental health services significantly less than White adolescents and demonstrate higher therapy dropout rates (de Haan, Boon, de Jong, Geluk, & Vermeiren, 2014). Nonetheless, future research should examine the extent to which social media competency predicts therapeutic alliance ratings among adolescents of diverse racial and ethnic groups.…”

Section: Discussionmentioning

confidence: 99%

Adolescents’ perceptions of their therapists’ social media competency and the therapeutic alliance.

Pagnotta

Blumberg

Ponterotto

et al. 2018

Professional Psychology: Research and Practice

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Adolescents' lives are now experienced in sophisticated digital environments, potentially warranting their consideration as a distinct cultural group. As such, clinicians who work with this population may be expected to be conversant with their clients' digital habits to establish an efficacious therapeutic alliance and bolster treatment outcomes. We investigated linkages between adolescents' social media habits and therapeutic alliance ratings based on perceptions of their therapists' social media competency and traditional multicultural competency (MCC). Seventy-seven 14-to 17-year-olds currently receiving therapy services completed an online survey assessing their social media habits, perceptions of their therapists' social media competency and traditional MCC, and ratings of therapeutic alliance. Adolescents' perceptions of therapists' social media competency positively predicted therapeutic alliance ratings, regardless of variations in participants' social media use. A positive relationship was also found between perceived traditional MCC and therapeutic alliance ratings. Finally, preliminary validation for a newly adapted measure of therapists' perceived social media competency was demonstrated. These findings may be among the first to establish social media competency as a contemporary form of MCC, which may inform new avenues for training and professional development for psychologists working with adolescents. Public Significance StatementThis study suggests that adolescents' perceptions of their therapists' social media competency may impact their perceptions of the therapeutic alliance. Additionally, the study introduces a new instrument for assessing perceptions of therapists' social media competency.

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“…Important predictors of drop-out rates among adolescents include poorer therapeutic alliance early in treatment [8][9][10][11] and a decline in the quality of the therapeutic relationship during therapy [12]. The therapists are often unaware of the adolescents´ dissatisfaction [5].…”

Section: Open Accessmentioning

confidence: 99%

The nature of youth in the eyes of mental-health care workers: therapists’ conceptualization of adolescents coming to therapy at others’ initiative

Barca

Moltu

Veseth

et al. 2020

Int J Ment Health Syst

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Background Adolescent clients often come to therapy at the initiative of others and show a higher drop-out rate compared to adult clients. Therapeutic relationships are critical for preventing drop-outs and attaining good outcomes, yet few empirical studies have investigated how therapists conceptualize and meet adolescent clients who come reluctantly to therapy. Methods We conducted ten focus-group interviews in this study with a total of 51 therapists at different Norwegian specialist outpatient clinics for children and adolescents with mental-health problems to explore how therapists view and understand adolescents who come to therapy at the initiative of someone else. We used a reflexive approach to thematic analysis to analyze the transcripts. Results We found five main themes, expressing variations in participants’ understanding: The hurt and distrustful adolescent; The adolescent lacking hope for the future; The adolescent engulfed in the burden of mental-health suffering; The adolescent as something more than a psychiatric patient; and The adolescent meeting a system with varying flexibility and space for engagement. Conclusions Several conceptualizations of the adolescent client coexist within and between clinics, resulting in variability of services for adolescents even within the frames of a strong welfare system.

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Therapeutic relationship and dropout in youth mental health care with ethnic minority children and adolescents

Abstract: Background: Dropout in youth psychotherapy is high, especially for ethnic

Cited by 14 publications

References 32 publications

Exploring the development and maintenance of therapeutic relationships through e-Health support: A narrative analysis of therapist experiences

Exploring the development and maintenance of therapeutic relationships through e-Health support: A narrative analysis of therapist experiences

Adolescents’ perceptions of their therapists’ social media competency and the therapeutic alliance.

The nature of youth in the eyes of mental-health care workers: therapists’ conceptualization of adolescents coming to therapy at others’ initiative

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