Abstract
This exploratory qualitative study describes treatment barriers to receiving family-focused child mental health services for
youths with disruptive behavior problems from multiple perspectives. Data were collected during a series of focus groups and
interviews, including: 4 therapist focus groups (n = 26), 3 parent focus groups (n = 14), and 10 youth (10–13 years) semi-structured
interviews. Data analysis followed inductive, iterative processes typical of qualitative research using an editing style and
thematic content analysis approach. Therapist, parent, and youth stakeholder participants discussed perceived barriers to
effective treatment, the problems with current child outpatient therapy, and desired changes (i.e., policy, intervention,
etc.) to improve mental health services. Results indicate similar themes around treatment barriers and dissatisfaction with
services within and across multiple stakeholder groups, including inadequate service system support, lack of family involvement
and feeling overwhelmed with the complexities of families’ needs; however, parents and therapists, in particular, identified
different contributing factors to these barriers. Therapists highly endorse using family-focused therapy and desire parent
participation; however, parents feel unsupported by their child’s therapist. Parents’ report feeling blamed and not heard
by service providers which negatively impacts their attitude about service delivery, causing discomfort and resistance to
participation in their youth’s treatment. Youth also discussed dissatisfaction with mental health services, specifically related
to their direct experiences in therapy, and desired more active, directive family-focused approaches. Overall, stakeholders
reported much frustration and dissatisfaction with current community-based outpatient child therapy services. Study findings
can inform service provision, intervention development, and future research.
youths with disruptive behavior problems from multiple perspectives. Data were collected during a series of focus groups and
interviews, including: 4 therapist focus groups (n = 26), 3 parent focus groups (n = 14), and 10 youth (10–13 years) semi-structured
interviews. Data analysis followed inductive, iterative processes typical of qualitative research using an editing style and
thematic content analysis approach. Therapist, parent, and youth stakeholder participants discussed perceived barriers to
effective treatment, the problems with current child outpatient therapy, and desired changes (i.e., policy, intervention,
etc.) to improve mental health services. Results indicate similar themes around treatment barriers and dissatisfaction with
services within and across multiple stakeholder groups, including inadequate service system support, lack of family involvement
and feeling overwhelmed with the complexities of families’ needs; however, parents and therapists, in particular, identified
different contributing factors to these barriers. Therapists highly endorse using family-focused therapy and desire parent
participation; however, parents feel unsupported by their child’s therapist. Parents’ report feeling blamed and not heard
by service providers which negatively impacts their attitude about service delivery, causing discomfort and resistance to
participation in their youth’s treatment. Youth also discussed dissatisfaction with mental health services, specifically related
to their direct experiences in therapy, and desired more active, directive family-focused approaches. Overall, stakeholders
reported much frustration and dissatisfaction with current community-based outpatient child therapy services. Study findings
can inform service provision, intervention development, and future research.
- Content Type Journal Article
- Category Original Paper
- Pages 1-15
- DOI 10.1007/s10826-012-9644-7
- Authors
- Mary J. Baker-Ericzén, Child and Adolescent Services Research Center, Rady Children’s Hospital, 3020 Children’s Way MC5033, San Diego, CA 92123, USA
- Melissa M. Jenkins, University of North Carolina, Chapel Hill, NC, USA
- Rachel Haine-Schlagel, Child and Adolescent Services Research Center, Rady Children’s Hospital, 3020 Children’s Way MC5033, San Diego, CA 92123, USA
- Journal Journal of Child and Family Studies
- Online ISSN 1573-2843
- Print ISSN 1062-1024