There have been impressive, recent advances in the development of efficacious treatments for child and adolescent behavior problems. However, specific methods for delivering these treatments in a way that amplifies their efficacy have not been well articulated. Although many factors may be involved, attendance and adherence to treatment are arguably the most basic necessities for effective treatment delivery. We provide a conceptual and empirical review of past research on attendance and adherence to child and adolescent therapy, with a special focus on the importance of parents/guardians in managing treatment participation. Our review demonstrates that attendance and adherence are associated with a range of significant methodological, clinical, and financial outcomes. Several pretreatment predictors of attendance and adherence have been identified; however, to date only 12 controlled, clinical trials have evaluated strategies for enhancing attendance and adherence to child therapy. We conclude with an agenda for advancing research on the prediction and enhancement of attendance and adherence to child therapy as a means of improving the efficiency and effectiveness of child treatments.

No abstract

We assessed parents' beliefs about treatment credibility and effectiveness and examined the influence of these beliefs on subsequent treatment participation. Seventysix parents completed the Credibility/Expectancies Questionnaire-Parent Version (CEQ-P), and subsequently participated in treatment for their child's clinically referred conduct problems. The key findings were that: (a) the CEQ-P is composed of two components that measure parents' treatment credibility and expectancies; (b) the total scale and each component are internally consistent and have strong test-retest reliability; (c) scores on the CEQ-P are significantly associated with scores on a measure of parent motivation for treatment, supporting the construct validity of this measure; and (d) scores on the CEQ-P at the first clinic visit significantly predict subsequent adherence to treatment procedures above and beyond demographic variables and parent motivation for treatment. This study provides an efficient and psychometrically sound measure of parent beliefs about treatment and demonstrates the importance of such beliefs for subsequent treatment adherence.

This paper describes the rationale, development, and implementation of a group parent training program designed to assist caregivers in the management of their child's eating disorder while facilitating the development of a healthy home environment for sustained change. The content of this program instructs caregivers in disorder management and capitalizes on caregivers as role models of adaptive behavior. Strategies are provided to address acute disorder management, features of caregivers that may impede task implementation, and environmental and attitudinal changes. The group format enhances social support, accountability, and self-efficacy. A preliminary qualitative evaluation and future directions are described to assist healthcare professionals in better meeting the needs of caregivers of these disorders.

Respondent‐based or subjective, ratings of stressor severity are posited to be influenced by systematic biases related to current mood and trait neuroticism which may confound associations between environmental stressors and psychological outcomes. The current study examined the effects of current mood state and neuroticism on subjective ratings of severity for real‐life stressors in a sample of 76 (30 males) undergraduates. Subjective ratings of stressor severity were collected in the context of an interview‐based stress assessment and were assessed on two separate occasions. Changes in mood state across the two assessments did not correspond with changes in subjective ratings of stressor severity. Neuroticism independently predicted subjective ratings of stressor severity, as did female gender and investigator‐based ratings of objective stressor severity. In addition, there was evidence to suggest that neuroticism fully accounted for observed associations between current mood state and subjective ratings of stressor severity. The findings are discussed with regard to the potential confounding influence of neuroticism in studies that rely on respondent‐based ratings of stressor severity in predicting psychological outcomes. Copyright © 2010 John Wiley & Sons, Ltd.