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Purpose-Much has been written about conceptual concern for voluntary assent with children and adolescents. However, little empirical data exists examining the frequency with which, or context in which, adolescents and parents disagree on research participation decisions. The purpose of this study was to compare parent and adolescent willingness to participate in minimal and above minimal risk pediatric asthma research protocols.Method-36 adolescents diagnosed with asthma and one of their parents independently rated their willingness to participate in 9 pediatric asthma research protocol vignettes. The selected protocols were chosen by an expert panel as representative of typical minimal and above minimal risk pediatric asthma studies.Results-Parents and adolescents were significantly less likely to agree to enroll in above minimal risk studies. However, this was qualified by a finding that adolescents were significantly more willing than parents to enroll in above minimal risk research. Across all 9 studies, parents and adolescents held concordant views on participation decisions approximately 60% of the time. Perception of potential study benefit was the most frequent reason provided for participation decisions by both parents and adolescents.Conclusion-Parents and their adolescents report a consistent 40% discordance in their views about participating in asthma research across a variety of asthma research protocols, with adolescents more willing than their parents to enroll in above minimal risk studies. These differences of opinion highlight the need to carefully consider the process by which families are offered the option of adolescent research participation. The role of the adolescent in research participation decision-making is ambiguous. While federal regulations give parents legal responsibility for providing permission, consensus standards view adolescent assent as a moral and ethical imperative [1][2][3][4], with an adolescent's desire to dissent generally considered binding, particularly for non-therapeutic research. KeywordsSeveral models for adolescent participation in research and treatment decision-making have been proposed [5][6][7][8]. Inherent in the formulation of these models are differing views on the best way to protect the rights and interests of children and adolescents. Autonomy focused models [6,9] propose that adolescents should be approached alone after parental permission has been granted. This procedure highlights concern that adolescents exercise decision-making independently of their parents and treatment providers. Proponents of this model argue there may be competing interests between parents and adolescents in participation decision-making that result in different choices [10][11][12] Recent interview studies of parents and adolescents involved in research find that parents see their role as ensuring their child's best interest is upheld and protecting them from harm [6,17]. Factors that appear salient to parents' attitudes on what constitutes the child's best interest...

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Prepracticum service‐learning is an integral part of the curriculum for counselor education students at a large southwestern university. Service‐learning is accomplished by placing novice students in school or community agency settings to acquire early, practical, field‐based experience. Activities are more structured and supervised than in an internship or practicum. Analysis indicated that prepracticum service‐learning had a positive significant relationship with counselor self‐efficacy and a significant negative relationship with student anxiety. However, substantial counseling course work and experience with counseling‐related work both had a stronger influence than did prepracticum service‐learning, indicating that the latter is more appropriate for novice students.

Therapeutic engagement of adolescents is critical to maximizing the success of any psychotherapy intervention. Therapists have found that engaging adolescents is especially challenging and that there are several reasons for this. Most psychotherapy models are based on treatments that work for adults. These methods are frequently not conducive to engaging adolescents because of their developmental immaturity, the stigma many adolescents associate with psychotherapy, and adolescents feeling forced into psychotherapy. Existing empirical and clinical knowledge about therapy process, adolescent development, and adolescent interactions with their social ecology can be used to guide psychotherapists working with this population. Engaging adolescents in psychotherapy and establishing a strong therapeutic alliance with adolescents require that therapists express empathy and genuineness, utilize developmentally appropriate interventions, address the stigma, and increase choice in therapy. The prevalence and impact of mental health issues among adolescents are astonishing. Recent reports indicate that 1 in 10 children and adolescents suffer from impairing mental illness (Kessler, McGonagle, & Shayang, 1994; U.S. Public Health Service, 2000). Depression and depressive syndromes are common among adolescents, with more than 25% of high school students reporting persistent dysphoria and hopelessness severe enough to affect social and academic functioning, and 8 to 9% of youths admitting to attempts at suicide (Centers for Disease Control and Prevention [CDC], 2002). Five percent of all high school youths report weight control strategies that indicate a potential eating disorder (CDC, 2002). Nearly 27% of eighth graders, increasing to nearly 54% of high school seniors, report illicit substance use (National Institute on Drug Abuse, 2001), with 11% of high school students having a substance abuse problem.These mental health problems lead to serious consequences that include impaired social, academic, and occupational functioning; increased risk for behavioral problems; and accidental injury and death. Yet, fewer than one in five youths in need of mental health services receive the needed treatment (National Institute of Mental Health [NIMH], 1999). So, while adolescent mental health problems are pervasive and increasing, access to treatment is decreasing (NIMH, 1999). Consequently, maximizing adolescent use of psychotherapy and providing effective mental health services to adolescents are significant concerns for therapists (Dakof, Tejeda, & Liddle, 2001). However, therapy with adolescents is thought to be difficult (Church,