The authors present the results of two studies designed to improve treatment engagement among urban youths with conduct and oppositional behavioral difficulties. In the first study, information on attitudes about mental health treatment was obtained from 159 adult caregivers of children who were referred to an urban child mental health clinic because of disruptive behavioral difficulties. The caregivers listed insufficient time, lack of transportation, the child's not wanting to attend treatment, and the caregiver's concern that treatment might not help as barriers to service use. The data from study 1 were used to design a multiple-family group intervention to be tested in study 2. The families who participated in these groups attended an average of seven sessions during the 16-week study, compared with four sessions for families who participated in family therapy and three for families who participated in individual psychotherapy.

This study reports patterns of involvement in a family-focused preventive intervention, Schools and Families Educating (SAFE) Children, targeting early predictors of risk for delinquency and drug use among 175 African American and Latino first-grade children living in economically disadvantaged inner-city neighborhoods. Three empirically derived patterns emerged: joiners, responders, and minimal responders. Joiners were immediately responsive and enthusiastic and participated fully. Responders attended fully only after extensive effort was made to recruit and retain them. However, once engaged, they attended fully and participated with enthusiasm. Minimal responders attended a few sessions sporadically even with extensive, ongoing effort to engage them. Ethnicity, marital status, parental antisocial behavior, economic and loss stressors, monitoring, and child's depression and hyperactivity were significant discriminators of group membership.

Objective: This article presents an evaluation of a multiple family group intervention (MFG) designed to meet the mental health needs of low-income minority children and families. Method:Children participating in the MFG are compared with children demographically and clinically similar who received individual or family therapy services at an urban mental health center. Results: Of the children referred for MFG, 59% were still in service by the 16th group meeting. Of the children assigned to individual or family therapy, only 39% were in service after 16 weeks. Data from the subsamples that attended 16 weeks of MFG or therapy sessions were analyzed, and significant decreases in total disruptive behavior, conduct problems, learning difficulties, hyperactivity, and impulsivity were associated with MFG participation. Conclusion: Follow-up interviews revealed that 70% of MFG parents noted child improvements, in comparison to 54% of parents whose children received individual family therapy.

In an effort to improve parenting assessments for mothers with mental illness, this study examined the relationship between caregiving attitudes and maternal behavior. Participants included 44 mothers with major mental illness who were involved with the child welfare system and their young children. The Parenting Opinion Questionnaire (POQ) was administered to assess caregiving attitudes. Maternal behavior was assessed directly in a videotaped observation. Unrealistic maternal caregiving attitudes, especially attitudes that a child should provide a parent with support and comfort, were associated with at-risk maternal behavior. The findings support the application of the POQ for use in multimeasure, multimethod parenting evaluations.

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