The Youth Self Report (YSR) is a widely used measure of youth emotional and behavioral problems. Although the YSR was designed for youths ages 11-18, no studies have systematically evaluated whether youths under the age of 11 can make valid reports using the YSR broad-band, syndrome and DSM-oriented scales. This study thus examined the reliability and validity of the YSR scales scores for younger (ages 7-10; n=184) and older (ages 11-14; n=147) youths. Results demonstrated that younger youths were able to provide reliable reports on the YSR broad band (Internalizing, Externalizing) scales, though less so on the narrow band scales. Across all scales, the externalizing scales performed more favorably than the internalizing scales among both younger and older youth. Younger youths' DSM-oriented scales corresponded significantly with DSM diagnoses. Model fit of the narrow and broad band scales were also supported in both younger and older samples. These results provide initial support for administration of the YSR to younger youths.
In this sample, age significantly affected absorption and metabolism of MPH, so that preschool children had greater exposure than school-aged children to the same weight-adjusted dose. These data suggest additional studies should be performed to characterize age-related differences in PK properties of MPH that may inform practitioners about dosing strategies based on the age and size of children being treated.
Objective The purpose of this pilot study was to examine preliminary feasibility, acceptability, and effectiveness of a toolkit (Parent And Caregiver Active Participation Toolkit) to increase parent participation in community-based child mental health services. Method Study participants included 29 therapists (93% female; mean age 34.1 years; 38% Latino) and 20 parent/child dyads (children 80% female with a mean age of 8.6 years; parents 40% Latino) in six diverse community mental health clinics. Therapists were randomly assigned to standard care or the toolkit with standard care. Therapist and parent survey data and observational coding of treatment sessions were utilized. Results Mean comparisons and repeated measures analyses were used to test differences between study conditions over four months. Results supported preliminary feasibility and acceptability of the toolkit, with therapists assigned to the toolkit participating in ongoing training, adhering to toolkit use, and perceiving the toolkit as feasible and acceptable within their setting. Results preliminarily demonstrated improvement in therapists’ job attitudes as well as actual use of parent engagement strategies. Results also preliminarily demonstrated increases in parent participation in child therapy sessions, more regular attendance, as well as some indication of support for perceived treatment effectiveness. Conclusions Overall, results suggest the feasibility, acceptability, and potential effectiveness of the toolkit to enhance therapist job attitudes, practices that support parent engagement, parent engagement, and consumer perspectives on treatment outcomes and the potential promise of future research in the area of parent participation interventions in child mental health services.
Objective To examine racial disparities in mental health service use by problem type (internalizing vs. externalizing) for youths in contact with the child welfare system. Methods Participants included 1,693 non-Hispanic white, African American, and Hispanic youths (ages 4-14) from the National Survey of Child and Adolescent Well-Being, a national probability study of youths who were the subject of investigations of maltreatment by child welfare agencies. Mental health need, assessed at baseline, was considered present if the youth had internalizing/externalizing scores in the clinical range on either the Child Behavior Checklist or Youth Self-Report. Outpatient mental health service use in the subsequent year was assessed prospectively. Results Children who were removed from the home and those investigated for abuse (vs. neglect) were more likely to receive services in the year following the child welfare investigation. Overall, African American youths were less likely to receive mental health services relative to non-Hispanic white youths. However, race moderated the association between externalizing need and service use such that African Americans were more likely to receive services when externalizing need was present (26% vs. 4%) compared to non-Hispanic white youths (30% vs. 14%). Race/ethnicity did not moderate the association between youth internalizing need and service use, but internalizing need was only associated with increased probability of service use for non-Hispanic white youths. Conclusions Examinations of overall racial disparities in service use may obscure important problem-specific disparities. Additional research is needed to identify factors that lead to disparities and to develop strategies for reducing them.
Social support networks may encourage or dissuade help-seeking for youth behavior problems in ways that contribute to racial/ethnic disparities in mental health services. We examined how parental social network characteristics were related to the use of mental health services in a diverse sample of families in contact with Child Welfare. Data from 1519 families of White (n=812), African American (n=418), and Latino (n=289) origin were drawn from the National Survey of Child and Adolescent Well-Being. Data were collected prospectively after the initiation of a Child Welfare investigation for alleged maltreatment. Results revealed that parental perceptions of support were negatively associated with service use across racial/ethnic groups, and this association was explained by better subsequent mental health status enjoyed by children of parents with stronger social support. Moderator analyses suggested that larger social networks were associated with a decreased use of services among Whites and more highly educated families.
Purpose Well-documented ethnic disparities exist in the identification and provision of quality services among children receiving community-based mental health services. These disparities extend to parent treatment engagement, an important component of effective mental health services. Currently, little is known about differences in how providers support parents’ participation in treatment and the degree to which parents actively participate in it. The purpose of this paper is to examine potential differences in both provider and parent in-session participation behaviours. Design/methodology/approach Participants included 17 providers providing standard community-based mental health treatment for 18 parent-child dyads, with 44 per cent of the dyads self-identifying as Hispanic/Latino. In-session participation was measured with the parent participation engagement in child psychotherapy and therapist alliance, collaboration, and empowerment strategies observational coding systems. Findings Overall, results indicate significantly lower levels of parent participation behaviours among Hispanic/Latino families compared to their Non-Hispanic/Non-Latino counterparts. No significant differences were seen in providers’ in-session behaviours to support parent participation across Hispanic/Latino and Non-Hispanic/Non-Latino families. Research limitations/implications These findings contribute to the literature on ethnic differences in parent treatment engagement by utilising measures of in-session provider and parent behaviours and suggest that further investigation is warranted to documenting and understanding ethnic disparities in parents’ participation in community-based child mental health treatment. Originality/value This paper contributes to the evaluation of differences in parent treatment engagement through demonstrating the utility of an in-session observational coding system as a measure of treatment engagement.
Parent engagement in treatment for child disruptive behavior has been associated with improved child outcomes in care. However, many families who enter care do not receive an adequate dose of treatment, and parents are often not involved. We examined therapists' use of psychoeducation, a therapeutic practice used to present factual information about target problems and treatments, and its association with parent engagement in child psychotherapy. Participants were drawn from the Child System and Treatment Enhancement Projects' multisite trial contrasting standard evidence-based treatments, modular treatment, or usual care. We included an ethnically diverse sample of 46 youth (ages 7-13) who received treatment for disruptive behavior in modular treatment or usual care. A reliable observational coding system was developed to assess therapists' in-session use of psychoeducation strategies (e.g., discussing causes of misbehavior, describing and providing rationale for treatment, etc.), as well as other engagement strategies (e.g., collaborative goal setting, managing expectations, etc.), in the early phase of treatment. Findings revealed that modular treatment therapists provided more psychoeducation and other engagement strategies compared with usual care therapists. Furthermore, psychoeducation strategies employed by therapists early on uniquely predicted subsequent parent involvement in treatment, over and above the use of other engagement strategies. Finally, therapists' use of the psychoeducation strategy of discussing causes of child's misbehavior mediated the effect of treatment condition on parent involvement in their child's therapy. These findings suggest that the implementation of psychoeducation strategies upon entry into care promotes parent involvement in child psychotherapy for disruptive behavior.
Autism spectrum disorder (ASD) is a highly prevalent neurodevelopmental disorder. ASD communitybased organizations (ASD-CBOs) underutilize or inconsistently utilize evidence-based practices (ASD-EBPs) despite numerous available EBPs to treat ASD. Despite this, ASD-CBOs implement changes to practices regularly. Understanding ASD-CBO's implementation-as-usual (IAU) processes may assist to develop strategies to facilitate ASD-EBP adoption, implementation and sustainment. A convergent mixed methods (quan+QUAL) design was utilized. Twenty ASD-CBO agency leaders (ALs) and 26 direct providers (DPs), from 21 ASD-CBOs, completed the Autism Model of Implementation Survey Battery, including demographic and agency IAU process questions. Surveys were analyzed through descriptive and content analyses. A subset of 10 ALs provided qualitative interview data that were analyzed using coding, consensus and comparison methods to allow for a more comprehensive understanding of the IAU process within their ASD-CBOs. Quantitative analyses and qualitative coding were merged utilizing a joint display and compared. Results suggest that the IAU process follows some phases identi ed in the Exploration, Preparation, Implementation, Sustainment (EPIS) framework but were conducted in an informal manner-lacking speci city, structure and consistency across and within ASD-CBOs. Moreover, data suggest adding a speci c adoption decision phase to the framework. Nonetheless, most ALs felt previous implementation efforts were successful. IAU processes were explored to determine whether the implementation process may be an area for intervention to increase ASD-EBP utilization in ASD-CBOs. Developing a systematized implementation process may facilitate broader utilization of high quality ASD-EBPs within usual care settings, and ultimately improve the quality of life for individuals with ASD and their families.
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