Background: This article proposes a conceptual model of child and parent engagement in the mental health intervention process. Method: A scoping review was performed of articles on predictors of engagement in mental health interventions, the effectiveness of engagement interventions, and interpersonal aspects of care. A comprehensive search of PsycINFO and PsycARTICLES was performed for literature published in English from 2000 to 2012. Results: Based on the review, a motivational framework is proposed in which engagement is defined as a state comprised of a hopeful stance, conviction, and confidence, brought about when therapists optimize engagement processes of receptiveness, willingness, and self-efficacy. Conclusions: Implications concern the need to help clients understand what to expect from the therapy process, and to educate therapists about engagement strategies. Key Practitioner Message• Child and parent engagement in mental health treatment can be considered to be a multifaceted state of affective, cognitive, and behavioral commitment or investment in the client role over the intervention process • In an engaged state, the client is enthusiastic about intervention, believes that the offered or chosen treatment will be effective, and sees the intervention plan as manageable • Practitioners may benefit by considering whether clients have a hopeful stance, are convinced about the appropriateness of intervention goals and processes, and are confident in their ability to carry out the intervention plan • Practitioners can play a key role in optimizing client engagement by maximizing the client's receptivity, willingness, and self-efficacy

Children who are receiving prophylactic antibiotics and are admitted to the hospital for a UTI are often infected with an organism that is resistant to third-generation cephalosporins. These children are more appropriately treated with an aminoglycoside antibiotic.

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IMPORTANCE Bruising caused by physical abuse is the most common antecedent injury to be overlooked or misdiagnosed as nonabusive before an abuse-related fatality or near-fatality in a young child. Bruising occurs from both nonabuse and abuse, but differences identified by a clinical decision rule may allow improved and earlier recognition of the abused child.OBJECTIVE To refine and validate a previously derived bruising clinical decision rule (BCDR), the TEN-4 (bruising to torso, ear, or neck or any bruising on an infant <4.99 months of age), for identifying children at risk of having been physically abused. DESIGN, SETTING, AND PARTICIPANTSThis prospective cross-sectional study was conducted from December 1, 2011, to March 31, 2016, at emergency departments of 5 urban children's hospitals. Children younger than 4 years with bruising were identified through deliberate examination. Statistical analysis was completed in June 2020. EXPOSURES Bruising characteristics in 34 discrete body regions, patterned bruising, cumulative bruise counts, and patient's age. The BCDR was refined and validated based on these variables using binary recursive partitioning analysis. MAIN OUTCOMES AND MEASURES Injury from abusive vs nonabusive trauma was determined by the consensus judgment of a multidisciplinary expert panel. RESULTS A total of 21 123 children were consecutively screened for bruising, and 2161 patients

With increasing expertise, therapists use a supportive, educational, holistic, functional, and strengths-based approach; have heightened humility yet increased self-confidence; and understand how to facilitate and support client change and adaptation by using principles of engagement, coherence, and manageability. Expert therapists use enabling and customizing strategies to ensure a successful therapeutic session, optimize the child's functioning in the mid-term, and ensure child and family adaptation and accommodation over the longer-term.