Are Children with Anxiety Disorders Privately Referred to a University Clinic Like Those Referred from the Public Mental Health System?

Abstract

Compared two groups of children with anxiety disorders served at a single mental health clinic whose referral source differed: private referrals (i.e., parent/legal guardian initiated) and public referrals (e.g., via state contracts--Departments of Health and Education, juvenile justice system). Comparisons were made across three domains of variables: (a) symptoms/diagnoses, (b) functioning, and (c) environments. Few symptom differences emerged. However, large differences were evident for contextual variables like family income and life stressors. Overall, the pattern of differences point to possible directions for adaptation of treatments for use with children with anxiety disorders served in public mental health systems.

Predictors of Treatment Engagement in Ethnically Diverse, Urban Children Receiving Treatment for Trauma Exposure

“…Parents of children who are mandated to come to therapy may be less likely to believe that their child or family has a problem and may therefore be less motivated to engage in treatment (Snyder & Anderson, 2009). This may be particularly problematic in under-represented groups, as individuals from these groups are more likely to be mandatorily referred to therapy and distrust the mental health service system (Snyder & Anderson, 2009;Southam-Gerow, Chorpita, Miller & Gleacher, 2008). There is also evidence that children who are referred to treatment by child welfare, schools, or other public institutions are more likely to experience psychosocial stress, have lower incomes, come from single-parent households, have academic difficulties, and present with externalizing problems (SouthamGerow et.…”

Integrity of Evidence-Based Practice: Are Providers Modifying Practice Content or Practice Sequencing?

“…Given that many of the youths receiving public mental health services appear to have a higher degree of complexity and comorbidity than those in typical research trials (SouthamGerow, Chorpita, Miller, & Gleacher, 2008), one strategy for enhancing the fit between science and service has been to increase the flexibility of EBT protocols, which traditionally prescribe a predetermined sequence and set of practices for a single disorder, to allow providers to make real-time, informed adjustments in response to clinical events that might otherwise adversely affect treatment (Chorpita, Korathu-Larson, Knowles, & Guan, in press). For example, researchers have recommended treatment designs that involve the application of efficacious practices commonly cited within the clinical literature using a data-driven, guiding algorithm that allows for adaptations to the selection and sequencing of practices to address the client's unique needs (Chorpita & Daleiden, 2009;Chorpita & Daleiden, 2014;.…”

Characteristics of Anxious and Depressed Youth Seen in Two Different Clinical Contexts

“…A common claim is that the problems experienced by youth and families seen in community settings are more numerous and more severe than those in the clinics from which most of the research evidence has come (e.g., Weisz et al 1995). Another common assertion, recently backed by some data, is that the context (e.g., ethnicity, parental psychopathology, significant life events, family income) of the youth in research samples differs from that of youth in community samples (e.g., Hammen et al 1999;Southam-Gerow et al 2008). Differences on such variables are a concern because these variables appear to be associated with treatment outcome (e.g., Griffith et al 1998;Siqueland et al 2002).…”