Factors related to parental pre-treatment motivation in outpatient child and adolescent mental health care

Abstract

The aim of this study was to investigate the relation between a variety of child, parent, family and environmental factors and pre-treatment motivation of parents of children and adolescents newly referred to a mental health care clinic in The Netherlands. Data were collected of 521 parents most involved in the upbringing of the child (443 mothers and 78 fathers; Dutch origin 97.1%) of 207 girls and 314 boys (age M = 10.2, range 1-18 years). Treatment motivation was measured by the Parent Motivation Inventory. Least absolute shrinkage and selection operator (LASSO) regression was used to investigate the prediction strength of 33 factors in 5 domains: (1) source of referral and prior use of healthcare services, (2) child characteristics, (3) characteristics of the primary parent, (4) parenting characteristics of the primary parent, and (5) family characteristics. Twenty-one factors were statistically relevant, explaining 21.3% of the deviance in pre-treatment motivation. Child characteristics, mainly type and severity of problems, contributed most to the model. Notably, internalising problems contributed more than externalising problems. Furthermore, we found relations between parental pre-treatment motivation and parents' perceived self-efficacy, parents' perceived parenting competence, financial problems and source of referral. Our findings provide insight into the multifacetedness of parental motivation prior to starting treatment and inform health professionals of specific contextual factors of interest in parents' readiness to change their behaviour and participate in treatment.

Treatment Motivation and Burden of Stress among Parents of Adolescents with Non-Suicidal Self-Injury Presenting to a Child and Adolescent Psychiatric Emergency Service

“…However, the correlation between lower parental treatment motivation and NSSI of longer duration in children could also be due to a selection effect as a result of the study design (i.e., because children who were already in treatment were excluded from the study). Contrary to the results of this present study (that parents showed less readiness for change when their children engaged in NSSI for a longer duration), another study [34] found that the severity of internalizing problems, followed by externalizing problems, was the strongest predictor for higher parental treatment motivation. The difference to our study could be due to the fact that the aforementioned study used an outpatient sample in a child and adolescent psychiatric service.…”

“…The proportion of mothers filling in the questionnaires and thus acting as accompanying persons for the children was about 80% at T2. This proportion of mothers is found to be similar or even higher in other studies [31, 34, 55]. The GSI, an indicator of psychological distress, was assessed and we found higher GSI values in girls than in boys.…”

“…The difference to our study could be due to the fact that the aforementioned study used an outpatient sample in a child and adolescent psychiatric service. Furthermore, it was supposed to be about newly referred patients, the average age of patients was 10.2 years and children referred for eating disorders or forensic problems were not included because treatment motivation of parents could differ in this case [34]. Our patients show a significantly higher mean age and were recruited from emergency presentations.…”

“…Parental motivation for child and adolescent psychiatric treatment is therefore increasingly seen as a very influential aspect for treatment success and for preventing treatment discontinuation [30][31][32][33]. A strong factor influencing higher parental pre-treatment motivation was the severity of children's problems and perceived self-efficacy, but factors influencing lower pre-treatment motivation were financial problems, referral through school or health professionals, and perceived parenting competence [34]. In the treatment of children, it is parents' proactiveness, which is important in seeking treatment, in managing further appointments but also in agreeing to treatment procedures [30].…”

Factors Related to Perceived Stigma in Parents of Children and Adolescents in Outpatient Mental Healthcare

“…Participants were 317 parents (97% Dutch origin) with a child aged below 18 years referred to one of two child and adolescent psychiatry outpatient clinics with several locations in the Northern or Eastern part of the Netherlands including both rural and urban areas, covering a large catchment area. The current sample concerns the baseline and third wave (about one year later) of a larger three-wave study aimed at collecting data on a large number of child, family, and social-environmental factors that could influence outpatient treatment of children and adolescents referred to the clinic [37]. Children had to be newly referred (i.e., first referral to the respective mental healthcare clinic) to be eligible to participate in the study.…”