Observational Assessment of Engagement Strategies to Promote Parent Homework Planning in Community-Based Child Mental Health Treatment: A Pilot Study

Abstract

Therapy homework includes tasks given to clients to complete outside of session to facilitate new knowledge/skills or to advance treatment goals. Homework completion, an important element of parent engagement in child mental health (MH) treatment, has been associated with improved child outcomes. The current pilot study assessed the design/assign phase of the therapy homework process to examine a) the extent to which therapists implemented engagement strategies with parents and b) whether therapist deployment of engagement strategies in early treatment predicted subsequent parent participation in homework planning. We included an ethnically-diverse sample of 10 therapists and 11 parent/child dyads receiving community-based MH services who participated in a pilot intervention study. Two observational coding systems were developed to code treatment session recordings for the extent to which a) therapists implemented engagement strategies with parents and b) parents contributed to therapy homework planning. Findings revealed low extensiveness of therapist implementation of engagement strategies with parents. As hypothesized, therapist use of engagement strategies (Collaboration, Empowerment, and Psychoeducation) in early treatment significantly predicted subsequent parent homework planning (sharing perspective on homework planning). However, therapist use of Alliance was unrelated to parent homework planning. These preliminary results suggest that therapist implementation of engagement strategies in early treatment may promote parent participation in homework planning, which is an important precursor to homework completion. This pilot study suggests potential future directions for both research on and training for community-based therapists in implementing successful strategies to promote parent homework planning in child MH treatment.

Quantifying parent engagement in the randomized Fuel for Fun impact study identified design considerations and BMI relationships

“…Programs and interventions that address nutrition, obesity prevention, physical activity and other health-related issues for school-age youth recognize the value of parent engagement in tandem with youth involvement [1]. Parent participation features are considered in program development and methods to assure, motivate, personalize, and diversify parent engagement have been rigorously investigated [2][3][4][5][6][7][8][9][10][11]. Interviews and focus groups with target parents to learn of incentivizing factors may precede program development or implementation to better court parent participation [8,[12][13][14][15].…”

What got in the way? Caregiver-reported challenges to home practice of assigned intervention skills

“…We also aimed to identify potential contributors to increased challenges with home practice and to specific types of home practice challenges. Considering home practice and home practice challenges as one facet of intervention engagement, correlates of other types of engagement (e.g., attendance, participatory behaviors) may also contribute to understanding caregivers’ home practice challenges ( Martinez & Haine-Schlagel, 2018 ). Within engagement research, three major categories of challenges are potential barriers, perceived need, and implementation factors.…”

Quantifying Parent Engagement in Fuel for Fun Identified Design Considerations and BMI Relationships

“…These challenges are re ected in the way parent engagement is included in assessing program outcomes. For example, attendance or intention to participate dominate assessments of parent involvement followed by socio-economic and demographic descriptors of participating parents with few to no reports of participation quality or intensity [4,5,7,9,10,11,17,19]. In a literature review of 24 studies of parent engagement in child and family mental health treatments, 17 included at least one measure of engagement; the maximum number of measures was three.…”