Treatment Engagement with Caregivers of At-risk Children: Gaps in Research and Conceptualization

Abstract

The high rates of dropping out and other engagement problems are significant concerns in the delivery of mental health and adjunct services to the families of at-risk children. Consequently, researchers have examined the correlates of attrition and have developed interventions to increase engagement and retention. However, the lack of a clear definition of engagement and gaps in theory about the relationship of engagement to other treatment processes hinder knowledge development. In this paper the behavioral and attitudinal aspects of engagement are disentangled. Current knowledge about treatment barriers and interventions to increase appointment keeping is summarized. A preliminary conceptualization of the engagement process is presented and research needs and practice implications are discussed.

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

“…This study also did not examine a number of other factors that may mediate the relationship between race/ethnicity and treatment engagement, such as socioeconomic status (Betancourt & Lopez, 1993), child and parent perceptions of treatment (Gopalan et. al, 2010), and the therapeutic alliance (Staudt, 2007).…”

Preventive Parenting Interventions: Advancing Conceptualizations of Participation and Enhancing Reach

“…Despite discrepancies in terminology, there are parallels in how researchers conceptualize participation, engagement, and responsiveness. For example, there appears to be agreement that they encompass both behavioral and attitudinal or cognitive dimensions (Schoenfelder et al 2013;Staudt 2007). Behavioral dimensions include enrolling in a program, attending sessions, participating in session activities (e.g., group discussion), and practicing skills in-session and at home.…”

“…Moreover, home skills practice can be operationalized as parents' attempts, competency, efficacy, or fidelity in using skills (e.g., Berkel et al 2016). Attitudinal or cognitive dimensions are much more infrequently studied than behavioral dimensions but have been operationalized as treatment satisfaction and expectations, intent and motivation to learn program skills, and cognitive and emotional reactions to program content, facilitators, or participants (Coatsworth et al 2017;Schoenfelder et al 2013;Staudt 2007).…”

Collaborative practice in statutory in child protection practice: Parental agreements and procedural justice

“…However, based on the work of Yatchmenoff (2005) (see also Staudt, 2007) many commentators have highlighted the importance of differentiating between parent's behavioural engagement (e.g. turning up to meetings) with their attitudinal engagement, that is their 'buy-in' or belief in the value of the intervention or support service (Farmer & Owen, 1995;Gladstone et al, 2014;Horwitz & Marshall, 2015;Kemp et al, 2014;Schieber et al, 2013;Yatchmenoff, 2005).…”

“…These factors may make it difficult for parents to not only focus on their children (Daro, McCurdy, Falconnier, & Stojanovic, 2003) but also engage in decision-making and interventions (Howe, 2010). The evidence indicates that distrust of services may be further exacerbated for these parents (Littell & Tajima, 2000) and that they may be sceptical of the possibility for change (Staudt, 2007;Taylor, Toner, Templeton, & Velleman, 2008). These factors have negative implications for parent 'buy-in' (Yatchmenoff, 2005) and engagement, as they may have little hope, or confidence, in their own ability to engage and change (King et al, 2014).…”