Abstract
Families seeking treatment often experience barriers both tangible and intangible in nature, including practical obstacles such as time and cost, and poor attitudinal perceptions and expectations of treatment. Client factors including race, ethnicity, and socioeconomic status have been found to relate to the perception and experience of barriers to the treatment process. Further, the severity of a child's emotional problems may influence how much effort parents put into navigating barriers to treatment. Therefore, the present study sought to further understand the link between parent perceived barriers and youth treatment engagement, while examining how sociodemographic characteristics and youth clinical impairment predict and moderate this relationship, respectively.
Participants included 196 families, with youth ages 12 to 18, recruited as part of a larger multi-site effectiveness trial. Parents completed self-report measures on sociodemographic characteristics and perceived barriers to treatment participation. Youth were assessed for degree of clinical impairment prior to treatment via clinical interview with an independent evaluator. Treatment initiation, session attendance, and treatment termination status were collected as measures of treatment engagement. Analyses of variances and hierarchal modeling were used to examine the proposed models.
Results showed that perceived barriers did not differ significantly by sociodemographic characteristics. Perceived stressors and obstacles that compete with treatment did significantly predict fewer treatment sessions attended and a higher likelihood of premature treatment termination. Sociodemographic subgroups differed significantly on variables of treatment engagement, when compared. Youth clinical impairment was found to significantly moderate the relationship between perceived treatment demands and issues and treatment non-initiation.