Facilitating treatment attendance in child and adolescent mental health services: a community study

Failure of parents to attend and engage in treatment is a significant barrier to implementing effective interventions in child and adolescent mental health. Approaches to enhance treatment attendance and participation have targeted both structural operations of the clinic and aspects of the therapeutic process. Little research, however, has looked at clinicians' use of strategies to enhance treatment participation. Fifty-one mental health practitioners completed measures of strategies to increase treatment participation among families of conduct problem children. Client attendance was collected for each clinician over a 1-month period. As hypothesized, therapists were more aware of, and reported greater use of, therapy process compared to structural approaches to increase treatment participation. Clinician ratings of usefulness, competence and willingness to use therapy process strategies predicted client appointment attendance. The results are discussed in relation to the importance of training and supervision of professionals working with families in mental health services targeting a range of strategies to enhance treatment participation.