title: Pathway model of parental help seeking for adolescents experiencing first-episode psychosis.
abstract: OBJECTIVE
  Parents and caregivers are confronted with many challenges when caring for adolescents experiencing first-episode psychosis (FEP). Understanding and support for parental help-seeking process is essential for adolescents' timely access to treatment. The study aimed to develop a pathway model of parental help seeking for adolescents experiencing FEP and identify crucial time points for intervention.
  
  
  METHODS
  Directed content analysis was conducted on semi-structured qualitative interviews of 16 parents whose children had experienced FEP and focused on parents' experiences prior to and during FEP until first hospitalization.
  
  
  RESULTS
  The resultant parental help seeking for FEP model included two stages and six phases. The contemplation stage is composed of phases of initial awareness, recognizing severity and considering options. The action stage entailed help-seeking intention, securing help and service appraisal. All parents promptly began help seeking after recognizing severe symptoms and sought advice from professional and community supports, although parents' lack of initial awareness was common. Further analysis on individual parents' help-seeking trajectories showed that among the 50% parents who reported pre-existing childhood conditions, 87.5% did not report initial awareness of psychotic symptoms.
  
  
  CONCLUSIONS
  Findings recommend intervention at three specific periods of help seeking. First, psychoeducation is needed when parents first engage with health care for their children's disabling conditions. Professionals treating childhood conditions need training to vigilantly monitor the overall mental health of the children over time. Second, it is important to enhance the roles of formal and informal community resources in facilitating parental help seeking. Finally, family-focused interventions are essential in supporting the family for securing needed treatment.
authors.affiliation: School of Social Work, Columbia University, New York, New York, USA.
authors.forename: Fang-pei
authors.initials: FP
authors.lastname: Chen
authors.affiliation: School of Social Work, Columbia University, New York, New York, USA.
authors.forename: Robin E
authors.initials: RE
authors.lastname: Gearing
authors.affiliation: School of Social Work, Columbia University, New York, New York, USA.
authors.forename: Jordan E
authors.initials: JE
authors.lastname: DeVylder
authors.affiliation: School of Social Work, Columbia University, New York, New York, USA.
authors.forename: Hans Y
authors.initials: HY
authors.lastname: Oh
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D010290:Parents / Q000523:psychology*; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D011618:Psychotic Disorders / Q000523:psychology*
keywords: childhood condition; first-episode psychosis; help seeking; parental facilitation; pathway model