title: Using Observational Assessment to Help Identify Factors Associated with Parent Participation Engagement in Community-Based Child Mental Health Services.
abstract: BACKGROUND
  Parent engagement in child mental health (MH) services has received growing attention due to its significance in intervention outcomes and evidence-based care. In particular, parent participation engagement (PPE) reflects active and responsive contributions in and between sessions. Yet, limited research has examined factors associated with PPE, particularly within community-based MH services where PPE is low and highly diverse families are often served.
  
  
  OBJECTIVE
  This study examined child, parent, and therapist factors associated with PPE in a sample of racially/ethnically diverse parent-child dyads receiving publicly-funded, community-based MH services.
  
  
  METHODS
  This prospective study included 18 parent-child dyads receiving community-based MH services from 17 therapists in five outpatient clinics for child disruptive behaviors. PPE was measured using in-session observational assessment of therapy recordings. Child factors that were examined included age, first time child MH service use, and intensity of child behavior problems. Parent factors included ethnicity, education, depression symptoms, and parent motivation to participate in therapy. Therapist factors included therapist training in parent-mediation interventions, attitudes towards organizational functioning, and attitudes towards parent participation strategies.
  
  
  RESULTS
  Results from linear regression analyses indicated that first time child MH service use, intensity of child behavior problems, parent ethnicity and motivation to participate in therapy, as well as therapists' training and attitudes about their practice were each significantly associated with PPE.
  
  
  CONCLUSIONS
  Results highlight specific child, parent, and therapist characteristics that may impact observed PPE in child MH therapy. These findings underscore the importance of considering the influence of family and provider factors on PPE in community-based child MH services.
authors: University of California, San Diego, La Jolla, CA 92093, USA; Child and Adolescent Services Research Center (CASRC), 3020 Children's Way, MC 5033, San Diego, CA 92123, USA.
authors: Nicole A
authors: NA
authors: Stadnick
authors: Child and Adolescent Services Research Center (CASRC), 3020 Children's Way, MC 5033, San Diego, CA 92123, USA; San Diego State University, San Diego, CA, USA.
authors: Rachel
authors: R
authors: Haine-Schlagel
authors: California State University, Northridge, Los Angeles, CA, USA.
authors: Jonathan I
authors: JI
authors: Martinez
keywords: Child mental health treatment; Community-based; Disruptive behavior problems; Engagement; Parent; Participation