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Therapist Focus on Parent Involvement in Community-Based Youth Psychotherapy

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Abstract

Parent involvement in the treatment of childhood disruptive behavior problems is a critical component of effective care. Yet little is known about the amount of time therapists are involving parents in treatment and factors that predict therapists’ efforts to involve parents in routine care. The purpose of this study is to examine therapists’ within-session involvement of parents in community-based outpatient mental health treatment. The data are from a larger longitudinal observational study of psychotherapy for children ages 4–13 with disruptive behavior problems and include videotaped psychotherapy sessions coded for the therapeutic strategies delivered as well as measures of child, parent/family, and therapist characteristics at baseline. Parent involvement is defined as the proportion of time in the session that therapists direct treatment strategies towards parents. Results indicated that therapists directed treatment strategies towards parents an average of 44% of the time within a session. Multilevel modeling was used to examine client-level (child, parent, and family functioning) and provider-level (therapist experience and background) predictors of parent involvement. Therapists involved parents more when the child had higher levels of behavior problems, when the parent reported higher levels of internalized caregiver strain, and when the therapist was more experienced. The results highlight potential areas to target in efforts to increase parent involvement, including training less experienced therapists to increase their focus on directing strategies towards parents.

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Acknowledgments

Preparation of this article was supported by the following NIMH grants: R01-MH66070 (AG); K23-MH080149 (RHS); K23-MH077584 (LBF); K01-MH069665 (MBE). Additionally, Dr. Brookman-Frazee is an investigator with the Implementation Research Institute (IRI), at the George Warren Brown School of Social Work, Washington University in St. Louis; through an award from the National Institute of Mental Health (R25 MH080916) and the Department of Veterans Affairs, Health Services Research & Development Service, Quality Enhancement Research Initiative (QUERI). The authors thank Scott Roesch, PhD for assistance with data analysis. We also thank William Ganger, MA for assistance with data management, as well as Deb Dupuis, MPH and Robin Taylor for project management and the families and therapists who participated in this study.

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Authors and Affiliations

  1. San Diego State University, San Diego, CA, USA

    Rachel Haine-Schlagel

  2. Child and Adolescent Services Research Center, Rady Children’s Hospital-San Diego, 3020 Children’s Way MC 5033, San Diego, CA, 92123, USA

    Rachel Haine-Schlagel, Lauren Brookman-Frazee, Danielle L. Fettes, Mary Baker-Ericzén & Ann F. Garland

  3. University of California, San Diego, CA, USA

    Lauren Brookman-Frazee, Danielle L. Fettes & Ann F. Garland

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  1. Rachel Haine-Schlagel
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  2. Lauren Brookman-Frazee
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  3. Danielle L. Fettes
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  4. Mary Baker-Ericzén
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  5. Ann F. Garland
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Correspondence to Rachel Haine-Schlagel.

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Haine-Schlagel, R., Brookman-Frazee, L., Fettes, D.L. et al. Therapist Focus on Parent Involvement in Community-Based Youth Psychotherapy. J Child Fam Stud 21, 646–656 (2012). https://doi.org/10.1007/s10826-011-9517-5

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  • DOI: https://doi.org/10.1007/s10826-011-9517-5

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