Randomized Trial of the Parent And Caregiver Active Participation Toolkit for Child Mental Health Treatment

Abstract

The purpose of this pilot study was to examine preliminary feasibility, acceptability, and effectiveness of a toolkit (Parent And Caregiver Active Participation Toolkit) to increase parent participation in community-based child mental health services. Study participants included 29 therapists (93% female; M age = 34.1 years; 38% Latino) and 20 parent/child dyads (children 80% female; M age = 8.6 years; parents 40% Latino) in 6 diverse community mental health clinics. Therapists were randomly assigned to standard care or the toolkit with standard care. Therapist and parent survey data and observational coding of treatment sessions were utilized. Mean comparisons and repeated measures analyses were used to test differences between study conditions over 4 months. Results supported preliminary feasibility and acceptability of the toolkit, with therapists assigned to the toolkit participating in ongoing training, adhering to toolkit use, and perceiving the toolkit as feasible and acceptable within their setting. Results preliminarily demonstrated improvement in therapists’ job attitudes, as well as actual use of parent engagement strategies. Results also preliminarily demonstrated increases in parent participation in child therapy sessions and more regular attendance, as well as some indication of support for perceived treatment effectiveness. Overall, results suggest the feasibility, acceptability, and potential effectiveness of the toolkit to enhance therapist job attitudes; practices that support parent engagement, parent engagement itself, and consumer perspectives on treatment outcomes; and the potential promise of future research in the area of parent participation interventions in child mental health services.

ACKNOWLEDGMENTS

Cristina E. Bustos is a licensed psychologist currently practicing at military installations. Cortney Janicki is currently enrolled in the Clinical Mental Health Counseling master’s program at Hawaii Pacific University. We acknowledge Ann Garland, PhD, Mary McKay, PhD, Lauren Brookman-Frazee, PhD, and Amy Drahota, PhD, for their contributions to the project, as well as the participating clinics, therapists, and families. We also are grateful to Nicole Stadnick, PhD, MPH, and Natalia Walsh, MS, for reviewing an earlier version of the manuscript.

FUNDING

This study was supported by the National Institute of Mental Health of the National Institutes of Health under award number K23MH080149 (PI: Haine-Schlagel). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Notes

¹ For the therapist who enrolled two cases (Figure 1), only ratings for the first case are included here.

² Analyses across all sessions revealed an identical pattern of findings to those presented here.

³ Analyses across all sessions revealed an identical pattern to those presented here, with the exception that the effect on Agreement with/enthusiasm for home actions was no longer marginally significant but the large effect size remained.

⁴ Similar to results presented in Tables 4b and 5, results remained the same when the second case was removed for the therapist who enrolled two parent/child dyads.

Additional information

Funding

This study was supported by the National Institute of Mental Health of the National Institutes of Health under award number K23MH080149 (PI: Haine-Schlagel). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.