Engagement in Child and Adolescent Treatment: The Role of Parental Cognitions and Attributions

Parental engagement in the treatment process is influenced by parents' beliefs about the cause of their children's problems, perceptions about their ability to handle such problems, and expectations about the ability of therapy to help them. This paper examines the role of parental cognitions related to attributions and expectations in relation to engagement in child mental health treatment. Reviewed studies indicate that parental attributions and expectations influence three aspects of treatment: help seeking, engagement and retention, and outcome. This paper integrates findings from developmental and clinical research, highlights gaps in the literature, presents the beginnings of a model regarding the parental attributional process as it relates to engagement in treatment, recommends future research directions, and discusses clinical implications.

[1]  K. Wells,et al.  An examination of predictors of maternal perceptions of maladjustment in clinic-referred children. , 1979, Journal of abnormal psychology.

[2]  U. Bronfenbrenner Ecology of the family as a context for human development: research perspectives , 1986 .

[3]  E. Costello,et al.  Perceived parental burden and service use for child and adolescent psychiatric disorders. , 1998, American journal of public health.

[4]  D. Gelfand,et al.  Mothers' attributions regarding their children's social behavior and personality characteristics. , 1988 .

[5]  Barbara Britton,et al.  Engaging families through the letter writing technique. , 1991 .

[6]  R. Cialdini Influence: Science and practice, 3rd ed. , 1993 .

[7]  R. Prinz,et al.  Family-based treatment for childhood antisocial behavior: experimental influences on dropout and engagement. , 1994, Journal of consulting and clinical psychology.

[8]  B. Weiner An attributional theory of achievement motivation and emotion. , 1985, Psychological review.

[9]  J. M. Stedman,et al.  Factors associated with dropping out of child and family treatment , 1981 .

[10]  J. Gonzales,et al.  Addressing the barriers to mental health services for inner city children and their caretakers , 1996, Community mental health journal.

[11]  J. Plunkett,et al.  Parents' treatment expectations and attrition from a child psychiatric service. , 1984, Journal of clinical psychology.

[12]  David H. Barlow,et al.  Anxiety and its disorders : the nature and treatment of anxiety and panic , 1988 .

[13]  G. Patterson,et al.  Coercive Family Process , 1982 .

[14]  B. Weiner A Cognitive (Attribution)-Emotion-Action Model of Motivated Behavior: An Analysis of Judgments of Help-Giving. , 1980 .

[15]  Anna L. Rowe-Hallbert,et al.  Oppositional Child Behavior and Parental Locus of Control , 1992 .

[16]  B. Compas,et al.  Parent and child causal attributions during clinical interviews , 1982, Journal of abnormal child psychology.

[17]  J. McHale,et al.  Understanding Triadic and Family Group Interactions During Infancy and Toddlerhood , 1999, Clinical child and family psychology review.

[18]  P. Armbruster,et al.  Clinical, sociodemographic, and systems risk factors for attrition in a children's mental health clinic. , 1994, The American journal of orthopsychiatry.

[19]  B. Weiner,et al.  An Attributional Analysis of Maternal Beliefs about the Importance of Child-Rearing Practices. , 1991 .

[20]  J. Poertner,et al.  Promoting the preschooler's chances for success: A program efficacy review for behaviorally disordered or emotionally troubled children , 1995 .

[21]  W. Miller Motivation for treatment: a review with special emphasis on alcoholism. , 1985, Psychological bulletin.

[22]  J. Harvey,et al.  Perspectives on attributional processes , 1981 .

[23]  W. Miller,et al.  Motivational Interviewing: Preparing People to Change Addictive Behavior , 1991 .

[24]  S. Hinshaw,et al.  Cognitive-behavioral and pharmacologic interventions for hyperactive boys: comparative and combined effects. , 1984, Journal of consulting and clinical psychology.

[25]  T. Reimers,et al.  Relation between Parental Attributions and the Acceptability of Behavioral Treatments for Their Child's Behavior Problems , 1995 .

[26]  G J Connors,et al.  Strategies for Preparing Clients for Treatment , 1999, Behavior modification.

[27]  R. Barkley,et al.  The effects of methylphenidate on the mother-child interactions of hyperactive children. , 1979, Archives of general psychiatry.

[28]  J. Weisz,et al.  Giving up on child psychotherapy: who drops out? , 1987, Journal of consulting and clinical psychology.

[29]  C. Johnston Parent characteristics and parent-child interactions in families of nonproblem children and ADHD children with higher and lower levels of oppositional-defiant behavior , 1996, Journal of abnormal child psychology.

[30]  R. Cialdini Influence: Science and Practice , 1984 .

[31]  D. Ruble,et al.  Mothers' implicit theories of discipline: Child effects, parent effects, and the attribution process. , 1989 .

[32]  J. Q. Simmons,et al.  Parent Behavioral Training: Why and When Some Parents Drop Out , 1992 .

[33]  H. Liddle Conceptual and clinical dimensions of a multidimensional, multisystems engagement strategy in family-based adolescent treatment. , 1995 .

[34]  A. Laperriere,et al.  Efficacy of intervention for engaging youth and families into treatment and some variables that may contribute to differential effectiveness. , 1996 .

[35]  Charlotte Burck A Study of Families' Expectations and Experiences of a Child Guidance Clinic , 1978 .

[36]  Gary Yukl,et al.  Task importance, feasibility, and agent influence behavior as determinants of target commitment. , 1999 .

[37]  Carolyn Webster-Stratton,et al.  Coping With Conduct-Problem Children: Parents Gaining Knowledge and Control , 1991 .

[38]  D. Ruble,et al.  Social cognition in parents: inferential and affective reactions to children of three age levels. , 1986, Child development.

[39]  J. Rotter Generalized expectancies for internal versus external control of reinforcement. , 1966, Psychological monographs.

[40]  J. Prochaska,et al.  In Search of How People Change: Applications to Addictive Behaviors , 1992, The American psychologist.

[41]  J. Harmatz,et al.  Prediction of treatment acceptance by child guidance clinic applicants: an easily applied instrument. , 1972, The American journal of orthopsychiatry.

[42]  A. Carr Failure in family therapy: a catalogue of engagement mistakes , 1990 .

[43]  Matthew D. Selekman Solution-Focused Therapy with Children: Harnessing Family Strengths for Systemic Change , 1997 .

[44]  W. Furey,et al.  Predicting consumer satisfaction in parent training for noncompliant children , 1988 .

[45]  A. Kazdin,et al.  Risk for Attrition in Treatment of Antisocial Children and Families , 1993 .

[46]  A. Kazdin,et al.  Barriers to treatment participation and therapeutic change among children referred for conduct disorder. , 1999, Journal of clinical child psychology.

[47]  C. Webster-Stratton Mothers' and fathers' perceptions of child deviance: roles of parent and child behaviors and parent adjustment. , 1988, Journal of consulting and clinical psychology.

[48]  E. Holden,et al.  Multicultural training in pediatric and clinical child psychology predoctoral internship programs , 1994 .

[49]  G. Tornusciolo,et al.  Improving first appointment attendance rates in child psychiatry outpatient clinics. , 1990, Journal of the American Academy of Child and Adolescent Psychiatry.

[50]  P. Lewinsohn,et al.  Cognitive-behavioral group treatment of adolescent depression: Prediction of outcome , 1992 .

[51]  J. Dumas Parental perception and treatment outcome in families of aggressive children: A causal model* , 1986 .

[52]  J. Dumas Child, Adult-Interactional, and Socioeconomic Setting Events as Predictors of Parent Training Outcome. , 1984 .

[53]  B J Burns,et al.  Psychiatric disorders in pediatric primary care. Prevalence and risk factors. , 1988, Archives of general psychiatry.

[54]  C. Cunningham,et al.  Parents' attributions for achieving compliance from attention-deficit-disordered children , 1989, Journal of abnormal child psychology.

[55]  A. Kazdin,et al.  Family experience of barriers to treatment and premature termination from child therapy. , 1997, Journal of consulting and clinical psychology.

[56]  G. Curtiss,et al.  Dropout from adolescent psychotherapy: a preliminary study. , 1984, Journal of the American Academy of Child Psychiatry.

[57]  A. Kazdin,et al.  Attrition in Child Psychotherapy , 1994 .

[58]  S. Prentice-Dunn,et al.  The Parental Locus of Control Scale: Development and Validation , 1986 .

[59]  J. Goodnow Parents' ideas about parenting and development: a review of issues and recent work , 1984 .

[60]  Karen C. Wells,et al.  Behavioral family therapy with conduct disorders in children , 1983 .

[61]  J. McNamara,et al.  Parents' informed consent decisions regarding psychotherapy for their children: consideration of therapeutic risks and benefits , 1994 .

[62]  B. Baker,et al.  The effects of behavioral parent training on families with young hyperactive children. , 1990, Journal of behavior therapy and experimental psychiatry.

[63]  R. Prinz,et al.  Parental Engagement in Interventions for Children at Risk for Conduct Disorder , 1996 .

[64]  A. Kazdin,et al.  Dropping out of child psychotherapy: distinguishing early and late dropouts over the course of treatment. , 1994, Journal of consulting and clinical psychology.

[65]  D. Burns The feeling good handbook: Using the new mood therapy in everyday life. , 1989 .

[66]  S. Keane,et al.  Referred and Nonreferred Children's Predictions of Their Mothers' Behavior Evaluations , 1988 .

[67]  F. Heider The psychology of interpersonal relations , 1958 .

[68]  M. Stolar,et al.  Risk factors for dropping out of treatment among White and Black families. , 1995 .

[69]  D. Fischer,et al.  Depression, Mastery and Number of Group Sessions Attended Predict Outcome of Patients with Panic and Agoraphobia in a Behavioural/Medication Program , 1994, Canadian journal of psychiatry. Revue canadienne de psychiatrie.

[70]  H. Kelley The processes of causal attribution. , 1973 .

[71]  R. McMahon,et al.  An examination of differences between nonclinic and behavior-problem clinic-referred children and their mothers. , 1980, Journal of abnormal psychology.

[72]  D. M. Day,et al.  Relations among discipline style, child behaviour problems, and perceived ineffectiveness as a caregiver among parents with conduct problem children. , 1994 .

[73]  A. Kazdin,et al.  Barriers to Treatment Participation Scale: evaluation and validation in the context of child outpatient treatment. , 1997, Journal of child psychology and psychiatry, and allied disciplines.

[74]  Michael L. Bloomquist,et al.  Skills Training for Children with Behavior Disorders: A Parent and Therapist Guidebook , 1996 .

[75]  John S. Carroll,et al.  Causal attributions in expert parole decisions. , 1978 .

[76]  Scott A. Miller,et al.  Parents' Beliefs about Children's Cognitive Development. , 1988 .

[77]  G. Pekarik,et al.  Adult and Child Client Differences in Therapy Dropout Research , 1988 .

[78]  B. Bonner,et al.  Influence of client preparation and problem severity on attitudes and expectations in child psychotherapy. , 1986 .

[79]  C. Barton,et al.  The minimizing of blaming attributions and behaviors in delinquent families. , 1989, Journal of consulting and clinical psychology.

[80]  C. Johnston,et al.  Parental perceptions of child behavior problems, parenting self-esteem, and mothers' reported stress in younger and older hyperactive and normal children. , 1983, Journal of consulting and clinical psychology.

[81]  J. Watson Parental attributions of emotional disturbance and their relation to the outcome of therapy: Preliminary findings , 1986 .

[82]  A. Raviv,et al.  Parents of adolescents: help-seeking intentions as a function of help sources and parenting issues. , 1992, Journal of adolescence.

[83]  M. Kovács,et al.  Research on psychotherapy with children and adolescents: An overview of evolving trends and current issues , 1995, Journal of abnormal child psychology.

[84]  Peter Wright,et al.  Everyday persuasion knowledge , 1999 .

[85]  A. Kazdin,et al.  Child and parent evaluations of depression and aggression in psychiatric inpatient children , 1983, Journal of abnormal child psychology.

[86]  J. Beck,et al.  Cognitive Therapy: Basics and Beyond , 1995 .

[87]  M. Reznikoff,et al.  Preparation of children and parents for treatment at a children's psychiatric clinic through videotaped modeling. , 1980, Journal of consulting and clinical psychology.

[88]  D. Bugental,et al.  "Difficult" children as elicitors and targets of adult communication patterns: an attributional-behavioral transactional analysis. , 1984, Monographs of the Society for Research in Child Development.

[89]  H. Kelley Causal schemata and the attribution process , 1972 .

[90]  J. Goodnow Adult Social Cognition: Implications of Parents' Ideas for Approaches to Development. , 1984 .

[91]  D. Shaffer,et al.  The characteristics of dropouts from a child psychiatry clinic. , 1985, Journal of the American Academy of Child Psychiatry.

[92]  J. Goodnow Parents' Ideas, Actions, and Feelings: Models and Methods from Developmental and Social Psychology. , 1988 .

[93]  D. Bugental,et al.  Perceived Control over Caregiving Outcomes: Implications for Child Abuse. , 1989 .

[94]  J. M. Tuma,et al.  Stress, Locus of Control, and Role Satisfaction in Clinic and Control Mothers , 1988 .

[95]  C. Johnston,et al.  Measuring parental attributions: Conceptual and methodological issues. , 1998 .

[96]  J. Janssens Authoritarian Child Rearing, Parental Locus of Control, and the Child's Behaviour Style , 1994 .

[97]  J. Weisz,et al.  The lab versus the clinic. Effects of child and adolescent psychotherapy. , 1992, The American psychologist.

[98]  R. Spoth,et al.  Engaging families in longitudinal preventive intervention research: discrete-time survival analysis of socioeconomic and social-emotional risk factors. , 1999, Journal of consulting and clinical psychology.

[99]  B. Weiner An attributional theory of motivation and emotion , 1986 .

[100]  G. Howe,et al.  Mothers' attributions and expectancies regarding their conduct-disordered children , 1992, Journal of abnormal child psychology.

[101]  J. Belsky,et al.  An affective-cognitive model of mother-child aggression , 1990, Development and Psychopathology.

[102]  S. Fairhurst Promoting Change in Families: Treatment Matching in Residential Treatment Centers , 1996 .

[103]  A. Slep,et al.  The effects of maternal attributions on parenting : An experimental analysis , 1998 .