Barriers to treatment completion in low-income families of young children with behavior problems
This study examined the barriers to treatment completion among twelve mothers with young children with significant behavior problems. The mothers had several characteristics that were previously associated in the literature with premature termination of treatment (e.g., lower socioeconomic status, single parent, minority race). The mothers and their children began mental health treatment but terminated before completion. Qualitative interviews were conducted in the mothers' homes and were subsequently recorded and transcribed. The data were then analyzed utilizing the methodology of Consensual Qualitative Research (CQR; Hill, Knox, Thompson, Williams, Hess, & Ladany, 2005; Hill, Thompson, & Williams, 1997). The mothers were asked a sequence of questions about their reasons for beginning mental health services, their experiences in treatment, and their reasons for terminating services. In addition, the Barriers to Treatment Participation Scale--Parent Version (Kazdin, Holland, Crowley & Breton, 1997) was used to assess the number of barriers experienced. During the qualitative interviews, the mothers reported that their children benefitted from treatment and that their child's challenging behaviors decreased and/or prosocial behaviors increased. Some of the unhelpful aspects of treatment included the treatment strategies not consistently working or their child not benefitting due to personal factors (e.g., child having a cognitive delay). Most mothers reported that services ended due to external factors such as conflicts with other appointments or the mothers' own personal problems (e.g., mental health and medical concerns). Results from the Barriers to Treatment Participation Scale--Parent Version (Kazdin, Holland, Crowley & Breton, 1997) indicated that the mothers experienced a moderate number of barriers (e.g., difficulty in scheduling appointments, treatment being somewhat different than expected) which were less frequent than those experienced by non-completers in previous research. Other studies have found that as the number of perceived barriers increased so did the likelihood that the family would terminate from treatment prematurely. Considering this study found that mothers reported a fewer number of barriers on the scale, it appears that specific, individual barriers (e.g., difficulty scheduling appointments and caregivers' problems) were more associated with premature termination from treatment. The study's limitations, clinical applications, and suggestions for future research are also discussed.
Keller, Kathryn M, "Barriers to treatment completion in low-income families of young children with behavior problems" (2009). Dissertations (1962 - 2010) Access via Proquest Digital Dissertations. AAI3357956.