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Review of Interventions to Improve Family Engagement and Retention in Parent and Child Mental Health Programs

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Abstract

Engaging and retaining families in mental health prevention and intervention programs is critically important to insure maximum public health impact. We evaluated randomized-controlled trials testing methods to improve family engagement and retention in child mental health programs published since 1980 (N = 17). Brief, intensive engagement interventions in which providers explicitly addressed families’ practical (e.g. schedules, transportation) and psychological (e.g. family members’ resistance, beliefs about the treatment process) barriers as they entered treatment were effective in improving engagement in early sessions. The few interventions found to produce long-term impact on engagement and retention integrated motivational interviewing, family systems, and enhanced family stress and coping support strategies at multiple points throughout treatment. Few interventions have been tested in the context of prevention programs. There are promising approaches to increasing engagement and retention; they should be replicated and used as a foundation for future research in this area.

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References

  • Ajzen, I., & Fishbein, M. (1975). Understanding attitudes and predicting social behavior. New Jersey: Prentice Hall.

    Google Scholar 

  • American Psychological Association Publications and Communications Board Working Group on Journal Article Reporting Standards. (2008). Reporting standards for research in psychology: Why do we need them? What might they be? American Psychologist, 63, 839–851.

    Google Scholar 

  • Armbruster, P., & Kazdin, A. E. (1994). Attrition in child psychotherapy. Advances in Clinical Child Psychology, 16, 81–108.

    Google Scholar 

  • Bandura, A. (1977). Self-efficacy: Toward a unifying theory of behavioral change. Psychological Bulletin, 84, 191–203.

    Google Scholar 

  • Becker, D., Hogue, A., & Liddle, H. A. (2002). Methods of engagement in family-based preventive intervention. Child and Adolescent Social Work Journal, 19, 163–179.

    Article  Google Scholar 

  • Beeber, L. S., Cooper, C., Van Noy, B. E., Schwartz, T. A., Blanchard, H. C., Canuso, R., et al. (2007). Flying under the radar: Engagement and retention of depressed low-income mothers in a mental health intervention. Advances in Nursing Science, 30, 221–234.

    PubMed  Google Scholar 

  • Begg, C., Cho, M., Eastwood, S., Horton, R., Moher, D., Olkin, I., et al. (1996). Improving the quality of reporting of randomized controlled trials: The CONSORT statement. Journal of the American Medical Association, 276, 637–639.

    Article  PubMed  Google Scholar 

  • Cardemil, E. V., Kim, S., Pinedo, T. M., & Miller, I. W. (2005). Developing a culturally appropriate depression prevention program: The family coping skills program. Cultural Diversity and Ethnic Minority Psychology, 11, 99–112.

    Article  PubMed  Google Scholar 

  • Coatsworth, J. D., Santisteban, D. A., McBride, C. K., & Szapocznik, J. (2001). Brief strategic family therapy versus community control: Engagement, retention, and an exploration of the moderating role of adolescent symptom severity. Family Process, 40, 313–331.

    Article  PubMed  Google Scholar 

  • Costantino, J. N., Hashemi, N., Solis, E., Alon, T., Haley, S., McClure, S., et al. (2001). Supplementation of urban home visitation with a series of group meetings for parents and infants: Results of a “real-world” randomized, controlled trial. Child Abuse and Neglect, 25, 1571–1581.

    Article  Google Scholar 

  • Cunningham, C. E., Bremner, R., & Boyle, M. (1995). Large group community-based parenting for families of preschoolers at risk for disruptive behaviour disorders: Utilization, cost effectiveness, and outcome. Journal of Child Psychology and Psychiatry, 36, 1141–1159.

    Article  PubMed  Google Scholar 

  • Dadds, M. R., & McHugh, T. A. (1992). Social support and treatment outcome in behavioral family therapy for conduct problems. Journal of Consulting and Clinical Psychology, 60, 252–259.

    Article  PubMed  Google Scholar 

  • Dakof, G. A., Quille, T. J., Tejeda, M. J., Alberga, L. R., Bandstra, E., & Szapocznik, J. (2003). Enrolling and retaining mothers of substance-exposed infants in drug abuse treatment. Journal of Consulting and Clinical Psychology, 71, 764–772.

    Article  PubMed  Google Scholar 

  • Dillman, C., Mauricio, A. M., Gonzales, N. A., Millsap, R. E., Meza, C. M., Dumka, L. E., et al. (2007). Engaging Mexican origin families in a school-based preventive intervention. Journal of Primary Prevention, 28, 521–546.

    Article  Google Scholar 

  • Elvins, R., & Green, J. (2008). The conceptualization and measurement of therapeutic alliance: An empirical review. Clinical Psychology Review, 28, 1167–1187.

    Article  PubMed  Google Scholar 

  • Flay, B. R., Biglan, A., Boruch, R. F., Castro, F. G., Gottfredson, D., Kellam, S., et al. (2005). Standards of evidence: Criteria for efficacy, effectiveness and dissemination. Prevention Science, 6, 151–175.

    Article  PubMed  Google Scholar 

  • Fleischman, M. J. (1979). Using parenting salaries to control attrition and cooperation in therapy. Behavior Therapy, 10, 111–116.

    Article  Google Scholar 

  • Garvey, C., Julion, W., Fogg, L., Kratovil, A., & Gross, D. (2006). Measuring participation in a prevention trial with parents of young children. Research in Nursing and Health, 29, 212–222.

    Article  PubMed  Google Scholar 

  • Gomby, D. S. (2000). Promise and limitations of home visitation. Journal of the American Medical Association, 284, 1430–1431.

    Article  PubMed  Google Scholar 

  • Gross, D., Julion, W., & Fogg, L. (2001). What motivates participation and dropout among low-income urban families of color in a prevention intervention? Family Relations, 50, 246–254.

    Article  Google Scholar 

  • Grote, N. K., Swartz, H. A., & Zuckoff, A. (2008). Enhancing interpersonal psychotherapy for mothers and expectant mothers on low incomes: Adaptations and additions. Journal of Contemporary Psychotherapy, 38, 23–33.

    Article  Google Scholar 

  • Grote, N. K., Swarz, H. A., Geibel, S. L., Zuckoff, A., Houck, P. R., & Frank, E. (2009). A randomized controlled trial of culturally relevant, brief interpersonal psychotherapy for perinatal depression. Psychiatric Services, 60, 313–321.

    Article  PubMed  Google Scholar 

  • Grote, N. K., Zuckoff, A., Swarz, H., Bledsoe, S. E., & Geibel, S. (2007). Engaging women who are depressed and economically disadvantaged in mental health treatment. Social Work, 52, 295–308.

    PubMed  Google Scholar 

  • Guyll, M., Spoth, R., & Redmond, C. (2003). The effects of incentives and research requirements on participation rates for a community-based preventive intervention research study. Journal of Primary Prevention, 24, 25–41.

    Article  Google Scholar 

  • Heinrichs, N. (2006). The effects of two different incentives on recruitment rates of families into a prevention program. Journal of Primary Prevention, 27, 345–365.

    Article  PubMed  Google Scholar 

  • Kazdin, A. E. (1996). Dropping out of child psychotherapy: Issues for research and implications for practice. Clinical Child Psychology and Psychiatry, 1, 133–156.

    Article  Google Scholar 

  • Kazdin, A. E., Holland, L., & Crowley, M. (1997). Family experience of barriers to treatment and premature termination from child therapy. Journal of Consulting and Clinical Psychology, 65, 433–463.

    Article  Google Scholar 

  • Kazdin, A. E., & Whitely, M. K. (2003). Treatment of parental stress to enhance therapeutic change among children referred for aggressive and antisocial behavior. Journal of Consulting and Clinical Psychology, 71, 504–515.

    Article  PubMed  Google Scholar 

  • Korfmacher, J., Green, B., Staerkel, F., Peterson, C., Cook, G., Roggman, L., et al. (2008). Parent involvement in early childhood home visiting. Child & Youth Care Forum, 37, 171–196.

    Article  Google Scholar 

  • Korfmacher, J., O’Brien, R., Hiatt, S., & Olds, D. (1999). Differences in program implementation between nurses and paraprofessionals in prenatal and infancy home visitation: A randomized trial. American Journal of Public Health, 89, 1847–1851.

    Article  PubMed  Google Scholar 

  • Kumpfer, K. L., Alvarado, R., Smith, P., & Bellamy, N. (2002). Cultural sensitivity in universal family-based prevention interventions. Prevention Science, 3, 241–244.

    Article  PubMed  Google Scholar 

  • Lewis, G., Churchill, R., & Hotopf, M. (1997). Editorial: Systematic reviews and meta-analysis. Psychological Medicine, 27, 3–7.

    Article  PubMed  Google Scholar 

  • Liddle, H. A., Jackson-Gilfort, A., & Marvel, F. A. (2006). An empirically supported and culturally specific engagement and intervention strategy for African-American adolescent males. American Journal of Orthopsychiatry, 75, 215–225.

    Article  Google Scholar 

  • Masi, M. V., Miller, R. B., & Olson, M. M. (2003). Differences in dropout rates among individual, couple, and family therapy clients. Contemporary Family Therapy, 25, 63–75.

    Article  Google Scholar 

  • McCabe, K. M. (2002). Factors that predict premature termination among Mexican-American children in outpatient psychotherapy. Journal of Child and Family Studies, 11, 347–359.

    Article  Google Scholar 

  • McCurdy, K., & Daro, D. (2001). Parent involvement in family support programs: An integrated theory. Family Relations, 50, 113–121.

    Article  Google Scholar 

  • McGuigan, W. M., Katzev, A. R., & Pratt, C. C. (2003). Multi-level determinants of retention in a home-visiting child abuse prevention program. Child Abuse and Neglect, 27, 363–380.

    Article  PubMed  Google Scholar 

  • McKay, M. M., & Bannon, W. M. (2004). Engaging families in child mental health services. Child and Adolescent Psychiatry Clinics of North America, 13, 905–921.

    Article  Google Scholar 

  • McKay, M. M., Hibbert, R., Hoagwood, K., Rodriguez, J., Murray, L., Legerski, J., et al. (2004). Integrating evidence-based engagement interventions into “real world” child mental health settings. Brief Treatment and Crisis Intervention, 4, 177–186.

    Article  Google Scholar 

  • McKay, M. M., McCadam, K., & Gonzales, J. J. (1996a). Addressing the barriers to mental health services for inner city children and their caretakers. Community Mental Health Journal, 32, 353–361.

    Article  PubMed  Google Scholar 

  • McKay, M., Nudelman, R., & McCadam, K. (1996b). Involving inner-city families in mental health services: First interview engagement skills. Research on Social Work Practice, 6, 462–472.

    Article  Google Scholar 

  • McKay, M. M., Stoewe, J., McCadam, K., & Gonzales, J. (1998). Increasing access to child mental health services. Health and Social Work, 23, 9–16.

    PubMed  Google Scholar 

  • Miller, G. E., & Prinz, R. J. (1990). Enhancement of social learning family interventions for child conduct disorder. Psychological Bulletin, 108, 291–307.

    Article  PubMed  Google Scholar 

  • Miller, G. E., & Prinz, R. J. (2003). Engagement of families in treatment for childhood conduct problems. Behavior Therapy, 34, 517–534.

    Article  Google Scholar 

  • Miller, W. R., & Rollnick, S. (2002). Motivational interviewing: Preparing people for change. New York: Guilford Press.

    Google Scholar 

  • Miranda, J., Azocar, F., Organista, K. C., Munoz, R. F., & Lieberman, A. (1996). Recruiting and retaining low-income Latinos in psychotherapy research. Journal of Consulting and Clinical Psychology, 64, 868–874.

    Article  PubMed  Google Scholar 

  • Morrissey-Kane, E., & Prinz, R. J. (1999). Engagement in child and adolescent treatment: The role of parental cognitions and attributions. Clinical Child and Family Psychology Review, 2, 183–198.

    Article  PubMed  Google Scholar 

  • Mullins, S. M., Suarez, M., Ondersma, S. J., & Page, M. C. (2004). The impact of motivational interviewing on substance use treatment retention: A randomized control trial of women involved with child welfare. Journal of Substance Abuse Treatment, 27, 51–58.

    Article  PubMed  Google Scholar 

  • National Institute of Mental Health. (2001). Blueprint for change: Research on Child and Adolescent Mental Health’s Council’s Workgroup on Child and Adolescent Mental Health Intervention Development and Deployment. (DHHS Publication No. CG 031-591). Washington, DC: US Government Printing Office.

  • Nix, R. L., Bierman, K. L., & McMahon, R. J. (2009). How attendance and quality of participation affect treatment response to parent management training. Journal of Consulting and Clinical Psychology, 77, 429–438.

    Article  PubMed  Google Scholar 

  • Nock, M. K., & Ferriter, C. (2005). Parent management of attendance and adherence in child and adolescent therapy: a conceptual and empirical review. Clinical Child and Family Psychology Review, 8, 149–166.

    Article  PubMed  Google Scholar 

  • Nock, M. K., & Kazdin, A. E. (2001). Parent expectancies for child therapy: Assessment and relation to participation in treatment. Journal of Child and Family Studies, 10, 155–180.

    Article  Google Scholar 

  • Nock, M. K., & Kazdin, A. E. (2005). Randomized controlled trial of a brief intervention for increasing participation in parent management training. Journal of Consulting and Clinical Psychology, 73, 872–879.

    Article  PubMed  Google Scholar 

  • Olds, D. L., Sandler, L., & Kitzman, H. (2007). Programs for parents of infants and toddlers: recent evidence from randomized trials. Journal of Child Psychology and Psychiatry, 48, 355–391.

    Article  PubMed  Google Scholar 

  • Perrino, T., Coatsworth, J. D., Briones, E., Pantin, H., & Szapocznik, J. (2001). Initial engagement in parent-centered preventive interventions: A family systems perspective. Journal of Primary Prevention, 22, 21–44.

    Article  Google Scholar 

  • Poderefsky, D. L., McDonald-Dowdell, M., & Beardslee, W. R. (2001). Adaptation of preventive interventions for a low-income culturally diverse community. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 879–886.

    Article  Google Scholar 

  • Prinz, R. J., & Miller, G. E. (1994). Family-based treatment for childhood antisocial behavior: Experimental influences on dropout and engagement. Journal of Consulting and Clinical Psychology, 62(3), 645–650.

    Article  PubMed  Google Scholar 

  • Prinz, R. J., Smith, E. P., Dumas, J., Laughlin, J. E., White, D. W., & Barron, R. (2001). Recruitment and retention of participants in prevention trials involving family-based interventions. American Journal of Preventive Medicine, 20, 31–37.

    Article  PubMed  Google Scholar 

  • Prochaska, J. O., & Velicer, W. F. (1997). The Transtheoretical Model of health behavior change. American Journal of Health Promotion, 12, 38–48.

    PubMed  Google Scholar 

  • Rosenstock, I. M. (1966). Why people use health services. Milbank Memorial Fund Quarterly, 44, 94–124.

    Article  PubMed  Google Scholar 

  • Rotheram-Borus, M. J., Piacentini, J., Van Rossem, R., Graae, F., Cantwell, C., Castro-Blanco, D., et al. (1996). Enhancing treatment adherence with a specialized emergency room program for adolescent suicide attempters. Journal of the American Academy of Child and Adolescent Psychiatry, 35, 654–663.

    Article  PubMed  Google Scholar 

  • Ryan, R. M., & Deci, E. L. (2000). Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. American Psychologist, 55, 68–78.

    Article  PubMed  Google Scholar 

  • Santisteban, D. A., Szapocznik, J., Perez-Vidal, A., Kurtines, W. M., Murray, E. J., & LaPerriere, A. (1996). Efficacy of intervention for engaging youth and families into treatment and some variables that may contribute to differential effectiveness. Journal of Family Psychology, 10, 35–44.

    Article  Google Scholar 

  • Snell-Johns, J., Mendez, J. L., & Smith, B. H. (2004). Evidence-based solutions for overcoming access barriers, decreasing attrition, and promoting chance with underserved families. Journal of Family Psychology, 18, 19–35.

    Article  PubMed  Google Scholar 

  • Spoth, R., & Redmond, C. (1994). Effective recruitment of parents into family-focused prevention research: A comparison of two strategies. Psychology and Health: An International Journal, 9, 353–370.

    Article  Google Scholar 

  • Spoth, R., & Redmond, C. (1995). Parent motivation to enroll in parenting skills programs: A model of family context and health belief predictors. Journal of Family Psychology, 9, 294–310.

    Article  Google Scholar 

  • Spoth, R., & Redmond, C. (2000). Research on family engagement in preventive interventions: Toward improved use of scientific findings in primary prevention practice. Journal of Primary Prevention, 21, 267–284.

    Article  Google Scholar 

  • Staudt, M. (2003). Helping children access and use services: A review. Journal of Child and Family Studies, 12, 49–60.

    Article  Google Scholar 

  • Staudt, M. (2007). Treatment engagement with caregivers of at-risk children: Gaps in research and conceptualization. Journal of Child and Family Studies, 16, 183–196.

    Article  Google Scholar 

  • Stevens, J., Kelleher, K. J., Ward-Estes, J., & Hayes, J. (2006). Perceived barriers to treatment and psychotherapy attendance in child community mental health centers. Community Mental Health Journal, 42, 449–458.

    Article  PubMed  Google Scholar 

  • Swarz, H. A., Zuckoff, A., Grote, N. K., Spielvogle, H. N., Bledsoe, S. E., Shear, M. K., et al. (2007). Engaging depressed patients in psychotherapy: Integrating techniques from motivational interviewing and ethnographic interviewing to improve treatment participation. Professional Psychology: Research in Practice, 38, 430–439.

    Article  Google Scholar 

  • Szapocznik, J., Perez-Vidal, A., Brickman, A. L., Foote, F. H., Santisteban, D., Hervis, O., et al. (1988). Engaging adolescent drug abusers and their families in treatment: A strategic structural systems approach. Journal of Consulting and Clinical Psychology, 56, 552–557.

    Article  PubMed  Google Scholar 

  • Szapocznik, J., Santisteban, D., Rio, A. T., Perez-Vidal, A., & Kurtines, W. M. (1986). Family effectiveness training for Hispanic families: Strategic structural systems intervention for the prevention of drug abuse. In H. P. Lefley & P. B. Pedersen (Eds.), Cross cultural training for mental health professionals. Springfield, IL: Charles C. Thomas.

    Google Scholar 

  • Tait, R. J., Hulse, G. K., & Robertson, S. I. (2004). Effectiveness of a brief intervention and continuity of care in enhancing attendance for treatment by adolescent substance users. Drug and Alcohol Dependence, 74, 289–296.

    Article  PubMed  Google Scholar 

  • Thompson, S. J., Bender, K., Lantry, J., & Flynn, P. M. (2007). Treatment engagement: Building therapeutic alliance in home-based treatment with adolescents and their families. Contemporary Family Therapy, 29, 39–55.

    Article  PubMed  Google Scholar 

  • Vega, W. A., Kolody, B., Aguilar-Gaxiola, S., & Catalano, R. (1999). Gaps in service utilization by Mexican-Americans with mental health problems. American Journal of Psychiatry, 156, 928–934.

    PubMed  Google Scholar 

  • Watt, B. D., Hoyland, M., Best, D., & Dadds, M. R. (2007). Treatment participation among children with conduct problems and the role of telephone reminders. Journal of Child and Family Studies, 16, 522–530.

    Article  Google Scholar 

  • Watts, B. D., & Dadds, M. R. (2007). Facilitating treatment attendance in child and adolescent mental health services: A community study. Clinical Child Psychology and Psychiatry, 12, 105–116.

    Article  Google Scholar 

  • Wells, K., Klap, R., Koike, A., & Sherbourne, C. (2001). Ethnic disparities in unmet need for alcoholism, drug abuse, and mental health care. American Journal of Psychiatry, 158, 2027–2032.

    Article  PubMed  Google Scholar 

  • Yancey, A. K., Ortega, A. N., & Kumanyika, S. K. (2006). Effective recruitment and retention of minority research participants. Annual Review of Public Health, 27, 1–28.

    Article  PubMed  Google Scholar 

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Acknowledgments

This work was supported by an institutional NRSA post-doctoral research training program, 5T32 MH015442, “Developmental Psychopathology, Psychobiology, and Behavior.” I gratefully acknowledge comments and editorial assistance from David Olds and the Developmental Psychobiology Research Group faculty and post-doctoral fellows.

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  1. Prevention Research Center for Family and Child Health, Department of Pediatrics, University of Colorado Denver, Mail Stop #8410, 13121 E. 17th Ave., Room 5303, Aurora, CO, 80045, USA

    Erin M. Ingoldsby

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Ingoldsby, E.M. Review of Interventions to Improve Family Engagement and Retention in Parent and Child Mental Health Programs. J Child Fam Stud 19, 629–645 (2010). https://doi.org/10.1007/s10826-009-9350-2

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