Ofonedu Mirian E, Belcher Harolyn M E, Budhathoki Chakra, Gross Deborah A
Center for Child and Family Traumatic Stress, Kennedy Krieger Institute, 1750 East Fairmount Avenue, Baltimore, MD 21231, USA.
Center for Child and Family Traumatic Stress, Kennedy Krieger Institute, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD 21287.
J Child Fam Stud. 2017 Mar;26(3):863-876. doi: 10.1007/s10826-016-0603-6. Epub 2016 Nov 3.
This mixed method study examined factors associated with parents not attending their child's mental health treatment after initially seeking help for their 2-5 year old child. It was part of a larger study comparing two evidence-based treatments among low-income racial/ethnic minority families seeking child mental health services. Of 123 parents who initiated mental health treatment (71% African American or multi-racial; 97.6% low-income), 36 (29.3%) never attended their child's first treatment session. Socio-demographic characteristics, parenting stress, depression, severity of child behavior problems, and length of treatment delay from intake to first scheduled treatment session were compared for families who did and did not attend their first treatment session. Parents who never attended their child's first treatment session were more likely to live with more than 4 adults and children (p=.007) and have more depressive symptoms (p=.003). Median length of treatment delay was 80 days (IQR =55) for those who attended and 85 days (IQR =67.5) for those who did not attend their child's first treatment session (p=.142). Three themes emerged from caregiver interviews: (a) expectations about the treatment, (b) delays in getting help, and (c) ambivalence about research participation. Findings suggest the need to develop better strategies for addressing risk factors early in the treatment process and reducing the length of time families with adverse psychosocial circumstances must wait for child mental health treatment.
这项混合方法研究调查了在最初为其2至5岁孩子寻求帮助后，父母未参加孩子心理健康治疗的相关因素。它是一项更大规模研究的一部分，该研究比较了低收入种族/族裔少数群体家庭中两种循证治疗方法对儿童心理健康服务的效果。在123名开始接受心理健康治疗的父母中（71%为非裔美国人或多族裔；97.6%为低收入），有36名（29.3%）从未参加过孩子的首次治疗。对参加和未参加首次治疗的家庭，比较了其社会人口学特征、育儿压力、抑郁程度、儿童行为问题的严重程度以及从 intake 到首次预定治疗的治疗延迟时长。从未参加孩子首次治疗的父母更有可能与4名以上成年人和儿童共同生活（p = 0.007），且有更多抑郁症状（p = 0.003）。参加首次治疗的家庭治疗延迟中位数为80天（四分位距 = 55），未参加孩子首次治疗的家庭为85天（四分位距 = 67.5）（p = 0.142）。从照顾者访谈中出现了三个主题：（a）对治疗的期望，（b）获得帮助的延迟，以及（c）对参与研究的矛盾心理。研究结果表明，有必要制定更好的策略，在治疗过程早期解决风险因素，并缩短有不良社会心理状况的家庭等待儿童心理健康治疗的时间。 （注：“intake”此处可能是指治疗开始前的评估等环节，具体含义需结合研究背景确定）
