Parental Satisfaction and Treatment Outcome: A 3-Year Study in Children's Mental Health Services

By Rosso, Stephanie; Jurecska, Diomaris E. | International Journal of Child and Adolescent Health, April 1, 2013 | Go to article overview

Parental Satisfaction and Treatment Outcome: A 3-Year Study in Children's Mental Health Services


Rosso, Stephanie, Jurecska, Diomaris E., International Journal of Child and Adolescent Health


Introduction

In the United States alone, one in every four to five youth meets criteria for a psychiatric diagnosis (1). An extensive body of literature supports the indication that most psychiatric disorders emerge during childhood or adolescence, making early intervention and prevention vital to future youth's life outcomes (1-4). Recent trends show that externalizing disorders such as Attention Deficit and Hyperactivity Disorder (ADHD) have the highest national prevalence rates when compared to internalized childhood disorders (1). Current studies indicate that the presence of untreated psychiatric disorders leads to comorbidity and predicts severe impairment at the individual level (5). Barriers to mental health access for children are based on epidemiological, cultural, as well as economic factors (6-8).

In terms of demographics, both Hispanic and African American children are significantly less likely to access mental health services when compared to their Caucasian counterparts (1). Current statistics also show an unequal distribution between the genders regarding behavioral diagnoses with male rates being significantly higher than female (5). Fortunately, statistics indicate that some externalizing behaviors, such as ADHD, have the highest service rates 59.8% (1). Although externalizing childhood behaviors are present in a broad range of families; they are more prominent in families where risks outnumber protective factors (6). Barriers to mental health services, specifically for children, are strongly associated with poverty, culture, and being from minority groups (6-8).

Studies in adult services show that patient feedback is a key predictor of treatment efficacy. However; perception of quality of care in child and family services are not part of the current methods of treatment outcome evaluations (9). A lack of effective interventions has been associated with children's mental health services. Therefore, providing evidence-based treatment (EBT) has been identified as one of the key components for moving forward in efficacy research with this population (10). Efforts to promulgate best practices or EBT without including patient's perspective can be counterproductive to treatment. Specifically, when working with families, parental satisfaction needs to be identified as one of the key predictors of treatment success (11-16).

Despite this knowledge, customer satisfaction has often been neglected when evaluating outcomes of mental health services for children. A comprehensive review of the literature revealed less than a dozen studies asking how parents perceive the quality of psychiatric care for their children. Therefore, the aim of the study was to explore the relationship between overall satisfaction and treatment outcomes in children's mental health services.

Methods

The Developmental and Behavioral Pediatrics Clinic (BPC) at Children's Hospital and Research Center Oakland provides psychological evaluations and behavioral interventions to children ages 3 to 12 who are experiencing difficulties with behavioral regulation, attention, learning, and developmental issues. We value a multidisciplinary viewpoint and collaborate as a team with developmental behavioral pediatricians, and nurse practitioners who have had specialized training. We work from an integrative model of therapy, borrowing from psychodynamic, family systems, attachment theory, and cognitive behavioral therapy. As a teaching hospital, our services are provided by licensed clinical psychologists, pre-doctoral interns, and occupational therapists.

Participants

The total sample consisted of 72 survey parental responses, of which 70% were male and 30% were female. In terms of ethnic makeup, 38 were African American (52.8%), 17 were Hispanic American (23.6 %), 8 were European American (11.1%), 2 were Asian American (2.8%), and 1 was Native American (1.4%). The age reflects a range from 4 to 14 years with M = 8. …

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