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GENERAL DISCUSSION 131 MAIN RESEARCH FINDINGS We augmented the understanding of children’s and adolescents’ enrolment in psychosocial care by answering five research questions, as summarized below. The first research question (Chapter 2) was: How many parents and adolescents in the community sample expect barriers when considering seeking psychosocial care for the child? What types of barriers are most frequently expected? And which child and family characteristics are associated with these expectations regarding barriers to care? In the community sample we found that 64% of parents of children below age twelve, 59% of parents of adolescents (age 12-18), and 84% of adolescents expected one or more barriers. Parents and adolescents most frequently expected barriers with respect to (potential) ‘irrelevance of treatment’. Mainly parents with low educational level and their adolescents expected barriers regarding treatment: ‘irrelevance of treatment’, ‘problematic relationship with therapists’ and ‘treatment demands and issues’. Various characteristics of parents of adolescents were associated with expecting multiple barriers regarding ‘treatment demands and issues’: being single parents, having a lower educational level, being parents of adolescent boys, and being parents of adolescents with psychosocial problems. The second research question (Chapter 3) was: What are the psychometric properties of the Barriers to Treatment Participation Scale-Expectancies (BTPS-exp) in terms of internal consistency, scale structure, parent-adolescent agreement and validity? Using data from the community and care samples we found good internal consistency (reliability) of the total scale and subscales of both the parent and adolescent versions of the BTPS-exp. Moreover, the data had an acceptable fit with the assumed scale structure of the BTPS-exp. Correlation coefficients between parent and adolescent scores were low. Assessment of criterion validity showed that expectation of multiple barriers was significantly more likely in parents of non-Dutch ethnicity, of lower educational levels, in single-parent families, and in cases of child psychosocial problems. Moreover, adolescents with psychosocial problems were more likely to expect barriers. Assessment of criterion validity also showed that expecting multiple barriers did not affect the association between child psychosocial problems and care enrolment. We conclude that the BTPS-exp has good psychometric properties regarding reliability and structure, and is reasonably valid. We found that parents and adolescents have their own separate views on barriers to using and participating in care. The third research question (Chapter 4) was: What are the determinants of children’s and adolescents’ enrolment in and use of psychosocial care as reported in the literature?