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CHAPTER 7 136 theory states that attitudes − in this case prior pessimistic expectations of psychosocial care − might be changed once the experience − in this case the experience with psychosocial care − is different ( dissonant ) from the expectation [44]. This change of attitudes is called reduction of cognitive dissonance. Comparing parents from the community and from the care sample regarding their expectations of barriers to care, the pattern is slightly different than comparing adolescents from the community and the care sample. More often than parents in the care sample, parents from the community sample expected that treatment would be irrelevant and that the relationship with the therapist would be problematic. This also seems to reflect a rather pessimistic general parental view of psychosocial care, which could again also stem from negative media portrayal of children’s psychosocial care, or reflect a shaping of care not in line with the family’s situation. However, parents from the care sample expected more practical barriers compared to parents from the community sample, such as practical barriers at home (e.g., problems regarding transport, other children at home, activities, health), and barriers regarding treatment demands and issues (e.g., concerns about treatment cost and duration, having a voice in treatment, and confusing information). These barrier types might become more actual at the beginning of psychosocial care, when its utilisation requires time and finances from the family. This confirms the Pathways to Care model, and shows that specific factors play a role in how children and adolescents pass the various filters of the model [1]. To conclude, various factors play a role in the enrolment of children and adolescents in psychosocial care: psychosocial problems, socio-demographic characteristics, the social environment of the child, and expectations regarding barriers. This adds evidence to the Pathways to care model; it helps to understand why some children and adolescents in the community do pass the first filter to consult a professional for psychosocial problems, and others do not [1]. Once enroled in psychosocial care: care types and outcomes In the final part of this thesis we examined the process of enrolment, assessing the types and severity of problems upon enrolment, and associations with outcomes of care, i.e. care duration and problem solution after three and twelve months (Chapter 6). In the next paragraphs we will discuss these findings in the light of two assumptions behind the system of psychosocial care for children and adolescents in the Netherlands [45-47]. The first assumption is that PCH treats mild problems, and CASC and CAMH treat more severe problems; this assumption concerns the distribution of problem severity among the care types. The second assumption is that CAMH provides care for children with