15581-m-nanninga

SUMMARY 149 We found that the majority of parents and adolescents expected barriers to child and adolescent psychosocial care. Adolescents expected barriers more frequently than their parents did. The most frequently expected barriers were those with respect to treatment irrelevance, problematic relationship with therapists, and treatment demands. Several child and family characteristics were associated with almost all types of barriers, except for irrelevance of treatment. Mainly parents with low educational levels and their adolescent children expected barriers regarding treatment. Particularly parents of adolescents had several characteristics associated with expecting multiple barriers regarding treatment demands and issues: single-parenthood, lower educational level, and being parent of a male adolescent and/or of an adolescent with psychosocial problems. This study showed that in the community sample the majority expected barriers to psychosocial care. Attention to these barriers is important because they may hinder children and adolescents in need of psychosocial care – children with problems that they cannot manage or solve by themselves, in their family or with help of their social network – from enroling in psychosocial care. The BTPS-exp, or its themes, could be helpful in such cases. The Barriers to Treatment Participation Scale-Expectancies In Chapter 3 we describe the psychometric properties of the parent and adolescent versions of the BTPS-exp in terms of consistency, structure, parent-child agreement, and validity. We found good internal consistencies in the total scale and in the four subscales of both versions. Furthermore, the data appropriately fitted the assumed scale structure. Correlation coefficients between parent and adolescent scores were low. Regarding criterion validity, the BTPS-exp was, as assumed, associated with some child and family characteristics, but did not affect the association between children’s psychosocial problems and care enrolment. These findings indicate that the BTPS-exp is a good questionnaire for measuring views on barriers to psychosocial care and might be helpful in addressing these views among children, adolescents and parents in the community as well as those enroled in care. Determinants of enrolment in and use of psychosocial care by children and adolescents In Chapter 4 we discuss our systematic review of the literature on determinants of enrolment in and use of psychosocial care by children and adolescents. We found 22 relevant studies of high quality. We ascertained that many child and family characteristics were associated with enrolment in and use of psychosocial care. The main