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CHAPTER 2 36 parent families because these children also are more at risk and more often show psychosocial problems [12, 48, 53, 54, 55]. Barriers of single parents, i.e., regarding treatment demands and stressors at home, might, for example, be based on the burden they experience from having to organize the household on their own, or on a lack of finances to meet treatment costs. Parents of adolescent boys, who expected barriers regarding treatment demands and a problematic relationship with a therapist, might for example, more often be apt to expect that their child would refuse to attend treatment, simply as an expression of the more externalizing behaviour pattern that boys show [56], as compared to parents of female adolescents. This might also be the reason why adolescent boys themselves expected these barriers. Barriers related to stressors and obstacles that compete with treatment, which are mainly dependent on the family’s home situation, were expected on the part of parents of adolescent boys, and of one-parent families, of adolescents with psychosocial problems and/or who had used psychosocial care in the past. Also these findings might be explained by previously experienced barriers. However, it remains unclear why adolescent girls mainly expect this type of barriers, whereas the association is the other way around for their parents. Lastly, adolescents with parents with a university degree were especially likely to expect this type of barrier, which, for instance might be explained by a lack of time to attend treatment due to more leisure time activities, such as sports and music, compared to children from lower educated parents [57]. Strengths and limitations A strength of our study is that it is the first community-based evidence regarding parents’ and adolescents’ expectations of barriers to child and adolescent psychosocial care. Another strength is its extensive recruitment procedure, the successful actions to reduce missing data, and the relatively high response rate. A limitation of our study might be a potential selection bias. However, we found only small differences between respondents and non-respondents, and between respondents and children in the community, which thus decreases the likelihood of bias. A final limitation is that we did not adjust for correlation of data between adolescents and parents by accounting for the dyadic nature of the data [58, 59]. This is unlikely to have affected our findings in a major way.