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CHAPTER 3 48 Next, three other certified translators translated the Dutch translations back into English, one translation each. Finally, three of the authors (DEMCJ/EJK/SAR) compared the resulting English versions to the original BTPS-exp, and discussed and resolved discrepancies. Item 14 was the only item not applicable and therefore not included in the adolescent version (see Appendix). Parents and adolescents were asked to “imagine that you were seeking psychological help, counselling or advice [for your child]” and asked to indicate to what extent they agreed with 44 and 43 items, respectively, with answer categories from “totally disagree” to “totally agree” (five-point Likert scale). Mean scores were calculated for the total scale and subscales, when at least two-thirds of the items were answered. The subscales were stressors and obstacles competing with treatment (parents: 20 items; adolescents: 19 items), treatment demands and issues (10 items), perceived irrelevance of treatment (8 items), and problematic relationship with the therapist (6 items) (see Appendix). Child characteristics comprised age, gender, ethnicity, and psychosocial problems. Ethnicity was defined as either Dutch or non-Dutch (i.e. either the child and/or one of the parents was foreign-born). Psychosocial problems were measured using the total difficulties score of the “Strengths and Difficulties Questionnaire” (SDQ), based on the past six months (Cronbach’s α parent version=.74; adolescent version=.77) [30-33]. The score consists of 20 items describing positive and negative attributes of children for the following dimensions: emotional symptoms, conduct problems, hyperactivity/inattention, and peer problems. The scale was dichotomized into the “normal” range and the “borderline to abnormal,” using the UK cut-off points [30, 31]. Family characteristics comprised parental educational level and family composition. Parental educational level was the highest educational level achieved by either one of the parents/caregivers [34]. Family composition was categorized as “biological two-parent family” or “other” (for example, living with one parent, a foster family, or living in a residential care facility). Psychosocial care enrolment was defined as enrolment of the child in any new type of care in one of the main psychosocial care organizations because of psychosocial problems. Statistical analyses First, we described the background characteristics of the samples. Second, we determined the internal consistency of the total scale and subscales of the parent and adolescent versions of the BTPS-exp. A Cronbach’s alpha >0.7 was considered as good internal consistency. Next, we assessed whether the data fitted the assumed structure of