15581-m-nanninga

BTPS-EXP 57 decreases the likelihood of bias. In addition, we lacked information on those who had opted out of the study, but it seems reasonable to assume that they resemble the non- responders [52]. Finally, the BTPS-exp reflects some types of barrier expectations more than others. For example, the type ‘stressors and obstacles competing with treatment’ has much more weight, i.e. twenty items, than the type ‘problematic relationship with therapist’, which contains only six items. However, calculating the total score in the same way as the original BTPS enabled us to discriminate between those expecting few barriers and those expecting multiple barriers. Implications The BTPS-exp is reliable and reasonably valid, and is useful for detecting parents’ and adolescents’ expectations of barriers to psychosocial care for children and adolescents. The BTPS-exp might help to improve access to psychosocial care, as professionals with a gate keeping function, such as general practitioners, could already address and remedy barriers early in the help-seeking process. In addition, finding remedies for barriers at the beginning of treatment could be beneficial for treatment responses and change, including treatment continuation. This study also showed that parents and adolescents have their own views of barriers, which argues for including both in evaluation of psychosocial care and for extra attention for adolescents, since in particular these expect barriers. Our study has several implications for further research. First, research on whether a weight should be attached to the subscales in the calculation of the BTPS-exp total score is needed to better understand the validity of the BTPS-exp. Second, it should be examined whether the BTPS-exp, especially the adolescent version, must be expanded with other types of barriers such as stigma and lack of parental support. Third, research on the association between the BTPS-exp and psychosocial care enrolment in and treatment response to psychosocial care is needed on the role of barrier expectations in the care process and to also understand the validity of the BTPS-exp. Lastly, to facilitate wider use, the psychometric properties of the BTPS-exp need to be examined in other languages and cultures.