Publication Date

2017-07-21

Availability

Embargoed

Embargo Period

2018-07-21

Degree Type

Thesis

Degree Name

Master of Science (MS)

Department

Psychology (Arts and Sciences)

Date of Defense

2017-05-09

First Committee Member

Jill Ehrenreich-May

Second Committee Member

Amanda Jensen-Doss

Third Committee Member

Tatiana Perrino

Abstract

Internalizing disorders in youth are highly prevalent and impairing, yet most children and adolescents never receive treatment for these conditions. Of those who do seek services, it is estimated that as many as 35% of youth do not attend their initial appointments at mental health clinics. Prior research on predictors of and interventions for initial appointment or intake attendance in youth mental health settings has primarily utilized samples of children exhibiting externalizing disorders, with largely inconclusive or modest findings. However, there are indicators that predictors of initial appointment attendance may be unique based on clinical concerns (e.g. internalizing versus externalizing disorders), and clinically tailored interventions may be more effective for improving attendance, particularly in youth with internalizing disorders. This study aimed to better identify predictors of non-attendance at intake in a sample of families seeking treatment for youth with internalizing disorders, and to test the acceptability and utility of a preparatory video for improving intake attendance compared to usual screening procedures. An extended phone screen, which included a series of items hypothesized to predict attendance, was used to collect data prior to appointment scheduling. Fifty five families scheduled for an intake were randomized to receive either an informational video about the nature of the intake appointment and parenting tips for managing child anxiety and distress before the appointment (n = 27), or screening as usual (n = 28). Families that viewed the video rated it as moderately helpful, but only 51.85% viewed the video. Ratings of parent motivation were relatively high, and few parents reported concerns about their child being ambivalent about coming to the clinic. Furthermore, few families cancelled their appointments, and no families in the sample no-showed. This indicates the intervention tested may not have been needed in the present sample. Exploratory analyses using logistic regression revealed that higher family income was a marginally significant predictor of the odds of attendance without cancelling or rescheduling. Several bivariate correlations indicated significant associations between measures on the phone screen, including a positive relationship between family accommodation and anxiety symptom severity, as well as an inverse relationship between child age and parental participation in children’s anxiety related behaviors. Implications of the findings and future directions are discussed.

Keywords

child anxiety disorder; internalizing disorders; attendance; video; intervention; intake

Available for download on Saturday, July 21, 2018

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