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Member Research & Reports

Member Research & Reports

Georgia State Study Finds Caregiver Attitudes Influence Youth Therapy Outcomes

Attitudes of caregivers toward therapy and caregivers’ personal experiences with trauma and stress may be the best predictors of whether traumatized youth receive mental health treatment, according to a study led by a researcher at the Georgia State University School of Public Health.

More than 680,000 American youth are victims of abuse each year, and about 14 percent experience a traumatic event during childhood, according to prior research. This abuse and trauma puts youth at risk for developing mental health symptoms and problems in school.

This study focused on caregivers — parents, legal guardians and custodians — because they “are the primary people who manage treatment participation for youth,” the researchers said. “In addition, caregivers promote optimal treatment outcomes through reinforcing skills from therapy and psychoeducation.”

Even though previous studies have shown that trauma-focused cognitive behavioral therapy may reduce symptoms of post-traumatic stress, it is not widely used among youth and their families who need it, the researchers said.

To determine what factors may influence enrollment in and completion of trauma-focused cognitive behavioral therapy, the team, led by a childhood trauma researcher, studied 41 caregivers of youth who were referred to services by local law enforcement and child protection agencies. Researchers surveyed the caregivers about their perceived stress, attitudes toward treatment and their own history of trauma.

Of the 41 caregivers in the study, 29 enrolled in therapy and nine completed it. The researchers found that a caregiver’s attitude toward treatment was the strongest predictor of enrollment in trauma-focused cognitive behavioral therapy.

“Based on our findings, families with positive attitudes towards treatment are unlikely to need additional engagement strategies related to decisions to enroll in therapy,” the researchers stated.

However, the study also found that caregivers with negative attitudes toward treatment were more likely to enroll if they had experienced their own trauma. More than half of the caregivers in the study reported at least one traumatic life experience. Families with caregivers who reported few of their own traumatic experiences were highly unlikely to complete treatment.

The results of the study are published in the article “Patterns of Caregiver Factors Predicting Participation in Trauma-Focused Cognitive Behavioral Therapy” in the Journal of Child & Adolescent Trauma. The study’s lead author is Dr. Betty Lai, assistant professor of epidemiology and biostatistics at Georgia State.

The study’s authors also include Dr. Ashwini Tiwari, a postdoctoral research fellow at the Offord Centre for Child Studies; Dr. Shannon Self-Brown, professor of health promotion and behavior at Georgia State; Dr. Peter Cronholm, with the Hospital of the University of Pennsylvania; and Dr. Kelly Kinnish, director of clinical services at the Georgia Center for Child Advocacy.