Abstract
This study examined the role of perceived barriers to participation in treatment and the acceptability of treatment among children and parents. Children (N = 144, ages 6–14) referred for outpatient treatment for oppositional, aggressive, and antisocial behavior and their families participated. The main findings were that: (a) perceived barriers to participation in treatment predicted treatment acceptability as rated by children and parents; (b) the effect was not accounted for by socioeconomic disadvantage, parent psychopathology and stress, and severity of child dysfunction; and (c) treatment acceptability was related to therapeutic change in the children over the course of therapy but the relation was small. Overall, the findings indicate that families vary considerably in the barriers they perceive in coming to treatment and that these barriers influence the extent to which they and their children evaluate the acceptability of the treatments they receive. The implications of treatment acceptability for evaluation and delivery of psychotherapy are discussed.
Similar content being viewed by others
REFERENCES
Abidin, R. R. (1990). Parenting Stress Index clinical manual. Charlottesville, VA: Pediatric Psychology Press.
Achenbach, T. M. (1991). Manual for the Child Behavior Checklist/4–18 and 1991 Profile. Burlington, VT: University of Vermont, Department of Psychiatry.
Allinder, R. M., & Oats, R. G. (1997). Effects of acceptability on teacher's implementation of cirriculum-based measurement and student achievement in mathematics computation. Rase: Remedial and Special Education, 18, 113–120.
American Psychiatric Association. (1987). Diagnostic and statistical manual of mental disorders (3rd ed., Revised). Washington, DC: Author.
Arndorfer, R. E., Allen, K. D., & Aljazireh, L. (1999). Behavioral health needs in pediatric medicine and the acceptability of behavioral solutions: Implications for behavioral psychologists. Behavior Therapy, 30, 137–148.
Banken, D. M., & Wilson, G. L. (1992). Treatment acceptability of alternative therapies for depression: A comparative analysis. Psychotherapy, 29, 610–619.
Beck, A. T., Ward, C. H., Mendelson, M., Mock, J., & Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 53–63.
Brestan, E. V., & Eyberg, S. M. (1998). Effective psychosocial treatment of conduct-disordered children and adolescents: 29 years, 82 studies, 5275 children. Journal of Clinical Child Psychology, 27, 180–189.
Calvert, S. C., & Johnston, C. (1990). Acceptability and treatments for child behavior problems: Issues and implications for future research. Journal of Clinical Child Psychology, 19, 61–74.
Chamberlain, P., & Reid, J. B. (1987). Parent observation and report of child symptoms. Behavioral Assessment, 9, 97–109.
Cobham, V. E., Dadds, M. R., & Spence, S. H. (1998). The role of parental anxiety in the treatment of childhood anxiety. Journal of Consulting and Clinical Psychology, 66, 893–905.
Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: Erlbaum.
Derogatis, L. R., & Cleary, P. A. (1977). Confirmation of the dimensional structure of the SCL-90: A study in construct validation. Journal of Clinical Psychology, 33, 981–989.
Dumas, J. E., & Wahler, R. G. (1983). Predictors of treatment outcome in parent training: Mother insularity and socioeconomic disadvantage. Behavioral Assessment, 5, 301–313.
Hollingshead, A. B. (1975). Four-factor index of social status. New Haven, CT: Yale University, Department of Sociology.
Kazdin, A. E. (1995). Conduct disorder in childhood and adolescence (2nd ed.). Newbury Park, CA: Sage.
Kazdin, A. E. (1996a). Dropping out of child psychotherapy: Issues for research and implications for practice. Clinical Child Psychology and Psychiatry, 1, 133–156.
Kazdin, A. E. (1996b). Problem solving and parent management in treating aggressive and antisocial behavior. In E. D. Hibbs & P. S. Jensen (Eds.), Psychosocial treatments for child and adolescent disorders: Empirically based strategies for clinical practice (pp. 377–408). Washington, DC: American Psychological Association.
Kazdin, A. E. (2000). Psychotherapy for children and adolescents: Directions for research and practice. New York: Oxford University Press.
Kazdin, A. E., Bass, D., Siegel, T., & Thomas, C. (1989). Cognitive-behavioral treatment and relationship therapy in the treatment of children referred for antisocial behavior. Journal of Consulting and Clinical Psychology, 57, 522–535.
Kazdin, A. E., & Esveldt-Dawson, K. (1986). The interview for antisocial behavior: Psychometric characteristics and concurrent validity with child psychiatric inpatients. Journal of Psychopathology and Behavioral Assessment, 8, 289–303.
Kazdin, A. E., French, N. H., & Sherick, R. B. (1981). Acceptability of alternative treatments for children: Evaluations by inpatient children, parents, and staff. Journal of Consulting and Clinical Psychology, 49, 900–907.
Kazdin, A. E., Holland, L., & Crowley, M. (1997). Family experience of barriers to treatment and premature termination from child therapy. Journal of Consulting and Clinical Psychology, 65, 453–463.
Kazdin, A. E., Holland, L., Crowley, M., & Breton, S. (1997). Barriers to participation in treatment scale: Evaluation and validation in the context of child outpatient treatment. Journal of Child Psychology and Psychiatry, 38, 1051–1062.
Kazdin, A. E., Siegel, T., & Bass, D. (1990). Drawing upon clinical practice to inform research on child and adolescent psychotherapy. Professional Psychology: Research and Practice, 21, 189–198.
Kazdin, A. E., Siegel, T., & Bass, D. (1992). Cognitive problem-solving skills training and parent management training in the treatment of antisocial behavior in children. Journal of Consulting and Clinical Psychology, 60, 733–747.
Kazdin, A. E., Stolar, M. J., & Marciano, P. L. (1995). Risk factors for dropping out of treatment among White and Black families. Journal of Family Psychology, 9, 402–417.
Kazdin, A. E., & Weisz, J. R. (1998). Identifying and developing empirically supported child and adolescent treatments. Journal of Consulting and Clinical Psychology, 66, 19–36.
Lochman, J. E., White, K. J., & Wayland, K. K. (1991). Cognitive-behavioral assessment and treatment with aggressive children. In P. C. Kendall (Ed.), Child and adolescent therapy: Cognitive-behavioral procedures (pp. 25–65). New York: Guilford.
Lonigan, C. J., & Elbert, J. C. (Eds.) (1998). Special issue on empirically supported psychosocial interventions for children. Journal of Clinical Child Psychology, 27, 138–226.
Miltenberger, R. G. (1990). Assessment of treatment acceptability: A review of the literature. Topics in Early Childhood Special Education, 10, 24–38.
Rasnake, L. K. (1993). Treatment acceptability research: Relevance to treatment selection decisions. Child and Adolescent Mental Health Care, 3, 31–47.
Reimers, T. M., Wacker, D. P., Cooper, L. J., & DeRaad, A. O. (1992). Clinical evaluation of the variables associated with treatment acceptability and their relation to compliance. Behavioral Disorders, 18, 67–76.
Robins, L. N. (1981). Epidemiological approaches to natural history research: Antisocial disorders in children. Journal of the American Academy of Child Psychiatry, 20, 566–680.
Webster-Stratton, C. (1996). Early intervention with videotape modeling: Programs for families of children with oppositional defiant disorder or conduct disorder. In E. D. Hibbs & P. Jensen (Eds.), Psychosocial treatment research of child and adolescent disorders: Empirically based strategies for clinical practice (pp. 435–474). Washington, DC: American Psychological Association.
Webster-Stratton, C., & Hammond, M. (1990). Predictors of treatment outcome in parent training for families with conduct problem children. Behavior Therapy, 21, 319–337.
Wechsler, D. (1974). Manual for the Wechsler Intelligence Scale for Children-Revised. New York: Psychological Corporation.
Wierzbicki, M., & Pekarik, G. (1993). A meta-analysis of psychotherapy dropout. Professional Psychology: Research and Practice, 24, 190–195.
Zoccolillo, M. (1993). Gender and the development of conduct disorder. Development and Psychopathology, 5, 65–78.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Kazdin, A.E. Perceived Barriers to Treatment Participation and Treatment Acceptability Among Antisocial Children and Their Families. Journal of Child and Family Studies 9, 157–174 (2000). https://doi.org/10.1023/A:1009414904228
Issue Date:
DOI: https://doi.org/10.1023/A:1009414904228