BACKGROUND: Parents play an important role in the psychosocial care of their children. Previous research has primarily examined their role in care entry, whereas evidence on their role in other stages of the care process is scarce and lacking particularly in regard to the perspective of care providers. Our aim was therefore to examine how psychosocial care providers perceive the role of parents in the process of psychosocial care for adolescents. METHODS: We used data from 25 semi-structured interviews with psychosocial care providers on the roles of parents in the care process. We analyzed data using consensual qualitative research and thematic analysis. RESULTS: Four main themes were identified: (1) parents as a source of adolescents' problems; (2) parents trying to escape from responsibility for adolescents with problems; (3) parents as an active part of the care for adolescents; and (4) parents as a barrier to effective care. CONCLUSION: Psychosocial care providers should specifically address the role of the parents in psychosocial care to improve outcomes. Specific interventions are needed to support the involvement of parents in care, as their role is important. Moreover, professionals can be better trained in working with multi-problem families also to resolve some of the negative perceptions of these parents.

Department of Community and Occupational Medicine University Medical Center Groningen University of Groningen Groningen Netherlands

Department of Health Psychology and Research Methodology Faculty of Medicine Pavol Jozef Safarik University Kosice Slovakia

Olomouc University Social Health Institute Palacky University Olomouc Olomouc Czechia

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Achenbach T. M., Howell C. T., Quay H. C., Conners C. K. (1991). National survey of problems and competencies among four to sixteen year-olds. Monogr. Soc. Res. Child Dev. 56, 1–31. doi: 10.2307/1166156 PubMed DOI

Barkmann C., Schulte-Markwort M. (2012). Prevalence of emotional and behavioral disorders in German children and adolescents: a meta-analysis. J. Epidemiol. Community Health 66, 194–203. doi: 10.1136/jech.2009.102467, PMID: PubMed DOI

Bornstein M. H., Hahn C. S., Suwalsky J. T. D. (2013). Language and internalizing and externalizing behavioral adjustment: developmental pathways from childhood to adolescence. Dev. Psychopathol. 25, 857–878. doi: 10.1017/S0954579413000217, PMID: PubMed DOI PMC

Braun V., Clarke V. (2006). Using thematic analysis in psychology. Qual. Res. Psychol. 3, 77–101.

Burns B. J., Costello E. J., Angold A., Tweed D., Stangl D., Farmer E. M., et al. . (1995). Children's mental health service use across service sectors. Health Aff. 14, 147–159. doi: 10.1377/hlthaff.14.3.147, PMID: PubMed DOI

Connolly E. J., Kavish N. (2019). The causal relationship between childhood adversity and developmental trajectories of delinquency: a consideration of genetic and environmental confounds. J. Youth Adolesc. 48, 199–211. doi: 10.1007/s10964-018-0960-0, PMID: PubMed DOI

Cooper P. (2011). Teacher strategies for effective intervention with students presenting social, emotional and behavioral difficulties: An international review. Eur. J. Spec. Needs Educ. 26, 7–86. doi: 10.1080/08856257.2011.543547 DOI

Cornelius J. R., Pringle J., Jernigan J., Kirisci L., Clark D. B. (2001). Correlates of mental health service utilization and unmet need among a sample of male adolescents. Addict. Behav. 26, 11–19. doi: 10.1016/S0306-4603(00)00075-7, PMID: PubMed DOI

Di Trani M., Di Roma F., Scatena M. C., Donfrancesco R. (2013). Severity of symptomatology and subtypes in ADHD children with comorbid oppositional defiant and conduct disorders. Int. J. Disab. Hum. Dev. 12, 283–287. doi: 10.1515/ijdhd-2012-0106 DOI

Dowell K. A., Ogles B. M. (2010). The effects of parent participation on child psychotherapy outcome: A meta-analytic review. J. Clin. Child Adolesc. Psychol. 39, 151–162. doi: 10.1080/15374410903532585, PMID: PubMed DOI

Evenboer K. E., Reijneveld S. A., Jansen D. E. M. C. (2018). Improving care for multi-problem families: context-specific effectiveness of interventions? Child Youth Serv. Rev. 88, 274–285. doi: 10.1016/j.childyouth.2018.03.024 DOI

Flicker S. M., Turner C. W., Waldron H. B., Brody J. L., Ozechowski T. J. (2008). Ethnic background, therapeutic alliance, and treatment retention in functional family therapy with adolescents who abuse substances. J. Fam. Psychol. 22, 167–170. doi: 10.1037/0893-3200.22.1.167, PMID: PubMed DOI

Flisher A. J., Kramer R. A., Grosser R. C., Alegria M., Bird H. R., Bourdon K. H., et al. . (1997). Correlates of unmet need for mental health services by children and adolescents. Psychol. Med. 27, 1145–1154. doi: 10.1017/S0033291797005412, PMID: PubMed DOI

Geckova Madarasova A. (eds). (2019). National report on health and health-related behavior in 11-, 13-a 15-old school-aged children. Bratislava: WHO Country Office.

Glascoe F. P., Dworkin P. H. (1995). The role of parents in the detection of developmental and behavioral problems. Pediatrics 95, 829–836. doi: 10.1542/peds.95.6.829, PMID: PubMed DOI

Gulliver A., Griffiths K. M., Christensen H. (2010). Perceived barriers and facilitators to mental health help-seeking in young people: a systematic review. BMC Psychiatry 10, 1–9. doi: 10.1186/1471-244X-10-113, PMID: PubMed DOI PMC

Hassett A., Green C., Zundel T. (2018). Parental involvement: a grounded theory of the role of parents in adolescent help seeking for mental health problems. SAGE Open 8:786. doi: 10.1177/2158244018807786 DOI

Hawley K. M., Weisz J. R. (2005). Youth versus parent working alliance in usual clinical care: distinctive associations with retention, satisfaction, and treatment outcome. J. Clin. Child Adolesc. Psychol. 34, 117–128. doi: 10.1207/s15374424jccp3401_11, PMID: PubMed DOI

Hill C. E., Thompson B. J., Williams E. N. (1997). A guide to conducting consensual qualitative research. Couns. Psychol. 25, 517–572. doi: 10.1177/0011000097254001, PMID: PubMed DOI

Hoagwood K. E. (2005). Family-based services in children's mental health: a research review and synthesis. J. Child Psychol. Psychiatry 46, 690–713. doi: 10.1111/j.1469-7610.2005.01451.x, PMID: PubMed DOI

Jager M., De Winter A. F., Metselaar J., Knorth E. J., Reijneveld S. A. (2015). Priorities in the communication needs of adolescents with psychosocial problems and their parents. Health Expect. 18, 2811–2824. doi: 10.1111/hex.12259, PMID: PubMed DOI PMC

Kataoka S. H., Zhang L., Wells K. B. (2002). Unmet need for mental health care among US children: variation by ethnicity and insurance status. Am. J. Psychiatr. 159, 1548–1555. doi: 10.1176/appi.ajp.159.9.1548, PMID: PubMed DOI

Kazdin A. E., Holland L., Crowley M. (1997a). Family experience of barriers to treatment and premature termination from child therapy. J. Consult. Clin. Psychol. 65, 453–463. doi: 10.1037//0022-006x.65.3.453, PMID: PubMed DOI

Kazdin A. E., Holland L., Crowley M., Breton S. (1997b). Barriers to treatment participation scale: evaluation and validation in the context of child outpatient treatment. J. Child Psychol. Psychiatry 38, 1051–1062. doi: 10.1111/j.1469-7610.1997.tb01621.x, PMID: PubMed DOI

Kelly M., Coughlan B. (2019). A theory of youth mental health recovery from a parental perspective. Child Adolesc. Mental Health 24, 161–169. doi: 10.1111/camh.12300, PMID: PubMed DOI

Lackova Rebicova M., Dankulincova Veselska Z., Husarova D., Madarasova Geckova A., van Dijk J. P., Reijneveld S. A. (2019). The number of adverse childhood experiences is associated with emotional and behavioral problems among adolescents. Int. J. Environ. Res. Public Health 16:2446. doi: 10.3390/ijerph16132446, PMID: PubMed DOI PMC

Logan D. E., King C. A. (2001). Parental facilitation of adolescent mental health service utilization: a conceptual and empirical review. Clin. Psychol. Sci. Pract. 8:319. doi: 10.1093/clipsy.8.3.319 DOI

Muzi S., Pace C. S. (2020). A pilot study on alexithymia in adopted youths: prevalence and relationships with emotional-behavioral problems. Mediter. J. Clin. Psychol. 8, 1–19. doi: 10.6092/2282-1619/mjcp-2583 DOI

Nanninga M., Jansen D. E., Knorth E. J., Reijneveld S. A. (2015). Enrolment of children and adolescents in psychosocial care: more likely with low family social support and poor parenting skills. Eur. Child Adolesc. Psychiatry 24, 407–416. doi: 10.1007/s00787-014-0590-3, PMID: PubMed DOI

Ngui E. M., Flores G. (2007). Unmet needs for specialty, dental, mental, and allied health care among children with special health care needs: are there racial/ethnic disparities? J. Health Care Poor Underserved 18, 931–949. doi: 10.1353/hpu.2007.0102, PMID: PubMed DOI

Nobile C., Drotar D. (2003). Research on the quality of parent-provider communication in pediatric care: implications and recommendations. J. Dev. Behav. Pediatr. 24, 279–290. doi: 10.1097/00004703-200308000-00010, PMID: PubMed DOI

Nock M. K., Ferriter C. (2005). Parent management of attendance and adherence in child and adolescent therapy: a conceptual and empirical review. Clin. Child. Fam. Psychol. Rev. 8, 149–166. doi: 10.1007/s10567-005-4753-0, PMID: PubMed DOI

O’Brien M., Crickard E., Lee J., Holmes C. (2013). Attitudes and experience of youth and their parents with psychiatric medication and relationship to self-reported adherence. Community Ment. Health J. 49, 567–575. doi: 10.1007/s10597-012-9526-x, PMID: PubMed DOI

Ogundele M. O. (2018). Behavioral and emotional disorders in childhood: a brief overview for pediatricians. World J. Clin. Pediatr. 7, 9–26. doi: 10.5409/wjcp.v7.i1.9, PMID: PubMed DOI PMC

Oh E., Bayer J. K. (2015). Parents’ help-seeking processes for early childhood mental health problems. Child Adolesc. Mental Health 20, 149–154. doi: 10.1111/camh.12081, PMID: PubMed DOI

O'Sullivan K. R., Russell H. (2006). Parents and professionals: breaking cycles of blame. Reclaim. Children Youth 15, 37–39.

Owens P. L., Hoagwood K., Horwitz S. M., Leaf P. J., Poduska J. M., Kellam S. G., et al. . (2002). Barriers to children's mental health services. J. Am. Acad. Child Adolesc. Psychiatry 41, 731–738. doi: 10.1097/00004583-200206000-00013, PMID: PubMed DOI

Ozturk Y., Moretti M., Barone L. (2019). Addressing parental stress and adolescents’ behavioral problems through an attachment-based program: an intervention study. Int. J. Psychol. Psychol. Ther. 19, 89–100.

Paclikova K., Dankulincova Veselska Z., Madarasova Geckova A., Dijk J. P. V., Reijneveld S. A. (2020). Adolescent enrollment in psychosocial care: do parents make a difference? Int. J. Environ. Res. Public Health 17:7066. doi: 10.3390/ijerph17197066, PMID: PubMed DOI PMC

Pannebakker N. M., Kocken P. L., Theunissen M. H., van Mourik K., Crone M. R., Numans M. E., et al. . (2018). Services use by children and parents in multi-problem families. Child Youth Serv. Rev. 84, 222–228. doi: 10.1016/j.childyouth.2017.12.003, PMID: PubMed DOI

Philipp J., Zeiler M., Waldherr K., Truttmann S., Dür W., Karwautz A. F., et al. . (2018). Prevalence of emotional and behavioral problems and subthreshold psychiatric disorders in Austrian adolescents and the need for prevention. Soc. Psychiatry Psychiatr. Epidemiol. 53, 1325–1337. doi: 10.1007/s00127-018-1586-y, PMID: PubMed DOI PMC

Radovic A., Reynolds K., McCauley H. L., Sucato G. S., Stein B. D., Miller E. (2015). Parents' role in adolescent depression care: primary care provider perspectives. J. Pediatr. 167, 911–918. doi: 10.1016/j.jpeds.2015.05.049, PMID: PubMed DOI PMC

Richardson L. A. (2001). Seeking and obtaining mental health services: what do parents expect? Arch. Psychiatr. Nurs. 15, 223–231. doi: 10.1053/apnu.2001.27019, PMID: PubMed DOI

Seamark D., Gabriel L. (2018). Barriers to support: a qualitative exploration into the help-seeking and avoidance factors of young adults. Br. J. Guid. Counsell. 46, 120–131. doi: 10.1080/03069885.2016.1213372, PMID: PubMed DOI

Sun M., Rith-Najarian L. R., Williamson T. J., Chorpita B. F. (2019). Treatment features associated with youth cognitive behavioral therapy follow-up effects for internalizing disorders: a meta-analysis. J. Clin. Child Adolesc. Psychol. 48, S269–S283. doi: 10.1080/15374416.2018.1443459, PMID: PubMed DOI PMC

Wahlin T., Deane F. (2012). Discrepancies between parent-and adolescent-perceived problem severity and influences on help seeking from mental health services Australian and New Zealand. J. Psychiatry 46, 553–560. doi: 10.1177/0004867412441929, PMID: PubMed DOI

Yang Y., Qi Y., Cui Y., Li B., Zhang Z., Zhou Y., et al. . (2019). Emotional and behavioral problems, social competence and risk factors in 6–16-year-old students in Beijing China. PloS One 14:e0223970. doi: 10.1371/journal.pone.0223970, PMID: PubMed DOI PMC

Zwaanswijk M., Verhaak P. F., Bensing J. M., Van der Ende J., Verhulst F. C. (2003). Help seeking for emotional and behavioral problems in children and adolescents. Eur. Child Adolesc. Psychiatry 12, 153–161. doi: 10.1007/s00787-003-0322-6, PMID: PubMed DOI

Care providers' view of the barriers in providing care for adolescents with emotional and behavioral problems