Child and parent engagement in the mental health intervention process: a motivational framework

Scoping studies are increasingly undertaken as distinct activities. The interpretation, methodology and expectations of scoping are highly variable. This suggests that conceptually, scoping is a poorly defined ambiguous term. The distinction between scoping as an integral preliminary process in the development of a research proposal or a formative, methodologically rigorous activity in its own right has not been extensively examined. The aim of this review is to explore the nature and status of scoping studies within the nursing literature and develop a working definition to ensure consistency in the future use of scoping as a research related activity. This paper follows an interpretative scoping review methodology. An explicit systematic search strategy included literary and web-based key word searches and advice from key researchers. Electronic sources included bibliographic and national research register databases and a general browser. The scoping studies varied widely in terms of intent, procedural and methodological rigor. An atheoretical stance was common although explicit conceptual clarification and development of a topic was limited. Four different levels of inquiry ranging from preliminary descriptive surveys to more substantive conceptual approaches were conceptualised. These levels reflected differing dimensional distinctions in which some activities constitute research whereas in others the scoping activities appear to fall outside the remit of research. Reconnaissance emerges as a common synthesising construct to explain the purpose of scoping. Scoping studies in relation to nursing are embryonic and continue to evolve. Its main strengths lie in its ability to extract the essence of a diverse body of evidence giving it meaning and significance that is both developmental and intellectually creative. As with other approaches to research and evidence synthesis a more standardized approach is required.

Barriers to participation in treatment were proposed as a basis for dropping out of treatment among children seen in outpatient therapy. Families (N = 242) of children referred for treatment for oppositional, aggressive, and antisocial behavior participated. The main findings were that (a) barriers to participation in treatment contributed significantly to dropping out of therapy; (b) perceived barriers to treatment were not explained by family, parent, and child characteristics that also predicted dropping out; and (c) among families at high risk for dropping out of treatment, the perception of few barriers attenuated risk. Parent perceptions of the difficulties of participating in treatment (including stressors and obstacles associated with treatment, perceptions that treatment is not very relevant, and a poor relationship with the therapist) influenced who dropped out.

This meta-analysis examines associations between therapeutic relationship variables, and the extent to which they account for variability in treatment outcomes, in 49 youth treatment studies. Correlations between therapeutic relationship variables ranged from modest to strong. Among the best predictors of youth outcomes were counselor interpersonal skills, therapist direct influence skills, youth willingness to participate in treatment, parent willingness to participate in treatment, youth participation in treatment, and parent participation in treatment. Adequacy of current approaches to conceptualizing and measuring therapeutic relationship variables, such as the therapeutic alliance, in youth and family therapy is discussed. This paper represents the most comprehensive analysis of therapeutic relationship constructs in the youth treatment literature.