Are We on the Same Page? Therapist and Caregiver Agreement on Therapist Evidence-Based Strategy Use in Youth Mental Health

ABSTRACT

This study examines therapist and caregiver report of evidence-based intervention (EBI) strategy use in the context of a community effectiveness trial of An Individualized Mental Health Intervention for Autism (AIM HI), a caregiver and child skill-building mental health intervention for school-aged children with autism. This study explores whether child, caregiver, or therapist characteristics or therapist training are associated with agreement between caregiver and therapist raters. Data were drawn from a cluster randomized effectiveness trial of AIM HI, in which therapists were trained and delivered AIM HI or treatment as usual. Therapists and caregivers completed assessments at baseline. At 6 months post baseline, therapists and caregivers reported on perceptions of therapist EBI delivery across sessions. Caregiver-therapist agreement on therapist EBI strategy use was generally high, with both reporters indicating trained therapists used more extensive EBI strategies than usual care therapists. When there were significant differences between therapists and caregivers, caregivers tended to rate therapists higher on EBI strategy delivery. The presence of an internalizing co-occurring mental health diagnosis and higher levels of child behavior problems were associated with lower caregiver-therapist agreement. Therapists with more years of experience and those with self-identified autism expertise had higher levels of therapist-caregiver disagreement. Results suggest that therapist EBI training results in increased report of therapist EBI strategy delivery from multiple reporters. There was general agreement between therapists and caregiver reporters. Examination of strategy ratings provides critical information about how stakeholders experience the delivery of EBI strategies in routine mental health services.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Disclaimer

The views expressed in this article are solely those of the authors and do not reflect the endorsement or the official policy or position of the National Institute of Mental Health.

Access to data

Dr. Colby Chlebowski (UCSD), Dr. Teresa Lind (SDSU) and Dr. Lauren Brookman-Frazee (UCSD) had full access to all the data in the study and take responsibility for the integrity of the data. Dr. Teresa Lind (SDSU) conducted and is responsible for the data analysis.

Additional information

Funding

This work was supported by grant R01MH094317 from the National Institute of Mental Health. The funder had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or decision to submit the manuscript for publication.