McKay asks: What if you get only one treatment encounter?

April 16, 2012
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NYU researcher states that for too many children, parents decide once is enough. What can providers do?
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“Two thirds of children who need mental health services never get them,” said Mary McKay PhD, of the Silver School of Social Work at New York University. And of the one third that receive services, it is the parents, not the children, who decide to drop out from needed treatment after just one, two or three sessions.

In a day two session at the 42nd National Council Conference in Chicago, McKay said that “What happens in the early encounters influences the course of children’s lives, families, and communities. She noted that “If it’s a negative encounter, families won’t come back with their children.  And, they’ll tell others—their friends and neighbors.  They can influence the reputation of mental health providers and our profession.” And worse, she adds, “These negative feelings delay the likelihood and timing of treatment and help.”

For provider personnel, especially in urban settings, McKay asserts that it is essential to make the first treatment encounter count—as much for the parents as for the child. “Parents are people too—they really feel the stress of kids who are struggling, and of their own circumstances. They come to a treatment encounter with a sense of dread and confusion, and a fear of being blamed, being misinformed, or that they’ll have no choice in the treatment of the child,” she adds.

“Parents come to that first encounter hoping for some relief,” she explains, noting that providers ought to adopt several basic goals for the first encounter:

·         Turn dread into relief

·         Address confusion with clarity

·         Change fear into hope

·         Turn questions into answers

“It’s important for us to understand that the data suggest that parents who come to service system the first time haven’t made up their minds as to whether they’ll be back again,” states McKay. “They approach the first encounter as though they are considering whether it’s the right decision, the right approach. And they’re looking for reassurance, something to make them feel confident.  We’ve got to help them make a positive choice.”  

To that end, McKay suggested a number of key points of information that are helpful to that choice.  “Families need to know:  ‘How common is the problem with my child?’ so that they will know that they’re not alone.  They need to understand how they can help their child feel better, what the treatment options are, and how treatment works.  And, they need to know that they’ve got choices in the care that they pursue.”  The last point is especially important, she continued. “We must avoid coercing parents. We’ve got to motivate them with a sense that they are joining as a partner in treatment.” 

When families prepare to leave after the first episode of treatment, McKay suggests that provider staff ask them what they are feeling.  A sample of “positive” responses—responses that indicate openness to additional treatment— might include statements like these:

·         “Not too bad.” or “Better than I thought it would be.”

·         “I don’t feel blamed, criticized or talk down to.”

·         “People listened to us and tried to understand.”

·         “This is a common thing—lots of children and families struggle with it.”

·         “I learned something that I didn’t know.”

·         “Maybe I’ll give this another try!”

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