(PS10-11) Associations Between Barriers to Treatment Participation and Motivation for Treatment Among caregivers of Juvenile Legal System-involved Youth

Abstract Text: Many youth involved in the juvenile legal system (JLS) have difficulty accessing treatment (Rawal et al., 2004; Yonek et al., 2019). Caregivers of these youth are typically responsible for getting their children into treatment (Cauce et al., 2002). However, caregivers experience barriers to accessing treatment for their child, including practical issues such as lack of transportation, lack of insurance, and a shortage of providers. Caregiver expectations and attitudes towards treatment (e.g., stigma, relevance of care, and provider rapport) may further serve as barriers. Work by Shepherd and colleagues (2019) demonstrated that caregiver attitudes towards interventions account for significant variance in treatment outcomes for JLS-involved youth. Therefore, it is important to understand their perceptions of the relevance of treatment alongside barriers to treatment participation. We examined how caregiver-reported barriers to treatment participation are associated with caregiver-reported motivation for the youth’s treatment among a sample of youth with JLS involvement. The sample includes caregivers of youth recruited from a family court diversionary program. Caregivers (n = 199) identified 41% as White, 15% as Black, 5% as American Indian, 14% as Multiracial, and 23% as Other. Additionally, 38% of the caregivers identified as Hispanic/Latinx. Caregivers completed the Motivation for Youth’s Treatment Scale – caregiver version (MYTS; Breda & Riemer, 2012) and the Barriers to Treatment Participation Scale (BTPS; Kazdin et al., 1997). The MYTS is an 8-item caregiver-reported measure of their intrinsic motivation to support the youth’s treatment engagement and includes Problem Recognition and Readiness for Treatment subscales. The BTPS is a 58-item caregiver-reported measure that assesses Stressors and Obstacles that compete with treatment. We conducted linear regression models (n = 199) to examine whether particular perceived barriers to treatment were associated with caregiver-reported motivation for treatment (i.e., problem recognition and readiness for treatment). Covariates in the model included caregiver age and caregiver gender. The model for caregiver-reported readiness for treatment was not significant; however, the model for problem recognition was significant. Barriers to treatment participation accounted for a significant portion of variance in problem recognition (R² = 0.20). Specifically, measures of reported demands (β = -.19, p</em> = .032) and treatment irrelevance (β = .13, p</em> < .001) significantly predicts variance. Our results indicated that perceived barriers to treatment were associated with caregiver’s motivation for youth treatment, such that the expected demands of treatment were inversely related to the problem recognition and the expected irrelevance of treatment was positively associated with problem recognition. These findings suggest that providing psychoeducation regarding expected treatment demands and treatment relevance may increase the caregiver’s motivation with JLS-involved youth to engage in treatment. This work has implications for improving access for treatment among this vulnerable population.