(PS11-88) Predictors and Outcomes of Parent Involvement in the Early and Active Phases of a Transdiagnostic Intervention for Youth

Youth anxiety and depression are prevalent, co-occurring, and highly familial. Involving parents in treatment may promote better outcomes for youth; however, effects vary with the degree and definition of involvement and by characteristics of the parent/family (Haine-Schlagel & Walsh 2015). The present study examined relationships between (a) two measures of parent involvement, (b) parent/family characteristics, and (c) youth outcome post-treatment. Participants included 95 youth and parents who completed 8 to 12 Brief Behavioral Therapy (BBT) sessions (Weersing et al., 2017). Parent engagement was defined as parents’ support of and participation in youth’s treatment, rated by therapists on a 5-point scale each session. Parent attendance was defined as the number of minutes parents spent in session. Mean ratings of engagement and attendance were calculated for (a) early, didactic (sessions 2-4) and (b) active, practice (sessions 6-11) phases of BBT. Independent-samples t-tests and Pearson correlation coefficients were used to assess relationships between involvement and parent/family characteristics. Attendance was significantly predicted by ethnicity and youth age, with Latinx parents and parents of younger youth spending more minutes in both early (t(35) = -4.28, p < .001; r(88) = -.27, p = .011) and active (t(26) = -3.92, p < .001; r(88) = -.23, p = .030) treatment sessions. Lower parent engagement early in treatment was predicted by higher baseline parental depression (r(89) = -.31, p = .003) and anxiety (r(89) = -.28, p = .007). Similarly, lower engagement during active treatment was predicted by parental depression (r(86) = -.35, p < .001) and anxiety (r(86) = -.27, p = .011) and by lower family income (r(67) = .27, p = .026). Relationships between parent involvement measures and youth outcomes were tested with multiple linear regressions. Parent/family characteristics that significantly predicted involvement in previous analyses were included as covariates (i.e., youth age, ethnicity, family income, baseline parent depression, baseline parent anxiety). Baseline values of each outcome measure were also included in analyses predicting that outcome at post-treatment. Youths with more engaged parents had lower levels of anxiety post-treatment, with both early (β = -2.284, p < .001) and active engagement (β = -1.592, p = .018) significantly predicting anxiety outcomes. Furthermore, better youth functioning post-BBT was predicted by early parent engagement (β = 4.088, p = .003). Parent attendance was not significantly associated with youth post-treatment anxiety or functioning, and neither engagement nor attendance predicted youth depression outcomes. Taken together, the findings indicate that carefully calibrated parent involvement, informed by each family's unique needs and cultural preferences, is critical to promoting youth treatment success. Future efforts to facilitate involvement may benefit from engaging with and addressing the needs of parents who may be economically stressed or psychologically vulnerable.