Exploring barriers to outpatient adolescent therapeutic interventions

As many as one in five adolescents in the United States has been diagnosed with an Axis-I psychiatric disorder. Adolescents with Axis-I psychiatric disorders face significant short- and long-term consequences if they do not obtain mental health treatment. There remains a significant gap in the literature when it comes to understanding adolescent perspectives on mental health care. Research to date has focused on child and adult populations with little focus on the unique issues that are likely to impact adolescent mental health treatment. The theoretical underpinnings for understanding adolescent mental health treatment are explored in relation to adolescent psychological development, the working alliance, the Theory of Planned Behavior/Theory of Reasoned Action and the Health Belief Model.;This dissertation aimed to clinically characterize adolescents seeking mental health treatment and explore their perceptions of being referred to and attending mental health treatment. This mixed methods study explores adolescent perspectives of mental health treatment and examines the relationship between psychosocial functioning, treatment utilization and symptom abatement. The study sample consists of adolescents who were referred to mental health treatment by a school based referral program: the Student Assistance Program (SAP). Twenty-eight adolescents participated in the baseline interview and twenty-five participated in the follow-up interview. The quantitative data analysis indicated that there was a significant difference in the symptomatology between participants who obtained treatment and those who did not at the baseline time point. There were no main effects for time, and the time x treatment interaction only approached significance for one measure---the Columbia Impairment Scale. In the qualitative interviews, adolescents identified a number of themes that related to their referral and treatment experience. These themes highlight the importance of adolescent development, the working alliance and certain theoretical underpinnings for understanding adolescent actions and perceptions of mental health treatment.;Study findings suggest social work professionals can bring clarity to the referral process. Training specifically focused on meeting the unique needs of adolescents in the referral and treatment process will enhance social workers' abilities to improve service delivery. Future directions for research include the creation of an adolescent-specific treatment engagement interview.