The impact of caregiver treatment satisfaction upon child and parent outcomes

Background: Parental perceptions about treatment influence their child's engagement in and ongoing utilization of mental health services, but less is known about the association between caregiver expectancies and family outcomes. The literature is particularly lacking with families of color, who are at high risk for the onset and perpetuation of disruptive behaviors. Methods: The purpose of this study was to examine caregiver treatment satisfaction among 320 youth of color aged 7–11 and their families who were assigned to either a Multiple Family Group intervention or services-as-usual condition. Caregiver stress was measured by the Parenting Stress Index-Short Form full scale and child oppositional defiant behaviors were measured using the Iowa Connors Rating Scale–Oppositional/Defiant subscale both at baseline and post-test. Satisfaction with treatment was measured using the Metropolitan Area Child Study process measures program satisfaction subscale at post-test. Results: The two main effects models that focused on satisfaction with treatment were predictive of parental stress and child oppositional defiant behaviors independently. Satisfaction with treatment accounted for 31% of the variance in child oppositional behavior and 24% of parental stress improvements across time, holding all covariates constant. Conclusions: Our findings support previous research that shows parental expectancies, including treatment satisfaction, are powerful mechanisms of treatment outcomes for children with disruptive behavior disorders as well as parental emotional health. Furthermore, parental expectancies may be enhanced by the involvement of families in the development of treatment approaches for children and a greater focus on caregiver emotional health for the benefit of the family as a whole.