20.2 Service Use Differences for Families Who Participated in an Evidence-Based Preschool Mental Health Intervention

Abstract

Little is known about family service use patterns following participation in psychotherapeutic interventions for high-risk children. Ideally, the need for, and use of, subsequent services for domains targeted in the original intervention would decrease, whereas engagement in typical community activities (eg, recreation) and services addressing complementary needs (eg, parent mental health problems) would increase. This study aimed to determine whether this pattern occurred for families following participation in an evidence-based preschool intervention. Data were available at 12 months follow-up for 86% of a baseline sample composed of 104 children (mean age = 41 [SD 10] months) randomized to a preschool version of the Family Check-Up (a family management intervention with a parenting skill component) and 103 (mean age = 41 [SD 11] months) to a community comparison. A standardized service use interview of the primary caregiver (mostly biological mothers) was completed 12 months following intervention initiation. The 2 groups were contrasted using χ2 analyses on the use of recreation services, parenting programs, and child and parent counseling. The statistical significance level was set at p < 0.05. The service receipt for the community comparison (CC) and intervention group (IG) was 8% and 9% for other parenting programs and 14% and 8% for child counseling, respectively. The use of these services was not significantly lower for the intervention group as hypothesized. The service receipt for the CC and IG was 61% and 59% for formal recreation activities (eg, sports, arts) and 29% and 37% for counseling for parents, respectively. The use of these services was not significantly higher for the intervention group as hypothesized. None of the hypothesized service patterns was found postpreschool intervention. Psychotherapeutic interventions may need to have more explicit service use outcome targets with explicit strategies to achieve them if they are to result in postintervention service changes. However, there is also a need for a more detailed examination of service availability and accessibility to better understand how service contexts may shape service use patterns.