Youth who are untreated for mental health problems are at risk for a number of consequences, including academic underachievement, substance use, delinquency, and future mental illness in adulthood. Nearly 80% of youth who need mental health services do not receive them, and of those children and families referred, it is estimated that between 30 and 80% terminate from therapy prematurely. Some common barriers to treatment retention for youth clients and families have been identified in the literature, including financial barriers, transportation and other logistical barriers, as well as therapeutic barriers, such as poor therapeutic alliance. Therefore, it is imperative to identify the most commonly used strategies for effectively overcoming barriers to treatment for youth clients and families. In order to gain a clearer understanding of common strategies being utilized to overcome barriers in treatment-as-usual settings, a qualitative examination was conducted with 36 mental health providers to determine the strategies they used with their youth and family clients. Qualitative data analysis procedures based on grounded theory were undertaken to code data collected from narrative interviews. The major themes that emerged included therapeutic relationship / rapport building, therapeutic techniques, directness / transparency, coordination of care / providing resources, providing psychoeducation, cultural acknowledgment, and clinician’s intuition. Limitations, strengths, and recommendations for future directions are discussed.

Library of Congress Subject Headings

Dissertations (PsyD) -- Psychology; Mental illness -- Treatment.; Child mental health services

Date of Award


School Affiliation

Graduate School of Education and Psychology



Degree Type


Degree Name


Faculty Advisor

Ho, Judy;