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Posted February, 2002

Why Are We Here at the Clinic? Parent versus Child Reports of Children's Problems at Entry into Treatment

Many studies have revealed low to moderate agreement between different informants' reports about children's problems. Agreement is usually highest between pairs of adults who play similar roles with respect to the children, such as pairs of parents and pairs of teachers. Agreement is lower between adults who play different roles and see children in different contexts, such as parents vs. teachers. And agreement is still lower between adults and the children themselves. Agreement between informants may be limited by differences in the behavior that the informants know about, differences in what they remember, and differences in their thresholds for reporting particular problems. Agreement between adults and children may also be limited by children's inability to conceptualize and report problems, as well as by differences in what adults and children consider to be problematic. Inconsistencies may be especially crucial when children are brought for mental health services, because they may bias interventions toward either the adults' views or the children's views. To shed light on these issues, UCLA researchers May Yeh and John Weisz (2001) tested agreement between parents' and children's reports of the problems for which the children most needed help when the children were brought for mental health services. The participants were 381 7-18-year-olds and their parents who were seen at 9 California mental health clinics. The CBCL and YSR were administered by interviewers. Agreement was assessed in terms of specific problems identified by each parent and child pair as the major problems for which help was needed. Agreement was also assessed in terms of categories of problems, which were defined according to the 8 cross-informant syndromes derived from the CBCL, TRF, and YSR. Yeh and Weisz found that only 37% of the parent-child pairs agreed on at least one specific problem, although 66% agreed on at least one cross-informant syndrome. The researchers concluded that "The extent to which parents and children agree on problems for which they want help may affect their ability to work together in pursuit of therapy goals . . . And conversely, parent-child disagreement may be one factor that contributes to the poor outcomes often associated with conventional clinic-based treatment for children" (p. 1024). To help mental health professionals pinpoint particular agreements and disagreements, ASEBA software compares scores obtained from up to 8 informants per child. The software also displays correlations between problem scores for each pair of informants in relation to correlations obtained for large reference samples of similar informants. By identifying specific agreements and disagreements and the overall level of agreement between parents, their children, and other informants, mental health professionals can tailor interventions more precisely to each individual case.

Reference: Yeh, M., & Weisz, J.R. (2001). Why Are We Here at the Clinic? Parent-Child (Dis)Agreement on Referral Problems at Outpatient Treatment Entry. Journal of Consulting and Clinical Psychology, 69, 1018-1025.


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