Adolescents’ Willingness to Attend Sessions During Mental Health Counseling Treatment and Their Ratings of the Service Quality

Abstract

Background

Collecting clients experiences of service quality has become routine for mental health services. Young people value the relational aspects of care and the usefulness of treatment, but often encounter mental health services on the initiative of others, suggesting that they may experience low volition about commencing treatment.

Methods

Using a repeated within-subjects design, adolescents’ volition in attending sessions was examined in relation to session-climate and usefulness of sessions. Data were collected at the beginning and end of treatment from 66 adolescents attending a social service facility because of mental health problems.

Results

Adolescents reporting high volition at both time points (54%) perceived the session-climate and usefulness of sessions more positively compared to those experiencing low volition at both time points (26%). Adolescents changing from high to low volition experienced a deterioration in the session-climate and did not report an improvement in how useful the sessions were. The source of referral was not related to the volition profiles. Girls were more likely than boys to experience high volition.

Conclusions

The results suggest that key factors of adolescents’ service experiences interact with their level of volition. Moreover, the source of referral may not influence the adolescent’s willingness to attend sessions.

Plain Language Summary

Why was the Study Done?

Young people see the relational aspects of care and the usefulness of treatment as key factors in service quality. However, they often encounter mental health services on the initiative of parents, school professionals, or other influential adults, suggesting that they may be at risk of a low sense of willingness in starting treatment. Also, the source of referral (self-referred or on someone else’s initiative) has been assumed to reflect willingness to attend.

What was Done

Sixty-six adolescents attending an outpatient social services facility because of mental health issues answered a questionnaire about the relational aspects of care, the usefulness of treatment sessions, and whether they attended sessions because they themselves wanted to. The questionnaire was answered at the start and at the end of treatment.

What was Found

Four willingness profiles were found: 54% of the adolescents reported high willingness at both time points, 26% reported low willingness at both time points; 10% changed from low to high willingness, and 10% from high to low willingness. Girls were more likely than boys to report high willingness. Adolescents reporting high willingness at both time points perceived the session-climate and the usefulness of the treatment sessions more positively than those experiencing low willingness at both time points. Further, the source of referral (self or other) was unrelated to willingness to attend treatment sessions.

What the Findings Mean

The results show that adolescents’ willingness to attend, their assessment of the session-climate and the usefulness of the treatment sessions are related both at the start and at the end of the treatment. Further, the study suggests gender differences in willingness, with girls reporting coming to sessions more willingly than boys. Finally, in clinical practice, adolescents’ willingness to come to sessions cannot be assumed from the source of referral alone.