Abstract
Untreated mental disorder is a major problem, and barriers to care are not well understood. Four hundred and sixty-two mothers bringing children to community mental health centers reported barriers on the BTPS. Exploratory factor analysis (EFA) was performed on the first split-half sample to identify factor structure. Confirmatory factor analysis (CFA) was performed on the remaining half sample using structural equation modeling. EFA revealed two factors measuring “treatment expectations” and “external demands.” CFA revealed good model fit for this two-factor solution. This analysis contributes to ongoing empirical validation of barriers measures in community settings, emphasizing the development of a short, community applicable measure.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Anderson, C. M., Robins, C. S., Greeno, C. G., Cahalane, H., Copeland, V. C., & Andrews, R. M. (2006). Why low-income mothers do not engage with the formal mental health care system: Perceived barriers to care. Qualitative Health Journal, 16, 926–943.
Armbruster, P., & Fallon, T. (1994). Clinical, sociodemographic, and systems risk factors for attrition in a children’s mental health clinic. American Journal of Orthopsychiatry, 64, 577–585.
Armbruster, P., & Kazdin, A. E. (1994). Attrition in child psychotherapy. Advances in Clinical Child Psychology, 16, 81–108.
Bentler, P. M. (2004). EQS 6 structural equations program manual. Encino, CA: Multivariate Software.
Child and Adolescent Health Measurement Initiative (2005). National survey of children with special health care needs. Data Resource Center on Child and Adolescent Health website. Retrieved 01/25/06 from www.cshcndata.org.
Compton, M. T. (2005). Barriers to initial outpatient treatment engagement following first hospitalization for a first episode of nonaffective psychosis: A descriptive case series. Journal of Psychiatric Practice, 11, 62–69.
Craske, M. G., Edlund, M. J., Sullivan, G., Roy-Byrne, P., Sherbourne, C., Bystritsky, A., & Stein, M. B. (2005). Perceived unmet need for mental health treatment and barriers to care among patients with panic disorder. Psychiatric Services, 56, 988–994.
Flisher, A. J., Kramer, R. A., Grosser, R. C., Alegria, M., Bird, H. R., Bourdon, K. H., Goodman, S. H., Greenwald, S., Horwitz, S. M., Moore, R. E., Narrow, W. E., & Hoven, C. W. (1997). Correlates of unmet needs for mental health services by children and adolescents. Psychological Medicine, 27, 1145–1154.
Garcia, J. A., & Weisz, J. R. (2002). When youth mental health care stops: Therapeutic relationship problems and other reasons for ending youth outpatient treatment. Journal of Consulting and Clinical Psychology, 70, 439–443.
Gorsuch, R. L. (1983). Factor Analysis (2nd ed.). Hillsdale, NJ: Erlbaum.
Greeno, C. G., Anderson, C. M., Stork, E., Kelleher, K. J., Shear, M. K., & Mike, G. (2002). Return to treatment after assessment in a community children’s mental health clinic. Psychiatric Services, 53, 624–626.
Greeno, C., Colonna-Pydyn, C., & Shumway, M. (in press). The need to adapt standardized outcomes measures for community mental health. Journal of Health and Social Policy.
Howard, K. I., Cornille, T. A., & Lyons, J. S. (1996). Patterns of mental health service utilization. Archives of General Psychiatry, 53, 696–703.
Katon, W. J., & Ludman, E. J. (2003). Improving services for women with depression in primary care settings. Psychology of Women Quarterly, 27, 114–120.
Kazdin, A. E., Holland, L., & Crowley, M. (1997a). Family experience of barriers to treatment and premature termination from child therapy. Journal of Consulting and Clinical Psychology, 65, 453–463.
Kazdin, A. E., Holland, L., Crowley, M., & Breton, S. (1997b). Barriers to treatment participation scale: Evaluation and validation in the context of child outpatient treatment. Journal of Child Psychology and Psychiatry, 38, 1051–1062.
Kendall, P. C., & Sugarman, A. (1997). Attrition in the treatment of childhood anxiety disorders. Journal of Consulting and Clinical Psychology, 65, 883–888.
Kline, P. (1998). The new psychometrics. New York, NY: Routledge.
Kline, R. B. (2005). Principles and practice of structural equation modeling (2nd ed.). New York, NY: Guilford Press.
Kouyoumdjian, H., Zamboanga, B. L., & Hansen, D. J. (2003). Barriers to community mental health services for Latinos: Treatment considerations. Clinical Psychology: Science and Practice, 10, 394–422.
Matthews, A. K., & Peterman, A. H. (1998). Improving provision of effective treatment for racial and cultural minorities. Psychotherapy, 35, 291–305.
Mitrani, V. B., Prado, G., Feaster, D. J., Robinson-Batista, C., & Szapocznik, J. (2003). Relational factors and family treatment engagement among low-income, HIV-positive African American mothers. Family Process, 42, 31–45.
Nock, M. K., & Kazdin, A. E. (2001). Parent expectancies for child therapy: Assessment and relation to participation in treatment. Journal of Child and Family Studies, 10, 155–180.
Norquist, G. S., & Regier, D. A. (1996). The epidemiology of psychiatric disorders and the de facto mental health care system. Annual Review of Medicine, 47, 473–479.
Owens, P. L., Hoagwood, K., Horwitz, S. M., Leaf, P. J., Poduska, J. M., Kellam, S. G., & Ialongo, N. S. (2002). Barriers to children’s mental health services. Journal of the American Academy of Child and Adolescent Psychiatry, 41, 731–738.
Sanders Thompson, V. L., Bazile, A., & Akbar, M. (2004). African Americans’ perceptions of psychotherapy and psychotherapists. Professional Psychology: Research and Practice, 35, 19–26.
Swartz, H. A., Shear, M. K., Wren, F. J., Greeno, C. G., Sales, E., Sullivan, B. K., & Ludewig, D. P. (2005). Depression and anxiety among mothers who bring their children to a pediatric mental health clinic. Psychiatric Services, 56, 1077–1083.
Thompson, B. (2004). Exploratory and confirmatory factor analysis: Understanding concepts and applications. Washington, DC: American Psychological Association.
Wells, K. B., Miranda, J., Bauer, M. S., Bruce, M. L., Durham, M., Escobar, J., Ford, D., Gonzalez, J., Hoagwood, K., Horwitz, S. M., Lawson, W., Lewis, L., McGuire, T., Pincus, H., Scheffler, R., Smith, W. A., & Unützer, J. (2002). Overcoming barriers to reducing the burden of affective disorders. Biological Psychiatry, 52, 655–675.
Author information
Authors and Affiliations
Corresponding author
Additional information
Presented at the annual meeting of the Society for Social Work and Research, January 13, 2007.
Rights and permissions
About this article
Cite this article
Colonna-Pydyn, C., Gjesfjeld, C.D. & Greeno, C.G. The Factor Structure of the Barriers to Treatment Participation Scale (BTPS): Implications for Future Barriers Scale Development. Adm Policy Ment Health 34, 563–569 (2007). https://doi.org/10.1007/s10488-007-0139-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10488-007-0139-6