Therapeutic Engagement with Adolescents with Emotional and Behavioural Disorders

The purpose of this study was to explore the degree and quality of youth engagement in the therapeutic process, as well as the factors associated with engagement in a sample of youth with an emotional and/or behaviour disorder (EBD) in residential and day treatment programs based in Southern Ontario. Cross-sectional surveys of standardized measures were administered to youth and a separate survey to their Prime Workers. Relevant constructs included client engagement (as rated by youth and Prime Workers), and youth-rated behavioural screen, family functioning, and interpersonal problems. Both Prime Workers and youth rated youth as moderate in their level of engagement in therapy. Furthermore, Prime Worker and youth ratings did not significantly differ, suggesting that youth may have actually engaged at a moderate level. Surprisingly, significantly more day treatment youth reported having mental health diagnoses than residential treatment youth, and residential treatment youth reported low scores in conduct and hyperactivity problems. Interpersonal problems were shown to be negatively associated with youth engagement, and family functioning was approaching significance after controlling for the aforementioned differences in residential and day treatment youth. Clinicians may benefit from youth engagement evaluations in practice. In future research, consideration of sociodemographic variables, resiliency promoting factors, and emotion regulation is recommended.