Evidence-based practice in child and adolescent mental health · 2026
Parental Influence on Mental Health Therapy for a Health Disparity Population: A Qualitative Study.
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Condon Madelaine, Nordman Caelyn, Rabadya Cecilia, Mulkern Patrick, Price Maggi A
Аннотация
BACKGROUND: Parents influence children's access and engagement in mental health therapy, through factors like parent attitudes and session attendance. This is especially true for transgender and gender-diverse (TGD) youth, who benefit most from affirming therapy - compared to non-affirming therapy - which is tailored to support a client's gender and linked with enhanced treatment engagement. To support TGD youth's ability to engage in optimal treatment, it is important to understand parent's influence on youth's therapy experiences.
OBJECTIVE: Analyze qualitative data from TGD youth, parents, and therapist to (1) understand how parents influence therapist's ability to provide affirming therapy and (2) develop research-guided recommendations for therapists.
METHODS: Mental health therapists (N = 52) who recently completed training on affirming practices for working with TGD youth responded to open-ended survey questions about how parents influence their work with TGD youth. A subset of these therapists (n = 16) completed semi-structured interviews on using affirming practices three months post-training. Interviews with TGD youth (N = 6; ages 14-22) treated by therapists trained in affirming therapy and parents (N = 3) were conducted eight months post-training. Responses and interview transcripts were analyzed via rapid and traditional content analysis, identifying ways parents influence affirming therapy and strategies to work with parents.
RESULTS: Parents influenced affirming therapy in several ways, representing five overarching themes: parents' beliefs about gender or affirming therapy; parents' therapy involvement; parents' emotions; parents' knowledge about gender or affirming therapy; and family dynamics. Strategies for working with parents included: exposure, parent training, resources, support groups, and therapist training.
DISCUSSION: We offer five recommendations for therapists working with parents of TGD youth to enhance their ability to provide affirming therapy: expose parents to TGD people through stories; train parents in gender affirmation; provide trustworthy resources; connect parents with support groups; and enhance therapists' ability to navigate parent-child conflicts.
OBJECTIVE: Analyze qualitative data from TGD youth, parents, and therapist to (1) understand how parents influence therapist's ability to provide affirming therapy and (2) develop research-guided recommendations for therapists.
METHODS: Mental health therapists (N = 52) who recently completed training on affirming practices for working with TGD youth responded to open-ended survey questions about how parents influence their work with TGD youth. A subset of these therapists (n = 16) completed semi-structured interviews on using affirming practices three months post-training. Interviews with TGD youth (N = 6; ages 14-22) treated by therapists trained in affirming therapy and parents (N = 3) were conducted eight months post-training. Responses and interview transcripts were analyzed via rapid and traditional content analysis, identifying ways parents influence affirming therapy and strategies to work with parents.
RESULTS: Parents influenced affirming therapy in several ways, representing five overarching themes: parents' beliefs about gender or affirming therapy; parents' therapy involvement; parents' emotions; parents' knowledge about gender or affirming therapy; and family dynamics. Strategies for working with parents included: exposure, parent training, resources, support groups, and therapist training.
DISCUSSION: We offer five recommendations for therapists working with parents of TGD youth to enhance their ability to provide affirming therapy: expose parents to TGD people through stories; train parents in gender affirmation; provide trustworthy resources; connect parents with support groups; and enhance therapists' ability to navigate parent-child conflicts.