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Symposia

Dissemination & Implementation Science

Socio-Ecological Perspectives on Assessing and Intervening on Barriers to Psychological Treatment Among Diverse Adolescents and Young Adults

2 - (SYM 71) A Mixed Methods Approach to Assessing Socio-ecological Barriers to Engagement in a Brief Trauma-focused Intervention Imbedded in Primary Care

Sunday, November 23, 2025
2:18 PM - 2:32 PM CST
Location: Empire C, Level 2
Keywords: Adolescents, College Students, Mental Health Disparities
Recommended Readings: Mongelli, F., Georgakopoulos, P., & Pato, M. T. (2020). Challenges and opportunities to meet the mental health needs of underserved and disenfranchised populations in the United States. Focus (American Psychiatric Publishing), 18(1), 16–24. https://doi.org/10.1176/appi.focus.20190028,   Garney, W., Wilson, K., Ajayi, K. V., Panjwani, S., Love, S. M., Flores, S., Garcia, K., & Esquivel, C. (2021). Social-ecological barriers to access to healthcare for adolescents: A scoping review. International Journal of Environmental Research and Public Health, 18(8), 4138. https://doi.org/10.3390/ijerph18084138,   Benton, T.D., Boyd, R.C., Njoroge, W.F. (2021). Addressing the global crisis of child and adolescent mental health. JAMA Pediatrics,175(11),1108–1110. doi:10.1001/jamapediatrics.2021.2479,   ,  
Abstract Body
Low treatment engagement is a significant, and common, barrier to symptom improvement among diverse youth receiving evidence-based psychotherapy interventions. There has been significant research into socio-ecological factors that may predict problems with treatment engagement, but findings have been inconsistent across studies with no current “gold standard” method of assessing barriers to engagement. The goal of this mixed methods study was to pilot test a novel approach to assessing individual, interpersonal, and structural barriers to psychotherapy engagement during a randomized control trial of a brief, trauma-focused, intervention delivered in a primary care setting. Of note, embedding psychological interventions within primary care settings has been proposed as a promising approach to improve treatment engagement among diverse youths. Preliminary results from nine participants will be described in this presentation. The average age of the participants was 16.67 years old, the majority identified as Hispanic, and all were low income. When asked prospectively, all participants identified at least one possible anticipated barrier to treatment engagement. Consistent with previous research, there were significant challenges with engagement in this study, with participants most likely to identify individual level barriers to treatment participation and least likely to identify structural level barriers. Notably, participants were more likely to identify a range of barriers to treatment when assessed quantitatively as compared to qualitatively. In particular, participants were unlikely to identify interpersonal-level barriers to engagement (e.g. experiences of interpersonal mental health stigma) when assessed qualitatively. When taken together, results highlight promising strategies of assessing and, ultimately, intervening on barriers to treatment engagement in integrated primary care settings.