Background Globally, nearly 140 million children have experienced the death of one or both parents, and as a result many experience higher rates of mental health problems. Trauma-focused cognitive behavioral therapy (TF-CBT) delivered by lay counselors has been shown to improve mental health outcomes for children experiencing traumatic grief due to parental loss; however, challenges with treatment attendance limit the public health impact of mental health services. This study used qualitative methods to assess barriers and facilitators of child and guardian attendance of school-based lay counselor delivered TF-CBT. Methods Semi-structured interviews were conducted with 36 lay counselors (18 teachers; 18 community health volunteers) who delivered TF-CBT to explore their perceptions of barriers of facilitators of child and guardian attendance of group-based sessions delivered in schools. Results Counselors identified attendance barriers and facilitators related to the delivery setting, resources, participant characteristics, intervention characteristics and counselor behaviors. The findings revealed a greater number of facilitators than barriers. Common facilitators included participant and counselor resources, counselor commitment behaviors and communication efforts to encourage attendance. Barriers were less frequently endorsed, with participant resources, child or guardian illness and communication challenges most commonly mentioned. Conclusions Attention to barriers and facilitators of attendance in the context in which mental health interventions are delivered allows for identification of ways to improve attendance and treatment engagement and achieve the potential promise of providing accessible mental health services.

中文翻译：

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肯尼亚西部学校儿童和监护人参加任务转移心理健康服务的障碍和促进因素

背景 在全球范围内，近 1.4 亿儿童经历了父母一方或双方的死亡，因此许多儿童出现心理健康问题的几率更高。由非专业咨询师提供的以创伤为中心的认知行为疗法（TF-CBT）已被证明可以改善因失去父母而经历创伤性悲伤的儿童的心理健康结果；然而，治疗就诊方面的挑战限制了精神卫生服务对公共卫生的影响。本研究使用定性方法来评估儿童和监护人参加校内非专业辅导员提供的 TF-CBT 的障碍和促进因素。方法 对 36 名提供 TF-CBT 的非专业辅导员（18 名教师；18 名社区卫生志愿者）进行半结构化访谈，探讨他们对儿童和监护人参加学校小组课程的促进者的障碍的看法。结果 辅导员确定了与交付环境、资源、参与者特征、干预特征和辅导员行为相关的出勤障碍和促进因素。调查结果显示，促进因素的数量多于障碍因素。常见的促进因素包括参与者和辅导员资源、辅导员承诺行为以及鼓励参加的沟通努力。障碍较少被认可，最常提到的是参与者资源、儿童或监护人疾病以及沟通挑战。结论 在提供心理健康干预措施的背景下，关注出勤的障碍和促进因素，可以确定提高出勤率和治疗参与度的方法，并实现提供可及的心理健康服务的潜在承诺。