Date of Award

Spring 2017

Degree Type


Degree Name

Master of Science (MS)


Department of Counselor Education

First Advisor

Dr. Patricia Goodspeed


A reported one in five children in the United States lives with a diagnosable mental illness, but only about 20% receive adequate treatment and approximately 40-60% of those drop out before achieving treatment goals and/or without the agreement of the therapist. This study examines the perceptions of clinicians working in a child and adolescent community mental health clinic regarding the barriers clients face as well the strategies they utilize to enhance engagement and treatment adherence. Results support existing literature and indicate that parents play the most significant role in treatment adherence and that logistical barriers such as transportation and finding childcare are most common. Participants also reported using several engagement strategies known to promote the therapeutic alliance and treatment adherence such as involving family in treatment planning and providing crisis intervention. Limitations to the study and implications for counseling practice are also discussed.