Bridging Disciplinary Boundaries (January 11 - 14, 2007)

Purpose: Attracting and retaining adults and children to mental health treatment is a significant mental public health problem. Community mental health providers need to have a better understanding of the types of barriers their clients face. The Barriers to Treatment Participation Scale (BTPS) was developed in an academic setting using feedback from therapists; validation with clients accessing community settings is much needed. This study evaluates the BTPS in measuring barriers among a population seeking services at community mental health centers. Furthermore, since the BTPS uses subscales that were developed a priori, we used factor analysis reveal the underlying factor structure. Using those results, we created a revised 20-item BTPS, an instrument that is more relevant and useful in community settings. Methods: The BTPS was part of the assessment battery administered to the mothers. Data were obtained from participants in studies 1, 2, and 3 (N = 526). Exploratory factor analysis was performed on items 1-44 of the BTPS. Items were retained based on factor loadings and factor relevance. Results: EFA suggested two orthogonal factors, explaining 34.43% of the variance. 20 items from the original instrument were retained in these two factors. Factor one was labeled “expectations of treatment” and consists of 10 items related to the core concepts of client engagement (α = 0.868). The 10 items retained in factor two, “external demands,” relate to events and obligations that compete with getting to and staying in treatment (α = 0.766). Implications: Shorter, less cognitively complex instruments are preferable in community settings. A brief barriers instrument for screening and quality assurance can aid clinicians in meeting their clients' needs, and can aid researchers in understanding treatment access and engagement patterns. The revised version of the BTPS represents a more useful tool for addressing barriers in community settings.