Family Engagement and Involvement in Trauma Mental Health

An introduction to the topic from Teresa Huizar, Executive Director, National Children's Alliance.

Key Points for CAC Directors to Know

What is Family Engagement?

Family engagement is the process of identifying, enrolling, and retaining families in treatment services. Because caregivers play a crucial role in the physical and emotional development of their children, it is critical that parents are also involved in their child’s mental health treatment. While attendance is important, true engagement is motivating and empowering families to recognize their own needs, strengths, and resources and to take an active role in changing things for the better.

Why is Family Engagement so Important to Helping Children Heal?

Evidence-based practices for children exposed to trauma frequently involve treatment for both the child and their primary caregivers. Research has identified that involving caregivers in treatment services significantly increases the likelihood of positive outcomes for children. Engaged caregivers aid the treatment process by ensuring the child's attendance and participation in treatment to completion. Further, as the experts in their children, caregivers can aid clinicians in increasing treatment compliance and the practice of skills at home. Engaged caregivers provide their children with additional supports that significantly increase their likelihood of success. 

What are Potential Barriers to the Child and Caregiver Actually being Engaged in Treatment?

A number of barriers are likely to impede family engagement in child trauma services. Caregivers may face internal barriers such as personal mental health issues, medical problems, limited cognitive capacity, substance abuse, or emotional dependency. Further, a caregiver’s own fears, past negative experiences with mental health treatment, or a cultural belief system that prevents them from valuing or utilizing mental health treatment may also contribute to their decreased engagement. External barriers such as scheduling conflicts, financial and economic struggles, lack of access to transportation or child care, and family stressors may complicate this issue further.  

Whatever barriers families face, it is critical that the MDT recognizes and works to identify family and community resources that can aid in decreasing these barriers, allowing families to successfully engage.

What Specific Strategies Can be Used to Enhance Family Engagement?

Research has clarified a number of strategies that can be used to enhance family engagement in the treatment process. Prior to the onset of services, MDT partners should strive to identify barriers that may arise for each family. Upon first contact with the caregiver, the treatment process should be clarified and a foundation should be established for a collaborative working relationship. Service providers may use this time to build positive expectations for therapy by emphasizing the evidence supporting treatment as well as a brief rationale for the services. Following meeting with the family, providers should strive to focus on immediate, practical concerns of the family such as barriers to transportation or scheduling conflicts. Personal barriers such as negative beliefs about mental health treatment or significant family life stressors should also be discussed at this time. Services can be modified as necessary to support the families’ success in treatment. MDT partners should work collaboratively to overcome these barriers by identifying community resources and providing necessary education. Progress and barriers should be monitored and re-assessed throughout the course of treatment and praise should be used frequently to encourage continued engagement in the treatment process.

How Can All MDT Partners be Involved in Providing Support to Enhance Family Engagement?

While it is likely that not all MDT partners will have a strong background in providing trauma-informed care, there are certainly ways that MDT members can enhance family engagement in treatment. MDT members should first strive to gain an understanding of how trauma impacts the entire family as well as the valuable role of treatment. Once accomplished, MDT partners can support family engagement through coordination and collaboration, assessment, service plan development, and monitoring of treatment interventions.

Partners can enhance the engagement process by utilizing their specific backgrounds and skill sets. For example, Law Enforcement can provide information to the court system regarding the need for treatment following the investigation process. Child Protective Services can utilize trauma screening and assessment to identify treatment needs, monitor treatment progress, and make recommendations regarding safety and placement based on the outcome of treatment. Mental Health partners can advocate for the benefits of treatment, provide detailed information on treatment options, and monitor families' engagement through completion of treatment services. Lastly, Victim Advocates can support the family by promoting the benefits of treatment and advocating for each families' unique needs to eliminate barriers to treatment completion before they begin.


Questions and Answers

Q: What is Family Engagement?

 Jennifer Shields, a Doris Duke Research Fellow, defines family engagement.



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Q: Why is Family Engagement so Crucial to Helping Families Heal?

Jennifer Shields, a Doris Duke Research Fellow, describes the importance of family engagement.


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Q: What are Potential Barriers to the Family Being Engaged in Treatment?

Jennifer Shields, a Doris Duke Research Fellow, lists the barriers to family engagement.


Length of the audio - 1 minute and 00 seconds

Q: What Specific Strategies Can be Used to Enhance Family Engagement?

Jennifer Hossler, a Child Welfare Systems Change Specialist, identifies strategies for family engagement.



Length of the video - 1 minute and 18 seconds

Q: How Can all MDT Partners be Involved in Providing Support to Enhance Family Engagement?

Jennifer Shields, a Doris Duke Research Fellow, discusses how all MDT partners can be involved in family engagement.




Length of the audio - 1 minute and 01 seconds


Additional Resources

Click here to download a printable summary of the information on this page.
This report explores key themes emerging from the research literature on family engagement in child mental health services and identifies evidence based strategies to promote the engagement of families.