Aspects of mental health communication skills training that predict parent and child outcomes in pediatric primary care

Patient Educ Couns. 2011 Feb;82(2):226-32. doi: 10.1016/j.pec.2010.03.019. Epub 2010 May 5.


Objective: Training in communication can change clinician behaviors, but brief training may function by altering attitudes rather than teaching new skills. We used data from a trial of mental health training for office-based primary care to determine indicators of uptake that predicted parent and child outcomes.

Methods: Clinicians (n=50) were randomized to be controls or receive training. Uptake was determined comparing pre- and post-training visits with standardized patients (SPs) coded for skills and patient centeredness. Clinical outcomes were assessed by recruiting and following 403 children/youth ages 5-16 making visits to participants. At 6 months, change in mental health was assessed by parent and youth reports using the Strengths and Difficulties Questionnaire.

Results: Trained clinicians used more agenda setting, time, and anger management skills than controls and showed increased patient centeredness toward SP parents, but not adolescents. Increased patient-centeredness toward parents predicted improvement in child/youth symptoms and functioning (rated by parents), and improvement in youth-rated symptoms. Increased skills alone were not associated with improvement, but patients of clinicians above the mean for both skill and patient-centeredness change improved most.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Attitude of Health Personnel
  • Child
  • Child, Preschool
  • Clinical Competence / statistics & numerical data
  • Communication*
  • Community Mental Health Services*
  • Confidence Intervals
  • District of Columbia
  • Educational Measurement
  • Educational Status
  • Female
  • Health Care Surveys
  • Humans
  • Male
  • Maryland
  • Mental Health*
  • New York
  • Patient-Centered Care
  • Pediatrics / education*
  • Physician-Patient Relations*
  • Primary Health Care / methods*
  • Psychometrics
  • Referral and Consultation
  • Statistics as Topic
  • Surveys and Questionnaires
  • Treatment Outcome