Document Type
Article
Abstract
Objective: This study aimed to characterize and validate potential therapist “missteps,” or inadvertent behaviors that may impact youth and family engagement in mental health services.
Method: Ten misstep types were coded from 224 treatment sessions provided by 92 therapists. Rapid qualitative analysis using key informant interviews was conducted to examine insights related to the occurrence, expected impact, and perceived severity of therapist missteps as an indicator of the face validity of the missteps construct and types.
Results: All 10 misstep types demonstrated good reliability (Fleiss’ k = .71−.88). All 10 misstep types appeared to have facevalidity with key informants. Key informants posited case-, therapist-, and setting-level factors that may increase frequency oftherapist missteps.
Conclusion: Missteps can be reliably observed in youth psychotherapy and were deemed by community partners to be valid measures of behaviors that are potentially harmful to treatment engagement. Future directions involve exploring the impact of missteps on youth and family engagement and developing clinical supports to mitigate their occurrence and effects.
Digital Object Identifier (DOI)
Publication Info
Published in Psychotherapy Research, 2024.
Rights
© 2025 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited, and is not altered, transformed, or built upon in any way. The terms on which this article has been published allow the posting of the Accepted Manuscript in a repository by the author(s) or with their consent.
APA Citation
Park, H. S., Becker, K. D., Chu, W., Reeder, K., Lechuga, C., Ahuna, J. K., Wu, E., Darden, L., Williams, R., Serrano, R., & Chorpita, B. F. (2025). Identification of Potential Therapist “Missteps” in the Context of Engagement in Public Mental Health Services: Analysis of Digital Recordings and Key Informant Validation. Psychotherapy Research, 1–15. https://doi.org/10.1080/10503307.2025.2521792