Caregiver Perceptions of the Potential Utility of a Specialized Family Peer Program for Anxious Youth

Caregivers of anxious youth face significant and unique barriers to accessing evidence-based care for their children. Family Peer (FP) support is a promising strategy used within children’s mental health services to address barriers to accessing and engaging in mental health treatment. However, it has not yet been developed or tested specifically for caregivers of anxious youth. This study gathered perspectives from caregivers who scheduled but did not attend their initial appointment at a specialized pediatric anxiety clinic in a Northeastern city in the United States. We purposely recruited caregivers with either public (Medicaid) or private commercial insurance (provided through an employer). Twelve recruited caregivers completed qualitative interviews to report on barriers and facilitators to accessing mental health services and their perceptions of the potential utility of FP support. They also provided brief quantitative ratings of the utility of different types of support that FPs can provide. Caregivers described significant barriers to accessing care. They shared positive reactions and interest in engaging with FP support. They expressed importance of the FP having a child of similar age and sharing diagnostic features. Themes differed between Medicaid-insured and commercially-insured families. Overall, Medicaid-insured families expressed more interest in engaging with FP support in interviews and provided significantly higher quantitative ratings of the potential utility of FP support for four of six types of support queried. We also observed differences by insurance status for other key themes, including preferences for how they would want the FP to support families and descriptions of how FP support might be most helpful. Results of this study will be used to guide the development of an FP program specifically tailored for caregivers of youth with pediatric anxiety disorders. We also discuss the broader implications of these findings related to the potential of FP support for pediatric anxiety. Family Peer (FP) support shows promise in the broader child mental health literature but has not yet been developed or tested specifically for caregivers of anxious youth. This study interviewed caregivers of anxious youth who scheduled but did not attend an initial appointment at a specialty pediatric anxiety clinic. Results discuss barriers and facilitators to attending the appointment, as well as perceptions of the potential utility of FP support. FP support was deemed acceptable and of interest to caregivers in the sample, with differences observed by insurance type. We discuss how these findings inform the development of a pediatric anxiety specific FP program at our clinic as well as the broader policy implications of these findings.