Additionally, recent findings suggest reciprocal relationships between parental behavior and youth mental
health (Bradley and Corwyn 2013; Roche et al. 2011; Wang et al. 2011; Williams and Steinberg 2011). The
strength and reciprocity of these relationships may be more relevant to treatment-seeking youth compared with community youth. When youths’ mental health problems are severe enough that families seek treatment, these problems have likely resulted in disruptions or changes to parenting
behaviors (e.g., Bradley and Corwyn 2013; Wang et al.
2011). For example, youth with externalizing problems may be expelled from school or become involved in the
juvenile justice system, while youth with internalizing problems may require additional caretaking or parental
advocacy for school accommodations. As a result, parents may experience elevated parenting stress and psychopathology, and struggle to communicate, even if they have positive communication skills in less stressful situations.
Given the potential for this strong reciprocal relationship, it is important to examine the family stress model in treatment-seeking populations to determine if interventions should initially aim to reduce youth symptoms through
parenting or through other means.