An Examination of Treatment Completers and Non-Completers at a Child and Adolescent Community Mental Health Clinic

Abstract

This study examined sociodemographic and clinical characteristics of treatment completers (N = 114) and non-completers (N = 136) at a child and adolescent community mental health clinic. Results indicated that children who completed treatment significantly differ from those who prematurely drop out of treatment. Noncompleters presented with considerably more impairment in functioning and psychiatric symptoms, and their caregiver reported experiencing significantly more parenting stress and depressive symptoms. Results suggest that mental health treatment is not readily provided to the most difficult to reach and most at-risk youth and their families.

Examination of risk factors for dropout in a child and adolescent psychiatry outpatient clinic

“…Absence of a father figure, large household size, 25 socioeconomic disadvantage, single-parent household, severity and disruptive nature of the child's s symptoms, 26 stress and depression in parents, 27 that have been shown to predict treatment attrition have not been replicated in the present study. Having diagnosis of an externalizing disorder given by the clinician and externalizing problems reported by teachers and parents were reported to be strong child-related predictors of dropout in a meta-analytic review.…”

Integrity of Evidence-Based Practice: Are Providers Modifying Practice Content or Practice Sequencing?

“…Given that subsequent service use is likely associated with youths' level of psychopathology at posttreatment and that treatment effects may be limited for youths who prematurely drop out of therapy (e.g., no show for their remaining treatment sessions; discontinue services due to a change in health insurance) (e.g., Pellerin, Costa, Weems, & Dalton, 2010), this study examined service use for a subsample of youths who had a routine termination from therapy (n = 82) in addition to the full sample. Youths in the Standard condition were classified as having a routine termination once their assigned treatment protocol was completed; youths in the Modular condition were classified as having a routine termination if agreed upon by the Principal Investigators, who reviewed and discussed the youths' therapeutic progress and outcomes on a weekly basis; and youths in UC were classified as having a routine termination when agreement to end the episode of care was reached amongst the family, provider, and study investigators.…”

Do Parent Perceptions Predict Continuity of Publicly Funded Care for Attention-Deficit/Hyperactivity Disorder?

“…45,46 Child, parent, and system-level factors are posited to influence access to and use of mental health services, yet whether parent perceptions about care are predictiveof stayinginlonger term ADHD treatment is less established. Influential individual-level characteristics for mental health service use include child sociodemographic characteristics, 43,[47][48][49][50] clinical severity, 49,[51][52][53][54] and parental mental health. 51,52,[54][55][56][57][58][59] In addition, parentperceived barriers to care 50,60 and attitudes are hypothesized to affect access to and continuity of care, such as stigma, [61][62][63][64][65] recognition of symptoms or a problem, [66][67][68][69] and receptivity to stimulant medication treatment.…”

“…67,70 -72 On the system level, the considerable overlap in mental health and special education service use may increase the likelihood of staying in care through shared problem recognition and monitoring. 49,51,73 However, across these studies, continuity of care is broadly and variably defined, ranging from accessing care 43,49,51 to premature termination of long-term behavioral therapy, 50 and the outpatient setting is restricted to primary care, 53 specialty mental health, 47,48,50,54,56,57 or is unspecified. 49,51 This study had 2 objectives.…”