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Attrition in Child Psychotherapy

  • Chapter
Advances in Clinical Child Psychology

Part of the book series: Advances in Clinical Child Psychology ((ACCP,volume 16))

Abstract

Attrition or loss of cases poses a significant problem in the evaluation and delivery of children’s psychiatric services (Garfield, 1986; Howard, Krause, & Orlinsky, 1986; Stark, 1992). From 28% to 59% of children and families drop out from treatment (Gould, Shaffer, & Kaplan, 1985). Since two-thirds of children in need of mental health intervention already fail to receive this service (U.S. Congress, 1986, 1991), attrition exacerbates the problem of too few services to children in need of care. Furthermore, and inextricably related, attrition is a major problem in treatment research (Kazdin, 1988). Loss of subjects prohibits drawing valid inferences from the aspect of treatment under study.

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References

  • American Psychiatric Association (1987). Diagnostic and statistical manual of mental disorders (3rd ed.-Revised). Washington: Author.

    Google Scholar 

  • Armbruster, P., & Schwab-Stone, M. (1992, March). Child guidance clinic drop outs: Socio-demographic factors. Paper presented at the 5th Annual Research Conference, Research and Training Center for Children’s Mental Health, Tampa, Florida.

    Google Scholar 

  • Armstrong, H. E., Ishiki, P., Heiman, J., Mundt, J., & Womack, W. (1984). Service utilization by black and white clientele in an urban community mental health center: Revised assessment of an old problem. Community Mental Health Journal, 20, 269–280.

    Article  PubMed  Google Scholar 

  • Baekeland, F., & Lundwall, L. (1975). Dropping out of treatment: A critical review. Psychological Bulletin, 82, 738–783.

    Article  PubMed  Google Scholar 

  • Beneke, W. N., & Harris, M. B. (1972). Teaching self-control of study behavior. Behaviour Research and Therapy, 10, 35–41.

    Article  PubMed  Google Scholar 

  • Chess, S., & Thomas, A. (1986). Temperament in clinical practice. New York: Guilford Press.

    Google Scholar 

  • Cheung, F. K., & Snowden, L. R. (1990). Community mental health and ethnic minority populations. Community Mental Health journal, 26, 277–290.

    Article  PubMed  Google Scholar 

  • Cohen, R. L., & Richardson, C. H. (1970). A retrospective study of case attrition in a child psychiatric clinic. Social Psychiatry, 5, 77–83.

    Article  Google Scholar 

  • Cole, J. K., & Magnussen, M. G. (1967). Family situation factors related to remainers and terminators of treatment. Psychotherapy: Theory, Research and Practice, 4, 107–109.

    Article  Google Scholar 

  • Cottrell, D., Hill, P., Walk, D., Dearnaley, J., & lerotheou, A. (1988). Factors influencing non-attendance at child psychiatry out-patient appointments. British Journal of Psychiatry, 152, 201–204.

    Article  PubMed  Google Scholar 

  • Dadds, M. R., & McHugh, T. A. (1992). Social support and treatment outcome in behavioral family therapy for child conduct problems. Journal of Consulting and Clinical Psychology, 60, 252–259.

    Article  PubMed  Google Scholar 

  • Deane, F. P. (1991). Improving attendance at intake in children’s outpatient services of a community mental health centre. Child: Care, Health and Development, 17, 115–121.

    Article  Google Scholar 

  • Dumas, J. E., & Wahler, R. G. (1983). Predictors of treatment outcomes in parent training: Mother insularity and socioeconomic disadvantage. Behavioral Assessment, 5, 301–313.

    Google Scholar 

  • Ewalt, P. L., Cohen, M., & Harmatz, J. S. (1972). Prediction of treatment acceptance by child guidance clinic applicants: An easily applied instrument. American Journal of Orthopsychiatry, 42, 857–864.

    Article  PubMed  Google Scholar 

  • Farley, O. W., Peterson, K. D., & Spanos, G. (1975). Self-termination from a child guidance center. Community Mental Health Journal, 11, 325–334.

    Article  PubMed  Google Scholar 

  • Flaskerud, J. (1986). The effects of culture-compatible intervention on the utilization of mental health services by minority clients. Community Mental Health Journal, 22, 127–141.

    Article  PubMed  Google Scholar 

  • Flick, S. N. (1988). Managing attrition in clinical research. Clinical Psychology Review, 8, 499–515.

    Article  Google Scholar 

  • Gaines, T, Jr. (1978). Factors influencing failure to show for a family evaluation. International Journal of Family Counseling, 6, 57–61.

    Article  Google Scholar 

  • Garfield, S. L. (1986). Research on client variables in psychotherapy. In S. L. Garfield & A. E. Bergin (Eds.), Handbook of psychotherapy and behavior change (3rd ed., pp. 213–256). New York: Wiley.

    Google Scholar 

  • Garfield, S. L. (1989). Giving up on child psychotherapy: Who drops out? Comment on Weisz, Weiss, and Langmeyer. Journal of Consulting and Clinical Psychology, 57, 168–169.

    Article  PubMed  Google Scholar 

  • Goodman, A., & Siegel, C. (1978). Differences in white/nonwhite community mental health service utilization patterns. Evaluation and Program Planning, 1, 51–63.

    Article  PubMed  Google Scholar 

  • Gould, M. S., Shaffer, D., & Kaplan, D. (1985). The characteristics of dropouts from a child psychiatry clinic. Journal of the American Academy of Child Psychiatry, 24, 316–328.

    Article  PubMed  Google Scholar 

  • Heinicke, C. M., & Goldman, A. (1960). Research on psychotherapy with children: A review and suggestions for further study. American Journal of Orthopsychiatry, 30, 483–494

    Article  PubMed  Google Scholar 

  • Hollingshead, A. B., & Redlich, F. C. (1958). Social class and mental illness. New York: Wiley.

    Book  Google Scholar 

  • Hood-Williams, J.(1960). The results of psychotherapy with children: A reevaluation. Journal of Consulting Psychology, 24, 84–88.

    Article  Google Scholar 

  • Howard, K. I., Krause, M. S., & Orlinsky, D. E. (1986). The attrition dilemma: Toward a new strategy for psychotherapy research. Journal of Consulting and Clinical Psychology54, 106–110. ,

    Article  PubMed  Google Scholar 

  • Kazdin, A. E. (1987). Conduct disorders in childhood and adolescence. Newbury Park, CA: Sage.

    Google Scholar 

  • Kazdin, A. E. (1988). Child psychotherapy: Developing and identifying effective treatments. Elmsford, NY: Pergamon.

    Google Scholar 

  • Kazdin, A. E. (1990). Premature termination from treatment among children referred for antisocial behavior. Journal of Child Psychology and Psychiatry, 31, 415–425.

    Article  PubMed  Google Scholar 

  • Kazdin, A. E. (1992). Research design in clinical psychology (2nd ed.). Needham Heights, MA:Allyn & Bacon.

    Google Scholar 

  • Kazdin, A. E., Siegel, T. C., & Bass, D. (1990). Drawing upon clinical practice to inform research on child and adolescent psychotherapy: A survey of practitioners. Professional Psychology: Research and Practice, 21, 189–198.

    Article  Google Scholar 

  • Kazdin, A. E., Mazurick, J. L., & Bass, D. (1993). Risk for attrition in treatment of antisocial children and families. Journal of Clinical Child Psychology, 22, 2–16.

    Article  Google Scholar 

  • Kiesler, D. J. (1971). Experimental designs in psychotherapy research. In A. E. Bergin & S. L. Garfield (Eds.), Handbook of psychotherapy and behavior change: An empirical analysis (pp. 36–74). New York: Wiley.

    Google Scholar 

  • Kournay, R. F. C., Garber, J., & Tornusciolo, G. (1990). Improving first appointment attendance rates in child psychiatry outpatient clinics. Journal of the American Academy of Child Psychiatry, 29, 657–660.

    Article  Google Scholar 

  • Lake, M., & Levinger, G. (1960). Continuance beyond application interviews at a child guidance clinic. Social Casework, 91, 303–309.

    Google Scholar 

  • Larsen, D. L., Nguyen, T. D., Green, R. S., & Attkisson, C. C. (1983). Enhancing the utilization of outpatient mental health services. New York: Human Sciences Press.

    Google Scholar 

  • Levitt, E. E. (1957a). The results of psychotherapy with children: An evaluation. Journal of Consulting Psychology, 21, 189–196.

    Article  PubMed  Google Scholar 

  • Levitt, E. E. (1957b). A comparison of “remainers” and “defectors” among child clinic patients. Journal of Consulting Psychology, 21, 316.

    Article  PubMed  Google Scholar 

  • Levitt, E. E. (1958). A comparative judgmental study of “defection” from treatment at a child guidance clinic. Journal of Clinical Psychology, 14, 429–432.

    Article  PubMed  Google Scholar 

  • Levitt, E. E. (1963). Psychotherapy with children: A further evaluation. Behaviour Research and Therapy, 60, 326–329.

    Google Scholar 

  • Lovaas, O. I. (1987). Behavioral treatment and normal educational/intellectual functioning in young autistic children. Journal of Consulting and Clinical Psychology, 55, 3–9.

    Article  PubMed  Google Scholar 

  • Madger, D., & Werry, J. S. (1966). Defection from a treatment waiting list in a child psychiatric clinic. Journal of American Academy of Child Psychiatry, 5, 706–720.

    Article  Google Scholar 

  • McAdoo, W. G., & Roeske, N. A. (1973). A comparison of defectors and continuers in a child guidance clinic. Journal of Consulting and Clinical Psychology, 40, 328–334.

    Article  PubMed  Google Scholar 

  • McMahon, R. J., Forehand, R., Griest, D. L., & Wells, K. C. (1981). Who drops out of treatment during parent behavioral training? Behavioral Counseling Quarterly, 1, 79–85.

    Google Scholar 

  • Mirin, S. M., & Namerow, M. J. (1991). Why study treatment outcome? Hospital and Community Psychiatry, 42, 1007–1013.

    PubMed  Google Scholar 

  • Novick, J., Benson, R., & Rembar, J. (1981). Patterns of termination in an outpatient clinic for children and adolescents. Journal of the American Academy of Child Psychiatry, 20, 834–844.

    Article  PubMed  Google Scholar 

  • Pekarik, G., & Stephenson, L. A. (1988). Adult and child client differences in therapy dropout research. Journal of Clinical Child Psychology, 17, 316–321.

    Article  Google Scholar 

  • Pepler, D. J., & Rubin, K. H. (Eds.). (1991). The development and treatment of childhood aggression. Hillsdale, NJ: Erlbaum.

    Google Scholar 

  • Phillips, E. L. (1985). Psychotherapy revised: New frontiers in research and practice. Hillsdale, NJ: Erlbaum.

    Google Scholar 

  • Reid, J. B., & Patterson, G. R. (1976). Follow-up analyses of a behavioral treatment program for boys with conduct problems: A reply to Kent. Journal of Consulting and Clinical Psychology, 44, 299–302.

    Article  Google Scholar 

  • Richmond, R. (1992). Discriminating variables among psychotherapy dropouts from a psychological training clinic. Professional Psychology: Research and Practice, 23, 123–130.

    Article  Google Scholar 

  • Robins, L., & Rutter, M. (Eds.). (1990). Straight and devious pathways from childhood to adulthood. Cambridge: Cambridge University Press.

    Google Scholar 

  • Ross, A. O., & Lacey, H. M. (1961). Characteristics of terminators and remainers in child guidance treatment. Journal of Consulting Psychology, 25, 420–424.

    Article  PubMed  Google Scholar 

  • Schaefer, C. E., & Swanson, A. J. (1988). Children in residential care: Critical Issues in treatment. New York: Van Nostrand Reinhold.

    Google Scholar 

  • Singh, H., Janes, C. L., & Schechtman, J. M. (1982). Problem children’s treatment attrition and parents’ perception of the diagnostic evaluation. Journal of Psychiatric Treatment Evaluation, 4, 257–263.

    Google Scholar 

  • Sue, S. (1977). Community mental health services to minority groups. American Psychologist, 32, 616–624.

    Article  PubMed  Google Scholar 

  • Sue, S., McKinney, H. L., & Allen, D. B. (1976). Predictors of duration of therapy for clients in the community mental health system. Community Mental Health Journal, 12, 365–375.

    Article  PubMed  Google Scholar 

  • Stark, M. J. (1992). Dropping out of substance abuse treatment: A clinically oriented review. Clinical Psychology Review, 12, 93–116.

    Article  Google Scholar 

  • Szapocznik, J., Perez-Vidal, A., Brickman, A., Foote, F. H., Santisteban, D., Hervis, O., & Kurtines, W. H. (1988). Engaging adolescent drug abusers and their families into treatment: A strategic structural systems approach. Journal of Consulting and Clinical Psychology, 56, 552–557.

    Article  PubMed  Google Scholar 

  • Tuckman, J., & Lavell, M. (1959). Attrition in psychiatric clinics for children. Public Health Reports, 74, 309–315.

    Article  PubMed  Google Scholar 

  • United States Congress, Office of Technology Assessment. (1986). Children’s mental health: Problems and services—A background paper (OTA-BP-H-33). Washington, DC: US Government Printing Office.

    Google Scholar 

  • United States Congress, Office of Technology Assessment. (1991). Adolescent health (OTA-H-468). Washington, DC: U.S. Government Printing Office.

    Google Scholar 

  • Vail, A. (1978). Factors influencing lower-class Black patients’ remaining in treatment. Journal of Consulting and Clinical Psychology, 46, 341.

    Article  PubMed  Google Scholar 

  • Vernon, S. W., & Roberts, R. E. (1982). Prevalence of treated and untreated psychiatric disorders in three ethnic groups. Social Science and Medicine, 16, 1575–1582.

    Article  PubMed  Google Scholar 

  • Viale-Val, G., Rosenthal, R. H., Curtiss, G., & Marohn, R. C. (1984). Dropout from adolescent psychotherapy: A preliminary study. Journal of the American Academy of Child Psychiatry, 23, 562–568.

    Article  PubMed  Google Scholar 

  • Webster-Stratton, C. (1985). Predictors of treatment outcome in parent training for conduct disordered children. Behavior Therapy, 16, 223–243.

    Article  Google Scholar 

  • Weisz, J. R., Weiss, B., & Langmeyer, D. B. (1987). Giving up on child psychotherapy: Who drops out? Journal of Consulting and Clinical Psychology, 55, 916–918.

    Article  PubMed  Google Scholar 

  • Williams, R., & Pollack, R. H. (1964). Some non-psychological variables in therapy defection in a child guidance clinic. Journal of Psychology, 58, 145–155.

    Article  PubMed  Google Scholar 

  • Williams, S. J., Diekr, P., Druker, W. L., & Richardson, W. C. (1979). Mental health services: Utilization by low income enrollees in a prepared group practice plan and in an independent practice plan. Medical Care, 17, 139–151.

    Article  PubMed  Google Scholar 

  • Winsberg, B. G., Bialer, I., Kupietz, S., Botti, E., & Balka, E. B. (1980). Home vs. hospital care of children with behavior disorders. Archives of General Psychiatry, 37, 413–418.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Child Study Center, Yale University School of Medicine, New Haven, Connecticut, 06510-8009, USA

    Paula Armbruster

  2. Department of Psychology, Yale University, New Haven, Connecticut, 06520-7447, USA

    Alan E. Kazdin

Authors
  1. Paula Armbruster
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  2. Alan E. Kazdin
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Editor information

Editors and Affiliations

  1. Virginia Polytechnic Institute and State University, Blacksburg, Virginia, USA

    Thomas H. Ollendick

  2. University of South Carolina, Columbia, South Carolina, USA

    Ronald J. Prinz

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© 1994 Springer Science+Business Media New York

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Armbruster, P., Kazdin, A.E. (1994). Attrition in Child Psychotherapy. In: Ollendick, T.H., Prinz, R.J. (eds) Advances in Clinical Child Psychology. Advances in Clinical Child Psychology, vol 16. Springer, Boston, MA. https://doi.org/10.1007/978-1-4757-9041-2_3

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  • DOI: https://doi.org/10.1007/978-1-4757-9041-2_3

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4757-9043-6

  • Online ISBN: 978-1-4757-9041-2

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