Abstract
The present study examined predictors of youth client retention in therapy in a large community-based sample. We used several conceptualizations of retention, including (a) “intake retention” (i.e., returned to treatment after intake session); (b) “mutual termination” (i.e., termination agreed upon by family and therapist), (c) “mean treatment duration” (i.e., completing the mean number of sessions in the agency), and (d) “total treatment duration” (i.e., total number of sessions). Archival data from over 400 children and adolescents who sought treatment at a large public mental health clinic were analyzed using regression analyses. Although different predictors were identified across the various conceptualizations, a few robust predictors emerged including ethnicity and client symptom severity. Clinical implications and future research directions are discussed.
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Notes
In some cases, where the point of therapy initiation is defined as the first phone call to obtain mental health services, the construct of “preintake attrition” is examined. This refers to the phenomenon of an individual making an appointment with a mental health provider and failing to attend their first scheduled appointment (Masi et al. 2003; Sparks et al. 2003). Preintake attrition is distinct from therapy attrition in that there has not been any face-to-face contact between the mental health services provider and the client(s). This can be viewed as a related construct within the umbrella of therapy attrition.
Some individuals had more than one “episode of care”, that is, they received services from the clinic for more than one discrete time period. It should be noted that some information was archived so it cannot be determined whether a client received services prior to July 1995.
These data are similar to those found in the locality, as reported in 2000 Census data (http://www.dataplace.org/area_overview/Chesterfield%20County,%20VA), though the proportion of African-Americans in the clinic was larger than that found in the locality as a whole (17% in the population, 27% in the sample).
These estimates also take into account the number of individuals dependent on the income.
As noted earlier, a large number (n = 168) fell into an “other” category for which information about therapist’s perception of termination was not available. These participants were not included in subsequent analyses for the mutual termination conceptualization.
Preliminary analyses suggested that variances were unequal between groups—thus, the degrees of freedom were adjusted accordingly.
Preliminary analyses suggested that variances were unequal between groups—thus, the degrees of freedom were adjusted accordingly.
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Preparation of this article was supported in part through a grant from the National Institute of Mental Health Grant K23 MH69421. Portions of this manuscript were submitted in partial fulfillment of a Master’s in Science degree by Lauren M. Miller.
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Miller, L.M., Southam-Gerow, M.A. & Allin, R.B. Who Stays in Treatment? Child and Family Predictors of Youth Client Retention in a Public Mental Health Agency. Child Youth Care Forum 37, 153–170 (2008). https://doi.org/10.1007/s10566-008-9058-2
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DOI: https://doi.org/10.1007/s10566-008-9058-2