Characteristics of attrition among children receiving trauma-focused treatment

Identifying the factors related to premature termination from trauma-focused child therapy is an important first step in ultimately preventing attrition in at-risk families. The primary aim of the present study was to investigate whether demographic factors and pretreatment symptom levels were associated with premature termination among children who received trauma-focused treatment. Because different definitions of attrition may influence results, candidate factors were examined in relation to 2 operational definitions of attrition.

Four hundred and sixty-six children (ages 2-18 years; M = 9.23, SD = 3.78; 66.1% females) who were referred to a Child Advocacy Center (CAC) for trauma-focused therapy were included in the study. Demographic and family variables, characteristics of the traumatic event, and caregiver- and child-reported pretreatment symptoms levels were assessed in relation to both clinician-rated treatment status and whether the child received an adequate dose of treatment (i.e., ≥12 sessions).

Several demographic factors (e.g., child's age, minority status, household income, maternal years of education), Child Protective Services (CPS) involvement, type of treatment received, number of traumatic events, and caregiver-rated pretreatment symptom levels were related to clinician-rated treatment status. Relatively fewer factors were associated with the adequate dose operationalization of attrition. Children's symptom reports were unrelated to either attrition definition.

Demographic and family factors, trauma characteristics, and level of caregiver-reported symptoms may help identify families at risk for premature termination. Efforts to understand the interactions between attrition factors, as well the use of different operational definitions in relation to premature termination, are warranted. (PsycINFO Database Record