title: Factors related to attrition from trauma-focused cognitive behavioral therapy.
abstract: Attrition from child trauma-focused treatments such as Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is common; yet, the factors of children who prematurely terminate are unknown. The aim of the current study was to identify risk factors for attrition from TF-CBT. One hundred and twenty-two children (ages 3-18; M=9.97, SD=3.56; 67.2% females; 50.8% Caucasian) who received TF-CBT were included in the study. Demographic and family variables, characteristics of the trauma, and caregiver- and child-reported pretreatment symptoms levels were assessed in relation to two operational definitions of attrition: 1) clinician-rated dropout, and 2) whether the child received an adequate dose of treatment (i.e., 12 or more sessions). Several demographic factors, number of traumatic events, and children's caregiver-rated pretreatment symptoms were related to clinician-rated dropout. Fewer factors were associated with the adequate dose definition. Child Protective Services involvement, complex trauma exposure, and child-reported pretreatment trauma symptoms were unrelated to either attrition definition. Demographics, trauma characteristics, and level of caregiver-reported symptoms may help to identify clients at risk for premature termination from TF-CBT. Clinical and research implications for different operational definitions and suggestions for future work will be presented.
authors.affiliation: Department of Psychological Sciences, University of Missouri-St. Louis, St. Louis, MO, USA. Electronic address: WamserR@umsl.edu.
authors.forename: Rachel
authors.initials: R
authors.lastname: Wamser-Nanney
authors.affiliation: Department of Psychological Sciences, University of Missouri-St. Louis, St. Louis, MO, USA.
authors.forename: Cazzie E
authors.initials: CE
authors.lastname: Steinzor
mesh_terms: D000293:Adolescent; D017028:Caregivers; D002648:Child; D002649:Child Abuse / Q000628:therapy*; D002675:Child, Preschool; D015928:Cognitive Behavioral Therapy; D005260:Female; D006801:Humans; D008297:Male; D010352:Patient Dropouts / Q000523:psychology; D013313:Stress Disorders, Post-Traumatic / Q000628:therapy*
keywords: Attrition; Children and adolescents; Cognitive behavioral therapy; PTSD; Trauma-Focused Cognitive Behavioral Therapy