Predictors of Treatment Attrition Among an Outpatient Clinic Sample of Youths With Clinically Significant Anxiety

Predictors of treatment attrition were examined in a sample of 197 youths (ages 5–18) with clinically-significant symptoms of anxiety seeking psychotherapy services at a community-based outpatient mental health clinic (OMHC). Two related definitions of attrition were considered: (a) clinician-rated dropout (CR), and (b) CR dropout qualified by phase of treatment (pre, early, or late phases) (PT). Across both definitions, rates of attrition in the OMHC sample were higher than those for anxious youths treated in randomized controlled trials, and comorbid depression symptoms predicted dropout, with a higher rate of depressed youths dropping out later in treatment (after 6 sessions). Using the PT definition, minority status also predicted attrition, with more African-American youths lost pre-treatment. Other demographic (age, gender, single parent status) and clinical (externalizing symptoms, anxiety severity) characteristics were not significantly associated with attrition using either definition. Implications for services for anxious youths in public service settings are discussed. Results highlight the important role of comorbid depression in the treatment of anxious youth and the potential value of targeted retention efforts for ethnic minority families early in the treatment process

Clinician and Parent Perspectives on Parent and Family Contextual Factors that Impact Community Mental Health Services for Children with Behavior Problems

The present study employed qualitative methods to examine multiple stakeholder perspectives regarding the role of parent and family contextual factors on community child mental health treatment for children with behavior problems. Findings suggest agreement between clinicians and parents on the number, types and importance of parent and family factors in children’s mental health services; however, stakeholders differed in reports of which factors were most salient. Specifically, clinicians endorsed most factors as being equally salient, while parents described a few salient factors, with parental stress and inadequate social support being the most frequently discussed. These qualitative data further elucidate the context of community services and have implications for evidence-based practice implementation and improving community care

An Investigation of Factors that Influence Acceptability of Parent Training

Parent training is an effective intervention for parents of children with a variety of childhood disorders, including conduct problems, and parents often view behavioral parent training as acceptable. Explanations and rationales for parent training are commonly provided at the beginning of treatment. The purpose of this study was to determine whether changing the description of a behavioral parenting intervention influenced parents’ acceptability ratings and whether mothers and fathers differed in their ratings. There were 78 participants (39 mother-father dyads) in this study. Participants viewed one of two descriptions of parent training that focused on either addressing deficits in parenting skills or enhancing existing parenting skills. Parents’ acceptability of the treatment descriptions was evaluated using the Treatment Evaluation Inventory—Short Form. Participants also completed the Eyberg Child Behavior Inventory and The Parental Locus of Control Scale. A multiple linear regression and a mixed factorial ANOVA were used to analyze the data. There was not a significant interaction between parent gender and parent training description type. There was also not a significant difference in the acceptability of the two parent training descriptions. However, mothers rated both treatment descriptions as more acceptable than did fathers. Results indicated that parental locus of control significantly predicted acceptability of the parent training descriptions. The results of the current study suggested that treatment acceptability was not influenced by the way that the interventions were described. Future research should focus on how to increase acceptability of parent training for fathers and parents with an external locus of control