Child-reported posttraumatic stress symptoms and attrition from therapy.

Abstract

BACKGROUND\nHigh rates of attrition from child trauma-focused treatment are a significant barrier to mitigating children s trauma-related difficulties. Nonetheless, to date, only one study has investigated child-reported posttraumatic stress symptoms (PTSS) in relation to dropout from trauma-focused therapy and the posttraumatic stress disorder (PTSD) symptom clusters remain unexamined.\n\n\nOBJECTIVE\nThe present study sought to determine whether higher levels of child-reported PTSS, as well as the specific DSM-IV PTSD symptom clusters, predicted attrition from trauma-focused cognitive behavioral therapy (TF-CBT).\n\n\nPARTICIPANTS/SETTING/METHOD\nOne hundred and seventy one children ages 7-18 (M\xa0=\xa011.76, SD\xa0=\xa02.71; 67.4% female; 55.8% Black) were included in the study from an archival database. Dropout was investigated by two operational definitions: 1) clinician-rated dropout, and 2) whether the child received an adequate dose of treatment (i.e., 12 or more sessions).\n\n\nRESULTS\nSixty eight percent (68.4%) of the children prematurely terminated treatment per their clinician, yet 70.2% received an adequate treatment dose. Child s age and income were related to clinician-rated attrition, but PTSS did not correspond with either attrition definition. None of the PTSD symptom clusters were associated with clinician-rated dropout; however, higher levels of avoidance symptoms were tied to increased likelihood of the child receiving an adequate dose of treatment.\n\n\nCONCLUSION\nFrom a public health perspective, it is encouraging that children who are reporting higher levels of PTSS may not be at greater risk for attrition.