Treatment outcome among children with externalizing disorder who terminate prematurely versus those who complete psychotherapy

Abstract

Objective: To compare the clinical dysfunction at the end of treatment of children who dropped out of therapy prematurely (dropouts) versus those who completed treatment (completers). We predicted that (1) children who terminated prematurely would show greater impairment at the end of treatment than would children who completed treatment, and (2) the differences at posttreatment would result from subject selection variables and severity of child dysfunction at pretreatment rather than from termination of treatment, per se.

Method: Children (N = 75, aged 4 to 13 years) referred for oppositional, aggressive, and antisocial behavior formed three groups: dropouts, completers, and completers matched to dropouts on subject and demographic variables and severity of child dysfunction.

Results: At the end of treatment children who terminated prematurely showed greater impairment at home, at school, and in the community, compared with children who completed treatment. Outcome differences were less evident between dropouts and completers when pretreatment child severity of dysfunction was controlled.

Conclusions: The findings suggest that selection factors and severity of impairment may relate both to attrition and limited responsiveness among patients who continue.