Predictors of dropout from community clinic child CBT for anxiety disorders

Gro Janne H Wergeland; Krister W Fjermestad; Carla E Marin; Bente Storm-Mowatt Haugland; Wendy K Silverman; Lars-Göran Öst; Odd E Havik; Einar R Heiervang

doi:10.1016/j.janxdis.2015.01.004

Predictors of dropout from community clinic child CBT for anxiety disorders

J Anxiety Disord. 2015 Apr:31:1-10. doi: 10.1016/j.janxdis.2015.01.004. Epub 2015 Jan 22.

Authors

Gro Janne H Wergeland¹, Krister W Fjermestad², Carla E Marin³, Bente Storm-Mowatt Haugland⁴, Wendy K Silverman³, Lars-Göran Öst⁵, Odd E Havik⁶, Einar R Heiervang⁷

Affiliations

¹ Anxiety Research Network, Haukeland University Hospital, Bergen, Norway; Department of Child and Adolescent Psychiatry, Haukeland University Hospital, Bergen, Norway. Electronic address: gjwergeland@gmail.com.
² Anxiety Research Network, Haukeland University Hospital, Bergen, Norway; Frambu Resource Centre for Rare Disorders, Siggerud, Norway.
³ Child Study Center, Yale University School of Medicine, New Haven, CT, USA.
⁴ Anxiety Research Network, Haukeland University Hospital, Bergen, Norway; Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Research Health, Bergen, Norway.
⁵ Anxiety Research Network, Haukeland University Hospital, Bergen, Norway; Department of Clinical Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway; Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Department of Psychology, University of Stockholm, Stockholm, Sweden.
⁶ Anxiety Research Network, Haukeland University Hospital, Bergen, Norway; Department of Clinical Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway.
⁷ Anxiety Research Network, Haukeland University Hospital, Bergen, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.

PMID: 25637909
DOI: 10.1016/j.janxdis.2015.01.004

Abstract

The aim was to investigate predictors of treatment dropout among 182 children (aged 8-15 years) participating in an effectiveness trial of manual-based 10-session individual and group cognitive behavior therapy (CBT) for anxiety disorders in community clinics. The dropout rate was 14.4%, with no significant difference between the two treatment conditions. We examined predictors for overall dropout (n=26), early (≤session 4, n=15), and late dropout (≥session 5, n=11). Overall dropout was predicted by low child and parent rated treatment credibility, and high parent self-rated internalizing symptoms. Low child rated treatment credibility predicted both early and late dropout. High parent self-rated internalizing symptoms predicted early dropout, whereas low parent rated treatment credibility predicted late dropout. These results highlight the importance of addressing treatment credibility, and to offer support for parents with internalizing symptoms, to help children and families remain in treatment.

Keywords: Anxiety; Children; Cognitive behavior therapy; Dropout; Effectiveness.

Publication types

Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Ambulatory Care / psychology
Ambulatory Care / statistics & numerical data
Anxiety Disorders / psychology
Anxiety Disorders / therapy*
Attitude to Health
Child
Cognitive Behavioral Therapy / methods
Cognitive Behavioral Therapy / statistics & numerical data*
Community Mental Health Centers / statistics & numerical data
Female
Humans
Internal-External Control
Male
Motivation
Parents / psychology
Patient Dropouts / psychology
Patient Dropouts / statistics & numerical data*
Psychiatric Status Rating Scales
Psychotherapy, Group / statistics & numerical data*
Self Concept
Surveys and Questionnaires