The use of symptom severity measured just before termination to predict child treatment dropout

Chasson, Gregory S.; Vincent, John P.; Harris, G.F.

doi:10.1002/jclp.20494

Cited by 27 publications

(44 citation statements)

References 32 publications

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“…Chasson et al 482 point out that treatment is not static and neither is symptom severity (and possibly other factors that influence engagement). In their study, 482 which explored the predictive value for dropout (from exposure-based CBT) of trauma-related symptom severity, they found that baseline symptom severity failed to predict dropout.…”

Section: Discussionmentioning

confidence: 99%

“…Of the 73 included acceptability studies, the majority were set in the USA (42 studies 107,108,161,175,176,482,492,504,505,510,515,526,533,621, ). The remainder were in Canada (four studies 170,[658][659][660][661] ), the UK (14 studies 145,169,481,511,538,[662][663][664][665][666][667][668][669][670] ) and elsewhere in Europe: the Netherlands (three studies 497,671,672 ), Norway (three studies [673][674][675] ) and Sweden (one study 676 ), with one multisite review of services 145,146,640,[665][666][667][668][669]…”

Section: Description Of Included Acceptability Studiesmentioning

confidence: 99%

“…621,629 ) to a large national sample of n = 1085. 634 The majority of sample sizes were < 50 cases (40 studies 169,175,497,504,506,510,511,526,533,538,621,629,[636][637][638][639][641][642][643]645,646,648,651,652,658,[661][662][663]665,666,[668][669][670]675,677,678,680 ), between 50 and 100 cases (15 studies 107,170,176,481,482,492,505,644,647,…”

Section: Description Of Included Acceptability Studiesmentioning

confidence: 99%

“…Regression analyses were used in four 482,630,631,633 studies to examine treatment completion. Caregivers' perceptions of the severity of abuse appear to be a common theme relating to treatment completion.…”

Section: Treatment Completionmentioning

confidence: 99%

“…Caregivers' perceptions of the severity of abuse appear to be a common theme relating to treatment completion. Chasson et al 482 reported that higher levels of depressive symptoms and feelings of intrusion during treatment were associated with dropout from TF-CBT. In a later study, 630 in which they analysed data from the same group of children augmented with additional cases, the authors found that children who had been abused by another child (not by a parental/adult figure), or had experienced a single event and had not suffered a life-threatening or serious injury, were more likely to drop out than those children exposed to multiple, physical injurious abuse by an adult.…”

Section: Treatment Completionmentioning

confidence: 99%

See 4 more Smart Citations

The effectiveness, acceptability and cost-effectiveness of psychosocial interventions for maltreated children and adolescents: an evidence synthesis

Macdonald

Livingstone

Hanratty

et al. 2016

Health Technol Assess

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BackgroundChild maltreatment is a substantial social problem that affects large numbers of children and young people in the UK, resulting in a range of significant short- and long-term psychosocial problems.ObjectivesTo synthesise evidence of the effectiveness, cost-effectiveness and acceptability of interventions addressing the adverse consequences of child maltreatment.Study designFor effectiveness, we included any controlled study. Other study designs were considered for economic decision modelling. For acceptability, we included any study that asked participants for their views.ParticipantsChildren and young people up to 24 years 11 months, who had experienced maltreatment before the age of 17 years 11 months.InterventionsAny psychosocial intervention provided in any setting aiming to address the consequences of maltreatment.Main outcome measuresPsychological distress [particularly post-traumatic stress disorder (PTSD), depression and anxiety, and self-harm], behaviour, social functioning, quality of life and acceptability.MethodsYoung Persons and Professional Advisory Groups guided the project, which was conducted in accordance with Cochrane Collaboration and NHS Centre for Reviews and Dissemination guidance. Departures from the published protocol were recorded and explained. Meta-analyses and cost-effectiveness analyses of available data were undertaken where possible.ResultsWe identified 198 effectiveness studies (including 62 randomised trials); six economic evaluations (five using trial data and one decision-analytic model); and 73 studies investigating treatment acceptability. Pooled data on cognitive–behavioural therapy (CBT) for sexual abuse suggested post-treatment reductions in PTSD [standardised mean difference (SMD) –0.44 (95% CI –4.43 to –1.53)], depression [mean difference –2.83 (95% CI –4.53 to –1.13)] and anxiety [SMD –0.23 (95% CI –0.03 to –0.42)]. No differences were observed for post-treatment sexualised behaviour, externalising behaviour, behaviour management skills of parents, or parental support to the child. Findings from attachment-focused interventions suggested improvements in secure attachment [odds ratio 0.14 (95% CI 0.03 to 0.70)] and reductions in disorganised behaviour [SMD 0.23 (95% CI 0.13 to 0.42)], but no differences in avoidant attachment or externalising behaviour. Few studies addressed the role of caregivers, or the impact of the therapist–child relationship. Economic evaluations suffered methodological limitations and provided conflicting results. As a result, decision-analytic modelling was not possible, but cost-effectiveness analysis using effectiveness data from meta-analyses was undertaken for the most promising intervention: CBT for sexual abuse. Analyses of the cost-effectiveness of CBT were limited by the lack of cost data beyond the cost of CBT itself.ConclusionsIt is not possible to draw firm conclusions about which interventions are effective for children with different maltreatment profiles, which are of no benefit or are harmful, and which factors encourage people to seek therapy, accept the offer of therapy and actively engage with therapy. Little is known about the cost-effectiveness of alternative interventions.LimitationsStudies were largely conducted outside the UK. The heterogeneity of outcomes and measures seriously impacted on the ability to conduct meta-analyses.Future workStudies are needed that assess the effectiveness of interventions within a UK context, which address the wider effects of maltreatment, as well as specific clinical outcomes.Study registrationThis study is registered as PROSPERO CRD42013003889.FundingThe National Institute for Health Research Health Technology Assessment programme.

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Section: Discussionmentioning

confidence: 99%

Section: Description Of Included Acceptability Studiesmentioning

confidence: 99%

Section: Description Of Included Acceptability Studiesmentioning

confidence: 99%

Section: Treatment Completionmentioning

confidence: 99%

Section: Treatment Completionmentioning

confidence: 99%

See 3 more Smart Citations

The effectiveness, acceptability and cost-effectiveness of psychosocial interventions for maltreated children and adolescents: an evidence synthesis

Macdonald

Livingstone

Hanratty

et al. 2016

Health Technol Assess

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Methodological changes to improve retention: Results from two pediatric cognitive behavioral therapy studies

Cromer,

Pangelinan,

El Sabbagh

et al. 2023

J Clin Psychol

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ObjectiveRetention is challenging in clinical research with pediatric populations. The retention obstacles that are experienced in adult samples are compounded because child samples depend on caregiver support and engagement. The present paper describes retention improvements following protocol adaptations across a pair of cognitive behavioral pilot studies for nightmare sufferers aged 6–17.MethodsStudy 1 (N = 20) focused retention efforts on rapport and engagement, flexible scheduling, treatment location choice, and incentives. Study 2 (N = 31) sought to increase retention by improving continuity of care, increasing scheduling flexibility, reducing participant time and effort, and increasing choice and attractiveness of incentives.ResultsOnly 13 participants (65%) were retained in Study 1; n = 6 (54.5%) treatment and n = 7 (77.78%) waitlist. In contrast, 29 participants (93.5%) were retained in Study 2; n = 15 (93.8%) treatment and n = 14 (93.3%) waitlist.ConclusionWe conclude that asking for and responding to patient feedback to assess all perceived barriers and burdens for participants is essential to ensure that benefits exceed effort. Allowing choices in size and frequency of incentives, as well as improving continuity of care, and reducing session length even while increasing number of sessions, were noted improvements in Study 2.

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Predictors of Study Retention From a Multisite Study of Interventions for Children and Families Exposed to Violence

Cross

Jaycox

Hickman

et al. 2013

Journal Community Psychology

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The use of symptom severity measured just before termination to predict child treatment dropout

Cited by 27 publications

References 32 publications

The effectiveness, acceptability and cost-effectiveness of psychosocial interventions for maltreated children and adolescents: an evidence synthesis

The effectiveness, acceptability and cost-effectiveness of psychosocial interventions for maltreated children and adolescents: an evidence synthesis

Methodological changes to improve retention: Results from two pediatric cognitive behavioral therapy studies

Predictors of Study Retention From a Multisite Study of Interventions for Children and Families Exposed to Violence

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