Predicting retention in a filial therapy program
Topham, Glade LeGrand
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High rates of premature dropout from child psychotherapy programs are a concern for mental health professionals as well as researchers. Of primary concern is the number of children and families who are failing to receive the services they need. Additional concerns are that premature dropout leads to a reduction of treatment effectiveness and to weakened validity of treatment research. Unfortunately, efforts to identify the factors predicting premature dropout have yielded mixed and conflicting results. Furthermore, research has not yet investigated the predictors of dropout or retention for many child psychotherapy programs. This study examined the relationship between select client characteristics and retention in a short-term filial therapy program in order to identify important predictors of program retention. Filial therapy, developed by Bernard and Louise Guemey in the early 1960s, is a program targeting the parent-child relationship as a means for preventing or remediating child and/or family problems. A large amount of research has supported the effectiveness of filial therapy programs; however, previous research has not examined the predictors of program retention or dropout. The filial therapy program investigated in this study was provided at a university family therapy clinic and included 10 treatment sessions conducted in an individual family treatment format. Parents (N = 27) and children were recruited through schools, family court judges, and community mental health agencies and were included in the study if the child was between the ages of 2 and 10 and if the parent had full or joint custody of the child. It was expected that parents and children would attend a greater number of treatment sessions if (a) Parents were Caucasian, (b) Parents had less severe symptoms of stress, (c) Parents had a lower socioeconomic status (as measured by income and education), (d) Children had less severe behavioral problems, and (e) Parents were more accepting of their child's emotions. The results indicated that less severe parent symptoms of stress and less severe child behavior problems were significantly related to retention in the program. Results point to the importance of directly addressing parent distress and child behavior problems early in treatment.