Date of Award

5-12-2008

Document Type

Dissertation

Degree Name

Doctor of Psychology (PsyD)

Department

Psychology

First Advisor

Beverly J. Goodwin, Ph.D.

Second Advisor

Kimberely J. Husenits, Psy.D.

Third Advisor

Ralph May, Psy.D.

Abstract

This study attempts to understand premature termination from psychotherapy by children. It attempts to supply recommendations for two different mental health settings to reduce premature termination from their programs. The programs were the Center for Applied Psychology at Indiana University of Pennsylvania (CAP) and the Community Guidance Center (CGC), both located in Indiana, Pennsylvania. Premature termination is a serious problem in the delivery of services across populations. Estimated rates of premature termination approach 60% (Kazdin, 1998). Much of the research has been conducted on adult populations with substantially less research conducted on children (Pekarik & Stephenson, 1988). This is in contrast to epidemiological data that finds prevalence rates of mental illness in children to run at 16% (Benway et al., 2003). Of those children determined to need mental health services, 70% do not receive appropriate services. The problem of premature termination exacerbates the dilemma of providing services to children. Much research attests to the efficacy of therapy for children, thus, a better understanding of how to facilitate treatment compliance, including attendance, throughout the proscribed course of therapy, is needed (Benway et al., 2003, Kovacs & Lohr, 1995). However, much of the literature on children is emergent and contradictory (Snell-Johns, Mendez, & Smith, 2004). A thorough review of the current literature was conducted to support the hypotheses developed in this study. Client files were reviewed to ascertain if therapists followed on-site procedures. Site policies were examined to determine their efficacy in addressing premature termination. Chi-Square analysis was conducted upon two data sets from the CGC to determine if recently enacted policy changes had an effect upon premature termination rates. Results indicated that student-therapists at the CAP were far less likely to follow on-site procedures than therapists at the CGC. Research based recommendations were created in an effort to aid these mental health providers reduce the rate of premature termination from psychotherapy by children and their families.

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