Administration and Policy in Mental Health and Mental Health Services Research

, Volume 41, Issue 1, pp 93–103

Shifting the Treatment Model: Impact on Engagement in Outpatient Therapy


    • Child Study CenterYale University
  • Karen Bearss
    • Child Study CenterYale University
  • V. Robin Weersing
    • San Diego Joint Doctoral Program in Clinical PsychologySan Diego State University/University of California
  • Lawrence Scahill
    • Child Study CenterYale University
    • School of NursingYale University
  • Joseph Woolston
    • Child Study CenterYale University
Original Article

DOI: 10.1007/s10488-012-0439-3

Cite this article as:
Warnick, E.M., Bearss, K., Weersing, V.R. et al. Adm Policy Ment Health (2014) 41: 93. doi:10.1007/s10488-012-0439-3


Attrition in youth outpatient mental health clinics ranges from 30 to 70 % and often occurs early in treatment. We implemented specific treatment planning strategies designed to reduce early attrition. Following implementation, 14.3 % of clients dropped out during the first five sessions compared to 26.1 % in the historical control (p < 0.001). During treatment, 33.6 % of clients dropped out in the intervention compared to 55.5 % in the historical control (p < 0.001). Engagement is central to the therapeutic process and may be particularly relevant early in treatment. Implementing evidence-based strategies to promote a collaborative relationship between the family and the clinician may increase engagement and decrease attrition.


Child mental healthAttritionDropoutChild guidance clinic

Copyright information

© Springer Science+Business Media, LLC 2012