Shifting the Treatment Model: Impact on Engagement in Outpatient Therapy

  • Erin M. Warnick
  • Karen Bearss
  • V. Robin Weersing
  • Lawrence Scahill
  • Joseph Woolston
Original Article


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 health Attrition Dropout Child guidance clinic 


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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Erin M. Warnick
    • 1
  • Karen Bearss
    • 1
  • V. Robin Weersing
    • 2
  • Lawrence Scahill
    • 1
    • 3
  • Joseph Woolston
    • 1
  1. 1.Child Study CenterYale UniversityNew HavenUSA
  2. 2.San Diego Joint Doctoral Program in Clinical PsychologySan Diego State University/University of CaliforniaSan DiegoUSA
  3. 3.School of NursingYale UniversityNew HavenUSA

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