Barriers to treatment participation and therapeutic change among children referred for conduct disorder

Examined predictors of therapeutic change among children seen in outpatient therapy. Children (N = 200) referred for oppositional, aggressive, and ant isocial behavior and their families participated. The major findings were t hat (a) socioeconomic disadvantage, parent psychopathology and stress, and child dysfunction predicted therapeutic change from pretreatment to posttre atment; (b) barriers to participation in treatment also were significantly associated with therapeutic change and this effect was not explained by the other family, parent, and child predictors; (c) as the level of perceived barriers to participation in treatment increased among families, the amount of therapeutic change decreased; and (d) among children at risk for relati vely little therapeutic change, the perception of few barriers to treatment increased the degree of child improvement. The implications for further wo rk on predictors of therapeutic change and the role of barriers in the trea tment process are discussed.