Children with persistent conduct problems who dropout of treatment

Dropout of treatment is one of the key issues in outcome in a child and ado lescent mental health service. We report two studies focusing on the treatm ent process and the dropout rate of children with persistent conduct proble ms presenting to a community mental health service, using a prospective des ign. The first study included 32 children and used a randomised controlled treatment design comparing a CBT approach with conjoint family therapy and an eclectic approach. The overall dropout rate was 36%. Dropout occurred si gnificantly less frequently in the CBT group. The dropout group was associa ted with mothers who were younger and less educated, a poorer rating by the clinicians at the last meeting, parental dissatisfaction with the treatmen t service and perception that the treatment was less organised and having l ess behavioural tasks. In the second study we used a naturalistic follow-up design. Forty-six children were included, The overall dropout rate was 48% . Again, the children who defaulted were rated by clinicians as less likely to have improved and dropout was also significantly associated with parent al perception of a less organised treatment. In both studies dropout usuall y occurred after assessment and at the early phase of treatment.