Maternal Support and Attrition from Child Trauma-Focused Therapy.

Abstract

Many children prematurely terminate from trauma-focused therapy (TFT), and attrition is a critical barrier in addressing the impacts of childhood sexual abuse (CSA). The field's knowledge of risk factors for dropout is growing; however, one aspect of the child's environment that remains unexamined is maternal support following the CSA disclosure/discovery. Maternal support has been theorized to play a valuable role in influencing children's outcomes after CSA and may be relevant in understanding attrition. The objective of the current study was to investigate the associations between children's symptoms, relationship to the perpetrator, and maternal support in relation to premature termination from TFT among 186 sexually abused children (Mage = 9.24 years, SD = 3.72, 67.3% female). Two operational definitions of attrition were used: (a) clinician-rated dropout (i.e., clinician's ratings of whether the child completed treatment) and (b) whether the child received an adequate treatment dose treatment (i.e., ≥12 sessions). Maternal marital status was the only factor associated with clinician-rated treatment dropout, OR = 2.35, whereas maternal support and blame/doubt were unrelated. Living farther from the clinic was tied to an increased risk of receiving an inadequate treatment dose, OR = 0.96. Replication of these findings is needed, particularly using a clinician-administered measure of caregiver support; yet, maternal emotional support and blame/doubt may not evince strong ties to dropout from TFT among sexually abused children. Additional work is needed to discern if there are key subgroups for whom support is more strongly related to the risk of premature termination following CSA.