Noncompletion of Evidence-Based Parent Training: An Empirical Examination Among Families of Children in Foster Care

Abstract

ABSTRACTChild welfare have historically experienced high dropout rates. As evidence-based interventions (EBIs) spread to the child welfare field, treatment noncompletion could interfere with successful outcomes. Using a mixed methods approach, this study investigated the differences between completers and noncompleters, and reasons for treatment noncompletion of an EBI for families of children in foster care. The sample comprised 315 families randomized to receive Parent Management Training, Oregon Model (PMTO). Researchers examined clinicians' discharge notes to explore reasons for noncompletion. Using data collected from a battery of assessments, bivariate logistic regression compared completers and noncompleters on demographics, socioeconomic factors, children's social-emotional functioning, and parents' functioning. About one third of families were noncompleters. Single fathers and parents with lower socioeconomic status were more likely to drop out. By contrast, parents with lower functioning on child behavior and parenting trended toward higher completion rates. Formidable challenges were parental substance abuse and mental illness. Results suggest parent training may require tailoring for specific subgroups and pairing with strategies for enhancing early engagement and reducing treatment barriers. Future research is needed to include parents' views on noncompletion and to more closely examine the influence of specific factors, such as severity of parental mental illness and substance abuse.