Reported Maltreatment Among Clinic-Referred Children: Implications for Presenting Problems, Treatment Attrition, and Long-Term Outcomes

Abstract

To examine the treatment implications of a reported history of maltreatment in a sample of 343 children referred to Los Angeles area mental health clinics for emotional and behavioral problems. Child Protective Service records identified 161 of the 343 families as having a documented history of maltreatment. Parent reports of child behavior problems were obtained following clinic intake and at 2-year follow-up, and attrition was assessed via medical records. The authors examined the associations between a history of maltreatment and severity of child presenting problems, treatment attrition, and long-term mental health outcomes. Compared to other clinic-referred children, youngsters with a history of maltreatment entered treatment with more externalizing behavior problems, were more likely to exit treatment early and without therapist consent, and continued to show greater externalizing problems 2 years later. Maltreated children have significant mental health needs that may not be well addressed currently in community mental health clinics.