The Prevalence and Treatment of Adjustment Disorders Among Children at Outpatient Mental Health Clinics

Abstract

ABSTRACT Adjustment disorder is commonly diagnosed in children, yet few studies have explored the types of treatment and outcomes for this disorder in routine clinical care. Cognitive-behavioral therapies (CBT) are evidence-based treatments (EBTs) for many mental health disorders but there is limited research evaluating the use of CBT in usual care for children with adjustment disorders. This study used administrative data from a statewide system of outpatient clinics to examine 1) intake differences between children with adjustment disorders and other common diagnoses, 2) how often children with adjustment disorders received CBT, and 3) outcome differences amongst children with adjustment disorders who received CBT, non-cognitive-behavioral EBTs, or no EBT. The sample included 22,353 children ages 3–17 with a primary diagnosis of adjustment disorder, conduct problem, depression, anxiety, or post-traumatic stress disorder. Data were collected as part of routine care, including child demographic characteristics, diagnosis, treatment type, and problem severity and functioning based on the Ohio Scales. Children with adjustment disorders had lower problem severity and higher functioning at intake, and were less likely to receive cognitive-behavioral EBTs than children with other disorders. However, in the subsample of children diagnosed with adjustment disorders (n = 8,966), those who received cognitive-behavioral EBTs improved the most, highlighting the applicability of cognitive-behavioral therapies for children with adjustment disorders.