(PS4-D77) Association Between Caregiver Psychopathology and Attrition in Trauma-specific Cognitive Behavioral Therapy

Attrition prevents children from receiving an adequate dose of therapy, and those with abuse histories are more likely to drop out of treatment (Lau & Weisz, 2003; Tebbett et al., 2017). Although caregiver involvement in trauma-specific therapies, like Alternatives for Families: A Cognitive Behavioral Therapy (AF-CBT), is important for treatment success and the overall effectiveness of their child’s treatment (Brown et al., 2020; Maliken & Katz, 2013), little is known about how caregivers’ trauma-related psychopathology (e.g., PTSD, depression, and anger) may impact attrition. Two studies found that caregivers’ stress, perception of treatment, and use of adverse child-rearing practices were associated with attrition in treatments for child trauma (McKay & Bannon, 2004; Yasinski et al., 2018). In contrast, Tebbett et al. (2017) found that caregivers’ global severity index on a symptom screener did not impact attrition. Although studies suggest that children’s trauma-related symptoms (e.g., depression, PTSD) are associated with attrition from trauma-focused therapies (Sprang, 2013), these constructs have not been examined in caregivers. Thus, the aim of this presentation is to examine the relations between caregivers’ trauma-related psychopathology (specifically PTSD, depression, and hostility), and attrition (yes/no) in AF-CBT. We hypothesize that as the severity of caregivers’ PTSD, depression and hostility increases, their odds of completing AF-CBT decreases.

Data used were from a randomized controlled trial providing free AF-CBT for traumatized children, aged 4-17, and their caregivers in community settings. Children were aged 4-17, and identified by their caregivers as African American, Caribbean American, and/or Latino. Caregiver PTSD, depression, and hostility were collected from the PTSD Scale-Self Report for DSM 5 (PSS-SR5; ), Patient Health Questionnaire (PHQ; Kroenke et al., 2001), and Brief Symptom Inventory-53 (BSI; Derogatis & Melisaratos, 1983), respectively. Completion Status was categorized as a binary response (completion vs attrition).

We conducted a logistic regression with caregiver PTSD, depression, and hostility as predictors, and treatment completion as our outcome (Agresti, 2007). There were no significant predictors of Completion Status, χ² (3, N = 40) =1.590, p = .662. Results suggest that caregiver psychopathology may not impact treatment completion when trauma interventions are implemented in community settings. Further clinical implications and future directions will be discussed.