PMID: 11921880Apr 2, 2002Paper

Discontinuation of treatment in child and adolescent ambulatory psychiatric care in Basel: an evaluation within the scope of quality assurance

Praxis der Kinderpsychologie und Kinderpsychiatrie
Alain Di GalloDieter Bürgin

Abstract

Attrition in child and adolescent psychiatry occurs frequently and has often been investigated. Attempts to establish general criteria that are associated with dropping-out have produced contradictory results. In the present study, factors that influenced attrition at a child psychiatry outpatient clinic in Basel were assessed during two separate periods. Between the two assessments, the results of the first period were presented to the staff and were discussed. At first assessment, attrition was increased in patients who were referred as emergencies or by somatic hospitals. In contrast, attrition was low in patients who were referred involuntarily. At second assessment, there was a significant decrease in dropping-out for the total sample and for emergencies. This result may be explained by a more careful clarification of the setting before first consultation and, as a consequence, by higher congruence between patients' expectations and the clinic's offers. Further studies on the subject of attrition in child and adolescent psychiatry should focus on clearly defined clinical situations and samples and include measures of patients' expectations as well as of the therapeutic relationship.

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