Tomorrow we discuss ways to prevent treatment dropout at our live #traumaresearch Twitter chat (26 April; 9pm Melbourne, 13u Amsterdam; see your local time). Julia Diehle will join us as a special guest. She conducts research on Cognitive Behavioral Therapy and EMDR with children, and wrote last week’s guestpost. If you would like to join us tomorrow but don’t have Twitter experience, here’s the information on how to use Twitter and participate in a live chat.

In preparation for the chat, I wanted to share some more information on one of the papers Julia referred to. Glenn Saxe and colleagues conducted a trial with an innovative treatment approach that integrates and tailors different services (psychotherapy, psychopharmacology, home- and community based care, and advocacy) for children and their families. It’s called Trauma Systems Therapy. The authors wanted to conduct a proper randomized controlled trial to compare the effects of TST with the effects of treatment as usual. However, this is what happened: at the 3-month follow-up

• 90% of the children in the TST group were still enrolled, while
• 90% of the children in the control group had dropped out.

Both shocking and fascinating…

The paper on the trial is open-access and worth a read. For now, I thought it would be valuable to share the authors’ key practitioner messages:

1. Premature treatment dropout is a significant problem in child mental health treatment in general and in trauma treatment specifically.
2. Treatment dropout is especially problematic in community care settings (vs. research settings) and with marginalized populations, such as urban and ethnic minority children and adolescents and their families.
3. Improved engagement and retention in trauma-treatment can be attained by a combination of a) forming a treatment alliance with the family; b) troubleshooting practical barriers to treatment engagement; and c) psychoeducation about the nature of traumatic stress and the family’s involvement with treatment.
4. An exclusive and strategic focus on treatment engagement and retention at the outset of service delivery can lead to better outcomes.

I’m very interested in your views on what helps to make PTSD treatment for children and adolescents a success:

• Do you know best practices in engagement and retention in treatment?
• What kind of research should we do to better understand dropout and how we can make sure that clients complete the therapy that would help them feel better?