Factors Influencing Parental Engagement in a Community Child and Adolescent Mental Health Service: A Qualitative Comparison of Completers and Non-Completers

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Abstract
Attrition is a significant problem in child mental health services. Research investigating the factors associated with attrition has produced conflicting results, and failed to consider clients' own decision to terminate treatment prematurely. This study investigated parental accounts of why they completed or discontinued treatment. Completers and non-completers were interviewed using an open-ended interview schedule. All completed the Strengths and Difficulties Questionnaire (SDQ) before beginning treatment, but the sample size was too small to yield meaningful results. Core differences were found in the accounts of parents who completed treatment and parents who discontinued treatment. Completers' accounts were more focused on the child's problem and identified more factors that facilitated the effectiveness of the intervention; whereas non-completers' accounts were more focused on family problems and identified more obstacles that interfered with the effectiveness of the intervention. The findings have implications for the way in which non-completers are conceptualized for understanding the process of engagement.