| This study focused on identifying factors that predict successful treatment with maltreated children. The aim of the study was to provide clinicians with a process for recognizing children more likely to experience successful outcomes that in turn highlights children at high risk for treatment failure. At intake or early in treatment, clinicians can identify a child's level of risk that will inform clinical decisions and help them tailor treatment to increase the likelihood that a child experiences successful treatment outcomes.; Several literature-acknowledged categories of factors were investigated, including child factors, abuse-related factors, and environmental factors. Child factors included age, gender, and ethnicity. Abuse-related factors included the severity of abuse and severity of symptom variables such as sexual, physical, and exposure to domestic violence as well as the child's social competency, expectations for the future, and initial level of distress. Environmental factors included caregiver support of the child in treatment. The data were analyzed using information on the child's Background Information Questionnaire; child's scores on the Social Behavior Inventory, Expectations Test, and Child Behavior Checklist; and therapist's rating of caregiver support. The study included a dataset sample of 945 maltreated children (i.e., victims of sexual abuse, physical abuse, and exposure to domestic violence abuse). Analysis involved hierarchical linear modeling due to the nesting of children in therapists. Each factor was entered into a two-level hierarchical linear model independently with the dichotomous outcome variable of either successful or premature termination of treatment.; Results illustrated that several factors significantly influence successful treatment outcomes. A child's exposure to domestic violence, social competence, initial distress at intake, and expectation for future sexual abuse predicts successful treatment outcomes. Additional analysis of internalizing and externalizing behaviors, client perceived improvement, and a 17-item therapy outcome measure (identifying specific areas of progress related to treatment) also added to the significant findings of this study. Based on the results, the discussion suggested risk-reduction strategies that may increase successful treatment outcomes with maltreated children. Limitations and future directions were discussed. |
