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The present study examined possible predictors of youth client retention in therapy in a large community-based sample. We used several conceptualizations of retention, including (a) “intake retention” (i.e., returned to treatment after intake session); (b) “mutual termination” (i.e., termination agreed upon by family and therapist), (c) “mean treatment duration” (i.e., completing the mean number of sessions in the agency), and (d) “total treatment duration” (i.e., total number of sessions). Archival data from over 400 children and adolescents who sought treatment at a large public mental health clinic were analyzed using regression analyses. Although different predictors were identified across the various conceptualizations, a few robust predictors emerged including ethnicity and client symptom severity. Clinical implications and future research directions are discussed.

As a natural result of the process of growing up, all children are in a constant state of change.  Every child is just a little bit different every day.  Very young children grow rapidly and noticeably.  Change in school-age children is less obvious but, nevertheless, there are big differences over the course of a year.  At adolescence, some of the physical and emotional changes are dramatic.  Families continually and automatically adjust their parenting and lifestyle to suit the evolving abilities and needs of their children.  It is this dynamic quality that makes children so very different from adults and creates their extended need for adult support and guidance.  Family and child serving systems, including managed care, must have the flexibility to respond rapidly and appropriately to the changing physical, emotional, mental, and social development of infants, toddlers, children and youth.