When youth mental health care stops: therapeutic relationship problems and other reasons for ending youth outpatient treatment.

Child and adolescent treatment ends for a variety of reasons, but little is known about the underlying factors or about whether any such factors are linked to premature dropout. To address these gaps, the authors administered their Reasons for Ending Treatment Questionnaire (RETQ) to the parents of 344 referred youth (aged 7-18 years), from 10 clinics, who had ended outpatient treatment. A factor analysis identified six factors, all showing good test-retest reliability and internal consistency. One of these, Therapeutic Relationship Problems, accounted for the most variance (16%) and was the only factor, other than Money Issues, that distinguished therapy dropouts from completers. The findings highlight major themes underlying decisions to end child therapy, and they highlight the importance of the therapeutic relationship.