Date of Award




Document Type


Degree Name

Doctor of Philosophy (PhD)


Department of Psychology


Clinical Psychology

Content Description

1 online resource (v, 85 pages) : 1 illustration.

Dissertation/Thesis Chair

James Boswell

Committee Members

Leslie Halpern, Betty Lin, Kerry Brand


ACEs, children, psychotherapy, trauma, youth, Child psychotherapy, Child mental health, Child mental health services, Stress in children, Patient compliance

Subject Categories

Clinical Psychology | Psychology


Child maltreatment and childhood adversity are associated with a broad range of poor mental and physical health outcomes throughout the lifespan. The consequences of childhood adversity have led psychologists in efforts to identify the most effective therapeutic approaches and interventions with which to address the negative effects of childhood trauma. Even as a number of efficacious treatments have been established as best practices for treating childhood trauma, barriers exist in community mental health settings that oftentimes prevent full implementation of these interventions and practices. A growing body of research has focused on better understanding the high rates of attrition from child psychotherapy, particularly in community settings. Research has identified several treatment factors that may influence premature termination from psychotherapy. Identification of these factors is important so that barriers to treatment completion can be reduced and children can receive the full benefits of psychotherapy. The current study examined the effect of adverse childhood experiences (ACEs) on psychotherapy; specifically, associations between ACEs and psychological diagnoses, as well as child factors, family factors, and therapeutic factors that may interact with a child’s level of exposure to adverse childhood experiences to predict premature termination from psychotherapy. Results of this study show that ACEs are not more associated with certain mental disorders than others in children, that ACEs do not significantly impact child psychotherapy completion, nor do they interact with potential moderators to influence completion of psychotherapy. This study does support that consistent attendance may be associated with psychotherapy completion. Furthermore, the finding that ACEs do not significantly impact psychotherapy completion supports the idea that community mental health clinics can retain children in treatment as usual regardless of the level of trauma exposure.