A Predictive Model of Adolescent Persistence in Counseling

Adolescence is a developmental period characterized by profound social and emotional changes. Counseling can serve as a protective factor for decreasing the long-term negative emotional effects. Despite this fact, counselors continue to struggle with high rates of attrition among adolescent clients. When examining trends of client persistence in counseling across the lifespan, researchers found a relationship between the presence of internalizing and externalizing behaviors. Additionally, they found that high levels of familial stress predicted premature termination from counseling. The purpose of the current study was to create a predictive model of adolescent persistence in counseling. I examined both personal and environmental characteristics of adolescents who sought counseling services (N = 72) from an on-campus university counseling clinic that serves as a training facility for master’s and doctoral students at an accredited counselor education program in the southwestern United States. Participants were predominantly White (67.6%, n = 50), with a mean age of 14.23 (SD = 1.65). Nearly 60% (n = 44) of the clients were female, and 37.8% were male (n = 28). Beyond descriptive variables, eight predictor variables were examined: adolescent involvement in their intake, time spent on the wait list, four domains of parental stress, and parent perceptions of adolescent internalizing and externalizing behaviors. A multiple linear regression was conducted to understand how much of the variance in the number of counseling sessions attended by adolescent clients was explained by the predictor variables. The regression analysis was statistically significant (p = .008) and accounted for 29.1% (R2adj = .192) of the variance in sessions attended. Of the variables examined, externalizing behaviors (42.82%) accounted for the most variance in sessions attended, followed by whether the adolescent was involved in the intake (29.16%), internalizing behaviors (12.96%), and parent-focused stress (10.30%). An examination of the two strongest predictors in correlation to the number of sessions attended revealed a negative relationship with externalizing behaviors and a positive relationship with involvement in the intake, suggesting that adolescents who present with externalizing behaviors and who are not involved in their intake are likely to attend fewer counseling sessions. To understand the differences among adolescents who prematurely terminate from counseling and those who persist in counseling, I conducted a series of univariate and multivariate analyses. Comparing the means of the predictor variables revealed no significant differences between any of the predictor variables examined, although internalizing and externalizing behavior scores fell within the borderline clinical range for adolescents who persisted in counseling. Finally, a predictive discriminant analysis to assess to what degree identified variables predicted premature termination from or persistence in counseling yielded a 75% hit rate. Given this knowledge, counselors may be able to pro-actively identify adolescents who are at risk of prematurely terminating from counseling and implement retention strategies.