Table 2 Barriers to adolescent treatment retention

THEMES AND SUBTHEMES

Family-related

 Limited family participation/visits

 Family members use substances

 Other¹: costs associated with treatment, adolescent is caretaker, violence in the home

Policy/Systems

 Health insurance barriers

 Inappropriate placement

 Other¹: Transportation system

Client

 Lack of motivation/readiness

 Difficulty adjusting to rules/structure

 Trauma history/mental health comorbidity

 Younger age

 Other¹: Withdrawals symptoms at treatment entry, marijuana as main substance, run away

Facility

 Staff burnout /turnover

 Other¹: Non-smoking policies, following traditional model of talk therapy/coming to clinic, program location