Predicting psychotherapy dropout
Psychotherapy dropout is widely recognized as a significant and long-standing problem in mental health care delivery. Reviews of the literature consistently indicate that between 30% and 60% of psychotherapy clients terminate prematurely. The present study investigated the predictive utility of variables that are easy to collect and amenable to intervention by the therapist early in the treatment process to prevent dropout. Predictor variables included client's readiness to change, expected duration of therapy, expected success of therapy, therapeutic bond, and missed early sessions. A discriminant function analysis was performed using these variables as predictors of membership in dropout and continuer groups on a sample of 48 outpatient psychotherapy clients. The dropout rate in this sample was 35%. The discriminant function was significant, chi-square (8, N = 48) = 19.99, $p < .05$, and accounted for 38% of the variability between the dropout and continuer groups. The analysis indicated that attendance at the first four therapy sessions and the strength of the early therapeutic bond were the best predictors of dropout. Dropouts were found to have missed more early sessions and reported less positive therapeutic bonding with the therapist following intake than did continuers. The practical significance of the findings in terms of therapist interventions to prevent dropout, limitations of the study, and future research directions are discussed. ^
Diane Duchon Young,
"Predicting psychotherapy dropout"
Dissertations and Master's Theses (Campus Access).