Predicting Psychotherapy Dropouts: A Multilevel Approach
Publisher DOI
PubMed ID
24782040
Abstract
The role of therapeutic processes in predicting premature termination of psychotherapy has been a particular focus of recent research. The purpose of this study was to contrast outpatients who completed therapy and those who dropped out with respect to their self-reported in-session experiences of self-esteem, mastery, clarification and the therapeutic alliance. The 296 patients with mixed disorders were treated with an integrative form of cognitive–behavioural therapy without pre-determined time limit (M = 20.2 sessions). Multilevel analyses indicated that patients who did not completetreatment reported, on average, lower levels of self-esteem, mastery and clarification and lower ratings of their therapeutic alliance in treatment in contrast to patients who completed therapy. Patient-reported change in self-esteem experiences over the course of treatment turned out to be the strongest predictor of dropout from psychotherapy or successful completion. When dropout occurred before the average treatment length was reached, patients reported fewer clarifying experiences as early as the first session and their ratings of the therapeutic alliance were characterized by an absence of positive development. Both of these aspects seem to be involved in patients' decisions to leave treatment early. The findings underscore the importance of the therapeutic process in understanding the mechanisms behind treatment dropout. Copyright © 2014 John Wiley & Sons, Ltd.
Date Issued
2014-04-29
Publication Type
Article
Subject(s)
Subjects
Process-outcome
•
Dropout
•
Completion
•
Cognitive–Behavioural Therapy
•
Psychotherapy Integration
Language(s)
en
Author(s)
Additional Credits
Journal
Clinical psychology & psychotherapy
Publisher
Wiley-Blackwell
ISSN
1063-3995
Access(Rights)
restricted