Who Is Most Likely to Drop Out of Therapy and Why?

A client that drops out of therapy is one who does not complete the recommended course of treatment. Many therapeutic approaches, such as cognitive behavioral therapy, do not have a specific treatment deadline, and clients are considered dropouts when they have voluntarily stopped therapy prior to resolving the issues and symptoms that brought them there to begin with. Dropout is a serious concern for the medical community and the general population. Individuals who drop out of therapy are more likely to have future psychological complications and seek services multiple times, which places an economic burden on society. Because they do not learn adaptive coping strategies and fail to address the issues that plague them most seriously, they are likely to be less than productive in their careers, families, and communities. Additionally, therapists who experience client dropout may begin to question their ability to help clients and their own adequacy.

Understanding the factors that contribute to dropout can provide clinicians with the information they need to address the problem. Joshua K. Swift of the Department of Psychology at the University of Alaska in Anchorage wanted to explore this problem further and made it the focus of his most recent study. Swift analyzed over 650 studies that included more than 83,000 clients and looked at factors such as client age, therapy setting, therapist experience, type of therapy, issues addressed in therapy, and clinician definition of dropout.

Swift found that nearly 20% of all the clients in the studies ended their treatment early. He found that some variables, such as therapy setting, influenced the rates of dropout. He also discovered that rates of dropout were highest among the youngest participants and those seeking treatment for personality or eating problems. Swift believes that more work is needed to determine specific nuances that effect retention. He hopes efforts will be aimed at isolating psychological issues, such as anxiety or depression, and approaches, such as psychodynamic or behavioral therapy, in order to get a clearer idea of the different dimensions affecting treatment completion. Swift said, “By paying attention to these variables and making adaptations where needed, clinicians may be able to reduce rates of premature discontinuation in their work with clients.”

Reference:
Swift, J. K., Greenberg, R. P. (2012). Premature discontinuation in adult psychotherapy: A meta-analysis. Journal of Consulting and Clinical Psychology80.4: 547-559.

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  • ian

    August 9th, 2012 at 6:52 PM

    but how exactly is ‘complete cure’ defined in therapy?that may be one reason for the high dropout,you know.suppose i have a physical injury and end up in the hospital,there are definitive signs of cure and i move out of the facility once the wounds have healed and i have regained strength.but how is this defined for therapy?

  • Mindy

    September 24th, 2017 at 1:47 AM

    That is why it’s so important to come in with a very specific goal. When you feel that you have accomplished what you came for, it’s time to discuss termination with your therapist. The journey may take you down different paths, with surprising discoveries, but ultimately everything that comes up should be a stepping stone to accomplishing what you came for. It’s about staying focused about why you came, and being open to facing painful realities about how got to where you are in the first place.

  • Lou

    August 10th, 2012 at 4:17 AM

    What I think that you will see out of clients who do not complete the recommended course of therapy is that these are the same people who have in essence always had a hard time committing to anything in life. These are the people who never follow through with assignments or projects, and have always just kind of coasted through life on the backs of others. Maybe all of this is the result of whatever they are actually seeking treatment for to begin with, but it just always seems to follow them around, and has become a pattern of predictable behavior throughout their lives.

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