Which Clients Are Most Likely to Drop Out of Therapy and Why?
August 9th, 2012
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.
Related articles:
50 Signs of Good Therapy
What is CBT?
Must Therapy be Warranted by Mental Illness Alone?
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13 Comments | Click here to leave a comment.
Comments
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?
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.
Perhaps more counselors should look at their own selves when they are trying to figure out who’s dropping out of therapy and why.
Suppose that it is something that they are or are not doing that is causing patients to leave before they have gone through the treatment plan.
Sometimes it is about more than just the patient you know. Maybe the professionals in that picture could be doing a little more which would encourage their clients to stay with the program.
I have dropped out of therapy before.And it was only because I did not feel the connection with my therapist.But I did find a better therapist late on and went through therapy.So if someone quits it does not mean they will not see another therapist.So this 20% figure could be a lot more than what is in reality.
If this is a big problem with younger adults, then why not more of an effort to get parents involved to keep them enrolled?
How bout a program wherein clients can leave messages or something that lets them express why they r discontinuing.this could be protected and confidential information but will give a chance to help them n also doesnt leave d therapist askin themselves y.
Retention is always a difficult obstacle facing therapists and clients alike. We all know how it is when you start taking an antibiotic for example- you probably will start to feel better after a day or two of the medicine, but your doctor says you have to take it for the full ten days to be completely free of the bug. But you don’t want to go the distance, taking the medication is a hassle. So you stop taking it before the meds have run their course. And then guess what? In a few days or weeks there you are all over again at his office admitting that you need more antibiotices because you didn’t finish up the last round.
Therapy is the same way. You may begin to feel better after just a few visits, especially if you are working with someone who has allowed you to pretty quickly get at the root of your problem and has made you feel improved in just a few sssions. But just like the antibiotic, if you are unwilling to stick this through and complete what has been recommended for you, then there is no doubt that you have only just begun to scratch the surface of your issues and you are bound to be back there sooner or later.
This kind of therapy isn’t for everyone
Not everyone who gets involved in this with a therapist will be a success, and it shouldn’t be expected to be that way
How about being open to more alternative forms of therapy? Like maybe onlibe sessions or even group sessions that are open to patients dropping in and out at will?
If someone is getting something out of it, sure it may not be for them every day of the week, but couldn’t they come and go with the meetings as they choose or see necessary, a la AA or groups like that?
Something and attending sometimes is of more benefit than nothing at all
This is not the fault of the therapist, We have to remember that part of therapy is becoming accountable for your own actions
Have we looked at the financial ramifications of being and staying in therapy for a long period of time?
This is a very expensive undertaking for many people, especially those for whom health insurance coverage is not an option.
I think that if we find a way to make our healthcare system more fair, equitable, and accessible, then you would see far fewer people dropping out of therapy, especially when they are experiencing improvement from the therapy.
If I thought that a family member of mine needed treatment still but was dropping out of it too early, then I would be that person who would step in make this my business, to see to it that they were not giving up too soon or that they at least sought help form another therapist if that just wasn’t the right fit for them.
This is something that you have to commit to and be willing to go the distance with. If you aren’t there, then it is highly unlikely that you will complete all of the therapy that you could need for healing.
“This is not the fault of the therapist, We have to remember that part of therapy is becoming accountable for your own actions”
…Unless your therapist really just SUCKS
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