New Study Offers Insight into Current Therapy Dropout Rates

Clients who drop out of therapy can increase the strain on community mental health services. Dropping out is classified as terminating treatment prior to reaching outcome goals or the recommended number of sessions. When clients drop out, they often end up back in treatment repeatedly, creating a burden on overtaxed mental health resources and clinicians. Therapists who treat clients that drop out of treatment may experience a sense of incompetency that can impair their ability to effectively treat other clients. Additionally, the repetitive nature of starting and stopping treatment seen in clients who drop out can limit the therapists’ availability to treat other clients in need. In order to address this issue and develop strategies to decrease dropout rates, Joshua K. Swift of the Department of Psychology at the University of Alaska in Anchorage recently led a study that analyzed over 83,000 client records from 669 different studies.

Swift examined primarily studies addressing mood issues and anxiety. The therapies assessed were individual and cognitive in nature and were designed to be completed in fewer than 20 sessions.  The results revealed that the most common type of drop out was described as failure to complete therapy, which occurred in nearly 20% of the clients studied. The findings also revealed that the highest dropout rates were found in the youngest clients and those being treated for either an eating problem or personality disorder. Additionally, dropout rates were disproportionately high for clients who were treated at a teaching clinic by a clinician in training.

This study provided evidence that supports previous research. Namely, the results showed that most dropouts are client initiated. However, there is still confusion with respect to a clear definition of a dropout. Swift believes that this term needs to be clarified in order to gauge accurate rates of dropouts in the clinical population. The results of this study also underscore the need for additional research that explores different therapy approaches, settings, and goals. Swift believes understanding the rates of dropout in anxiety clients versus substance abuse clients could help clinicians target factors that lead to premature termination. It is also important to look at how different modes of treatment, such as family therapy and marital therapy, vary with respect to client retention.  Swift added, “Although premature discontinuation is occurring at a lower rate than what was estimated 20 years ago (Wierzbicki & Pekarik, 1993), it is still a significant problem, with about 1 in every 5 clients dropping out of therapy.”

Swift, J. K., Greenberg, R. P. (2012). Premature discontinuation in adult psychotherapy: A meta-analysis. Journal of Consulting and Clinical Psychology. Advance online publication. doi: 10.1037/a0028226

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  • RayRay


    May 2nd, 2012 at 11:27 AM

    I get where you are going with this and trying to get a good idea of what a dropout really is. But pardon me for speaking up but it kind of sounds like you are suggesting or implying that if people keep dropping out then agencies might lose funding. I know that money is important, and we have to have it to keep services going. But those who stop therapy have their reasons, good or bad, and maybe we should focus a little more on the things causing them to stop and creating a path for them to seek treatment once again in a way that is going to be meaningful to them and will have them committing to the completion of their treatment plan.

  • Kendall


    May 2nd, 2012 at 2:57 PM

    If a client drops out of therapy, then why should the counselor feel inadequate?
    If they know that they have done the best that they can for the patient then they can’t feel guilty.
    Sometimes this is just something that the patient has to work thru, and there is nothing that could have been said or done to prevent it.
    I really don’t see why this should affect the way that they feel about their competence, and they definitely should not let it affect how they treat their other clients who have stayed in the game.

  • Chas


    May 3rd, 2012 at 4:22 AM

    If a client drops out, I fault the therapist. I do. Something is being done or not being done that causes the patient to lose focus and to lose motivation. I know that these are adults and have to take responsibility for their own actions, but they need leadership at this point in time, and they need their therapist to offer that to them. If they are not getting that from them, then of course they will stop coming. You have to do something at each meeting to make them continue to want to be there until they are at a point where they know that they might not necessarily want to be there but that they need to be there.

  • bonnie b

    bonnie b

    May 4th, 2012 at 2:57 PM

    I am kind of surprised that some of the highest dropout numbers are among those seeking help for food and eating addicttions. As much as you hear about dieting and all of that stuff, and as much as they profess to want to lsoe weight and get help, you would think that they would stick to the programlike nobody else.

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