A significant number of psychotherapy clients remain untreated, and dropping out is one of the main reasons. Still, the literature around this subject is incoherent. The present study explores potential pre-treatment predictors of dropout in a sample of clients who took part in a clinical trial designed to test the efficacy of narrative therapy for major depressive disorder compared to cognitive-behavioral therapy. Logistic regression analysis showed that: (1) treatment assignment did not predict dropout, (2) clients taking psychiatric medication at intake were 80% less likely to drop out from therapy, compared to clients who were not taking medication, and (3) clients presenting anxious comorbidity at intake were 82% less likely to dropout compared to those clients not presenting anxious comorbidity. Results suggest that clinicians should pay attention to depressed clients who are not taking psychiatric medication or have no comorbid anxiety. More research is needed in order to understand this relationship.
A high number of psychotherapy clients remain untreated and dropout is one of the main reasons, since rates are high (approx. 20%, up to 74%; Swift & Greenberg, 2012). Few predictors of dropout have emerged recurrently in research, such as low socio-economic status (Reis & Brown, 1999), being married or living with a partner, previous experience with psychotherapy (Werner-Wilson & Winter, 2010), low education (Swift & Greenberg, 2012), older age (Pomp, Fleig, Schwarzer, & Lippke, 2013), being African-American (Lester, Artz, Resick, & Young-Xu, 2010), being female (Shamir, Szor, & Melamed, 2010), suffering from low levels of anxiety and/or depression (Baekeland & Lundwall, 1975), less clinical experience of therapists (Roos and Werbart, 2013 and Swift and Greenberg, 2012) and weaker alliance (Sharf, Primavera, & Diener, 2010). Still, most researchers who have investigated psychotherapy dropout agree that there is no clear evidence for a pattern of dropout predictors (Baekeland and Lundwall, 1975, Casares-López et al., 2011 and Swift and Greenberg, 2012). The aim of this study is to explore the attrition data of a psychotherapy clinical trial by assessing potential pre-treatment predictors for dropping out of treatment.
Of the 23 clients who eventually dropped out, 48% did so by the end of the fourth session, and 91% left treatment before the 11th session. Mean length of stay in treatment for the dropout group was 6.4 (SD = 4.4).
