Dropout from individual psychotherapy for major depression: A meta-analysis of randomized clinical trials
Abstract
Dropout from mental health treatment poses a substantial problem, but rates vary substantially across studies and diagnoses. Focused reviews are needed to provide more detailed estimates for specific areas of research. Randomized clinical trials involving individual psychotherapy for unipolar depression are ubiquitous and important, but empirical data on average dropout rates from these studies is lacking. We conducted a random-effects meta-analysis of 54 such studies (N=5852) including 80 psychotherapy conditions, and evaluated a number of predictors of treatment- and study-level dropout rates. Our overall weighted dropout estimates were 19.9% at the study level, and 17.5% for psychotherapy conditions specifically. Therapy orientation did not significantly account for variance in dropout estimates, but estimates were significantly higher in psychotherapy conditions with more patients of minority racial status or with comorbid personality disorders. Treatment duration was also positively associated with dropout rates at trend level. Studies with an inactive control comparison had higher dropout rates than those without such a condition. Limitations include the inability to test certain potential predictors (e.g., socioeconomic status) due to infrequent reporting. Overall, our findings suggest the need to consider how specific patient and study characteristics may influence dropout rates in clinical research on individual therapy for depression.
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A more focused meta-analysis found similar drop-out rate of 19.9% for individual psychotherapy for major depression (Cooper & Conklin, 2015).
“A more focused meta-analysis reviewing only individual psychotherapy for major depression found a similar drop-out rate of 19.9% (Cooper & Conklin, 2015).”
From Acceptability and Feasibility of an Intervention to Enhance Social Group Belonging: Evidence From Three Trials of Groups 4 Health (2022) · cites this paper as Cooper & Conklin, 2015
Copper and Conklin found increased attrition risk of 23.5% from trials involving inactive control condition.
“First, Copper and Conklin found an increased attrition risk of 23.5% from trials involving an inactive control condition (which is relevant to Phases I and II of our data here).”
From Acceptability and Feasibility of an Intervention to Enhance Social Group Belonging: Evidence From Three Trials of Groups 4 Health (2022) · cites this paper as Cooper & Conklin, 2015
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“In fact, the average dropout rate across the studies was 15.7%, which is perfectly in line with a recent meta-analysis on dropouts from individual psychotherapy for major depression (Cooper & Conklin, 2015).”
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“5% obtained from a meta-analysis of dropout from RCTs of psychotherapy for depression [24] that defined dropout as unexpected attrition among individuals who were randomized to a treatment but failed to complete it.”
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“Furthermore, treatment dropout rates can be significantly higher in these vulnerable populations due to limited transport, insurance-coverage difficulties, child-care responsibilities, work schedule conflicts, and lack of knowledge about available treatments (Cooper and Conklin, 2015).”
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“…treatment for PTSD (18.3%; Imel, Laska, Jakupcak, Simpson, 2013) as well as patients receiving individual psyhotherapy for major depression (17.5%; Cooper & Conklin, 2015). he rates for ERP are also less than that for outpatient CBT for nipolar depression (24.6%; Hans & Hiller, 2013) and for CBT…”
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“Identifying consistent reasons for dropout could provide insight towards ways in which these reasons could be prevented in subsequent trials (Cooper & Conklin, 2015).”
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“We adopted a definition of dropout consistent with its typical use in RCTs: unexpected patient attrition among individuals who were randomized to a treatment but failed to complete it until the end of the study (Cooper & Conklin, 2015).”
MethodFernández, D., Vigo, D., Sampson, N. A., Hwang, I., Aguilar-Gaxiola, S., Al-Hamzawi, A. O., Alonso, J., Andrade, L. H., Bromet, E. J., de Girolamo, G., et al. (2021) · Psychological Medicine · doi:10.1017/s0033291720000884 · Cited by 65 · see citing works
“Numerous studies have been conducted to understand the causes and consequences of treatment dropout (Cooper & Conklin, 2015; Fassino, Pierò, Tomba, & AbbateDaga, 2009; Roos & Werbart, 2013).”
BackgroundJardine, J., Nadal, C., Robinson, S., Enrique, Á., Hanratty, M., & Doherty, G. J. (2023) · ACM Transactions on Computer-Human Interaction · doi:10.1145/3635472 · Cited by 55 · see citing works
Erritzøe, D., Barba, T., Greenway, K. T., Murphy, R., Martell, J., Giribaldi, B., Timmermann, C., Murphy-Beiner, A., Baker-Jones, M., Nutt, D., et al. (2024) · EClinicalMedicine · doi:10.1016/j.eclinm.2024.102799 · Cited by 63 · see citing works
“14,15 Further, both SSRIs and psychotherapy are relatively slow-acting, often requiring weeks or months to achieve clinical response.”
Understanding Men’s Engagement and Disengagement When Seeking Support for Mental Health
Kwon, M., Lawn, S., & Kaine, C. (2023) · American Journal of Men s Health · doi:10.1177/15579883231157971 · Cited by 50 · see citing works
Wright, I. M., Mughal, F., Bowers, G., & Meiser‐Stedman, R. (2020) · Journal of Affective Disorders · doi:10.1016/j.jad.2020.11.039 · Cited by 47 · see citing works
“Meta-analyses investigating psychotherapy interventions for depression in adults have found average dropout rates from 17.5% to 19.2% (Cooper & Conklin, 2015; Swift & Greenberg, 2014).”
BackgroundMethodResultInfluentialCristea, I. A. (2019) · Epidemiology and Psychiatric Sciences · doi:10.1017/s2045796018000665 · Cited by 47 · see citing works
“Another study (Cooper and Conklin, 2015) showed that in trials of psychotherapy for depression, inactive control conditions (a category inclusive of WL and placebo, but not of TAU) were associated with higher overall drop-out rates than active ones.”
BackgroundCooper, A. A., Kline, A. C., Baier, A. L., & Feeny, N. C. (2018) · Behavior Modification · doi:10.1177/0145445518792251 · Cited by 48 · see citing works
“In addition, dropout may have a particularly insidious and invisible effect on meta-analytic reviews, where detecting its influence is dependent on the degree to which authors of primary literature studies adhere to reporting standards (Cooper & Conklin, 2015; Rief & Hofmann, 2008).”
BackgroundSelf-citationCognitive Behavioral Therapy for Insomnia in People With Chronic Disease
Scott, A. J., Correa, A. B., Bisby, M. A., Chandra, S. S., Rahimi, M. M., Christina, S., Heriseanu, A. I., & Dear, B. F. (2025) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2025.4610 · Cited by 42 · see citing works
Yang, X., Zhao, J., Chen, Y., Zu, S., & Zhao, J. (2018) · Journal of Affective Disorders · doi:10.1016/j.jad.2017.10.014 · Cited by 40 · see citing works
“9% (Cooper and Conklin, 2015), the dropout rate in the current study was relatively low when taking into account the long duration of the intervention program.”
Overall and differential attrition in mindfulness-based interventions: A meta-analysis
Lam, S. U., Kirvin-Quamme, A., & Goldberg, S. B. (2022) · Mindfulness · doi:10.1007/s12671-022-01970-z · Cited by 39 · see citing works
“Estimates based on the RCT literature (e.g., individual psychotherapy for major depressive disorder) have been similar (17.5%; Cooper & Conklin, 2015).”
MethodInfluentialLinardon, J., Fitzsimmons‐Craft, E. E., Brennan, L., Barillaro, M., & Wilfley, D. E. (2018) · Psychotherapy Research · doi:10.1080/10503307.2018.1497215 · Cited by 40 · see citing works
“…makes it difficult for researchers to (i) develop, implement, and evaluate strategies aimed at reducing dropout; (ii) identify predictors and moderators of dropout; and (iii) devote effort toward improving the effectiveness of treatments such as IPT (Cooper & Conklin, 2015; Miller & Brennan, 2014).”
BackgroundMethodResultInfluentialSimmonds‐Buckley, M., Kellett, S., & Waller, G. (2019) · Behavior Therapy · doi:10.1016/j.beth.2019.01.003 · Cited by 41 · see citing works
Lopez‐Gomez, I., Chaves, C., Hervas, G., & Vazquez, C. (2017) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.2129 · Cited by 39 · see citing works
“These meta-analyses have found that the dropout in CBT was 17% in randomized clinical trials (Cooper & Conklin, 2015) and 25% in non-randomized effectiveness studies (Hans & Hiller, 2013).”
BackgroundKemmeren, L. L., van Schaik, A., Smit, J. H., Ruwaard, J., Rocha, A., Henriques, M., Ebert, D. D., Titzler, I., Hazo, J.-B., Dorsey, M., et al. (2019) · JMIR Mental Health · doi:10.2196/12707 · Cited by 36 · see citing works
“5% not compliant with the allocated treatment) were in line with those observed in traditional FTF CBT, being around 17% in randomized trials [52] and 25% in nonrandomized effectiveness studies [53].”
MethodCooper, A. A., Strunk, D. R., Ryan, E. T., DeRubeis, R. J., Hollon, S. D., & Gallop, R. (2015) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2015.06.005 · Cited by 36 · see citing works
“As dropout is an important therapeutic outcome, there is a need to identify its predictors, as well as intervention strategies that reduce the risk of dropout (Cooper & Conklin, 2015; Swift & Greenberg, 2012; Swift, Greenberg, Whipple, & Kominiak, 2012).”
BackgroundSelf-citationDo psychosocial treatment outcomes vary by race or ethnicity? A review of meta-analyses
Cougle, J. R., & Grubaugh, A. L. (2022) · Clinical Psychology Review · doi:10.1016/j.cpr.2022.102192 · Cited by 36 · see citing works
Psilocybin and Other Classic Psychedelics in Depression
Nutt, D., Peill, J. M., Weiss, B., Godfrey, K., Carhart-Harris, R. L., & Erritzøe, D. (2023) · Current topics in behavioral neurosciences · doi:10.1007/7854_2023_451 · Cited by 37 · see citing works
Atefi, G., Koh, W. Q., Kohl, G., Seydavi, M., Swift, J. K., Akbari, M., & de Vugt, M. E. (2024) · American Journal of Geriatric Psychiatry · doi:10.1016/j.jagp.2024.04.008 · Cited by 34 · see citing works
Kopf-Beck, J., Müller, C. L., Tamm, J., Fietz, J., Rek, N., Just, L., Spock, Z. I., Weweck, K., Takano, K., Rein, M., et al. (2024) · Psychotherapy and Psychosomatics · doi:10.1159/000535492 · Cited by 30 · see citing works
“The overall dropout rate of about 29% is above average for psychotherapy trials for depression [50], but within the normal range, given the higher dropout rates in trials using medication and/or naturalistic settings [51].”
BackgroundSunnhed, R., Hesser, H., Andersson, G., Carlbring, P., Morin, C. M., Harvey, A. G., & Jansson‐Fröjmark, M. (2019) · SLEEP · doi:10.1093/sleep/zsz245 · Cited by 32 · see citing works
“5%) [75], and no significant difference emerged between the therapies, it may still limit the interpretation of the findings.”
BackgroundBreland‐Noble, A. M., Streets, F. J., & Jordan, A. (2023) · The Lancet Psychiatry · doi:10.1016/s2215-0366(23)00338-3 · Cited by 32 · see citing works
Predicting treatment effects in unipolar depression: A meta-review
Gillett, G., Tomlinson, A., Efthimiou, O., & Cipriani, A. (2020) · Pharmacology & Therapeutics · doi:10.1016/j.pharmthera.2020.107557 · Cited by 33 · see citing works
Carneiro, L., Afonso, J., Ramirez-Campillo, R., Murawska-Ciałowciz, E., Marques, A., & Clemente, F. M. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17186715 · Cited by 31 · see citing works
“Dropouts from exercise treatment represent a huge barrier that impedes individual benefit from an intervention, and appear to be a particular problem in persons with depression [54].”
BackgroundEllis, S., Bostian, C. M., Feng, W., Fischer, E. G., Schwartz, G., Eisen, K., Lean, M., Conlan, E., Ostacher, M. J., Aaronson, S. T., et al. (2024) · Journal of Affective Disorders · doi:10.1016/j.jad.2024.09.133 · Cited by 30 · see citing works
Digital Interventions to Enhance Readiness for Psychological Therapy: Scoping Review
Jardine, J., Bowman, R., & Doherty, G. J. (2022) · Journal of Medical Internet Research · doi:10.2196/37851 · Cited by 28 · see citing works
“Low use and high dropout rates are persistent problems when it comes to digital solutions [15], although similar problems also affect FTF modalities; between 17% and 25% of clients are estimated to drop out of FTF psychotherapy [8,16,17].”
Praško, J. P., Grambal, A., Kasalová, P., Kamarádová, D., Ocisková, M., Holubová, M., Vrbová, K., Sigmundova, Z., Látalová, K., Šlepecký, M., et al. (2016) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s118058 · Cited by 26 · see citing works
“There are several studies that reported worse treatment results in patients with depressive disorders comorbid with PDs. 57,90,91 94 Differences in the results of these studies can be explained by the different patient populations studied.”
Influentialvan Bronswijk, S. C., Lemmens, L. H. J. M., Huibers, M. J. H., Arntz, A. R., & Peeters, F. P. M. L. (2018) · Journal of Affective Disorders · doi:10.1016/j.jad.2018.02.003 · Cited by 26 · see citing works
“…low motivation for change, poor therapeutic alliance, low treatment credibility and failure to improve early in treat-ment (Arnow et al., 2007; Cooper and Conklin, 2015; Schindler et al., 2013; Taylor et al., 2012)), individual risks for dropout should be estimated, and speci fi c…”
Soucy, I., Provencher, M. D., Fortier, M., & McFadden, T. (2017) · Cognitive Behaviour Therapy · doi:10.1080/16506073.2017.1337806 · Cited by 26 · see citing works
“…self-help interventions ranging between 2.2 and 45.5% (Cuijpers, Donker, van Straten, Li, & Andersson, 2010; Newman, Szkodny, Llera, & Przeworski, 2011), psychotherapy interventions estimated at 17.5% (Cooper & Conklin, 2015), and exercise interventions estimated at 17.2% (Stubbs et al., 2016).”
InfluentialWho will stay and who will go? Identifying risk factors for psychotherapy dropout
McGovern, C., Athey, A. J., Beale, E. E., Overholser, J. C., Gomez, S. H., & Silva, C. (2024) · Counselling and Psychotherapy Research · doi:10.1002/capr.12783 · Cited by 30 · see citing works
Simmonds‐Buckley, M., Osivwemu, E.-O., Kellett, S., & Taylor, C. A. (2022) · Clinical Psychology Review · doi:10.1016/j.cpr.2022.102187 · Cited by 25 · see citing works
Männliche Formen der Depression und deren Behandlung
Walther, A., & Seidler, Z. E. (2020) · PiD - Psychotherapie im Dialog · doi:10.1055/a-0987-5902 · Cited by 25 · see citing works
“Während diese Hypothese substanzielle Unterstützung auf Basis einiger Primärstudien erhalten hat, wurde dies wiederum in einer Meta-Analyse nicht bestätigt, die ähnliche Abbrecherquoten einer individuellen Psychotherapie bei Männern und Frauen mit Depressionen zeigt [14].”
BackgroundCruwys, T., Haslam, C., Haslam, S. A., Rathbone, J. A., & Donaldson, J. L. (2022) · Behavior Therapy · doi:10.1016/j.beth.2022.06.011 · Cited by 23 · see citing works
Osma, J., Péris-Baquero, Ó., Suso‐Ribera, C., Sauer-Zavala, S. E., & Barlow, D. H. (2021) · Cognitive Therapy and Research · doi:10.1007/s10608-021-10208-6 · Cited by 24 · see citing works
Frank, E., Wallace, M. L., Matthews, M. J., Kendrick, J., Leach, J., Moore, T., Aranovich, G. J., Choudhury, T., Shah, N. R., Framroze, Z., et al. (2022) · Frontiers in Digital Health · doi:10.3389/fdgth.2022.870522 · Cited by 24 · see citing works
“%) is among the lowest ever observed in a clinical trial of a depression intervention where drop-out rates in the 17.5% – 47.8% range are common (22).”
BackgroundInfluentialSimulating clinical trial visits yields patient insights into study design and recruitment
Lim, S.-Y., Kivitz, A., McKinnell, D., Pierson, M. E., & O'Brien, F. S. (2017) · Patient Preference and Adherence · doi:10.2147/ppa.s137416 · Cited by 24 · see citing works
“In addition, patients from racial minority groups have higher dropout rates in clinical trials compared with white patients.(5,7) This underrepresentation of African-Americans is particularly relevant for systemic lupus erythematosus (SLE) clinical trials.”
BackgroundSong, J., Litvin, B., Allred, R., Chen, S., Hull, T. D., & Areán, P. A. (2023) · Journal of Medical Internet Research · doi:10.2196/46052 · Cited by 25 · see citing works
“Still, on average, participants completed a considerable proportion of their treatment, and varying levels of treatment engagement are reflective of the psychotherapeutic treatments provided in community settings [38].”
Matthews, E. B., Savoy, M. L., Paranjape, A., Washington, D., Hackney, T., Galis, D., & Zisman‐Ilani, Y. (2022) · Journal of General Internal Medicine · doi:10.1007/s11606-022-07427-2 · Cited by 22 · see citing works
Lund, H. N., Pedersen, I. N., Heymann-Szlachcinska, A. M., Tuszewska, M., Bízik, G., Larsen, J. I., Drago, A., Kulhay, E., Larsen, A., Sørensen, H. Ø., et al. (2022) · Nordic Journal of Psychiatry · doi:10.1080/08039488.2022.2080254 · Cited by 22 · see citing works
“The study had a low dropout rate compared to the estimate of the protocol and to clinical trials of psychotherapy in depression [32].”
ResultShould rTMS be considered a first-line treatment for major depressive episodes in adults?
O’Sullivan, S. J., Buchanan, D. M., Batail, J.-M. V., & Williams, N. (2024) · Clinical Neurophysiology · doi:10.1016/j.clinph.2024.06.004 · Cited by 21 · see citing works
Jakobsen, H., Andersson, G., Havik, O., & Nordgreen, T. (2016) · Internet Interventions · doi:10.1016/j.invent.2016.11.002 · Cited by 23 · see citing works
“This is however somewhat higher than what has been found for individual CBT in a meta-analysis by Cooper and Conklin (2015).”
ResultZuccolo, P. F., Xavier, M. O., Matijasevich, A., Polanczyk, G. V., & Fatori, D. (2021) · Trials · doi:10.1186/s13063-021-05179-8 · Cited by 21 · see citing works
Luedke, A., Peluso, P. R., Diaz, P., Freund, R. R., & Baker, A. Z. (2017) · Journal of Counseling & Development · doi:10.1002/jcad.12125 · Cited by 20 · see citing works
van Bronswijk, S. C., Lemmens, L. H. J. M., Huibers, M. J. H., & Peeters, F. P. M. L. (2020) · Journal of Affective Disorders · doi:10.1016/j.jad.2020.09.135 · Cited by 21 · see citing works
Li, L., Wang, L., Duan, Y., Xiao, P., Zhou, Y., Luo, X., Liu, X., Xie, J., & Cheng, A. S. K. (2022) · Cancer Medicine · doi:10.1002/cam4.5030 · Cited by 18 · see citing works
Westhoff, M., Berg, M., Reif, A., Rief, W., & Hofmann, S. G. (2024) · Cognitive Therapy and Research · doi:10.1007/s10608-024-10487-9 · Cited by 26 · see citing works
“…effect sizes for anxiety and depression treatments remain moderate (Cuijpers et al., 2019; Weitz et al., 2018), with substantial therapy dropout (Cooper & Conklin, 2015; Gersh et al., 2017), high non-responder rates (Springer et al., 2018) and some patient subgroups deteriorating despite…”
Transcranial focused ultrasound targeting the default mode network for the treatment of depression
Schachtner, J. N., Dahill-Fuchel, J. F., Ehrmann, K., Bawiec, C. R., Hollender, P. J., Ornellas, S. B., Konecky, S. D., Achrol, A. S., & Allen, J. J. B. (2025) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2025.1451828 · Cited by 19 · see citing works
“…of participants dropped out due to lack of positive effects of the treatment, which is also signi fi cantly better than dropout rates in traditional clinical depression trials, such as individual psychotherapy and pharmaceuticals with up to one-third drop out prior to treatment completion (40 – 42).”
Rajan, G., Wachtler, C., Lee, S., Wändell, P. E., Philips, B., Wahlström, L., Svedin, C. G., & Carlsson, A. C. (2020) · Journal of Interpersonal Violence · doi:10.1177/0886260520965973 · Cited by 19 · see citing works
“…the dropout rates for PTSD treatment are often high in real clinical settings as opposed to the clinical trial settings (Najavits, 2015); even in study settings however, meta-analysis finds dropout rates of between 16 and 18% (Cooper & Conklin, 2015; Imel et al., 2013; Lewis et al., 2020).”
Henry, J. A., Goodworth, M.-C., Lima, E., Zaugg, T., & Thielman, E. J. (2022) · Ear & Hearing · doi:10.1097/aud.0000000000001150 · Cited by 18 · see citing works
“These average dropout rates of 14 to 16% are actually lower than the average of 17.5% observed from a meta-analysis of studies of in-person psychotherapy for depression (Cooper & Conklin 2015).”
BackgroundInfluentialThe therapeutic alliance and dropout in cognitive behavioral therapy of depression
Murphy, S. T., Garcia, R. A., Cheavens, J. S., & Strunk, D. R. (2022) · Psychotherapy Research · doi:10.1080/10503307.2021.2025277 · Cited by 18 · see citing works
“…a common occurrence, with a meta-analysis estimating the rate of dropout for individual psychotherapy of major depression to be about 20% overall (Cooper & Conklin, 2015) The effects of dropout are important to consider, as dropout is related to a range of negative effects, chief among them…”
BackgroundResultInfluentialGuimarães, M. E. A., Derhon, V., Signori, L. U., Seiffer, B., Wolf, S., & Schuch, F. B. (2024) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2024.08.025 · Cited by 28 · see citing works
Counseling dropout, retention, and ethnic/language match for Asian Americans.
Presley, S., & Day, S. X. (2018) · Psychological Services · doi:10.1037/ser0000223 · Cited by 18 · see citing works
Soucy, I., Provencher, M. D., Fortier, M., & McFadden, T. (2018) · Journal of Mental Health · doi:10.1080/09638237.2018.1466031 · Cited by 18 · see citing works
“While this attrition is comparable to other self-help (Newman et al., 2011), psychotherapy (Cooper & Conklin, 2015) and PA interventions (Stubbs et al., 2016), the authors consider it to be quite high given the many aspects of these guided selfhelp interventions that should promote adherence (e.g.…”
ResultGloster, A. T., Haller, E., Villanueva, J., Block, V., Benoy, C., Meyer, A. H., Brogli, S., Kuhweide, V., Karekla, M., Bader, K., et al. (2023) · Psychotherapy and Psychosomatics · doi:10.1159/000529411 · Cited by 16 · see citing works
Carpallo-González, M., Muñoz‐Navarro, R., González‐Blanch, C., & Vindel, A. C. (2023) · International Journal of Clinical and Health Psychology · doi:10.1016/j.ijchp.2023.100379 · Cited by 18 · see citing works
“…Imel, Laska, Jakupcak and Simpson (2013) 42 1850 PTSD Individual and group Hans and Hiller (2013) 34 1880 Depression Individual and group Cooper and Conklin (2015) 54 5852 Depression Individual Fern andez, Salem, Swift and Ramtahal (2015) 115 20995 Various disorders (DR disaggregated by disorder)…”
BackgroundMethodResultInfluentialNavigating treatment recommendations for PTSD: A rapid review
Lee, E., & Bowles, K. H. (2020) · International Journal of Mental Health · doi:10.1080/00207411.2020.1781407 · Cited by 19 · see citing works
“For example, two meta-analytic reviews note that the average dropout rate for depression as 19.9% (Cooper & Conklin, 2015) and anxiety as 16.99% (Gersh et al., 2017).”
BackgroundInfluentialTreatment dropout among veterans and their families: Quantitative and qualitative findings.
Amsalem, D., Lopez-Yianilos, A., Lowell, A., Pickover, A. M., Arnon, S., Zhu, X., Suarez-Jimenez, B., Ryba, M., Bergman, M., Such, S., et al. (2022) · Psychological Trauma: Theory, Research, Practice, and Policy · doi:10.1037/tra0001109 · Cited by 16 · see citing works
Benjet, C. L., Borges, G. L. G., Orozco, R., Aguilar‐Gaxiola, S., Andrade, L. H., Cía, A. H., Hwang, I. H., Kessler, R. C., Piazza, M., Posada‐Villa, J., et al. (2022) · Journal of Affective Disorders · doi:10.1016/j.jad.2022.02.019 · Cited by 16 · see citing works
Darnell, D. A., Pullmann, M. D., Hull, T. D., Chen, S., & Areán, P. A. (2022) · JMIR Formative Research · doi:10.2196/36521 · Cited by 17 · see citing works
“Marital status did not appear to be related to psychotherapy or mental health service disengagement in previous face-to-face psychotherapy studies [23,28,36].”
Backgroundvan Dijk, D. A., Deen, M. L., van den Boogaard, T. M., Ruhé, H. G., Spijker, J., & Peeters, F. P. M. L. (2022) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-022-01499-1 · Cited by 16 · see citing works
“Co-morbidity such as personality disorders and eating disorders [6, 9, 29] are considered to be risk enhancing by some, but other studies describe no or even a protective effect of personality pathology [13, 21].”
BackgroundResultInfluentialLatent Profiles of Comorbid Depression as Predictors of PTSD Treatment Outcome
Burton, M. S., Cooper, A. A., Mello, P. G., Feeny, N. C., & Zoellner, L. A. (2021) · Behavior Therapy · doi:10.1016/j.beth.2020.12.005 · Cited by 17 · see citing works
Self-citationWollmer, M. A., Neumann, I., Jung, S., Bechinie, A., Herrmann, J., Müller, A., Wohlmuth, P., Fournier-Kaiser, L., Sperling, C., Peters, L., et al. (2022) · Journal of Psychopharmacology · doi:10.1177/02698811211069108 · Cited by 16 · see citing works
“With randomized open allocation to either BTX or ACU treatment, we intended to avoid disappointment, higher attrition rates, and nocebo effects that may arise from discovering allocation to the placebo group (Cooper and Conklin, 2015; Doering et al., 2014; Furukawa et al., 2014).”
MethodVancampfort, D., Firth, J., Schuch, F. B., Rosenbaum, S., Probst, M., Ward, P. B., Damme, T. V., Binder, M. D., & Stubbs, B. (2016) · Mental health and physical activity · doi:10.1016/j.mhpa.2016.09.002 · Cited by 16 · see citing works
“…with its typical use in RCTs, and that adopted in other reviews of dropout in physical activity RCTs (Vancampfort et al 2016, Stubbs et al 2016), which was: ‘unexpected patient attrition among individuals who were randomized to a treatment but failed to complete it’ (Cooper & Conklin, 2015).”
MethodDetermining maximal achievable effect sizes of antidepressant therapies in placebo‐controlled trials
Hieronymus, F., Lisinski, A., Hieronymus, M., Näslund, J., Eriksson, E., & Østergaard, S. D. (2021) · Acta Psychiatrica Scandinavica · doi:10.1111/acps.13340 · Cited by 14 · see citing works
Oliveira, J. T., Sousa, I., Ribeiro, A. P., & Gonçalves, M. M. (2021) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.2694 · Cited by 15 · see citing works
Walther, A., Ehlert, U., Schneeberger, M., Eggenberger, L., Flückiger, C., Komlenac, N., Heald, A. H., Rice, T., Palm, S., Seidler, Z. E., et al. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1129386 · Cited by 15 · see citing works
Schulte-Frankenfeld, P. M., Breedvelt, J., Brouwer, M. E., van der Spek, N., Bosmans, G., & Bockting, C. (2024) · Clinical Psychology in Europe · doi:10.32872/cpe.13717 · Cited by 17 · see citing works
“%) and in line with estimates from other psychotherapy trials for depression in children and youth (Cooper & Conklin, 2015; Wright et al., 2021).”
Solomonov, N., & Barber, J. P. (2015) · Epidemiology and Psychiatric Sciences · doi:10.1017/s2045796015000815 · Cited by 15 · see citing works
“Meta-analyses comparing dropout rates in different psychotherapies have yielded mixed findings, from equal dropout rates across treatments (Cooper & Conklin, 2015), to significant differences between psychotherapies, with the highest rate in CBT and the lowest rate in PST (Cuijpers et al. 2008).”
BackgroundResultInfluentialMårtensson, E., Coumoundouros, C., Sörensdotter, R., von Essén, L., & Woodford, J. (2022) · Journal of Affective Disorders · doi:10.1016/j.jad.2022.09.093 · Cited by 15 · see citing works
“Future research should seek to enhance retention (Cooper and Conklin, 2015), and report intervention characteristics in detail, e.g. using the TIDieR checklist (Hoffmann et al., 2014).”
- Authors
- Cooper, A. A., & Conklin, L. R.
- Affiliations
- Case Western Reserve University (US)
- Boston University (US)
- Corresponding author
- Cooper, Andrew A.
- Venue
- Clinical Psychology Review
- Publisher
- Elsevier BV
- Published
- 2015-08
- Volume
- 40
- Pages
- 57-65
- ISSN
- 0272-7358 (ISSN-L)
- OpenAlex
- W243214355
- Cited by
- 264
- References
- 56
- Citations by year
- 2026: 35 · 2025: 32 · 2024: 30 · 2023: 30 · 2022: 29 · 2021: 24 · 2020: 25 · 2019: 9 · 2018: 18 · 2017: 14 · 2016: 11 · 2015: 4
- FWCI
- 2.23
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Psychology Review (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Social Sciences and Humanities Research Council of Canada
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- treatment discontinuation, individual psychotherapy, major depressive disorder, predictors of dropout, personality disorders, treatment duration, psychotherapy research
- MeSH terms
- Major Depressive Disorder, Humans, Patient Dropouts, Psychotherapy, Randomized Controlled Trials as Topic
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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