CoChat
Sign Up
Cited by 564Psychotherapy Techniques and ApplicationsMental Health Treatment and AccessCounseling Practices and Supervision

Early withdrawal from mental health treatment: Implications for psychotherapy practice.

Open access
Barrett, Marna S., Chua, Wee-Jhong, Crits-Christoph, Paul, Gibbons, Mary Beth, Thompson, Don·2008·Psychotherapy: Theory, Research, Practice, Training
DOI 10.1037/0033-3204.45.2.247PMC PMC2762228
Open this paper in CoChat — free account

Abstract

Despite more than 50 years of research on client attrition from therapy, obstacles to the delivery and success of treatments remain poorly understood, and effective methods to engage and retain clients in therapy are lacking. This article offers a review of the literature on attrition, highlighting the methodological challenges in effectively addressing the complex nature of this problem. Current interventions for reducing attrition are reviewed, and recommendations for implementing these interventions into psychotherapy practice are discussed.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1037/0033-3204.45.2.247

Cites

19 of 19 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Dropout, non-completion, and premature termination of an intervention constitute significant problems that limit the effectiveness of any intervention.

    “Dropout, non-completion, and the premature termination of an intervention constitute significant problems that limit the effectiveness of any intervention”

    From Examining the effectiveness and acceptability of a group-based ACT intervention delivered by videoconference to international university students during the COVID-19 pandemic. (2024) · cites this paper as Barrett, Chua, Crits-Christoph, Gibbons, & Thompson, 2008

    The “Why Is Attrition Problematic?” passage says premature termination hinders effective delivery of mental health services across settings, populations, and treatment modalities. The “Future Directions” passage says attrition seriously compromises treatment outcomes. These passages support the claim for mental health treatment, but not its unqualified extension to any intervention. (LLM, conf=0.85)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 178

  1. Acosta FX. Self-described reasons for premature termination of psychotherapy by Mexican American, Black American, and Anglo-American patients. Psychological Reports. 1980;47:435–443. doi: 10.2466/pr0.1980.47.2.435. [DOI] [PubMed] [Google Scholar] · DOI
  2. Affleck DC, Medwick SA. The use of the Rorschach Test in the production of the abrupt terminator in individual psychotherapy. Journal of Counseling Psychology. 1959;23:125–128. doi: 10.1037/h0042341. [DOI] [PubMed] [Google Scholar] · DOI
  3. Alvidrez J. Ethnic variations in mental health attitudes and service use among low-income African American, Latina, and European American young women. Community Mental Health Journal. 1999;35:515–530. doi: 10.1023/a:1018759201290. [DOI] [PubMed] [Google Scholar] · DOI
  4. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4, text rev. Washington, DC: Author; 2000. Outline for cultural formulation; pp. 843–849. [Google Scholar]
  5. Andersen RM. Behavioral model of families’ use of health services research (Series No. 25) Chicago: Center for Health Administration Studies, University of Chicago; 1968. [Google Scholar]
  6. Annis LV, Perry DF. Self-disclosure in unsupervised groups: Effects of videotaped models. Small Group Behavior. 1978;9:102–108. [Google Scholar]
  7. Baekeland F, Lundwall L. Dropping out of treatment: A critical review. Psychological Bulletin. 1975;82:738–783. doi: 10.1037/h0077132. [DOI] [PubMed] [Google Scholar] · DOI
  8. Baker A, Kochan N, Dixon J, Heather N. Controlled evaluation of a brief intervention for HIV prevention among injecting drug users not in treatment. AIDS Care. 1994;6:559–570. doi: 10.1080/09540129408258670. [DOI] [PubMed] [Google Scholar] · DOI
  9. Barber JP, Morse JQ, Krakauer ID, Chit-Tams J, Crits-Christoph K. Change in obsessive-compulsive and avoidant personality disorders following time-limited supportive-expressive therapy. Psychotherapy: Theory, Research, Practice, Training. 1997;34:133–143. [Google Scholar]
  10. Barkham M, Rees A, Stiles WB, Hardy GE, Shapiro D. Dose-effect relations for psychotherapy of mild depression: A quasi-experimental comparison of effects of 2, 8, and 16 sessions. Psychotherapy Research. 2002;12:263–274. [Google Scholar]
  11. Barkham M, Shapiro DA, Hardy GE, Rees A. Psychotherapy in two-plus-one sessions: Outcomes of a randomized controlled trial of cognitive–behavioral and psychodynamic–interpersonal therapy for subsyndromal depression. Journal of Consulting and Clinical Psychology. 1999;67:201–211. doi: 10.1037//0022-006x.67.2.201. [DOI] [PubMed] [Google Scholar] · DOI
  12. Barrett MS, Chua W, Thompson D. Predicting dropout among women receiving community-based mental health treatment; Paper presented at the annual meeting of the Society for Psychotherapy Research; Madison, WI. 2007. Jun, [Google Scholar]
  13. Beck NC, Lamberti J, Gamache M, Lake EA, Fraps CL, McReynolds WT, et al. Situational factors and behavioral self-prediction in the identification of clients at high risk to drop out of psychotherapy. Journal of Clinical Psychology. 1987;43:511–520. doi: 10.1002/1097-4679(198709)43:5<511::aid-jclp2270430515>3.0.co;2-u. [DOI] [PubMed] [Google Scholar] · DOI
  14. Beckham EE. Predicting patient dropout in psychotherapy. Psychotherapy: Theory, Research, Practice, Training. 1992;29:177–182. [Google Scholar]
  15. Belcher L, Kalichman S, Topping M, Smith S, Emshoff J, Norris F, Nurss J. A randomized trial of a brief HIV risk reduction counseling intervention for women. Journal of Consulting and Clinical Psychology. 1996;66:856–861. doi: 10.1037//0022-006x.66.5.856. [DOI] [PubMed] [Google Scholar] · DOI
  16. Berrigan LP, Garfield SL. Relationship of missed psychotherapy appointments to premature termination and social class. British Journal of Clinical Psychology. 1981;20:239–242. doi: 10.1111/j.2044-8260.1981.tb00524.x. [DOI] [PubMed] [Google Scholar] · DOI
  17. Beutler LE, Machado PPP, Neufeldt SA. Therapist variables. In: Bergin AE, Garfield SL, editors. Handbook of psychotherapy and behavior change. 4. New York: Wiley; 1994. pp. 229–269. [Google Scholar]
  18. Boyd-Franklin N. Black families in therapy: Understanding the African American experience. New York: Guilford Press; 2003. [Google Scholar]
  19. Brandt LW. Studies of “dropout” patients in psychotherapy: A review of findings. Psychotherapy: Theory, Research, & Practice. 1965;2:2–13. [Google Scholar]
  20. Brill NQ, Storrow HA. Social class and psychiatric treatment. Archives of General Psychiatry. 1960;3:340–344. doi: 10.1001/archpsyc.1962.01710240065003. [DOI] [PubMed] [Google Scholar] · DOI
  21. Brogan MM, Prochaska JO, Prochaska JM. Predicting termination and continuation status in psychotherapy using the transtheoretical model. Psychotherapy: Theory, Research, Practice, Training. 1999;36:105–113. [Google Scholar]
  22. Brown DR, Keith VM, editors. In and out of our right minds: The mental health of African American women. New York: Columbia University Press; 2004. [Google Scholar]
  23. Cahill J, Barkham M, Hardy G, Rees A, Shapiro DA, Stiles WB, Macaskill N. Outcomes of patients completing and not completing cognitive therapy for depression. British Journal of Clinical Psychology. 2003;42:133–143. doi: 10.1348/014466503321903553. [DOI] [PubMed] [Google Scholar] · DOI
  24. Carey MP, Kalichman SC, Forsyth AD, Wright EM, Johnson BT. Enhancing motivation to reduce the risk of HIV infection for economically disadvantaged urban women. Journal of Consulting and Clinical Psychology. 1997;65:531–541. doi: 10.1037//0022-006x.65.4.531. [DOI] [PMC free article] [PubMed] [Google Scholar] · DOI
  25. Carroll KM, Libby B, Sheehan J, Hyland N. Motivational interviewing to enhance treatment initiation in substance abusers: An effectiveness study. American Journal on Addictions. 2001;10:335–339. doi: 10.1080/aja.10.4.335.339. [DOI] [PMC free article] [PubMed] [Google Scholar] · DOI
  26. Cartwright D. Success in psychotherapy as a function of certain actuarial variables. Journal of Consulting Psychology. 1955;19:357–360. doi: 10.1037/h0045998. [DOI] [PubMed] [Google Scholar] · DOI
  27. Castonguay LG, Goldfried MR, Wiser S, Raue PJ, Hayes AM. Predicting the effect of cognitive therapy for depression: A study of unique and common factors. Journal of Consulting and Clinical Psychology. 1996;64:497–504. [PubMed] [Google Scholar]
  28. Castonguay LG, Schut AJ, Aikins D, Constantino MJ, Laurenceau JP, Bologh L, Burns DD. Integrative cognitive therapy: A preliminary investigation. Journal of Psychotherapy Integration. 2004;14:4–20. [Google Scholar]
  29. Chanut F, Brown TG, Dongier M. Motivational interviewing and clinical psychiatry. Canadian Journal of Psychiatry. 2005;50:548–554. doi: 10.1177/070674370505000908. [DOI] [PubMed] [Google Scholar] · DOI
  30. Chiesa M, Wright M, Neeld R. A description of an audit cycle of early dropouts from an inpatient psychotherapy unit. Psychoanalytic Psychotherapy. 2003;17:138–149. [Google Scholar]
  31. Childress R, Gillis JS. A study of pre-therapy role induction as an influence process. Journal of Clinical Psychology. 1977;33:540–544. doi: 10.1002/1097-4679(197704)33:2<540::aid-jclp2270330244>3.0.co;2-l. [DOI] [PubMed] [Google Scholar] · DOI
  32. Chua W-J, Barrett M. The influence of physical environment on engagement in psychotherapy; Paper presented at the annual meeting of the North American Society for Psychotherapy Research; New York. 2007. Oct, [Google Scholar]
  33. Colby SM, Monti PM, Barnett NP, Rohsenow DJ, Weissman K, Spirito A, et al. Brief motivational interviewing in a hospital setting for adolescent smoking: A preliminary study. Journal of Consulting and Clinical Psychology. 1998;66:574–578. doi: 10.1037//0022-006x.66.3.574. [DOI] [PubMed] [Google Scholar] · DOI
  34. Coleman DJ, Kaplan MS. Effects of pretherapy videotape preparation on child therapy outcomes. Professional Psychology: Research and Practice. 1990;21:199–203. [Google Scholar]
  35. Coles R, Coles JH. Women of crisis: Lives of struggle and hope. New York: Delacorte; 1978. [Google Scholar]
  36. Comas-Diaz L, Griffith EH. Clinical guidelines in cross-cultural mental health. New York: Wiley; 1988. [Google Scholar]
  37. Condelli WS. Domains of variables for understanding and improving retention in therapeutic communities. International Journal of the Addictions. 1994;29:593–607. doi: 10.3109/10826089409047402. [DOI] [PubMed] [Google Scholar] · DOI
  38. Corder BF, Haizlip T, Whiteside R, Vogel M. Pre-therapy training for adolescents in group psychotherapy: Contracts, guidelines, and pre-therapy preparation. Adolescence. 1980;15:699–706. [PubMed] [Google Scholar]
  39. Craig T, Huffine C. Correlates of patient attendance in an innercity mental health clinic. Amer-ican Journal of Psychiatry. 1976;133:61–64. doi: 10.1176/ajp.133.1.61. [DOI] [PubMed] [Google Scholar] · DOI
  40. Cross D, Warren C. Environmental factors associated with continuers and terminators in adult out-patient psychotherapy. British Journal of Medical Psychology. 1984;57:363–369. doi: 10.1111/j.2044-8341.1984.tb02601.x. [DOI] [PubMed] [Google Scholar] · DOI
  41. Curran TF. Anxiety reduction as a preliminary to group treatment. Psychotherapy: Theory, Research, & Practice. 1976;13:354–360. [Google Scholar]
  42. Denner B, Halprin F. Clients and therapists evaluate clinical services. American Journal of Community Psychology. 1974;2:373–378. doi: 10.1007/BF00878976. [DOI] [PubMed] [Google Scholar] · DOI
  43. Dodd J. A retrospective analysis of variables related to duration of treatment in a university psychiatric clinic. Journal of Nervous and Mental Disease. 1970;151:75–84. doi: 10.1097/00005053-197008000-00001. [DOI] [PubMed] [Google Scholar] · DOI
  44. Doster JA. Effects of instructions, modeling, and role rehearsal on interview verbal behavior. Journal of Consulting and Clinical Psychology. 1972;39:202–209. doi: 10.1037/h0033420. [DOI] [PubMed] [Google Scholar] · DOI
  45. Duehn WD, Proctor EK. Initial clinical interaction and premature discontinuance in treatment. American Journal of Orthopsychiatry. 1977;47:284–290. doi: 10.1111/j.1939-0025.1977.tb00983.x. [DOI] [PubMed] [Google Scholar] · DOI
  46. Dumont M. The absurd healer: Perspectives of a community psychiatrist. New York: Science House; 1968. [Google Scholar]
  47. Dunn C, Deroo L, Rivara FP. The use of brief interventions adapted from motivational interviewing across behavioral domains: A systematic review. Addiction. 2001;96:1725–1742. doi: 10.1046/j.1360-0443.2001.961217253.x. [DOI] [PubMed] [Google Scholar] · DOI
  48. Dyck RJ, Joyce AS, Azim HFA. Treatment noncompliance as a function of therapist attributes and social support. Canadian Journal of Psychiatry. 1984;29:212–216. doi: 10.1177/070674378402900305. [DOI] [PubMed] [Google Scholar] · DOI
  49. Feld R, Woodside DB, Kaplan AS, Olmsted MP, Carter JC. Pretreatment motivational enhancement therapy for eating disorders: A pilot study. International Journal of Eating Disorders. 2001;29:393–400. doi: 10.1002/eat.1035. [DOI] [PubMed] [Google Scholar] · DOI
  50. Festinger DS, Lamb RJ, Marlowe DB, Kirby KC. From telephone to office: Intake attendance as a function of appointment delay. Addictive Behaviors. 2002;27:131–137. doi: 10.1016/s0306-4603(01)00172-1. [DOI] [PubMed] [Google Scholar] · DOI
  51. Foreman S, Marmar R. Therapist actions that address initially poor therapeutic alliances in psychotherapy. American Journal of Psychiatry. 1985;142:922–926. doi: 10.1176/ajp.142.8.922. [DOI] [PubMed] [Google Scholar] · DOI
  52. Frank JD, Gliedman LH, Imber SD, Nash EH, Stone AR. Why patients leave psychotherapy. Archives of Neurology. 1957;77:283. doi: 10.1001/archneurpsyc.1957.02330330069013. [DOI] [PubMed] [Google Scholar] · DOI
  53. Fraps CL, McReynolds WT, Beck NC, Heisler GH. Predicting client attrition from psychotherapy through behavioral assessment procedures and a critical response approach. Journal of Clinical Psychology. 1982;38:759–764. doi: 10.1002/1097-4679(198210)38:4<759::aid-jclp2270380411>3.0.co;2-y. [DOI] [PubMed] [Google Scholar] · DOI
  54. Frayn DH. Assessment factors associated with premature psychotherapy termination. American Journal of Psychotherapy. 1992;46:250–261. doi: 10.1176/appi.psychotherapy.1992.46.2.250. [DOI] [PubMed] [Google Scholar] · DOI
  55. Garfield SL. A note on patients’ reasons for terminating therapy. Psychological Reports. 1963;13:38–38. [Google Scholar]
  56. Garfield SL. Research on client variables in psychotherapy. In: Bergin AE, Garfield SL, editors. Handbook of psychotherapy and behavior change. New York: Wiley; 1994. pp. 190–228. [Google Scholar]
  57. Gelso CJ, Carter JA. Components of the psychotherapy relationship: Their interaction and unfolding during treatment. Journal of Counseling Psychology. 1994;41:296–306. [Google Scholar]
  58. González GM. The emergence of Chicanos in the twenty-first century: Implications for counseling, research, and policy. Journal of Multicultural Counseling and Development. 1997;25:94–106. [Google Scholar]
  59. Greenspan M, Kulish NM. Factors in premature termination in long-term psychotherapy. Psychotherapy: Theory, Research, Practice, Training. 1985;22:75–82. [Google Scholar]
  60. Grimes WR, Murdock NL. Social influence revisited: Effects of counselor influence on outcome variables. Psychotherapy: Theory, Research, Practice, Training. 1989;26:469–474. [Google Scholar]
  61. Gunzburger DW, Henggeler SW, Watson SM. Factors related to premature termination of counseling relationships. Journal of College Student Personnel. 1985;26:456–460. [Google Scholar]
  62. Hampton NZ, Yeung T, Nguyen CH. Perceptions of mental illness and rehabilitation services in Chinese and Vietnamese Americans. Journal of Applied Rehabilitation Counseling. 2007;38(2):14–23. [Google Scholar]
  63. Hampton-Robb S, Qualls RC, Compton WC. Predicting first-session attendance: The influence of referral source and client income. Psychotherapy Research. 2003;13:223–233. [Google Scholar]
  64. Hannan C, Lambert M, Harmon C, Nielson S, Smart D, Shimokawa K, Sutton SW. A lab test and algorithms for identifying clients at risk for treatment failure. Journal of Clinical Psychology. 2005;61:155–163. doi: 10.1002/jclp.20108. [DOI] [PubMed] [Google Scholar] · DOI
  65. Hatchett GT, Han K, Cooker PG. Predicting premature termination from counseling using the Butcher Treatment Planning Inventory Assessment. Counseling Psychologist. 2002;9:156–163. doi: 10.1177/10791102009002006. [DOI] [PubMed] [Google Scholar] · DOI
  66. Hatchett GT, Park HL. Comparison of four operational definitions of premature termination. Psychotherapy: Theory, Research, Practice, Training. 2003;40:226–231. [Google Scholar]
  67. Head J. Black men and depression: Saving our lives, healing our families and friends. New York: Broadway Books; 2004. [Google Scholar]
  68. Hiler EW. An analysis of patient-therapy compatibility. Journal of Consulting Psychology. 1958;22:341–347. doi: 10.1037/h0045173. [DOI] [PubMed] [Google Scholar] · DOI
  69. Hoehn-Saric R, Frank JD, Imber SD, Nash EH, Stone AR, Battle CC. Systematic preparation of patients for psychotherapy: I. Effects on therapy behavior and outcome. Journal of Psychiatric Research. 1964;2:267–281. doi: 10.1016/0022-3956(64)90013-5. [DOI] [PubMed] [Google Scholar] · DOI
  70. Hoffman JJ. Client factors related to premature termination of psychotherapy. Psychotherapy: Theory, Research, & Practice. 1985;22:83–85. [Google Scholar]
  71. Hollingshead AB, Redlich FC. Social class and mental illness: A community study. New York: Wiley; 1958. [DOI] [PMC free article] [PubMed] [Google Scholar]
  72. Horvath AO, Bedi RP. The alliance. In: Norcross JC, editor. Psychotherapy relationships that work. New York: Oxford University Press; 2002. pp. 37–70. [Google Scholar]
  73. Howard KI, Moras K, Brill PL, Maretinovich Z, Lutz W. Evaluation of psychotherapy: Efficacy, effectiveness, and patient progress. American Psychologist. 1996;51:1059–1064. doi: 10.1037//0003-066x.51.10.1059. [DOI] [PubMed] [Google Scholar] · DOI
  74. Humfress H, Igel V, Lamont A, Tanner M, Morgan J, Schmidt U. The effect of a brief motivational intervention on community psychiatric patients’ attitudes to their care, motivation to change, compliance and outcome: A case control study. Journal of Mental Health. 2002;11:155–166. [Google Scholar]
  75. Hunsley J, Aubry TD, Verstervelt CM, Vito D. Comparing therapist and client perspectives on reasons for psychotherapy termination. Psychotherapy: Theory, Research, Practice, Training. 1999;36:380–388. [Google Scholar]
  76. Hynan DJ. Client reasons and experiences in treatment that influence termination of psychotherapy. Journal of Clinical Psychology. 1990;46:891–895. doi: 10.1002/1097-4679(199011)46:6<891::aid-jclp2270460631>3.0.co;2-8. [DOI] [PubMed] [Google Scholar] · DOI
  77. Iacoviello BM, McCarthy KS, Barrett MS, Rynn M, Gallop R, Barber JP. Treatment preferences affect the therapeutic alliance: Implications for randomized controlled trials. Journal of Consulting and Clinical Psychology. 2007;75:194–198. doi: 10.1037/0022-006X.75.1.194. [DOI] [PubMed] [Google Scholar] · DOI
  78. Illovsky ME. Mental health professionals, minorities, and the poor. New York: Brunner-Routledge; 2003. [Google Scholar]
  79. Jacobs D, Charles E, Jacobs T, Weinstein H, Mann D. Preparation for treatment of the disadvantaged patient: Effects on disposition and outcome. American Journal of Orthopsychiatry. 1972;42:666–674. doi: 10.1111/j.1939-0025.1972.tb02533.x. [DOI] [PubMed] [Google Scholar] · DOI
  80. Jenkins SJ, Fuqua DR, Blum CR. Factors related to duration of counseling in a university counseling center. Psychological Reports. 1986;58:467–472. doi: 10.2466/pr0.1986.58.2.467. [DOI] [PubMed] [Google Scholar] · DOI
  81. Joe GW, Simpson DD, Greener JM, Rowan-Szal GA. Integrative modeling of client engagement and outcomes during the first 6 months of methadone treatment. Addictive Behaviors. 1999;24:649–659. doi: 10.1016/s0306-4603(99)00024-6. [DOI] [PubMed] [Google Scholar] · DOI
  82. Johansson H, Eklund M. Helping alliance and early dropout from psychiatric out-patient care: The influence of patient factors. Social Psychiatry and Psychiatric Epidemiology. 2005;41:140–147. doi: 10.1007/s00127-005-0009-z. [DOI] [PubMed] [Google Scholar] · DOI
  83. Johansson SL, Silverberg R, Lilly RS. Therapy improvement in two out-patient mental health clinics. Journal of Community Psychology. 1980;8:34–44. doi: 10.1002/1520-6629(198001)8:1<34::aid-jcop2290080107>3.0.co;2-f. [DOI] [PubMed] [Google Scholar] · DOI
  84. Joshi PK, Maisami M, Coyle JT. Prospective study of intake procedures in a child psychiatry clinic. Journal of Clinical Psychiatry. 1986;47:111–113. [PubMed] [Google Scholar]
  85. Kazdin AE, Wassell G. Predictors of barriers to treatment and therapeutic change in outpatient therapy for antisocial children and their families. Mental Health Services Research. 2000;2:27–40. doi: 10.1023/a:1010191807861. [DOI] [PubMed] [Google Scholar] · DOI
  86. Kelleher WJ, Talcott GW, Haddock CK, Freeman RK. Military psychology in the age of managed care: The Wilford Hall model. Applied and Preventative Psychology. 1996;5:101–110. [Google Scholar]
  87. Klein EB, Stone WN, Hicks MW, Pritchard IL. Understanding dropouts. Journal of Mental Health Counseling. 2003;25:89–100. [Google Scholar]
  88. Kline F, Adrian A, Spevak M. Patients evaluate therapists. Archives of General Psychiatry. 1974;31:113–116. doi: 10.1001/archpsyc.1974.01760130087015. [DOI] [PubMed] [Google Scholar] · DOI
  89. Kokotovic AM, Tracey TJ. Premature termination at a university counseling center. Journal of Counseling Psychology. 1987;34:80–82. [Google Scholar]
  90. Kolb DL, Beutler LE, Davis CS, Crago M, Shanfield SB. Patient and therapy process variables relating to dropout and change in psychotherapy. Psychotherapy: Theory, Practice, & Research. 1985;22:702–710. [Google Scholar]
  91. Kopta SM, Howard KI, Lowry JL, Beutler LE. Patterns of symptomatic recovery in psychotherapy. Journal of Consulting and Clinical Psychology. 1994;62:1009–1016. doi: 10.1037//0022-006x.62.5.1009. [DOI] [PubMed] [Google Scholar] · DOI
  92. Kouyoumdjian H, Zamboanga BL, Hansen DJ. Barriers to community mental health services for Latinos: Treatment considerations. Clinical Psychology Science and Practice. 2003;10:394–422. [Google Scholar]
  93. Lambert MJ, Harmon C, Slade K, Whipple JL, Hawkins EJ. Providing feedback to psychotherapists on their patients’ progress: Clinical results and practice suggestions. Journal of Clinical Psychology. 2005;61:165–174. doi: 10.1002/jclp.20113. [DOI] [PubMed] [Google Scholar] · DOI
  94. Lambert MJ, Ogles BM. The efficacy and effectiveness of psychotherapy. In: Lambert MJ, editor. Bergin and Garfield’s handbook of psychotherapy and behavior change. 5. New York: Wiley; 2004. pp. 139–193. [Google Scholar]
  95. Lim RF, editor. Clinical manual of cultural psychiatry. Washington, DC: American Psychiatric Publishing; 2006. [Google Scholar]
  96. Lingiardi V, Filippucci L, Baiocco R. Therapeutic alliance evaluation in personality disorders psychotherapy. Psychotherapy Research. 2005;15:45–53. [Google Scholar]
  97. Lo H, Fung KP. Culturally competent psychotherapy. Canadian Journal of Psychiatry. 2003;48:161–170. doi: 10.1177/070674370304800304. [DOI] [PubMed] [Google Scholar] · DOI
  98. Longo D, Lent R, Brown S. Social cognitive variables in the prediction of client motivation and attrition. Journal of Counseling Psychology. 1992;39:447–452. [Google Scholar]
  99. Lonner WJ. Three paths leading to culturally competent psychological practitioners. International Journal of Intercultural Relevance. 1997;21:195–212. [Google Scholar]
  100. Lorion RP. Patient and therapist variables in the treatment of low-income patients. Psychological Bulletin. 1974;81:344–354. doi: 10.1037/h0036484. [DOI] [PubMed] [Google Scholar] · DOI
  101. Lorion RP. Research on psychotherapy and behavior change with the disadvantaged. In: Garfield SL, Bergin AE, editors. Handbook of psychotherapy and behavior change. 2. New York: Wiley; 1978. pp. 903–938. [Google Scholar]
  102. Lorion RP, Felner RE. Research on mental health interventions with the disadvantaged. In: Garfield SL, Bergin AE, editors. Handbook of psychotherapy and behavior change. 3. New York: Wiley; 1986. pp. 739–776. [Google Scholar]
  103. Lyons LC, Woods PJ. The efficacy of rational-emotive therapy: A quantitative review of the outcome research. Clinical Psychology Review. 1991;11:357–369. [Google Scholar]
  104. May JM. Number of sessions and psychotherapy outcome: Impact on community mental health center services (Doctoral dissertation, Loyola University of Chicago, 1984) Dissertation Abstracts International. 1984;45(5-B):1624. [Google Scholar]
  105. McCabe KM. Factors that predict premature termination among Mexican-American children in outpatient psychotherapy. Journal of Child & Family Studies. 2002;11:347–359. [Google Scholar]
  106. McKenna KF, Todd DM. Longitudinal utilization of mental health services: A time-line method, nine retrospective accounts, and a preliminary conceptualization. Psychotherapy Research. 1997;7:383–395. [Google Scholar]
  107. McNeill BW, May RJ, Lee VE. Perceptions of counselor source characteristics by premature and successful terminators. Journal of Counseling Psychology. 1987;34:86–89. [Google Scholar]
  108. Meier PS, Donmall MC, McElduff P, Barrow-Clough C, Heller RF. The role of the early therapeutic alliance in predicting drug treatment dropout. Drug and Alcohol Dependence. 2006;83:57–64. doi: 10.1016/j.drugalcdep.2005.10.010. [DOI] [PubMed] [Google Scholar] · DOI · Paper page
  109. Mental health: A report of the Surgeon General. Rockville, MD: U.S. Department of Health & Human Services, Substance Abuse & Mental Health Administration, Center for Mental Health Services, National Institutes of Health, National Institute of Mental Health; 1999. [Google Scholar]
  110. Messer SB. What makes brief psychodynamic therapy time efficient. Clinical Psychology: Science and Practice. 2001;8:5–22. [Google Scholar]
  111. Miller W. Motivational interviewing with problem drinkers. Behavioral Psychotherapy. 1983;11:147–172. [Google Scholar]
  112. Miller W, Rollnick S. Motivational interviewing: Preparing people to change addictive behaviors. New York: Guilford Press; 1991. [Google Scholar]
  113. Miller W, Sanchez V. Motivating young adults for treatment and lifestyle change. In: Howard G, editor. Issues in alcohol use and misuse by young adults. Notre Dame, IN: University of Notre Dame Press; 1994. pp. 55–82. [Google Scholar]
  114. Mohl PC, Martinez D, Ticknor C, Huang M, Cordell L. Early dropouts from psychotherapy. Journal of Nervous and Mental Disease. 1991;179:478–481. doi: 10.1097/00005053-199108000-00005. [DOI] [PubMed] [Google Scholar] · DOI
  115. Newman MG, Kenardy J, Herman S, Taylor CB. Comparison of cognitive– behavioral treatment of panic disorder with computer-assisted brief cognitive behavioral treatment. Journal of Consulting and Clinical Psychology. 1997;65:178–183. doi: 10.1037//0022-006x.65.1.178. [DOI] [PubMed] [Google Scholar] · DOI
  116. Ogrodniczuk JS, Joyce AS, Piper WE. Strategies for reducing patient-initiated premature termination of psychotherapy. Harvard Review of Psychiatry. 2005;13:57–70. doi: 10.1080/10673220590956429. [DOI] [PubMed] [Google Scholar] · DOI
  117. Orlinsky D, Grawe K, Parks BK. Process and outcome in psychotherapy—Noch einmal. In: Bergin AE, Garfield SL, editors. Handbook of psychotherapy and behavior change. 4. New York: Wiley; 1995. pp. 270–376. [Google Scholar]
  118. Owens PL, Hoagwood K, Horwitz SM, Leaf PJ, Poduska JM, Kellam SG, Ialongo NS. Barriers to children’s mental health services. Journal of the American Academy of Child & Adolescent Psychiatry. 2002;41:731–738. doi: 10.1097/00004583-200206000-00013. [DOI] [PubMed] [Google Scholar] · DOI · Paper page
  119. Parker WM, McDavis RJ. Attitudes of Blacks toward mental health agencies and counselors. Journal of Non-White Concerns in Personnel & Guidance. 1983;11:89–98. [Google Scholar]
  120. Pekarik G. Follow-up adjustment of outpatient dropouts. American Journal of Orthopsychiatry. 1983a;53:501–511. doi: 10.1111/j.1939-0025.1983.tb03394.x. [DOI] [PubMed] [Google Scholar] · DOI
  121. Pekarik G. Improvement in clients who have given different reasons for dropping out of treatment. Journal of Clinical Psychology. 1983b;39:909–913. doi: 10.1002/1097-4679(198311)39:6<909::aid-jclp2270390614>3.0.co;2-4. [DOI] [PubMed] [Google Scholar] · DOI
  122. Pekarik G. Coping with dropouts. Professional Psychology: Research and Practice. 1985;16:114–123. [Google Scholar]
  123. Pekarik G. Posttreatment adjustment of clients who drop out early vs. late in treatment. Journal of Clinical Psychology. 1992;48:379–387. doi: 10.1002/1097-4679(199205)48:3<379::aid-jclp2270480317>3.0.co;2-p. [DOI] [PubMed] [Google Scholar] · DOI
  124. Pekarik G, Finney-Owen K. Outpatient clinic therapist attitudes and beliefs relevant to client dropout. Community Mental Health Journal. 1987;23:120–130. doi: 10.1007/BF00757166. [DOI] [PubMed] [Google Scholar] · DOI
  125. Persons JB, Burns DD, Perloff JM. Predictors of dropout and outcome in cognitive therapy for depression in a private practice setting. Cognitive Therapy & Research. 1988;12:557–575. [Google Scholar]
  126. Phillips EL. Psychotherapy revised: New frontiers in research and practice. Hillsdale, NJ: Erlbaum; 1985. [Google Scholar]
  127. Piper WE, Perrault EL. Pretherapy preparation for group members. International Journal of Group Psychotherapy. 1989;39:17–34. doi: 10.1080/00207284.1989.11491146. [DOI] [PubMed] [Google Scholar] · DOI
  128. Prilleltensky I. Poverty and power. In: Carr SC, Sloan TS, editors. Poverty and psychology: From global perspective to local practice. New York: Kluwer Academic/Plenum Press; 2003. pp. 19–44. [Google Scholar]
  129. Reece MD. Dropout from community-based, HIV-related psychotherapy: The influence of health beliefs and perceptions of stigma (immune deficiency) Dissertation Abstracts International. 2001;61A:3075. [Google Scholar]
  130. Regan AM, Hill CE. Investigation of what clients and counselors do not say in brief therapy. Journal of Counseling Psychology. 1992;39:168–174. [Google Scholar]
  131. Rennie TA, Srole L, Opler MK, Langner TS. Urban life and mental health. American Journal of Psychiatry. 1957;113:831–837. doi: 10.1176/ajp.113.9.831. [DOI] [PubMed] [Google Scholar] · DOI
  132. Rhodes R, Hill CE, Thompson BJ, Elliott R. Client retrospective recall of resolved and unresolved misunderstanding events. Journal of Counseling Psychology. 1994;41:473–483. [Google Scholar]
  133. Richmond R. Discriminating variables among psychotherapy dropouts from a psychological training clinic. Professional Psychology: Research and Practice. 1992;23:123–130. [Google Scholar]
  134. Rodolfa ER, Rapaport R, Lee VE. Variables related to premature terminations in a university counseling services. Journal of Counseling Psychology. 1983;30:87–90. [Google Scholar]
  135. Rogers CP. Client-centered therapy. Boston: Houghton Mifflin; 1951. [Google Scholar]
  136. Rollnick S, Heather N, Bell A. Negotiating behaviour change in medical settings: The development of brief motivational interviewing. Journal of Mental Health. 1992;1:25–38. [Google Scholar]
  137. Rubenstein EA, Lorr MA. Comparison of terminators and remainers in outpatient psychotherapy. Journal of Clinical Psychology. 1956;12:345. doi: 10.1002/1097-4679(195610)12:4<345::aid-jclp2270120409>3.0.co;2-7. [DOI] [PubMed] [Google Scholar] · DOI
  138. Safran JD, Muran JC, Samstag LW, Stevens C. Repairing alliance ruptures. Psychotherapy: Theory, Research, Practice, Training. 2001;38:406–412. [Google Scholar]
  139. Safran JD, Muran JC, Samstag LW, Stevens C. Repairing alliance ruptures. In: Norcross JC, editor. Psychotherapy relationships that work. New York: Oxford University Press; 2002. pp. 235–254. [Google Scholar]
  140. Salta L, Buick WP. Impact of organizational change on the intake, referral and treatment of outpatients at a community mental health center. Journal of Mental Health Administration. 1989;16:71–79. doi: 10.1007/BF02521384. [DOI] [PubMed] [Google Scholar] · DOI
  141. Samstag LW, Batchelder ST, Muran JC, Safran JD, Winston A. Early identification of treatment failures in short-term psychotherapy: An assessment of therapeutic alliance and interpersonal behavior. Journal of Psychotherapy, Practice, & Research. 1998;7:126–143. [PMC free article] [PubMed] [Google Scholar]
  142. Sanchez F, Gaw A. Mental health care of Filipino Americans. Psychiatric Services. 2007;58:810–815. doi: 10.1176/ps.2007.58.6.810. [DOI] [PubMed] [Google Scholar] · DOI
  143. Saporito JM, Barrett MS, McCarthy KS, Iacoviello B, Barber JP. Predicting failure to attend intake appointment; Paper presented at the annual meeting of the Society for Psychotherapy Research; Weimar, Germany. 2003. Jun, [Google Scholar]
  144. Shapiro DA, Barkham M, Stiles WB, Hardy GE, Rees A, Reynolds S, Startup M. Time is of the essence: A selective review of the fall and rise of brief therapy research. Psychology and Psychotherapy: Theory, Research and Practice. 2003;76:211–235. doi: 10.1348/147608303322362460. [DOI] [PubMed] [Google Scholar] · DOI
  145. Silverman W, Beech RP. Are dropouts, dropouts? Journal of Community Psychology. 1979;7:236–242. doi: 10.1002/1520-6629(197907)7:3<236::aid-jcop2290070307>3.0.co;2-b. [DOI] [PubMed] [Google Scholar] · DOI
  146. Siqueland L, Crits-Christoph P, Barber JP, Butler SF, Thase M, Najavits L, Onken LS. The role of therapist characteristics in training effects in cognitive, supportive expressive and drug counseling therapies for cocaine dependence. Journal of Psychotherapy, Practice, and Research. 2000;9:123–130. [PMC free article] [PubMed] [Google Scholar]
  147. Sledge WH, Moras K, Hartley D, Levine M. Effect of time-limited psychotherapy on patient dropout rates. American Journal of Psychiatry. 1991;147:1341–1347. doi: 10.1176/ajp.147.10.1341. [DOI] [PubMed] [Google Scholar] · DOI
  148. Sloane BR, Cristol AH, Pepernik MC, Staples FR. Role preparation and expectation of improvement in psychotherapy. Journal of Nervous and Mental Disease. 1970;150:18–26. doi: 10.1097/00005053-197001000-00003. [DOI] [PubMed] [Google Scholar] · DOI
  149. Smith KJ, Subich LM, Kalodner C. The transtheoretical model’s stages and processes and their relation to premature termination. Journal of Counseling Psychology. 1995;42:34–40. [Google Scholar]
  150. Smith L. Psychotherapy, classism, and the poor: Conspicuous by their absence. American Psychologist. 2005;60:687–696. doi: 10.1037/0003-066X.60.7.687. [DOI] [PubMed] [Google Scholar] · DOI
  151. Smith TE, Koenigsberg HW, Yeomans FE, Clarkin JF, Selzer MA. Predictors of dropout in psychodynamic psychotherapy. Journal of Psychotherapy Practice and Research. 1995;4:205–213. [PMC free article] [PubMed] [Google Scholar]
  152. Sparks WA, Daniels JA, Johnson E. Relationship of referral source, race, and wait time on preintake attrition. Professional Psychology: Research and Practice. 2003;34:514–518. [Google Scholar]
  153. Stark MJ, Kane BJ. General and specific psychotherapy role induction with substance-abusing clients. International Journal of Additions. 1985;20:1135–1141. doi: 10.3109/10826088509056355. [DOI] [PubMed] [Google Scholar] · DOI
  154. Stasiewicz PR, Stalker R. A comparison of three “interventions” on pretreatment dropout rates in an outpatient substance abuse clinic. Addictive Behaviors. 1999;24:579–582. doi: 10.1016/s0306-4603(98)00082-3. [DOI] [PubMed] [Google Scholar] · DOI
  155. Stiles WB, Leiman M, Shapiro DA, Hardy GE, Barkham M, Detert NB, Llewelyn SP. What does the first exchange tell? Dialogical sequence analysis and assimilation in very brief therapy. Psychotherapy Research. 2006;16:408–421. [Google Scholar]
  156. Strauss JL, Hayes AM, Johnson SL, Newman CF, Brown GK, Barber JP, et al. Early alliance, alliance ruptures, and symptom change in a nonrandomized trial of cognitive therapy for avoidant and obsessive–compulsive personality disorders. Journal of Consulting and Clinical Psychology. 2006;74:337–345. doi: 10.1037/0022-006X.74.2.337. [DOI] [PMC free article] [PubMed] [Google Scholar] · DOI
  157. Strupp HH, Bloxom AL. Preparing lower-class patients for group psychotherapy: Development and evaluation of a role-induction film. Journal of Consulting and Clinical Psychology. 1973;41:373–384. doi: 10.1037/h0035380. [DOI] [PubMed] [Google Scholar] · DOI
  158. Sue S. Community mental health services to minority groups: Some optimism, some pessimism. American Psychologist. 1977;32:616–624. doi: 10.1037//0003-066x.32.8.616. [DOI] [PubMed] [Google Scholar] · DOI
  159. Sue S, Fujino DC, Hu L, Takeuchi DT, Zane NWS. Community mental health services for ethnic minority groups: A test of the cultural responsiveness hypothesis. Journal of Consulting and Clinical Psychology. 1991;59:533–540. doi: 10.1037//0022-006x.59.4.533. [DOI] [PubMed] [Google Scholar] · DOI
  160. Sue S, Lam AG. Cultural and demographic diversity. In: Norcross JC, editor. Psychotherapy relationships that work. New York: Oxford University Press; 2002. pp. 401–422. [Google Scholar]
  161. Sue S, McKinney HL, Allen D, Hall J. Delivery of community mental health services to black and white clients. Journal of Consulting and Clinical Psychology. 1974;42:594–601. doi: 10.1037/h0037579. [DOI] [PubMed] [Google Scholar] · DOI
  162. Sue S, Zane N, Young K. Research on psychotherapy with culturally diverse populations. In: Bergin AE, Garfield SL, editors. Handbook of psychotherapy and behavior change. 4. New York: Wiley; 1994. pp. 783–820. [Google Scholar]
  163. Tantam D, Klerman G. Patient transfer from one clinician to another and dropping out of outpatient treatment. Social Psychiatry. 1979;14:107–113. [Google Scholar]
  164. Thompson VL, Bazile A, Akbar M. African Americans’ perceptions of psychotherapy and psychotherapists. Professional Psychology: Research and Practice. 2004;35:19–26. [Google Scholar]
  165. Thormählen B, Weinryb RM, Norén K, Vinnars B, Bågedahl-Strindlund M, Barber JP. Patient factors predicting dropout from supportive-expressive psychotherapy for patients with personality disorders. Psychotherapy Research. 2003;13:493–509. doi: 10.1093/ptr/kpg039. [DOI] [PubMed] [Google Scholar] · DOI
  166. Todd DM, Deane FP, Bragdon RA. Client and therapist reasons for termination: A conceptualization and preliminary validation. Journal of Clinical Psychology. 2003;59:133–147. doi: 10.1002/jclp.10123. [DOI] [PubMed] [Google Scholar] · DOI
  167. Tracey TJG. Development of interests and competency beliefs: A one-year longitudinal study of fifth to eighth grade students using the ICA–R and structural equation modeling. Journal of Counseling Psychology. 2002;49:148–163. [Google Scholar]
  168. Trepka C. Attrition from an out-patient psychology clinic. British Journal of Medical Psychology. 1986;59:181–186. doi: 10.1111/j.2044-8341.1986.tb02683.x. [DOI] [PubMed] [Google Scholar] · DOI
  169. Tryon GS, Kane AS. Relationship of working alliance to mutual and unilateral termination. Journal of Counseling Psychology. 1993;40:33–36. [Google Scholar]
  170. Turner AJ, Vernon JC. Prompts to increase attendance in a community mental health center. Journal of Applied Behavior Analysis. 1976;9:141–145. doi: 10.1901/jaba.1976.9-141. [DOI] [PMC free article] [PubMed] [Google Scholar] · DOI
  171. Tutin J. A multivariate analysis of dropout status by length of stay in a rural community mental health center. Community Mental Health Journal. 1987;23:40–52. doi: 10.1007/BF00752823. [DOI] [PubMed] [Google Scholar] · DOI
  172. Vail A. Factors influencing lower-class Black patients remaining in treatment. Journal of Consulting and Clinical Psychology. 1978;46:341. doi: 10.1037//0022-006x.46.2.341. [DOI] [PubMed] [Google Scholar] · DOI
  173. Vogel DL, Wester SR. To seek help or not to seek help: The risks of self-disclosure. Journal of Counseling Psychology. 2003;50:351–361. [Google Scholar]
  174. Walitzer KS, Dermen KH, Connors GJ. Strategies for preparing clients for treatment: A review. Behavior Modification. 1999;23:129–151. doi: 10.1177/0145445599231006. [DOI] [PubMed] [Google Scholar] · DOI
  175. Westerman MA, Foote JP. Patient coordination: Contrasts with other conceptualizations of patients’ contribution to the alliance and validity in insight oriented psychotherapy. Psychotherapy: Theory, Research, Practice, Training. 1995;32:222–232. [Google Scholar]
  176. Whiston SC, Sexton TL. An overview of psychotherapy outcome research: Implications for practice. Professional Psychology: Research and Practice. 1993;24:43–51. [Google Scholar]
  177. Wickramasekera L. Clinical behavioral medicine: Some concepts and procedures. New York: Plenum Press; 1988. [Google Scholar]
  178. Wierzbicki M, Pekarik G. A meta-analysis of psychotherapy dropout. Professional Psychology: Research and Practice. 1993;24:190–195. [Google Scholar]

Cited by

Sorted by citations

Authors
Barrett, M. S., Chua, W.-J., Crits-Christoph, P., Gibbons, M. B., & Thompson, D.
Affiliations
University of Pennsylvania (US)
ORCID
Venue
Psychotherapy: Theory, Research, Practice, Training
Publisher
American Psychological Association (APA)
Published
2008
Volume
45
Issue
2
Pages
247-267
ISSN
  • 0033-3204 (ISSN-L)
  • 1939-1536
DOI
10.1037/0033-3204.45.2.247
PMC
PMC2762228
OpenAlex
W2008821255
Cited by
564
References
19
Citations by year
2026: 31 · 2025: 28 · 2024: 33 · 2023: 35 · 2022: 34 · 2021: 86 · 2020: 35 · 2019: 24 · 2018: 30 · 2017: 33 · 2016: 32 · 2015: 36 · 2014: 29 · 2013: 24 · 2012: 30
FWCI
14.93
Type
journal article
Language
en
Update notices
correction (2009-07-06)
Open access
Locations
  • Psychotherapy (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute of Mental Health (R01 MH61410; R24 MH070698-01A2)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Social Sciences › Psychology › Social Psychology › Counseling Practices and Supervision
Keywords
customer churn, psychotherapy dropout, customer retention, customer engagement, psychotherapy, psychotherapy practice

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 ›

Are you an author, or do you see a problem with this page? Request a review