Are psychotherapies with more dropouts less effective?

Abstract

Psychotherapy dropout is often regarded as an indicator of treatment failure; however, evidence of a relationship between dropout and outcome has not been well established. The current research consisted of three meta-analytic studies, the results of which found (a) individuals who dropped out began treatment more distressed than those who completed therapy, (b) individuals who dropped out of therapy were more distressed at posttreatment than individuals who completed therapy, and (c) treatments with higher rates of dropout were also less effective for the treatment completers. Dropout may particularly signal poor outcomes for shorter treatments. The continued ambiguity in the meaning of dropout is discussed as well as the promising potential for future research in the area of dropout as it relates to outcome.

Keywords:

• dropout
• premature termination
• psychotherapy outcome
• treatment outcome

Notes

1 The analyses were also conducted treating scores from each study as raw data without making assumptions about the distribution (e.g., see Robinson, Berman, & Neimeyer, 1990) and by a random effects models using maximum likelihood or method moments estimates (Raudenbush, 1994). Analysis from all three approaches yielded substantially the same results.

Additional information

Funding

This research was supported by a Centers of Excellence grant awarded to the Department of Psychology at the University of Memphis by the state of Tennessee. We would like to thank the research assistants who helped organize files and/or assisted with reliability coding, especially Chelsea Jones, Emily Richardson, Allison Fairchild, and Regina Turner.