PREDICTING PATIENT DROPOUT IN PSYCHOTHERAPY

The aim of this study was to identify characteristics of dropouts in an outpatient mental health clinic. Four primary predictor variables were examined: patient attitudes about the nature of psychological disorders and psychotherapy, practical difficulties faced by patients in coming to treatment, patient view of the therapist's ability to relate to the patient, and social class (a composite variable derived from income and education). Only one of the four a priori variables predicted early dropout -an initial negative impression of the therapist by the patient. Level of education, congruence of patient attitudes with a medical model of psychological illness, and anticipated practical problems were not predictors. However, after ending therapy, dropouts were more likely to attribute stopping to practical problems than were nondropouts. A posteriori analyses revealed that missed and canceled sessions in the early weeks of treatment were highly predictive of dropout.