Dropping Out of Psychotherapy May Be Preventable
Researchers from Harvard Medical School have provided guidelines for the
psychotherapist as well as the patient in order to prevent patients from dropping
out of therapy sessions. Surveys show that nearly half of people who begin
psychotherapy drop out , dissatisfied, against the recommendation of their
therapist. It's a big problem for both patient and therapist, and, in group therapy,
for other group members
The Harvard Mental Health Letter reports on recent research about dropout and
what therapists can do to prevent it. Useful steps include these:
Patient selection: Screening patients can help therapists distinguish the best
course of action for a patient and recognize ahead of time when a patient is
more likely to drop out and might do better placed elsewhere.
Preparation: It can help some patients if they know what to expect in therapy.
This may be especially important for group therapy, where a patient may be
more intimidated by a lack of privacy and control.
Short-term or time-limited therapy: Therapy that has a fixed end point may
encourage a sense of urgency and purpose in patients and reduce the
opportunity for leaving early.
Negotiation: The therapist and patient should agree ahead of time on what the
patient hopes to accomplish and how to work toward that goal.
Motivational enhancement: Promoting confidence in the ability to change and
creating a climate that encourages commitment to change may help patients
who aren't yet willing or ready to change.
Establishing the therapeutic alliance: The key feature of all successful
psychotherapy is a strong working relationship between the patient and the
therapist. There is no formula for achieving it, although warmth, empathy,
respect, and interest are always important. If the alliance is not formed quickly,
it may never develop at all.