Ephrem Fernandez1, Dara Salem2, Joshua K Swift3, Nirvana Ramtahal1. 1. Department of Psychology, University of Texas at San Antonio. 2. Department of Psychology, Long Island University Brooklyn. 3. Department of Psychology, University of Alaska Anchorage.
Abstract
UNLABELLED: In this era of insistence on evidence-based treatments, cognitive behavioral therapy (CBT) has emerged as a highly preferred choice for a spectrum of psychological disorders. Yet, it is by no means immune to some of the vagaries of client participation. Special concerns arise when clients drop out from treatment. OBJECTIVE: The aim of this study was to answer questions about the rate and timing of dropout from CBT, with specific reference to pretreatment versus during treatment phases. Also explored were several moderators of dropout. METHOD: A meta-analysis was performed on dropout data from 115 primary empirical studies involving 20,995 participants receiving CBT for a range of mental health disorders. RESULTS: Average weighted dropout rate was 15.9% at pretreatment, and 26.2% during treatment. Dropout was significantly associated with (a) diagnosis, with depression having the highest attrition rate; (b) format of treatment delivery, with e-therapy having the highest rates; (c) treatment setting, with fewer inpatient than outpatient dropouts; and (d) number of sessions, with treatment starters showing significantly reduced dropout as number of sessions increased. Dropout was not significantly associated with client type (adults or adolescents), therapist licensure status, study design (randomized control trial [RCT] vs. non-RCT), or publication recency. CONCLUSIONS: Findings are interpreted with reference to other reviews. Possible clinical applications include careful choice and supplementing of treatment setting/delivery according to the diagnosis, and use of preparatory strategies. Suggestions for future research include standardization of operational definitions of dropout, specification of timing of dropout, and exploration of additional moderator variables. (c) 2015 APA, all rights reserved).
UNLABELLED: In this era of insistence on evidence-based treatments, cognitive behavioral therapy (CBT) has emerged as a highly preferred choice for a spectrum of psychological disorders. Yet, it is by no means immune to some of the vagaries of client participation. Special concerns arise when clients drop out from treatment. OBJECTIVE: The aim of this study was to answer questions about the rate and timing of dropout from CBT, with specific reference to pretreatment versus during treatment phases. Also explored were several moderators of dropout. METHOD: A meta-analysis was performed on dropout data from 115 primary empirical studies involving 20,995 participants receiving CBT for a range of mental health disorders. RESULTS: Average weighted dropout rate was 15.9% at pretreatment, and 26.2% during treatment. Dropout was significantly associated with (a) diagnosis, with depression having the highest attrition rate; (b) format of treatment delivery, with e-therapy having the highest rates; (c) treatment setting, with fewer inpatient than outpatient dropouts; and (d) number of sessions, with treatment starters showing significantly reduced dropout as number of sessions increased. Dropout was not significantly associated with client type (adults or adolescents), therapist licensure status, study design (randomized control trial [RCT] vs. non-RCT), or publication recency. CONCLUSIONS: Findings are interpreted with reference to other reviews. Possible clinical applications include careful choice and supplementing of treatment setting/delivery according to the diagnosis, and use of preparatory strategies. Suggestions for future research include standardization of operational definitions of dropout, specification of timing of dropout, and exploration of additional moderator variables. (c) 2015 APA, all rights reserved).
Authors: Heather L Rusch; Michael Rosario; Lisa M Levison; Anlys Olivera; Whitney S Livingston; Tianxia Wu; Jessica M Gill Journal: Ann N Y Acad Sci Date: 2018-12-21 Impact factor: 5.691
Authors: Ingmar Heinig; Andre Pittig; Jan Richter; Katrin Hummel; Isabel Alt; Kristina Dickhöver; Jennifer Gamer; Maike Hollandt; Katja Koelkebeck; Anne Maenz; Sophia Tennie; Christina Totzeck; Yunbo Yang; Volker Arolt; Jürgen Deckert; Katharina Domschke; Thomas Fydrich; Alfons Hamm; Jürgen Hoyer; Tilo Kircher; Ulrike Lueken; Jürgen Margraf; Peter Neudeck; Paul Pauli; Winfried Rief; Silvia Schneider; Benjamin Straube; Andreas Ströhle; Hans-Ulrich Wittchen Journal: Int J Methods Psychiatr Res Date: 2017-03-21 Impact factor: 4.035
Authors: Lata K McGinn; Anna Van Meter; Ian Kronish; Jessica Gashin; Karen Burns; Natalie Kil; Thomas G McGinn Journal: Cognit Ther Res Date: 2019-02-12
Authors: Janine V Olthuis; Patrick J McGrath; Charles E Cunningham; Michael H Boyle; Patricia Lingley-Pottie; Graham J Reid; Alexa Bagnell; Ellen L Lipman; Karen Turner; Penny Corkum; Sherry H Stewart; Patrick Berrigan; Kathy Sdao-Jarvie Journal: J Abnorm Child Psychol Date: 2018-11
Authors: Anne Katrin Külz; Sarah Landmann; Barbara Cludius; Nina Rose; Thomas Heidenreich; Lena Jelinek; Heike Alsleben; Karina Wahl; Alexandra Philipsen; Ulrich Voderholzer; Jonathan G Maier; Steffen Moritz Journal: Eur Arch Psychiatry Clin Neurosci Date: 2018-11-16 Impact factor: 5.270
Authors: Laura A Meis; Siamak Noorbaloochi; Emily M Hagel Campbell; Christopher R Erbes; Melissa A Polusny; Tina L Velasquez; Ann Bangerter; Andrea Cutting; Afsoon Eftekhari; Craig S Rosen; Peter W Tuerk; Lori B Burmeister; Michele R Spoont Journal: J Consult Clin Psychol Date: 2019-03