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Monday, August 13, 2012

6 Practice Recommendations for Reducing Premature Termination in Therapy

Practice recommendations for reducing premature termination in therapy.
Swift, Joshua K.; Greenberg, Roger P.; Whipple, Jason L.; Kominiak, Nina
Professional Psychology: Research and Practice, Vol 43(4), Aug 2012, 379-387.
 
Abstract
 
Premature termination from therapy is a significant problem frequently encountered by practicing clinicians of all types. In fact, a recent meta-analytic review (J. K. Swift & R. P. Greenberg, 2012, Premature discontinuation in adult psychotherapy: A meta-analysis. Journal of Consulting and Clinical Psychology. doi:10.1037/a0028226) of 669 studies found that approximately 20% of all clients drop out of treatment prematurely, with higher rates among some types of clients and in some settings. Although this dropout rate is lower than previously estimated, a significant number of clients are still prematurely terminating, and thus further research toward a solution is warranted. Here we present a conceptualization of premature termination based on perceived and anticipated costs and benefits and review 6 practice strategies for reducing premature termination in therapy. These strategies include providing education about duration and patterns of change, providing role induction, incorporating client preferences, strengthening early hope, fostering the therapeutic alliance, and assessing and discussing treatment progress.
 
1. Help clients develop realistic expectations of treatment duration and recovery expectations at the beginning of treatment.
 
2. Utilize role induction prior to starting an intervention.
 
3. Pay attention to patient preferences, such as active versus passive therapist or whether homework will be assigned.
 
4. Instill a sense of hope that treatment will work
 
5. Foster the therapeutic alliance
 
6. Routinely monitor treatment outcomes.
 
Thanks to Ken Pope for this information.