Premature termination is a significant problem in psychotherapy, with deleterious impacts on both clients and therapists. For example, research shows that clients who prematurely terminate show poorer treatment outcomes, are less likely to make lasting changes in their symptoms, and are more likely to over-utilize the health care system. Research also shows that when clients end treatment prematurely, their therapists often experience a sense of failure with the loss. Additionally, repeated dropout by clients can lead to experiences of demoralization and burnout in their providers. Current estimates indicate that approximately 1 in 5 clients will drop out of psychotherapy and/or counseling prematurely. Although these numbers may differ depending on the setting and client type, almost all therapists will experience premature termination at some point in their practice.
The purpose of this workshop is provide strategies and approaches that therapists can use to reduce premature termination in their practice. This workshop will begin with a discussion of what premature termination is and why some clients choose to end treatment prematurely. It will then cover the latest research on the frequency of premature termination and client, therapist, treatment, and setting risk factors associated with its occurrence. In the second half of this workshop, eight evidence-based strategies for reducing premature termination will be presented. These strategies include: providing role induction, incorporating preferences into the treatment decision-making process, planning for appropriate termination, providing education about patterns of change in psychotherapy, strengthening hope, enhancing motivation for treatment, fostering the therapeutic alliance, and assessing and discussing treatment progress.