Premature Termination in Psychotherapy

Book excerpt: Premature termination is a significant yet often neglected problem in psychotherapy with significant consequences for clients and therapists alike. According to some estimates, as many as 20% of adult clients terminate psychotherapy prematurely. Even experienced practitioners using the best evidence-based techniques cannot successfully promote positive, long-term change in clients who do not complete the full course of treatment. This book helps therapists and clinical researchers identify the common factors that lead to premature termination, and it presents eight strategies to address these factors and reduce client dropout rates. Such evidence-based techniques will help therapists establish proper roles and behaviors, work with client preferences, educate clients on patterns of change, and plan for appropriate termination within the first few sessions. Additional strategies can be used throughout therapy to help strengthen and reinforce clients' feelings of hope, enhance their motivation to create change, develop and maintain the therapeutic alliance, and continually evaluate overall treatment progress. Case examples demonstrate how these strategies can be employed in real-life scenarios.