Drop out in Psychotherapy: A Holistic View

Abstract

Drop-out can be defined as when patients leave treatment sessions early in an unplanned manner before treatment has finished; patients stop attending without prior agreement. Drop out in therapy is caused by low socio-economic status, prior psychiatric treatment and personality variables, which include “social isolation, hostility, borderline diagnosis, lack of psychological mindedness, low tolerance for frustration, poor motivation, feeling uncomfortable with seeing a mental health professional and perception of the therapist as less competent and trustworthy”. Those who reported higher levels of impulsivity, disorganized behaviors, and a diagnosis of conduct disorder were more likely to drop out of treatment. The phenomenon of drop out can be observed in cognitive behavior therapy, family therapy, dialectical behaviour therapy, cognitive therapy, group therapy etc. at least a closing session should be available for the client and the therapist to work through the treatment termination to process treatment progress, consolidate therapeutic gains, empower the client in his or her readiness to do without therapy, process emotions for the impending separation, and discuss how the client would proceed and continue the change process without having therapy in his or her life before closing the therapeutic relationship. The drop out can be minimized by understanding the goals and expectations and sending appointment letters to the patients whenever they missed a scheduled visit.