Decreasing Premature Termination from Psychotherapy

Abstract

The present study tested a procedure for reducing dropout rates from psychotherapy. The procedure is based on research demonstrating that under certain conditions, explaining or imagining a hypothetical future behavior leads to increases in the subjective and actual likelihood of that behavior. In the present study, incoming clients imagined and explained why they (hypothetically) remained in therapy for four sessions. Sixty-five adult patients seeking therapy at a community mental health center participated in the project immediately before their intake appointment. Two experimental groups imagined and explained staying in therapy for four sessions; one of them also stated expectations for attending therapy. The control group imagined and explained an irrelevant event but received straightforward information regarding the importance of attendance. Dropout rates of 57 previous clients were obtained from their charts and comprised a historical-base-rate group. The hypothesis that clients who imagined and explained staying in therapy for four sessions would have lower dropout rates was supported. Theoretical and practical implications concerning the imagination-explanation procedures are discussed.