PSYCHOTHERAPY ENGAGERS VERSUS NON-ENGAGERS

Chapter 2: Review of the Literature
In this chapter, I review the literature in three sections: psychotherapy dropout,
therapist techniques, and helpings skills in intake sessions. Within the first section on
psychotherapy dropout, I discuss the definition of psychotherapy dropout, review the
most recent review articles on dropout, and review the literature specifically on early
dropout. Within the section on therapist techniques, I discuss the definition of therapist
techniques, provide historical background for the measure of therapist techniques being
used in the present study, and review the literature on therapist helping skills. Within the
section on helping skills in intake sessions, I review the literature on intake sessions,
review articles reporting overall proportions of helping skills used in intake sessions, and
review articles that report the amount of helping skills used in thirds of intake sessions
(including the only article on helping skills in relation to psychotherapy dropout).
Psychotherapy Dropout
Definition of psychotherapy dropout. Psychotherapy dropout can be defined as
occurring when a client has left therapy before completing therapy treatment (Hatchett &
Park, 2003). Although the conceptual definition of psychotherapy dropout is not difficult
to understand, the operational definition of psychotherapy dropout poses a more
complicated undertaking for researchers. Since the definition implies that a client has
begun treatment but did not finish treatment, exactly how one defines when treatment has
begun can vary – for example, it could be defined as when the client makes the initial call
to seek treatment, as after an intake appointment has been scheduled, as after the first
appointment has begun, or even only after the first therapy session has begun (not
counting intake). Even more complicated is the question of what would count as
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