PSYCHOTHERAPY ENGAGERS VERSUS NON-ENGAGERS

ange on the OQ-45.2 when beginning therapy and made at least 14 points of change
according to his/her OQ-45.2 scores, and both client and therapist agreed that the
treatment goals had not been met yet, but the client and therapist experience a rupture in
the therapeutic relationship and the client leaves to seek therapy elsewhere. Under the
clinically significant and/or reliable change definition, this client would not be classified
as a treatment dropout even though both the therapist and client would agree that the
client did indeed drop out of therapy with this particular therapist. Furthermore, an
additional problem with using the clinically significant change and/or reliable change
method is that it does not distinguish between different sub-types of dropouts. Some
studies may want to look at certain types of dropouts based on particular clinical
phenomena observed. For example, intake-only dropouts may differ in important ways
from later dropouts; perhaps the early dropouts were never ‘hooked in’ whereas the later
dropouts experienced ruptures in the therapeutic alliance.
Early dropouts, such as intake-only dropouts, may be especially important to
examine not only because early dropout may result from a differing set of factors than
later dropout (Barrett et al., 2008), but because clients who drop out early on in therapy
(e.g., after only one or two visits) have poorer outcomes than those who drop out later in
therapy (Pekarik, 1983, 1992). Thus, the present study will focus on psychotherapy
dropout occurring in the early phase of therapy rather than later on in therapy.
Since the focus of the present study is on psychotherapy dropout occurring after
intake, the definition of dropout that will be used for the present study refers to clients
who did not return for therapy after the initial intake session and have not reached their
therapeutic goals as determined by therapist judgment. Similarly, in previous studies,
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