Dropout from psychodynamic psychotherapies: a systematic review of correlated factors

Abstract

Dropout from psychotherapy is a complex and significant concern that affects patients, therapists, and mental health service providers. Although there is a growing fascination with experimental inquiries into the value and efficacy of psychodynamic therapies, there have been limited endeavours to explicitly scrutinise this topic so far. The aim of this study was to conduct a systematic review of the literature concerning individual psychodynamic therapy for adults, with the objective of identifying factors associated with treatment dropout. Employing the PRISMA method, pertinent documents were extracted from the APA PsychNet, PubMed, Cochrane Central Register of Controlled Trials, and ProQuest databases. The final review consisted of fourteen empirical studies. The median treatment dropout rate was 34.5%. Various factors, including patient characteristics, patient needs, patient beliefs, and environmental factors, were associated with treatment dropout. None of the studies conducted a specific assessment of the consequences of treatment dropout or the effectiveness of strategies aimed at minimising it. Implications for clinical practice and research are discussed.