Patient demographics and psychological functioning as predictors of unilateral termination of psychodynamic therapy

Abstract

Approximately one in five patients drops out of treatment before its completion. Little is known about consistent predictors of dropout, and most studies focus on patients’ demographic characteristics. A mass of information is collected daily at intake in clinical practice. Based on psychodynamic theoretical conceptualizations and accumulative clinical experience, this information may help predict dropout, and thereby expand the empirically based predictors of dropout. Objective: The present study aims at bridging between scientific research and clinical practice by investigating potential predictors of unilateral termination collected at intake, before therapy, in addition to predictors already identified in the literature. Method: The study was based on data from 413 patients from a university consulting center. Each patient completed a pre-intake questionnaire collecting demographic information, and underwent an interview conducted by a professional intaker. Results: Results indicate that the consistent predictors described in the literature, education, and age, were related to unilateral termination rates. Additionally, lower intrapsychic functionality, as evaluated by the intakers, was also found to contribute uniquely to higher unilateral termination rates. Conclusion: This finding attests to the unique value of professional evaluations of patients’ intrapsychic functionality, frequently conducted in clinical practice, to detect patients at risk of unilateral termination of treatment.