Treatment Compliance in Group Therapy: Issues and Interventions

Abstract

Treatment Compliance in Group Therapy Treatment has consistently been an issue in mental health treatment, and it can have very specific implications for treatment. Premature loss of members can result in lack of cohesion, reduced client outcomes, disillusionment of the therapist, and other client dropouts (Rice, 1996; Joyce, Piper, Ogrodniczuk, & Klein, 2007; Roth, 1990). This problem is extremely wide in scope, and therefore it is difficult to narrow down statistics on the frequency of its occurrence. Further, level of varies based on the type of offered and clients' specific characteristics. Though there are no general statistics regarding non-compliance in mental health as a whole, Wierzbicki and Pekarik (1993) conducted a metaanalysis of research studies throughout various types of and found an overall rate of 47%. Other studies support this rate specifically in settings (Klein & Carroll, 1986). In a study of increasing in therapy, researchers found a 30% rate even after extensive screening and preparing clients for (Lothstein, 1978). Regardless, is a significant problem that clinicians and researchers alike have been working to address for several decades. The definitions of treatment compliance and treatment dropout in vary, as different programs and theoretical approaches may have a different conceptualization of what these terms mean (Joyce et al., 2007). Treatment can include finishing a prescribed course of treatment, completing homework assignments or objectives to meet goals, or simply following through with until both the client and therapist agree that the goals have been fulfilled (Stone & Rutan, 1984). Conversely, Rice (1996) defines as someone who chooses not to, or is unable to, make a commitment to the and will most likely leave within 6 months of joining the group (p. 10). However, these definitions can change with modalities as other researchers have specific time restrictions that define when a client has officially dropped out (McMurran, Huband, & Overton, 2010). When clients drop out of therapy, they are less likely to experience improvement in mental health symptoms, and this can lead to further mental health problems down the road (Davis and Addis, 2002). Some research suggests that non-compliance is related to the value our society places on mental health treatment. Clients seem to under value mental health treatment, and are less likely to be compliant and maintain mental health appointments in comparison with medical appointments (Carter, Turovsky, Sbrocco, Meadows, & Barlow, 1995). This creates a problem for mental health providers. How do we deliver quality care and to clients when they refuse to comply with treatment, or terminate early? Evidence shows that there are characteristics of clients as well as characteristics of that are correlated with non-compliance. Knowledge of these variables can help counselors and administrators prevent drop-out and increase positive outcomes. Client Characteristics Demographics The demographics found to be correlated with in include age, race, socioeconomic status, and education level. These findings have been consistent through several studies and literature reviews on the topic (Berrigan & Garfield, 1981; Baekland & Lundwall, 1975; Wierzbicki & Pekarik, 1993). Age. Research suggests that the younger the client, the more likely he or she is to be non-compliant with treatment. We may even be more specific in terms of age. In a study of alcohol-dependent patients, rates were higher for patients who were 35 years old or younger, and a similar study found that clients aged 34 and younger were more likely to drop out (Hird, Williams, & Markham, 1997; Monras & Gaul, 2000). …