Veterans’ Treatment Engagement and Dropout from Couple and Family Therapy in a Veterans Affairs Health Care System

Abstract

The present study utilizes data from a Couple and Family Therapy Program in the Veterans Affairs Health Care System (VAHCS) seeks to understand veterans’ and their family members’ treatment engagement and dropout from initial referral for therapy to the active phase of treatment. Veterans (N = 177) referred to couple or family therapy were included in the study, and data about session attendance was collected through chart reviews. About 60% of couples and families dropped out at some point between referral to entering the active phase of treatment. Results showed that the majority of dropout occurred between the phone screen and the first session, with significant attrition also occurring between the first session and the assessment phase of treatment. In examining individual, relational, and logistical factors, a chronic pain diagnosis and serving during the Post-9/11 era were related to completion of various phases of therapy. Findings have implications for enhancing efforts to engage and retain veterans and their family members in treatment. Specific strategies for clinicians are discussed, with a focus on the shift to telehealth in the VAHCS and other health care settings in response to the COVID-19 pandemic.