Survival modeling of discontinuation from psychotherapy: A consumer decision-making perspective

Abstract

Objective: This study examines discontinuation of psychotherapy from a consumer decision-making perspective. Two plausible predictors, the level of illness and rate of progress from where the patient started, were examined as predictors of treatment discontinuation. Method: Using data from 139 patients (45.5% women; mean age = 32.18 years) participating in a 12-week transdiagnostic cognitive-behavioral therapy program for anxiety, weekly assessments of anxiety severity were examined to investigate the extent to which level of anxiety and rate of improvement predicted treatment discontinuation. Results: Support was found for a significant interaction effect wherein at higher anxiety levels, rate of progress was less associated with discontinuation than at lower anxiety levels. Conclusion: Faster rates of anxiety reduction are associated with greater likelihood of discontinuation when the client is at a lower level of anxiety, whereas rate of improvement is less associated with discontinuation if there remains continued impairment and room for improvement. As such, clinicians should monitor rates of improvement throughout treatment to help identify and evaluate patients at increased risk of premature discontinuation.