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Published Online: 1 July 2012

Is Dropout After a First Psychotherapy Visit Always a Bad Outcome?

Gregory E. Simon, M.D., M.P.H., Zachary E. Imel, Ph.D., Evette J. Ludman, Ph.D., and Bradley J. Steinfeld, Ph.D.Authors Info & Affiliations
Publication: Psychiatric Services
Volume 63, Number 7
https://doi.org/10.1176/appi.ps.201100309
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Abstract

Objective:

The authors compared outcomes reported by patients who did or did not return for treatment after an initial psychotherapy visit.

Methods:

Members of a group health plan were surveyed about initial psychotherapy visits occurring between March and September 2010. The survey assessed satisfaction with care and therapeutic alliance during the visit and later clinical improvement.

Results:

Of the 2,666 members who returned surveys, 906 (34%) did not return for a second visit within 45 days. The distribution of satisfaction, therapeutic alliance, and self-rated improvement scores between patients who did and did not return differed significantly (p<.001). Patients who did not return were more likely to report the most favorable and the least favorable outcomes.

Conclusions:

Failure to return after an initial psychotherapy visit can represent successful and satisfying treatment. Systematic outreach and outcome assessment are necessary to identify the patients who drop out of therapy after unsuccessful and unsatisfying treatment. (Psychiatric Services 63:705–707, 2012; doi: 10.1176/appi.ps.201100309)

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Figure 1 Satisfaction with treatment and self-rated improvement among patients who did or did not return for a second psychotherapy visit

Information & Authors

Information

Published In

Go to Psychiatric Services
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Cover: Flag on Orange Field, by Jasper Johns, 1967. Museum Ludwig, Cologne, Germany. © VAGA, New York. Photo © Erich Lessing/Art Resource, New York.
Psychiatric Services
Volume 63 • Number 7 • July 2012
Pages: 705 - 707
PubMed: 22752034

History

Published online: 1 July 2012
Published in print: July 2012

Authors

Affiliations

Gregory E. Simon, M.D., M.P.H.
Dr. Simon is affiliated with the Center for Health Studies, Dr. Ludman is with the Group Health Research Institute, and Dr. Steinfeld is with Behavioral Health Services, all at the Group Health Cooperative, 1730 Minor Ave., Suite 1600, Seattle, WA 98101 (e-mail: [email protected]). Dr. Imel is with the Department of Educational Psychology, University of Utah, Salt Lake City.
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Zachary E. Imel, Ph.D.
Dr. Simon is affiliated with the Center for Health Studies, Dr. Ludman is with the Group Health Research Institute, and Dr. Steinfeld is with Behavioral Health Services, all at the Group Health Cooperative, 1730 Minor Ave., Suite 1600, Seattle, WA 98101 (e-mail: [email protected]). Dr. Imel is with the Department of Educational Psychology, University of Utah, Salt Lake City.
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Evette J. Ludman, Ph.D.
Dr. Simon is affiliated with the Center for Health Studies, Dr. Ludman is with the Group Health Research Institute, and Dr. Steinfeld is with Behavioral Health Services, all at the Group Health Cooperative, 1730 Minor Ave., Suite 1600, Seattle, WA 98101 (e-mail: [email protected]). Dr. Imel is with the Department of Educational Psychology, University of Utah, Salt Lake City.
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Bradley J. Steinfeld, Ph.D.
Dr. Simon is affiliated with the Center for Health Studies, Dr. Ludman is with the Group Health Research Institute, and Dr. Steinfeld is with Behavioral Health Services, all at the Group Health Cooperative, 1730 Minor Ave., Suite 1600, Seattle, WA 98101 (e-mail: [email protected]). Dr. Imel is with the Department of Educational Psychology, University of Utah, Salt Lake City.
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