Premature Termination in Psychotherapy

When clients prematurely end individual psychotherapy or couple and family therapy, they risk continued distress and other negative outcomes. What’s more, they may form unfortunate opinions about therapy in general that prevent them from seeking therapeutic services from other providers or in the future. Premature termination in psychotherapy also has a negative impact on clinicians in terms of feelings of inadequacy, reduced income, and diminished reputations in the field.

In addition to the individual impacts to both client and therapist, premature termination in psychotherapy leaves no room for clinicians to learn better engagement skills or develop as therapists. Client feedback in therapy is an important way to keep clients engaged in therapy, improve outcomes by recapturing non-responding clients, and for practitioners to truly know about their effectiveness. The Partners for Change Outcome Management System (PCOMS), a client feedback system, has been shown to reduce premature termination in addition to its function as a valid outcome measure that allows clinicians and agencies to determine efficacy.

Studies show that a quarter to one half of all therapy clients never return after the initial intake session. Why?

Clients often cite unhappiness with the therapist as a reason for premature termination or the belief that the therapy itself will not be helpful. In other words, the client was not engaged in therapy and/or the possibility or hope of change didn’t arise from the experience -- leaving the client with feelings of doubt. These feelings of doubt can be enough of a deterrent, especially for clients who are reluctant about therapy from the outset.

When clients are empowered to give feedback in therapy -- to become true partners -- and there is a strong emphasis on relationship building from the outset, clients and therapists are poised for better outcomes. The Outcome Rating Scale and the Session Rating Scale, core elements of PCOMS, provide the means to ensure that the client is benefiting from therapy and that the client-therapist alliance is center stage -- both are prime deterrents to premature termination.

Premature termination in psychotherapy by the client has negative consequences for both the client and the therapist. Client feedback in therapy via PCOMS proactively addresses the reasons clients leave therapy early by engaging clients in a true partnership to monitor outcomes and the alliance.