Experimentar cierta mejoría se asocia a un abandono prematuro de la terapia
- Miriam Romero 1
- Cristina Casadevante 1
- Alba Luque 1
- 1 Universidad Autónoma de Madrid, España
ISSN: 1138-2635, 1989-3809
Datum der Publikation: 2022
Titel der Ausgabe: Nuevas tendencias en inteligencia emocional
Ausgabe: 15
Nummer: 2
Seiten: 59-68
Art: Artikel
Andere Publikationen in: Escritos de psicología
Zusammenfassung
Therapeutic dropout is an a priori detrimental phenomenon that frequently occurs in psychotherapy. This work aims to study the factors that may influence therapy dropout. An analysis was carried out on a sample of 298 users of the Applied Psychology Center of the Autonomous University of Madrid. Of these users, 88(29.5%) dropped out of therapy before its completion. The results show that the presence of severe symptoms at the beginning of therapy according to the therapist’s criteria, and the diagnosis of anxiety pro-blems, are associated with a higher dropout rate. In addition, it is observed that people who drop out have experienced significant improvement prior to leaving the treatment and show a high level of adaptation to the environment at the time of dropout. According to the therapist’s evaluation, however, those who complete the therapeutic process show a greater improvement. The implications of the study are discussed.
Bibliographische Referenzen
- American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR). Washington: American Psychiatric Association. DOI: https://doi.org/10.1176/appi.books.9780890423349
- Bados, A., Balaguer, G., y Saldaña, C. (2007). The efficacy of cognitive–behavioral therapy and the problem of drop‐out. Journal of clinical psychology, 63(6), 585-592. DOI: https://doi.org/10.1002/jclp.20368
- Beckham, E. E. (1992). Predicting patient dropout in psychotherapy. Psychotherapy: Theory, Research, & Practice, 29(2), 177–182. https://doi.org/10.1037/0033-3204.29.2.177 DOI: https://doi.org/10.1037/0033-3204.29.2.177
- Bueno-Heredia, A., Córdoba-Doña, J. A., Escolar-Pujolar, A., Carmona Calvo, J., & Rodriguez Gómez, C. (2001). El abandono terapéutico. Actas Españolas de Psiquiatría, 29, 33‐40.
- Freire-Arteta, B. (1990). Estudio comparativo de tres grupos de pacientes con distinta continuidad terapéutica. Revista Asociación Española de Neuropsiquiatría, 10, 221-227.
- García-Cabeza, I., Sánchez-Díaz, E. I., Sanz-Amador, M., Gutiérrez-Rodríguez, M., & Gonzalez-Chávez, M. (1999). Factores relacionados con la adherencia al tratamiento en pacientes esquizofrénicos. Actas Españolas de Psiquiatría, 27, 211-216.
- Gunderson, J. G., Frank, A. F., Ronningstam, E. F., Wachter, S., Lynch, V. J., & Wolf, P. J. (1989). Early discontinuance of borderline patients from psychotherapy. Journal of Nervous and Mental Disease, 177, 38–42. https://doi.org/10.1097/00005053-198901000-00006 DOI: https://doi.org/10.1097/00005053-198901000-00006
- Hamilton, S., Moore, A.M., Crane, D.R., & Payne, S.H. (2011). Psychotherapy dropouts: differences by modality, license, and DSM-IV diagnosis. Journal of Marital and Family Therapy, 37(3), 333-343. DOI: https://doi.org/10.1111/j.1752-0606.2010.00204.x
- Hatchett, G. T., & Park, H. L. (2003). Comparison of four operational definitions of premature termination. Psychotherapy: Theory, Research, Practice, Training, 40(3), 226-231. https://doi.org/10.1037/0033-3204.40.3.226 DOI: https://doi.org/10.1037/0033-3204.40.3.226
- Henzen, A., Moeglin, C., Giannakopoulos, P., & Sentissi, O. (2016). Determinants of dropout in a community based mental health crisis centre. BMC Psychiatry, 16:111. DOI: https://doi.org/10.1186/s12888-016-0819-4
- Karekla, M., Konstantinou, P., Ioannou, M., Kareklas, I., & Gloster, A. T. (2019). The Phenomenon of Treatment Dropout, Reasons and Moderators in Acceptance and Commitment Therapy and Other Active Treatments: A Meta-Analytic Review. Clinical Psychology in Europe, 1(3), 1-36. https://doi.org/10.32872/cpe.v1i3.33058 DOI: https://doi.org/10.32872/cpe.v1i3.33058
- Kazdin, A. E. (1990). Premature termination from treatment among children referred for antisocial behavior. Journal of Child Psychology and Psychiatry, 31, 415–425. DOI: https://doi.org/10.1111/j.1469-7610.1990.tb01578.x
- Klein, E. B., Stone, W. N., Hicks, M. W., & Pritchard, I. L. (2003). Understanding dropouts. Journal of Mental Health Counseling, 25(2), 89-100. DOI: https://doi.org/10.17744/mehc.25.2.xhyreggxdcd0q4ny
- Levitt, E. E. (1958). A comparative judgmental study of ‘defection’ from treatment at a child guidance clinic. Journal of Clinical Psychology, 14, 429–432. DOI: https://doi.org/10.1002/1097-4679(195810)14:4<429::AID-JCLP2270140424>3.0.CO;2-U
- Maslach, C. (1978). The client role in staff burn-out. Journal of Social Issues, 34(4), 111-124. DOI: https://doi.org/10.1111/j.1540-4560.1978.tb00778.x
- Pekarik, G. (1983). Improvement in clients who have given different reasons for dropping out of treatment. Journal of Clinical Psychology, 39(6), 909-913. DOI: https://doi.org/10.1002/1097-4679(198311)39:6<909::AID-JCLP2270390614>3.0.CO;2-4
- Pekarik, G. (1985). Coping with dropouts. Professional Psychology: Research and Practice, 16(1), 114-123. https://doi.org/10.1037/0735-7028.16.1.114 DOI: https://doi.org/10.1037/0735-7028.16.1.114
- Pekarik, G. (1992). Relationship of clients' reasons for dropping out of treatment to outcome and satisfaction. Journal of Clinical Psychology, 48, 91-98. https://doi.org/10.1002/1097-4679(199201)48:1<91:AID-JCLP2270480113>3.0.CO;2-W DOI: https://doi.org/10.1002/1097-4679(199201)48:1<91::AID-JCLP2270480113>3.0.CO;2-W
- Persons, J. B., Burns, D. D., & Perloff, J. M. (1988). Predictors of dropout and outcome in cognitive therapy for depression in a private practice setting. Cognitive Therapy and Research, 12, 557–575. https://doi.org/10.1007/BF01205010 DOI: https://doi.org/10.1007/BF01205010
- Sharf, J., & Primavera, L. H. (2009). Meta-analysis of psychotherapy dropout. Unpublished manuscript, Adelphi University.
- Sledge, W. H., Moras, K., Hartley, D., & Levine, M. (1990). Effect of time-limited psychotherapy on patient dropout rates. American Journal of Psychiatry, 147(10), 1341-1347. DOI: https://doi.org/10.1176/ajp.147.10.1341
- Steel, Z., Jones, J., Adcock, S., Clancy, R., Bridgford‐West, L., & Austin, J.(2000). Why the high rate of dropout from individualized cognitive‐behavior therapy for bulimia nervosa? International Journal of Eating Disorders, 28 (2), 209‐21. DOI: https://doi.org/10.1002/1098-108X(200009)28:2<209::AID-EAT10>3.0.CO;2-L
- Strakowski, S., Keck, PE., McElroy, S., et al. (1998). Twelve-month outcome after a first hospitalization for affective psychosis. Archives of General Psychiatry, 55, 49-55. DOI: https://doi.org/10.1001/archpsyc.55.1.49
- Swift, J. K., Callahan, J. L., & Levine, J. C. (2009). Using clinically significant change to identify premature termination. Psychotherapy, 46, 328-335. https://doi.org/10.1037/a0017003 DOI: https://doi.org/10.1037/a0017003
- Verdoux, H., Lengronne, J., Liraud, F., Gonzales, B., Assens, F., Abalan, F., & Van Os, J. (2000). Medication adherence in psychosis: predictors and impact on outcome. A 2-year follow-up of first-admitted subjects. Acta Psychiatrica Sacandinavica, 102, 203-210. DOI: https://doi.org/10.1034/j.1600-0447.2000.102003203.x
- Wierzbicki, M., & Pekarik, G. (1993). A meta-analysis of psychotherapy dropout. Professional Psychology: Research and Practice, 24(2), 190–195. https://doi.org/10.1037/0735-7028.24.2.190 DOI: https://doi.org/10.1037/0735-7028.24.2.190