What Happens to People Who “Drop Out” of Therapy?

All good things must come to an end, and that includes psychotherapy. For some people, psychotherapy comes to an end quite quickly.

A recent study by researchers from Portugal, Brazil and Israel looked at what happens to people who drop out of therapy after a short period of time.

The study followed 40 patients who completed therapy for depression and 23 who started therapy but dropped out. For the purposes of the study, dropping out of therapy was defined as “unilateral termination by the client without the therapist’s approval or knowledge.”

As it turned out, people who dropped out of therapy tended to have made slightly less progress by the time they dropped out. The researchers didn’t ask these people why they dropped out, but we could make an educated guess that not making as much progress in therapy didn’t help.

That said, 17 percent of the dropouts had already made clinically significant progress by the time they unilaterally ended their treatment.

And over the long-term, therapy dropouts tended to make up ground on those who stuck with therapy by making more gains in the time period after therapy had ended.

In fact, when the researchers followed up 31 months later, 62 percent of dropouts had experienced significant improvements in their symptoms, compared to 73 percent of non-dropouts. So while sticking with therapy yielded faster results, the dropouts were far from hopeless cases.

The researchers point to previous work that has suggested making sure people are informed about what to expect from therapy could help lower dropout rates. For example, a 2011 study showed that patients who were given information about the therapy they were receiving tended to continue therapy for longer and drop out less.

Overall, the researchers suggest two ways to look at the finding that therapy dropouts improve in the long run. “Ideally,” they say “these findings may suggest that dropouts will improve even without therapy.”

But the authors caution that this doesn’t mean there’s no difference at all between dropping out and staying the course with therapy: “Realistically, [the findings] suggest that improvements might take longer to occur for patients who abandon treatment than for patients who complete treatment.”

Image: Flickr/Hey Paul Studios