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Dropout revisited: Patient- and therapist-initiated discontinuation of psychotherapy as a function of organizational instability

Werbart, Andrzej; Andersson, Hakan and Sandell, Rolf LU (2014) In Psychotherapy Research 24(6). p.724-737
Abstract
Objective: To explore the association between the stability or instability of services' organizational structure and patient- and therapist-initiated discontinuation of therapy in routine mental health. Method: Three groups, comprising altogether 750 cases in routine mental health care in eight different clinics, were included: cases with patient-initiated discontinuation, therapist-initiated discontinuation, and patients remaining in treatment. Multilevel multinomial regression was used to estimate three models: An initial, unconditional intercept-only model, another one including patient variables, and a final model with significant patient and therapist variables including the organizational stability of the therapists' clinic. Results:... (More)
Objective: To explore the association between the stability or instability of services' organizational structure and patient- and therapist-initiated discontinuation of therapy in routine mental health. Method: Three groups, comprising altogether 750 cases in routine mental health care in eight different clinics, were included: cases with patient-initiated discontinuation, therapist-initiated discontinuation, and patients remaining in treatment. Multilevel multinomial regression was used to estimate three models: An initial, unconditional intercept-only model, another one including patient variables, and a final model with significant patient and therapist variables including the organizational stability of the therapists' clinic. Results: High between-therapist variability was noted. Odds ratios and significance tests indicated a strong association of organizational instability with patient-initiated premature termination in particular. Conclusions: The question of how organizational factors influence the treatment results needs further research. Future studies have to be designed in ways that permit clinically meaningful subdivision of the patients' and the therapists' decisions for premature termination. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
organizational factors, predictors, mental health services research, dropout, outcome research
in
Psychotherapy Research
volume
24
issue
6
pages
724 - 737
publisher
Taylor & Francis
external identifiers
  • wos:000342829500009
  • scopus:84908467058
ISSN
1468-4381
DOI
10.1080/10503307.2014.883087
language
English
LU publication?
yes
id
cdd04ebc-6095-485e-98b7-dfa2e67287a0 (old id 4796270)
date added to LUP
2014-11-21 15:00:35
date last changed
2017-01-15 03:55:30
@article{cdd04ebc-6095-485e-98b7-dfa2e67287a0,
  abstract     = {Objective: To explore the association between the stability or instability of services' organizational structure and patient- and therapist-initiated discontinuation of therapy in routine mental health. Method: Three groups, comprising altogether 750 cases in routine mental health care in eight different clinics, were included: cases with patient-initiated discontinuation, therapist-initiated discontinuation, and patients remaining in treatment. Multilevel multinomial regression was used to estimate three models: An initial, unconditional intercept-only model, another one including patient variables, and a final model with significant patient and therapist variables including the organizational stability of the therapists' clinic. Results: High between-therapist variability was noted. Odds ratios and significance tests indicated a strong association of organizational instability with patient-initiated premature termination in particular. Conclusions: The question of how organizational factors influence the treatment results needs further research. Future studies have to be designed in ways that permit clinically meaningful subdivision of the patients' and the therapists' decisions for premature termination.},
  author       = {Werbart, Andrzej and Andersson, Hakan and Sandell, Rolf},
  issn         = {1468-4381},
  keyword      = {organizational factors,predictors,mental health services research,dropout,outcome research},
  language     = {eng},
  number       = {6},
  pages        = {724--737},
  publisher    = {Taylor & Francis},
  series       = {Psychotherapy Research},
  title        = {Dropout revisited: Patient- and therapist-initiated discontinuation of psychotherapy as a function of organizational instability},
  url          = {http://dx.doi.org/10.1080/10503307.2014.883087},
  volume       = {24},
  year         = {2014},
}