Perceived Helpfulness of Previous Therapy: A Predictor of Premature Termination.

Premature termination is a common and enduring problem in clinical practice. Using data extracted from the medical records of 108 adults (Mage = 35.14, female = 63.9%) with prior therapy experiences, this study examined whether perceptions about the helpfulness of prior therapy predicted premature termination, defined as termination before achieving reliable change (RC) or clinically significant change (CSC) on the Outcome Questionnaire–45.2 (Lambert et al., 1996). In RC and CSC models, premature termination was, respectively, 3.05 and 3.06 times more likely among those with one or more prior unhelpful therapy experiences (vs. all helpful). In CSC models, premature termination was 4.04 times more likely among those with all prior unhelpful therapy experiences (vs. all helpful). Number of prior unhelpful therapy experiences was not a significant predictor of premature termination. Those who perceived all prior therapy as helpful attended significantly more therapy sessions than those who perceived all prior therapy as unhelpful. Findings suggest that the client perceptions of previous therapy may help predict premature termination. Individuals with a history of negative therapy experiences may benefit from interventions to improve engagement. Public Significance Statement: Findings from this study suggest that client perceptions of previous therapy may help predict whether a client prematurely terminates therapy. Specifically, this study found that perceiving prior therapy experiences as unhelpful predicted premature termination, defined as termination prior to achieving reliable change and clinically significant change on the OQ-45. Those who perceived all prior therapy as unhelpful attended the fewest therapy sessions, whereas those who perceived all prior therapy as helpful attended the most. Those with a self-reported history of unhelpful therapy may benefit from additional intervention to promote sustained engagement in treatment. [ABSTRACT FROM AUTHOR]