This meta-analytic review of 11 studies examined the relationship between psychotherapy dropout and therapeutic alliance in adult individual psychotherapy. Results of the meta-analysis demonstrate a moderately strong relationship between psychotherapy dropout and therapeutic alliance (d = .55). Findings indicate that clients with weaker therapeutic alliance are more likely to drop out of psychotherapy. The meta-analysis included a total of 1,301 participants, with an average of 118 participants per study, a standard deviation of 115 participants, and a range from 20 to 451 participants per study. Exploratory analyses were conducted to determine the influence of variables moderating the relationship between alliance and dropout. Client educational history, treatment length, and treatment setting were found to moderate the relationship between alliance and dropout. Studies with a larger percentage of clients who completed high school or higher demonstrated weaker relationships between alliance and dropout. Studies with lengthier treatments demonstrated stronger relationships between alliance and dropout. Inpatient settings demonstrated significantly larger effects than both counseling centers and research clinics. No significant differences were found between client-rated, therapist-rated, and observer/staff-rated alliance. Recommendations for clinicians and researchers are discussed.

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This study examined the relationship between continuation in an opiate treatment program and patient characteristics such as affect regulation, insight, and capacity for interpersonal relations. Participants consisted of 63 patients randomly selected from those completing an initial interview at a short-term heroin detoxification program. Patient characteristics were assessed using the Capacity for Dynamic Process Scale (CDPS). Results of this study indicated that the CDPS total score for each patient was related to the subsequent number of treatment sessions attended by that patient and significantly differentiated dropouts from completers. These findings support previous use of the CDPS in psychotherapy research. In addition, this study extends use of the CDPS to research on brief pharmacotherapy treatment of opiate addiction.

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