Early termination of cognitive-behavioural interventions: literature review

Abstract

Cognitive-behavioural therapy (CBT) is a well-recognised psychotherapeutic intervention for the treatment of a number of psychiatric conditions such as depression, anxiety, eating disorders and obsessive-compulsive disorder.1 Furthermore, CBT techniques have proven to be efficacious in targeting specific conditions such as chronic delusions and hallucinations in schizophrenia. Lord Layard examined the need for psychological treatments in the UK and speculated that there will be a demand to train 5000 more psychological therapists by 2013, mostly in CBT.

Impact of Self-Help Schema Therapy on Psychological Distress and Early Maladaptive Schemas: A Randomised Controlled Trial

“…A substantial dropout rate was observed, although this is not unusual for randomised controlled trials of treatment for anxiety and depression (Haby, Donnelly, Corry, & Vos, 2006). It is also not substantially different from the 19% to 50% dropout rates obtained in a review of early termination in standard CBT (Salmoiraghi & Sambhi, 2010). As well, a review of dropout rates from internet-based therapy with minimal therapist contact showed a range of 2% to 83%, with a weighted average dropout rate of 31% (Melville, Casey, & Kavanaugh, 2010).…”

Side effects of the metacognitive training for depression compared to a cognitive remediation training in patients with depression

“…However, possible reasons for dropouts are many and should thus be considered in line with O’Keeffe et al 9 , who argue that a dropout represents an unwanted event if patients drop out, for example, because they dislike the treatment or feel they have not benefited from it (“dissatisfied” dropout 9 ). Yet, a dropout might also be due to symptom improvement 10 , 11 (“got-what-they-needed” dropout 9 ) or practical reasons (e.g., time constraints, transportation) 12 and is thus not necessarily an unwanted event.…”

Cognitive Behavioral Therapy and Work Outcomes: Correlates of Treatment Engagement and Full and Partial Success in Schizophrenia

“…No prior published work has examined predictors of treatment acceptance in CBTp targeting functional outcomes. Extant psychotherapy literature has struggled to identify a consistent set of predictors for CBT engagement; however, there is tentative evidence that among them are symptom level, age, educational attainment (Salmoiraghi and Sambhi, 2010), and baseline expectations about treatment (Westra, Dozois and Boardman, 2002).…”