Reducing psychotherapy dropouts: Maximizing perspective convergence in the psychotherapy dyad.

Reviews 3 decades of research addressing premature termination of psychotherapy. Client, therapist, interpersonal dyadic, and administrative variables have been extensively investigated. Because of a variety of methodological problems, this literature is highly contradictory, and results are difficult to reconcile, with only socioeconomic status (SES) and ethnicity emerging as consistent predictors of dropout. Treatment matching studies have evaluated the effects of maximizing similarity (or convergence) and minimizing perspective divergence within the therapeutic dyad. Research looking at interactive and multidimensional factors such as working alliance, client satisfaction and expectations, client likability, and pretreatment preparation has proven useful. This research suggests that psychotherapy dropouts might be minimized if differences between therapists' and patients' perspectives on therapeutic enterprise are acknowledged and recognized as legitimate targets for intervention. (PsycINFO Database Record (c) 2010 APA, all rights reserved)