A preliminary study of an attraction-barrier model of patients' commitment and responses to dissatisfaction in psychotherapy.

In a cross-sectional study, 168 psychotherapy patients (mean age 24.57 yrs) reported on how they dealt with problems pertaining to the therapist or the therapy process. Ss were asked to think about a session in therapy when they experienced a problem or dissatisfying event pertaining to the therapist or the therapy process. It was found that commitment to therapy mediated the effect of level of Ss' disclosure in therapy in endorsing constructive accommodation (voice and loyalty as opposed to exit and neglect) to deal with the dissatisfying events. Severity of the dissatisfying event with the therapist had direct effects on increasing the use of voice and exit and decreasing loyalty; it also had indirect effects on accommodation via the mediating variable of commitment. The results are explained jointly in terms of G. Levinger's (1999) attraction-barrier model of commitment and C. E. Rusbult et al.'s (1991) model of accommodation processes. It is concluded that the proposed conceptual framework, derived from theory and research on the social psychology of personal relationships, may be useful in understanding when interpersonal problems between patients and therapists encourage patients to withdraw or drop out of therapy before it is therapeutically appropriate. (PsycINFO Database Record (c) 2010 APA, all rights reserved)