Attrition from Couple Therapy: Individual Symptoms, Relationship Adjustment, and Stage of Change

Abstract

Research has indicated that attrition in psychotherapy is a problem for therapists and clients. Additionally, there is a lack of research pertaining specifically to factors affecting dropout rates in couple therapy. In this study, this gap in the literature is addressed. The relationship between relationship quality, individual symptoms, stage of change, and premature termination from couple therapy was explored for males and for females. Sample data used were collected from 443 couples (886 total clients) at a training clinic for marriage and family therapy at a southeastern university. Measures of attrition were regressed on individual symptoms, relationship quality, and precontemplation and motivation stages of change. Overall findings indicate that low relationship quality significantly predicts higher attrition for females and lower attrition for males based on therapist rating. Low relationship quality also significantly predicted lower therapy completion based on treatment length for females. Possible explanations for findings are described, and implications of findings for future research and therapy practice are discussed.