The Relationship Between Fee for Services and Couples Therapy Dropout Moderated by Therapeutic Alliance in a Training Environment

Abstract

Dropout in psychotherapy is a common problem associated with a variety of negative outcomes for clients, service providers, and society (Anderson et al., 2019). Although many studies cite inconsistent findings between client demographics and dropout rates (Barrett et al., 2008; Swift & Greenburg, 2012), some research indicates that low-income clients may be at a higher risk of dropout (Anderson et al., 2019; Wierzbicki & Pekarik, 1993). Indeed, a recent study found that the more clients paid in therapy fees (as a percentage of their income), the more likely they were to dropout of therapy (Knizley, 2016). The present study investigated the associations between fee and dropout in a sample of couples at a marriage and family therapy training clinic in the southeast. Results from a hierarchical multiple regression indicated that higher fees were associated with fewer total sessions attended for both males and females. Theoretical and practical implications are discussed.