Premature Termination in Psychotherapy: Strategies for Engaging Clients and Improving Outcomes

Premature termination is a significant yet often neglected problem in psychotherapy with significant consequences for clients and therapists alike.

According to some estimates, as many as 20% of adult clients terminate psychotherapy prematurely. Even experienced practitioners using the best evidence-based techniques cannot successfully promote positive, long-term change in clients who do not complete the full course of treatment.

This book helps therapists and clinical researchers identify the common factors that lead to premature termination, and it presents eight strategies to address these factors and reduce client dropout rates. Such evidence-based techniques will help therapists establish proper roles and behaviors, work with client preferences, educate clients on patterns of change, and plan for appropriate termination within the first few sessions.

Additional strategies can be used throughout therapy to help strengthen and reinforce clients’ feelings of hope, enhance their motivation to create change, develop and maintain the therapeutic alliance, and continually evaluate overall treatment progress.

Case examples demonstrate how these strategies can be employed in real-life scenarios.

Joshua K. Swift, PhD, is an associate professor in the Department of Psychology at the University of Alaska Anchorage and a core faculty member in the Joint University of Alaska Fairbanks/University of Alaska Anchorage PhD Program in clinical-community psychology, where he directs the Psychotherapy Process and Outcome Research Lab. He is also a licensed psychologist in the state of Alaska.

As an early career psychologist he has authored or coauthored more than 80 professional publications and presentations. He has also been recognized with a number of awards, including the APA Division 29 (Psychotherapy) Distinguished Publication of Psychotherapy Research Award, Division 29 President’s Award for Psychotherapy Research, and University of Alaska Anchorage’s Chancellor’s Awards for Excellence in Teaching and Research.

Roger P. Greenberg, PhD, is Distinguished Professor and director of the Psychology Division at State University of New York (SUNY) Upstate Medical University in Syracuse. He is also the psychology internship training director at SUNY and a long-standing clinician in private practice.

He has authored or coauthored about 250 publications and presentations, including The Art and Science of Brief Psychotherapies: An Illustrated Guide (2012), From Placebo to Panacea: Putting Psychiatric Drugs to the Test (1997), and the award-winning The Scientific Credibility of Freud’s Theories and Therapy (1985).

He has received the National Register of Health Service Psychologists’ Alfred B. Wellner Lifetime Achievement Award, the New York State Psychological Association’s Joanne Lifshin Mentorship Award, the Association of Psychology Postdoctoral and Internship Centers’ Excellence in Training Award, and the SUNY President’s Award for Excellence in Teaching.