Do Distress Level and Waitlists Impact Termination in a Training Clinic?

Premature termination (PT) is a substantial problem in psychology training clinics, resulting in adverse effects for both clients and psychotherapists in training. Although a large meta-analysis found the rate of PT to fall at 19.7% across varied mental health care settings, moderation analyses reve...

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Bibliographic Details
Published in:Training and education in professional psychology 2019-05, Vol.13 (2), p.127-137
Main Authors: Al-Jabari, Rawya, Murrell, Amy R, Callahan, Jennifer L, Cox, Randall J, Lester, Ethan G
Format: Article
Language:English
Subjects:
Clients
Clinics
Distress
Female
Human
Male
Psychotherapists
Psychotherapy Training
Training
Treatment Outcomes
Treatment Termination
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Summary:Premature termination (PT) is a substantial problem in psychology training clinics, resulting in adverse effects for both clients and psychotherapists in training. Although a large meta-analysis found the rate of PT to fall at 19.7% across varied mental health care settings, moderation analyses revealed much higher rates of premature termination were specific to those being treated in campus mental health settings (Swift & Greenberg, 2012). A subsequent multisite study was able to focus specifically on psychology training clinic clients (as opposed to university counseling centers, etc.) and found that the rate of PT among clients in those clinics was ∼70% (Callahan et al., 2014). Other single-site studies in psychology training clinics have reported rates of nearly 80% (Aubuchon-Endsley & Callahan, 2009; Swift, Callahan, & Levine, 2009). In the current sample (N = 524) of adult clients who were treated by trainees across three accredited doctoral (Ph.D.) programs in a traditional university-based psychology training clinic, the rate of PT was found to fall in the range of 63% (based on trainees' subjective appraisals of client outcome) to 69.9% (based on scores from a routine outcome tracking measure). Neither client demographic variables (e.g., age, sex, race/ethnicity) nor psychotherapist training variables (e.g., years in doctoral program, direct client contact hours) were significantly associated with PT. Exploration of psychotherapy variables (e.g., alliance) and clinic variables (e.g., waitlist duration) revealed only small effects. Significant work remains in understanding the etiology of the high premature termination rates that are consistently demonstrated in psychology training clinics.
ISSN:1931-3918
1931-3926
DOI:10.1037/tep0000223