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An evaluation of predictors of dropout from an Emotional Coping Skills programme in a community mental health service

Published online by Cambridge University Press:  04 July 2019

Shalini Raman  and
Thomas Richardson
Shalini Raman*
Affiliation:
University of Southampton Doctoral Programme of Clinical Psychology, University of Southampton, Highfield Campus, Southampton SO17 1BJ, UK
Thomas Richardson
Affiliation:
Solent NHS Foundation Trust, Adult Mental Health, St Mary’s Community Health Campus, Milton Road, Portsmouth PO3 6AD, UK
*
*Corresponding author. Email: shaliniraman@hotmail.co.uk
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Abstract

Drop-out from mental health services is a significant problem, leading to inefficient use of resources and poorer outcomes for clients. Adapted dialectical behaviour therapy (DBT), often termed Emotional Coping Skills (ECS) programmes, show some of the highest rates of drop-out from therapy recorded in the literature. The present study aimed to add to the evidence base, by evaluating predictors of drop-out from an ECS programme in a UK-based Community Mental Health Team (CMHT). An existing data set of 49 clients, consisting of clients’ responses on a number of questionnaires, was evaluated for predictors of drop-out. Predictors of drop-out included symptom severity, substance use and client demographics. Independent-samples t-tests and chi-square cross tabs analyses revealed no significant differences between drop-outs and completers of therapy on any of the variables. This suggests that contrary to common assumptions and previous findings, clients using substances, who are highly anxious, or who experience a greater degree of emotion dysregulation, are not more likely to drop out from ECS programmes compared with other individuals. The clinical implications of these findings and future research are discussed within the wider context of the evidence base.

Key learning aims

  1. (1) To be familiar with common predictors of drop-out from psychological therapies, as indicated by the literature.

  2. (2) To understand the theories underlying factors that impact drop-out and the associated consequences for mental health services.

  3. (3) To understand the potential impact of staff assumptions of factors that affect drop-out on client retention.

  4. (4) To have an understanding of initiatives and strategies that may improve client-retention and engagement in services.

Keywords

cognitive behavioural interventiongroup psychotherapypersonality disorderservice evaluationtherapy outcometreatment adherence
Type
Original Research
Information
the Cognitive Behaviour Therapist , Volume 12 , 2019 , e35
Copyright
© British Association for Behavioural and Cognitive Psychotherapies 2019. 

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References

Further reading

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