Using Clinically Significant Change to Identify Premature Termination

What is it about?

Research examining treatment dropout is hindered by the inconsistencies in the methods used to operationalize the construct. In this article an operationalization based on the criteria of attaining clinically significant change prior to treatment discontinuation is reintroduced and compared with other existing dropout classification systems. A dropout rate of 77% was found in a university-based training clinic sample by using the clinically significant change (CSC) definition. This classification showed little agreement to classifications made by other popularly used definitions of dropout (median split, intake only, missed appointment, and therapist judgment). Further analysis indicated that the other popularly used definitions frequently classified clients as treatment dropouts when recovery had occurred or as treatment completers when recovery had not occurred. Uses and limitations of the CSC method and other popular definitions of treatment dropout are discussed.

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