Author : Shobha Teresa George
Publisher :
ISBN 13 :
Total Pages : 340 pages
Book Rating : 4.:/5 (232 download)
Book Synopsis The Effect of Therapeutic Alliance on Client Dropout by : Shobha Teresa George
Download or read book The Effect of Therapeutic Alliance on Client Dropout written by Shobha Teresa George and published by . This book was released on 2008 with total page 340 pages. Available in PDF, EPUB and Kindle. Book excerpt: Client dropout remains a challenging issue in psychotherapy despite acceptance of mental health issues among the general public and several strategic measures designed to reduce it. Client dropout has been of particular concern in university training facilities where intern therapists experience disappointment when clients do not return for scheduled appointments and tend to associate it with inexperience and failure. This study was based on the current trend toward client-centered progress research to explore the patterns of client dropout by looking at client feedback of therapeutic alliance. The Session Rating Scale (SRS) was used in this study to measure the quality of therapeutic alliance. The SRS is a clinical tool designed to address client expectations on a session-to-session basis, thus helping to prevent client dissatisfaction with treatment. An ex post facto research design, this study used archival data from a university training center in Texas that has an accredited program for Marriage and Family Therapy (MFT). The participants were from the surrounding community who attended therapy at the center. The dependent variable was therapeutic alliance, and independent variables were client dropout and demographic variables of the client and therapist. Due to its capacity to handle multilevel data and nested data with missing data, Hierarchical Modeling procedures were used to analyze the longitudinal data of therapeutic alliance and its relationship to dropout and client/therapist variables. The results showed variability in the therapeutic alliance scores based on whether clients dropped out or continued in treatment; decreasing alliance scores predicted risk for dropout. Other covariates were found to influence therapeutic alliance were client modality and interaction of client and therapist ethnicity. Individual clients were found to form better alliances with the therapists than families or couples. Therapists' ability in relating with ethnic and culturally different groups of clients was also found to influence therapeutic alliance. Other demographic variables of the clients, such as age, gender, marital status, referral source, fees, and education, were not found to influence variability in the therapeutic alliance scores. Hierarchical Modeling was practical and useful in analyzing the multilevel and nested data in the study as it allowed for the heteroscedastic and autocorrelated nature of the data. Future research in the area of dropout is recommended using a larger sample size and data from general practices.