Assessment factors associated with premature psychotherapy termination

Characteristics of patients accepted for both intensive psychotherapy and psychoanalysis were rated during their initial assessments. Twenty cases that terminated prematurely (most within the first month) were compared with twenty cases that continued in therapy. While neither specific diagnosis, type of insight therapy, nor gender of the patient or therapist was a reliable predictor of premature termination, it was found that psychodynamic and environmental assessment factors significantly differed between these two groups. In those patients who eventually dropped out, specific ego deficits, primarily introspection, frustration tolerance, impulse control, and motivation, were rated as significantly more impaired. The therapists' negative feelings toward their prospective patients and the patients' hostility toward past caretakers and present life circumstances were also associated with premature termination.