Therapist responsiveness and patient engagement in therapy

This study tests the hypothesis that therapist responsiveness in the first two sessions of therapy relates to three measures of early patient engagement in treatment. Using videotapes and data from the NIMH Treatment of Depression Collaborative Research Program (TDCRP), an instrument was developed to measure therapist responsiveness in the first two sessions of Cognitive Behavior Therapy and Interpersonal Psychotherapy. A factor measuring positive therapeutic atmosphere, as well as a global item of therapist responsiveness, predicted both the patient's positive perception of the therapeutic relationship after the second session and the patient's remaining in therapy for more than four sessions. A negative therapist behavior factor also predicted early termination. Factors measuring therapist attentiveness and early empathic responding did not predict the engagement variables.