A meta-analysis of dropout rates in acceptance and commitment therapy

Area of Science:

• Psychology and Behavioral Health
• Clinical Psychology
• Psychotherapy Research

Background:

• Psychotherapies like Cognitive Behavioral Therapy and Acceptance and Commitment Therapy (ACT) are effective for various mental health concerns.
• Client engagement is crucial for treatment efficacy, making dropout rates an important factor in assessing treatment utility.
• No prior meta-analytic research has specifically examined dropout rates in ACT.

Purpose of the Study:

• To determine the aggregate dropout rate for ACT in randomized controlled trials.
• To compare ACT dropout rates with those of other established psychotherapies.
• To identify potential moderators influencing dropout rates in ACT interventions.

Main Methods:

• A meta-analysis was conducted on 68 studies, including data from 4,729 participants.
• Dropout rates were calculated for ACT-exclusive and ACT-inclusive conditions.
• Comparisons were made between ACT and other psychotherapies, and potential moderators were analyzed.

Main Results:

• Weighted mean dropout rates for ACT were 15.8% (exclusive) and 16.0% (inclusive), not significantly different from other psychotherapies.
• Dropout rates did not vary based on client characteristics or study methodological quality.
• Higher dropout rates were associated with master's-level clinicians (29.9%) compared to psychologists (12.4%).

Conclusions:

• ACT demonstrates comparable dropout rates to established psychotherapies, suggesting similar client engagement levels.
• Therapist's level of qualification appears to be a moderator, with master's-level clinicians associated with higher dropout.
• Further research is needed to explore manipulable process variables, particularly therapist-related factors, that influence client dropout in ACT.