The Impact of COVID-19 and Telehealth Services on Attrition Rates in Psychotherapy

Attrition in psychotherapy has been identified as a significant obstacle in the productive delivery of mental health services. Defined generally as the ending of a treatment prior to proper optimal benefit, attrition both hinders treatment efficacy and costeffectiveness in therapy. With the demands for quality mental health services increasing, resources must be identified to reduce barriers to such services. The COVID-19 pandemic has resulted in the emergence of one potential resources: telehealth services. The current study aims to identify how COVID-19 and telehealth services have influenced attrition by analyzing attrition rates from both before and during the pandemic in a community health center where a transition to telehealth was made at the start of the pandemic. In addition, the variables of age, gender, socioeconomic status, and insurance coverage were also tested as potential predictors of attrition. Using de-identified patient information, clients who had participated in therapy services within a six-month period at a community health center (N = 329) were selected. A survival analysis was used to assess the time taken from initial appointment to the point of attrition. Results indicated that those who attended therapy via telehealth were less likely to stop attending treatment than those who participated in therapy in person. Individuals who used both in-person and telehealth visits were the least likely to terminate treatment prematurely. Clinical implications include the need for therapists to offer both telehealth and in-person services in order to give clients more resources to reduce a large barrier to needed mental healthcare treatment.

The online version contains supplementary material available at 10.1007/s10591-023-09661-0.