Attrition in group therapy with alcoholics: a survival analysis

Abstract

Three hundred and twenty-nine alcohol dependent patients, diagnosed according to DSM. III-R criteria who had participated in one of five different psychotherapy groups over a 5-year period, were studied using survival analysis statistics. Patients were followed-up until their discharge or withdrawal from the group to determine their retention in therapy, and to examine the effect of gender, age and family situation on compliance. Retention rates at 6, 12 and 24 months were 61%, 49% and 37%, respectively. Median retention time was 46 weeks. Women remained longer in treatment than men (median period 98 vs. 34 weeks), and this was due mainly to lower dropout rates in the first 3 months. Dropout rates were also higher in patients aged 35 years or younger. The first 3 months seem to be crucial in the process of deciding whether or not to remain in therapy. [Monras M, Gual A. Attrition in group therapy with alcoholics: a survival analysis. Drug Alcohol Rev 2000; 1: 55 63]

Attrition in Psychotherapy

“…Darnall, in particular, points to the danger of ''out of sight, out of mind'' (personal communication) and to clinicians' implicit theories behind why clients leave that are not always accurate. Because a substance-related diagnosis emerged as a particular risk in this setting, it may be worth noting that Monras and Gual (2000) echo this finding and conclude that, in their study of 329 adults diagnosed with alcohol dependence, the first 3 months of treatment were particularly important in participants' deciding whether or not to commit to group psychotherapy.…”

Predictors of Discontinuation From Individual Treatment in Men Perpetrators of Intimate Partner Violence

“…These key moments are comparable to those reported by Delgadillo et al (2014), who conducted a similar study in a population receiving an individual treatment of "low intensity" (e.g., psychosocial help, psychoeducation) for anxiety problems and depressive symptoms. Another study targeting group-format psychotherapy for alcoholism, however, identified later moments of cessation (Monras & Gual, 2000). It should be noted that these authors' treatment was held over 2 years and that their life table was based on 4-week intervals, limiting the precision of their analysis and comparison with the present study.…”

“…Such a high standard error may indicate bias, as these high values do not necessarily represent moments when cessation of treatment is more likely. Based on the analysis of the life table, the survival curve, the hazard (or failure rates), and relying on the work of Monras and Gual (2000), three key moments of cessation of treatment were identified: (a) early cessations (after 2 or 3 sessions); (b) short-term cessations (after 5 sessions); and (c) medium-term cessations (after 11 sessions).…”