Early Dropout in Men Voluntarily Undergoing Treatment for Intimate Partner Violence in Norway

Abstract

This study investigated psychotherapy dropout rates and predictors of dropping out of therapy early. We enrolled 1,166 men voluntarily admitted to psychotherapy for violent behavior against a female partner. In total, 315 (23.8%) subjects dropped out of therapy within the first 3 sessions. Dropouts were significantly younger, more likely to have a non-Norwegian ethnic background, less likely to have received previous mental health care, and were more likely to have been treated by a student therapist. Among those treated by a student therapist, unemployment was strongly associated with early dropout. Unadjusted and adjusted results were similar. Clients and therapists may benefit by matching unemployed men with experienced therapists. Finally, the high dropout rates among ethnically non-Norwegian clients points to a need for special treatment approaches for this subgroup.

ADVANCE integrated group intervention to address both substance use and intimate partner abuse perpetration by men in substance use treatment: a feasibility randomised controlled trial

“…We found a greater proportion of men who did not attend any ADVANCE intervention sessions were younger, lived in homeless or temporary accommodation or suffered from depression, anxiety or post-traumatic stress disorder. Similar findings have been reported in other studies, where dropout was associated with younger age; experiencing mental health problems, including substance use; lower income, unemployment or being from a lower socioeconomic or minority ethnic group [ 22 , 58 , 67 , 70 – 73 ].…”

“…In our trial, 34% of men did not attend any intervention sessions. High drop-out rates (around 40–60%) for perpetrator interventions have been reported, irrespective of the intervention’s format, duration or whether participants used substances [ 22 , 58 , 59 , 67 – 69 ]. We found a greater proportion of men who did not attend any ADVANCE intervention sessions were younger, lived in homeless or temporary accommodation or suffered from depression, anxiety or post-traumatic stress disorder.…”

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

“…Results suggest that younger clients are more likely to cease therapy, as reported by Jewell and Wormith (2010) in their meta-analysis. However, our study highlighted that age was a significant factor in predicting medium-term dropout only (from the 10th session), which contrasts with other studies that have highlighted younger age as a determinant of early dropout (e.g., Askeland & Heir, 2013;Richard et al, 2019). Perhaps, younger participants had little experience with therapy resulting in lower expectations toward the process.…”

“…The absence of a stable occupation-either as a worker or as a student-was linked to an early cessation of treatment, which is similar to the results of Askeland and Heir (2013). Indeed, unemployed, part-time workers, or retired men are more likely to discontinue treatment early than men who have a full-time occupation (work or study).…”

Finding a Common Ground: Therapist Responsiveness to Male Clients Who Have Acted Violently Against Their Female Partner

“…When researchers have investigated the client's role in establishing an alliance in IPV therapy, they have focused mainly on clients' pretreatment characteristics (Daly & Pelowski, 2000). For example, men who are unemployed, younger, with an ethnic minority background, and without prior therapy experiences are found to be particularly vulnerable to dropping out of therapy (see, for example, Askeland & Heir, 2013;Jewell & Wormith, 2010). In one study, even though there were no differences in alliance rating in the beginning of therapy, Caucasian clients reported a significant increase in alliance ratings over time, whereas clients of minority backgrounds did not report significant changes in the alliance over time (Walling et al, 2012).…”