Interactional Correlates of Premature Termination

Two studies were conducted to examine the relation of premature termination (PT) from individual psychotherapy to topic determination (TD), which was defined as the proportion of topic initiations subsequently followed by the other participant. It was hypothesized that those therapist-client dyads that terminated prematurely would evidence lower degrees of topic determination in the early sessions than continuing dyads. Study 1 compared 4 continuing dyads (2 successful and 2 unsuccessful) and 2 PT dyads. All dyads involved nonpsychotic clients seen at a university counseling center using a time-limited therapy format. The PT dyads had lower levels of TD than the continuing dyads. Furthermore, specific threshold levels of TD were associated with client failure to return. The second study, conducted at a different university counseling center, examined 18 dyads that also included clients of average disturbance (based on psychiatric outpatient norms). The results confirmed the PT-TD relation and the TD threshold found in the first study. For the continuing dyads, low TD values were also found to be associated with client "no-shows" but not with cancelled sessions.