Premium
What predicts failure to engage in or drop out from treatment for bulimia nervosa and what implications does this have for treatment?
Author(s) -
Bell Lorraine
Publication year - 2001
Publication title -
clinical psychology and psychotherapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.315
H-Index - 76
eISSN - 1099-0879
pISSN - 1063-3995
DOI - 10.1002/cpp.288
Subject(s) - attrition , drop out , psychology , bulimia nervosa , clinical psychology , personality , psychotherapist , eating disorders , psychiatry , social psychology , medicine , dentistry , economics , demographic economics
The aim of this review was to analyse and summarize the research findings regarding which factors predict failure to engage (FTE) or drop out from treatment for bulimia nervosa. A literature search was carried out with PubMed and PsychLit from 1985 to September 2000. Key terms searched were those classified as bulimia nervosa: outcome, FTE, drop‐out and attrition. Outcome studies were also screened for inclusion of characteristics of those who failed to engage or dropped out. Twenty‐eight studies were identified. They examined a range of factors—patient characteristics, patient–therapist and therapist factors. Three trials report different drop‐out rates between treatments. Most samples studied are small and studies vary methodologically, making comparison difficult. FTE and drop‐out is not a uniform phenomenon. The only robust finding for patient characteristics is that co‐morbid borderline personality disorder increases the risk of FTE or drop‐out. Discrepant expectations between patients and therapists may also contribute to drop‐out. Drop‐out is higher for medical treatment. Recommendations are made as to how clients may be more successfully engaged or maintained in treatment. Copyright © 2001 John Wiley & Sons, Ltd.