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Cognitive Therapy and Research

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16.11.2018 | Original Article

Predictors of Dropout in Internet-Based Cognitive Behavioral Therapy for Depression

verfasst von: Iony D. Schmidt, Nicholas R. Forand, Daniel R. Strunk

Erschienen in: Cognitive Therapy and Research | Ausgabe 3/2019

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Abstract

Internet-based cognitive behavioral therapy (iCBT), provided with guidance, has been shown to outperform wait-list control conditions and appears to perform on par with face-to-face psychotherapy. However, dropout remains an important problem. Dropout rates for iCBT programs for depression have ranged from 0 to 75%, with a mean of 32%. Drawing from a recent study in which 117 people participated in iCBT with support, we examined participant characteristics, participants’ use of iCBT skills, and their experience of technical difficulties with iCBT as predictors of dropout risk. Educational level, extraversion, and participant skill use predicted lower risk of dropout; technical difficulties and openness predicted higher dropout risk. We encourage future research on predictors of dropout in the hope that greater understanding of dropout risk will inform efforts to promote program engagement and retention.

Dropout rates across study segments were: 39% (23 of 59) among those randomized to BtB, 65% (13 of 20) among those randomized to wait-list and subsequently offered BtB, and 45% (17 of 38) among non-randomized participants offered BtB. The 20 participants who had initially been assigned to wait-list were a subset of a larger group of 30, as 10 opted to not continue participation. An initial test suggested that study segment was associated with differential dropout risk (RR = 1.67; 95% CI 1.06–2.62, p = 0.03). However, study segment failed to predict dropout in our multivariate model (see Table 4).

We included the number of contacts as a covariate out of concern for the possibility that our measure of CBT skills could have been confounded with clients who had more contact with their coach and thus more opportunities to convey their use of CBT skills. There was an average of 2.6 (SD = 1.54; range = 0–9) calls completed between participants and their coaches and an average of 5.05 (SD = 2.72; range 0–12) emails exchanged between participants and their coaches.

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Titel: Predictors of Dropout in Internet-Based Cognitive Behavioral Therapy for Depression
verfasst von: Iony D. Schmidt
Nicholas R. Forand
Daniel R. Strunk
Publikationsdatum: 16.11.2018
Verlag: Springer US
Erschienen in: Cognitive Therapy and Research / Ausgabe 3/2019
Print ISSN: 0147-5916
Elektronische ISSN: 1573-2819
DOI: https://doi.org/10.1007/s10608-018-9979-5

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