title: [Non-completion of insurance-funded outpatient psychotherapy: frequency, risk factors, outcome].
abstract: OBJECTIVE
  Because premature discontinuation of psychotherapy limits the effectiveness of the interventions, in a naturalistic design we examined the prevalence, predictors, and outcome of premature discontinuation.
  
  
  METHODS
  The sample included N = 584 patients with various mental disorders. Risk factors were identified using regression analysis. As outcome Patient Health Questionnaire scales were considered. We compared pre and post averages as well as post averages of premature discontinuation versus regular termination.
  
  
  RESULTS
  Risk factors were: female and/or unemployed patient, low patient and/or therapist ratings regarding therapy success, and extraordinarily high therapist ratings of the therapeutic alliance. Despite premature discontinuation we found significant reductions of depression, anxiety, somatic symptoms, and stress (ES = 0.30, …, 0.44). Compared to regular termination though, patients with premature discontinuation were more impaired at last measurement (ES = 0.17, …, 0.37).
  
  
  CONCLUSIONS
  Not each premature discontinuation is a psychotherapeutic failure. Warning signals for looming premature discontinuation are low ratings of therapy success while psychotherapeutic treatment.
authors.affiliation: Institut für Psychosoziale Medizin und Psychotherapie, Universitätsklinikum Jena.
authors.forename: Uwe
authors.initials: U
authors.lastname: Altmann
authors.affiliation: Otto-Selz-Institut für Angewandte Psychologie, Universität Mannheim.
authors.forename: Werner W
authors.initials: WW
authors.lastname: Wittmann
authors.affiliation: Fakultät für Angewandte Psychologie, SRH Hochschule Heidelberg.
authors.forename: Andrés
authors.initials: A
authors.lastname: Steffanowski
authors.affiliation: Institut für Qualitätsentwicklung in der Psychotherapie und Psychosomatik (IQP), München.
authors.forename: Friedrich
authors.initials: F
authors.lastname: von Heymann
authors.affiliation: Psychologische Psychotherapeutin, Feldafing.
authors.forename: Ellen
authors.initials: E
authors.lastname: Bruckmayer
authors.affiliation: Fachärztin für Psychosomatische Medizin und Psychotherapie, München.
authors.forename: Irmgard
authors.initials: I
authors.lastname: Pfaffinger
authors.affiliation: Fachärztin für Psychosomatische Medizin und Psychotherapie, München.
authors.forename: Emma
authors.initials: E
authors.lastname: Auch
authors.affiliation: Abteilung für Psychosomatik, Universitätsklinikum Regensburg.
authors.forename: Thomas
authors.initials: T
authors.lastname: Loew
authors.affiliation: Kassenärztliche Vereinigung Bayerns, KVB, München.
authors.forename: Dietmar
authors.initials: D
authors.lastname: Kramer
authors.affiliation: Kassenärztliche Vereinigung Bayerns, KVB, München.
authors.forename: Andrea
authors.initials: A
authors.lastname: Fembacher
authors.affiliation: Institut für Psychologie, Friedrich-Schiller-Universität, Jena.
authors.forename: Rolf
authors.initials: R
authors.lastname: Steyer
authors.affiliation: Institut für Psychosoziale Medizin und Psychotherapie, Universitätsklinikum Jena.
authors.forename: Anna
authors.initials: A
authors.lastname: Zimmermann
authors.affiliation: Institut für Psychosoziale Medizin und Psychotherapie, Universitätsklinikum Jena.
authors.forename: Bernhard M
authors.initials: BM
authors.lastname: Strauß
mesh_terms: D000328:Adult; D000553:Ambulatory Care; D001008:Anxiety Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D005260:Female; D005858:Germany; D006801:Humans; D019458:Insurance Coverage; D007358:Insurance, Psychiatric; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D008875:Middle Aged; D010352:Patient Dropouts / Q000523:psychology* / Q000706:statistics & numerical data*; D017060:Patient Satisfaction; D011613:Psychotherapy; D011785:Quality Assurance, Health Care; D012307:Risk Factors; D013001:Somatoform Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D013315:Stress, Psychological / Q000150:complications / Q000523:psychology; D017211:Treatment Failure