title: Predicting dropout in outpatient dialectical behavior therapy with patients with borderline personality disorder receiving psychiatric disability.
abstract: BACKGROUND
  Rates of treatment dropout in outpatient Dialectical Behavior Therapy (DBT) in the community can be as high as 24 % to 58 %, making dropout a great concern. The primary purpose of this article was to examine predictors of dropout from DBT in a community mental health setting.
  
  
  METHODS
  Participants were 56 consumers with borderline personality disorder (BPD) who were psychiatrically disabled participating in a larger feasibility trial of Dialectical Behavior Therapy- Accepting the Challenges of Exiting the System. The following variables were examined to see whether they predicted dropout in DBT: age, education level, baseline level of distress, baseline level of non-acceptance of emotional responses, and skills module in which a consumer started DBT skills group. These variables were chosen based on known predictors of dropout in consumers with BPD and in DBT, as well as an interest in what naturally occurring variables might impact dropout.
  
  
  RESULTS
  The dropout rate in this sample was 51.8 %. Results of the logistic regression show that younger age, higher levels of baseline distress, and a higher level of baseline non-acceptance of emotional responses were significantly associated with dropout. The DBT skills module in which an individual started group did not predict dropout.
  
  
  CONCLUSIONS
  The implications of these findings are that knowledge of consumer age and pretreatment levels of distress and non-acceptance of emotional responses can impact providers' choice of commitment and treatment strategies to reduce dropout. Future research should examine these strategies, as well as the impact of predictor variables on outcome and reasons for dropout.
authors: Department of Psychiatry and Behavioral Sciences, University of Washington at Harborview Medical Center, Box 359911, 325 Ninth Avenue, Seattle, WA 98104 USA ; Department of Psychiatry, Division of Health Services Research, University of Arkansas for Medical Sciences, 4301 W. Markham St., #755, Little Rock, AR 72205 USA ; VISN 16 Mental Illness Research, Education, and Clinical Center (MIRECC), Central Arkansas Veterans Healthcare System, 2200 Fort Roots Drive, North Little Rock, 72114 AR USA.
authors: Sara J
authors: SJ
authors: Landes
authors: Department of Psychiatry and Behavioral Sciences, University of Washington at Harborview Medical Center, Box 359911, 325 Ninth Avenue, Seattle, WA 98104 USA ; Department of Psychology, The Catholic University of America, O'Boyle Hall, Room 339, 620 Michigan Ave. NE, Washington, DC, 20064 USA.
authors: Samantha A
authors: SA
authors: Chalker
authors: Department of Psychiatry and Behavioral Sciences, University of Washington at Harborview Medical Center, Box 359911, 325 Ninth Avenue, Seattle, WA 98104 USA.
authors: Katherine Anne
authors: KA
authors: Comtois
keywords: Borderline personality disorder; Dialectical behavior therapy; Dropout; Predict; Skills group