5 - (SYM 22) Dropout Rate and Related Factors in Group Psychotherapy: A Retrospective Study

Objective

Group psychotherapy (hereafter, group) has been widely applied in the intervention for mental health disorders. However, patient dropout is an obstacle limiting therapeutic effectiveness. This study aims to investigate patient dropout and the factors contributing to dropout rates in outpatient groups.

Method

This study included 620 patients who participated in group at outpatient clinics of a psychiatric hospital between July 2023 and June 2025. Only groups grounded in cognitive behavioral therapy (CBT) or related techniques were included. Groups with fewer than three cohorts or those based on non-CBT orientations were excluded.

The final sample comprised 538 patients (86.77%) with ages ranging from 12 to 67 years. After excluding groups of Dialectical Behavior Therapy (DBT) for parents delivered on a family basis, the sample consisted of 133 males and 293 females.

Patient-, setting--, and therapist-related variables were retrospectively collected and analyzed. Group differences in dropout were examined, and correlation analyses were conducted to assess associations between therapist experience and dropout.

Result

Overall dropout rate for groups was 26%, ranging from 9.09%~28.66%. Dropout rates differed by patient gender, with a higher rate among females (30.0%) than among males (20.3%). Subgroup analyses among patients who dropped out revealed significant gender differences across group themes (χ²=11, p=0.03), with a higher proportion of males (60%) in CBT and Exposure groups.

Patients entered group an average of 27 days after initial interview. The calendar quarter in which the group initiated was associated with dropout (χ²=13, p=0.006), with the lowest rate of dropout in the third quarter (17.9%).

Therapists’ individual therapy experience showed a significant correlation with subsequent group dropout among patients they initially interviewed (r=-0.71, p=0.03). Group-leading experience was also correlated with dropout rates for which the therapist served as the group leader (r=-0.66, p=0.04).

Conclusion

Females show a higher dropout rate compared to males, specifically those in Mindfulness-based groups. The form of camps is associated with a lower dropout rate in DBT adolescent groups, suggesting that short-term, intense DBT protocol may help improve adherence in teenagers. The third quarter of the year appeared to be an optimal period for starting a group. Greater clinical experience of therapists was associated with lower dropout from group, suggesting the needs for enhanced training.