Technical University of Dresden, Germany (firstname.lastname@example.org)
Gloster, Andrew T.
Technical University of Dresden, Germany (email@example.com)
University of Cologne, Germany (firstname.lastname@example.org)
Ernst-Moritz-Arndt University Greifswald, Germany (email@example.com)
University of Würzburg, Germany (Deckert_J@klinik.uni-wuerzburg.de)
University of Berlin, Germany (Lydia.Fehm@hu-berlin.de)
Alpers, Georg W.
University of Mannheim, Germany (firstname.lastname@example.org)
Philipps University Marburg, Germany (email@example.com)
Universitätsmedizin Berlin, Germany (firstname.lastname@example.org)
University of Münster, Germany (email@example.com)
Technical University of Dresden, Germany (firstname.lastname@example.org)
Therapist adherence has been shown to contribute to the effectiveness of treatment interventions. The role in a patient’s decision to drop out of treatment, however, is unknown. This study investigates whether therapist adherence affects clinical outcome and the risk for dropout. Patients diagnosed with panic disorder with agoraphobia (N = 265) were treated in one of two CBT variations: with (T+) and without (T-) explicit therapist-guided exposure. Significant associations between lower levels of adherence and symptomatic improvement were observed in treatment completers in the T- condition and dropouts in T+ condition suggesting that adherence-outcome relations are potentially contributed by patient and treatment characteristics. Moreover, our results propose that patient related difficulties with exposure procedures may lead to lower adherence and dropout.
Keywords: treatment integrity; cognitive behavior therapy; exposure; anxiety; therapist variables