Psychologists' Perspectives on Therapy Termination and the Use of Therapy Engagement/Retention Strategies.

Unlabelled: Practicing psychologists (n = 269) were surveyed regarding their perspectives on client reasons for termination at different points in therapy and their use of strategies to engage and retain clients in therapy. Psychologists estimated that one-third of their caseload unilaterally terminated (M = 13% before the third therapy session; M = 20% after the third session). They viewed lack of readiness for change/insufficient motivation as the most important barrier to early treatment engagement, and symptom improvement as the most important reason for clients' unilateral decisions to end therapy after the third session.

Primary Care Provider Views About Usefulness and Dissemination of a Web-Based Depression Treatment Information Decision Aid.

Background: Decisions related to mental health are often complex, problems often remain undetected and untreated, information unavailable or not used, and treatment decisions frequently not informed by best practice or patient preferences.

Objective: The objective of this paper was to obtain the opinions of health professionals working in primary health care settings about a Web-based information decision aid (IDA) for patients concerning treatment options for depression and the dissemination of the resources in primary care settings.

Methods: Participants were recruited from primary care clinics in Winnipeg and Ottawa, Canada, and included 48 family physicians, nurses, and primary care staff.

The Process of Seeking Psychotherapy and Its Impact on Therapy Expectations and Experiences.

Unlabelled: Seeking psychotherapy can be conceptualized as having three stages: deciding that therapy might help, deciding to seek therapy and contacting a therapist. The present study examined the duration and difficulty of clients' decisions to seek psychotherapy and whether these experiences were predictive of expected difficulty and commitment to the therapy process. One-hundred and fifty-five adults seeking individual psychological services from a university training clinic were assessed before intake; 107 of these participants also completed measures between the third and fourth therapy sessions and at post-therapy.

Reasons for terminating psychotherapy: a general population study.

Clients' (N=693) reasons for ending psychotherapy and their associations with demographics, mental disorder caseness, and type of mental health care service provider were examined. The most frequently reported reason for termination was feeling better, however, a substantial minority of individuals reported terminating because of treatment dissatisfaction or wanting to solve problems independently. Lower income was associated with lower odds of termination because of feeling better and higher odds of termination because of a perception that therapy was not helping.

Client and therapist views of contextual factors related to termination from psychotherapy: a comparison between unilateral and mutual terminators.

Contextual variables potentially influencing premature termination were examined. Clients (n=83) and therapists (n=35) provided parallel data on early working alliance, psychotherapy termination decision (unilateral vs. mutual), clients' reasons for termination, and barriers to treatment participation.

Interpreting the magnitude of the placebo effect: mountain or Molehill?

The ambiguity involved in interpreting numbers and words is central to Hróbjartsson and Gøtzsche's (this issue) claim of "powerful spin" in the Wampold, Minami, Tierney, Baskin, and Bhati (2005) re-analysis of their meta-analytic findings on the placebo effect in medicine. Meta-analytic results reported by the two sets of authors are nearly identical, yet their conclusions differ dramatically. In our comment, we discuss the findings of the respective authors and consider options for representing and interpreting the magnitude of meta-analytic effect size estimates.