Predictors of dropout in cognitive behavior and interpersonal online brief psychotherapies for essential professionals during the COVID-19 pandemic

Abstract

Abstract Premature dropout from psychotherapy can harm patients and increase mental health costs. This study identified predictors of dropout in brief online psychotherapy for essential workers during the COVID-19 pandemic. This was a secondary analysis of a randomized trial on 4-week CBT or IPT protocols. Participants provided sociodemographic data and completed the Patient-Reported Outcomes Measurement Information System and Burnout Assessment Tool Short-Form. Predictors were analyzed in three blocks: sociodemographic, clinical, and therapist characteristics using bivariable and multivariable analyses. The sample included 804 individuals who attended at least the first session of either CBT (n = 403) or IPT (n = 401). A total of 17.2% (n = 138) of the participants dropped out during the protocol. Significant predictors of dropout included having children (IRR = 1.48; 95% CI: 1.07–2.05; p = 0.016), residing in specific regions of Brazil (Northeast IRR = 1.44; 95% CI:1.04–2.00; p = 0.02 and Midwest IRR = 1.73; 95%CI: 1.13–2.64; p = 0.01), therapist male sex (IRR = 2.04; 95% CI: 1.47–2.83; p = < 0.001), second wave of Covid-19 (IRR = 1.54; 95% CI: 1.01–2.34; p = 0.04) and low life satisfaction (IRR = 1.63; 95% CI: 1.06–2.50; p = 0.02). Our findings underscore the necessity for culturally tailored strategies, support for those with children, and targeted therapy for individuals with low life satisfaction. Implementation of these strategies may reduce dropout rates and improve treatment outcomes for essential workers in crisis.

Keywords

• Dropout
• Online psychotherapy
• Essential workers
• COVID-19 pandemic