Collaborative interviewing in mathematical analogy technique (part II): drop-out prediction in CBT

Background

CLIMATE is an acronym for Collaborative Interviewing in Mathematical Analogy Technique, a new technique developed to serve as a tool for socializing the client to CBT. CLIMATE is highly structured and it takes about 20 minutes to complete.

Studies on factors predicting drop-out from therapy often lead to different results. However, some significant factors seem to be younger age, male gender, low socioeconomic status, an obscure reason for consultation, substance abuse, previous drop-out from therapy and less frequent spacing of treatment sessions. High scores of SCL-90 subscales of Paranoid Ideation, Obsession-Compulsion and Depression as well as high scores of Anxiety in GHQ-28 are also related to drop-out from therapy among psychiatric patients.

Materials and methods

CLIMATE was applied to 43 consecutive clients suffering of various DSM-IV disorders. 29 clients (67%) completed treatment while 14 clients (33%) dropped out of treatment. We compared the two groups of clients along a series of answers given to structured CLIMATE questions as well as other CLIMATE variables such as time required to complete this technique. The mean time required to complete CLIMATE was 19 minutes (SD: 6 min, range: 10–35 min) and it was not related to educational level. Education was not related to drop-out.

Results

A variety of specific responses given to the structured questions of CLIMATE can predict adherence or premature termination of treatment.

Discussion

Also, paying attention to a client's specific answers may help us predict this client's response and acceptability (credibility) of CBT.