心理治疗中的脱落

doi:10.3724/SP.J.1042.2020.01187

摘要/Abstract

摘要：

脱落是指在心理咨询与治疗中, 来访者由于种种原因在导致他前来寻求帮助的心理困扰或问题尚未解决之前就终止治疗的现象。研究者对脱落概念内涵的理解比较一致, 但脱落的操作性定义存在多种且各有利弊。脱落在临床治疗中普遍存在; 脱落率在跨研究间的结果差异很大, 并受到脱落的操作性定义和研究设计类型的重要影响。传统的静态的变量在预测脱落时存在明显局限, 治疗同盟等治疗过程预测变量近年来得到更多重视, 并丰富了我们对来访者脱落的深入理解。为减少脱落, 研究者建议为来访者提供治疗前准备, 对治疗过程中的关键变量进行评估并根据具体情况采用合适的干预策略。未来研究需要完善脱落的操作性定义, 更多地在自然治疗设置下进行研究, 进一步深化脱落的预测变量研究, 并关注治疗外重要事件及文化背景对脱落的影响。

关键词: 脱落, 脱落率, 预测变量, 操作性定义, 心理治疗

Abstract:

Dropout in psychotherapy refers to the phenomenon of the client discontinuing psychotherapy prior to recovering from the problems or distress that led him or her to seek help. Although researchers have come to a consensus as to the connotation of dropout, there are a variety of operational definitions of dropout, each of which has advantages and disadvantages. Dropout is a widespread problem in clinic practice. However, the dropout percentages, which are strongly influenced by operational definitions of dropout and types of study designs, vary widely across studies. There are limitations for the traditional static predictors of dropout, so researchers gradually place greater importance to the process-oriented predictors of dropout (e.g., therapeutic alliance), which provide a good deal of insight into dropout. In order to reduce dropout from therapy, researchers suggest clinicians offer proper pre-therapy preparation for clients, assess important variables throughout the course of therapy, and tailor strategies according to situation. Future research should improve the operational definitions of dropout and further research also should be conducted in natural treatment settings. At the same time, predictors should be explored thoroughly and more. And more attention should be paid to the effects of critical events outside therapy as well as the cultural background of clients.

Key words: dropout, dropout percentage, predictors, operational definition, psychotherapy

中图分类号:

R395

何姣, 白宝玉, 夏勉. (2020). 心理治疗中的脱落. 心理科学进展 , 28(7), 1187-1198.

HE Jiao, BAI Baoyu, XIA Mian. (2020). Dropout in psychotherapy. Advances in Psychological Science, 28(7), 1187-1198.

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