Early premature termination from a university counseling center: a qualitative research study

A significant percentage of clients entering counseling or psychotherapy unilaterally discontinue after the first or second session. In the clinical and research literature these former clients are referred to as "early premature terminators" (EPTs) and are often presumed to be treatment failures. While considerable research has been performed regarding EPTs, very few studies have actually contacted this difficult- to-reach population. A group of former clients from The University of Utah Counseling Center (UCC) who met EPT criteria participated in this study. A semistructured interview was employed to examine the participants' perceptions of various aspects of their termination. Interviews were transcribed and analyzed for themes using a qualitative verbal data analysis process called the Constant Comparison Method. Emergent themes from the data concerned participants' perceptions and evaluations of UCC and their overall counseling experience, including perceptions of their counselor. Additional themes from the data included factors related to early termination and the processes associated with ending counseling. Most participants reported generally favorable counseling experiences and indicated they made progress and felt a diminished need to continue counseling. Some identified personality variables they believed were also associated with ending counseling when and how they did. The researcher incorporated these major themes into a data-based grounded theory of early termination. This theory holds that people who meet EPT criteria may actually perceive greater early progress in counseling (with an attendant sense of diminished counseling need) relative to the perceived "costs" of counseling than do clients who persist in counseling for a longer period. The findings and conclusions of the study, as distilled in the grounded theory, provide a new and different data-generated conceptual framework to guide and shape subsequent inquiry and practice in this area.