deal paint and herp ar aheto gre aboat when to terminate retntherapy Fowever nol erminatons fpegchatheapy arerocessly nga or mutual REVIEW Strategies for Reducing Patient-Initiated Premature Termination of Psychotherapy John S. Ogrodniceuk PRD, AsthonyS Joye, PRD, and Wiliam E. Pipes PAD Ref pcre prmatere termination in difren form of ysotheray ate com ‘ey ih Paid et watt som em ae he indecent sea resoheray. The rw denies many sei for eve ates temiaatin ut ck integration. Ti eviews tempat provide t Cmca 7 a seat tech er nel epee aves ay ‘easel fr mining patented peat trmiatn, A sarch way conde 99 ie ‘MEDLINE NFO, sod EMBASE drs fr rr poe bene Jay 19° a ‘March 200 Reeve! als were publ in Enh eertevewed fost snd fxd Seen sed pm mon yy nS Turgeon med ie atic pty ppt, te on ‘moan eocemen,facltaton ofthese itanc an ocain a aetaprion osc spp some ofthe sates fr rdacng premature termination However mtb Keywords doping out rowan rates, pcatherpy patient ultra dein to therapy. termined event, Somat termination i th elo Pihntintited promture trmination ror 89 pe Tron tpn Pit, Ung o Ba Gla (Br Opmtscat on Poh and Eprints ‘ere ra ede rina! mana rated 25 te 20 rd mont ane 15 cn 300 ssp option 17 Deer psi Oraics PAD, 209 Wak Mal ‘ayo at Catnhn one, BVP 1, Canada ‘Ena cnctderhengeatone 2005 Prien ond Pleo onan alee Sroween pase and therpist Such terminations re leo ‘etred tothe Mestre an untral eration i. ‘entnuiog r dropping ost. The specie components hat ‘kine prematare temiontion tpn denn, sii Deodng en the treatment coer. Therapie (9g an tervento, short tem Uerap, psychoanalysis open-end ‘up theres) ier on Important factors suchas te Sen bjecve, expectations conering the ath of the pant tyra anderen rattan lebih fnitedpreatare vermintion pil bt wt alma ‘cers eal in therapy before the patna bs experencod a58 Oprodnick ea hore appear ob na oma reason tas ervcesAccringy some nthar ave argued tht pre ‘entine af patented drratre termination sould ‘eth mat undamentalenieraon tina wo pro- ie preoterap ae pobems driog he sbbreviated ay im esp. ‘Taos, some pcients thou terminating cera ere ‘than pinned, dom aussie conumer Ober pain tei fe reamtanes precede contining. For exemple, patient ny make agengrplizal move bras ofa spo [ara whlch makes conning a hoapy pe (Others aay become physical inapactated (og eae illness ra lel prea), hich alo ater ‘ation necessary Algh nseleraieations oxo sooner {han expected tbe on teal agreement teen ‘et ana thrapist they een be regarded a6 appeopte espe hie pratt ‘CONSEQUENCES OF PATIENTINITIATED, PREMATURE TERMINATION Consequences for Patents {rough rmination Te pase often expences sense ff dannistacion rire which an vor ina woven Ing of protiens Indeed, paints who terminate pre ‘hry report lee therapeu progress abd more pyc Tope! dress Promatare tarminzare re more ely tobe eharacavised an chro pts, with ated 1a evra eric, in eee ene sonacing ei Ilse at tice the ate of punta cle a syprprate termietor [othe content of group Une tov daraptve, Dctntination drops group liar iy and can precinte ler peematore terminations Asiy meaningful work fr the rest of the group oan Teaving oer oup membre eling insear, Worried of Conte Surprising very tear been write bout th fect of patent inte premeturerminationo thera Mort lonmonly ti seknoneiged that patented yom {are erminaton an be Gemoralsng therapist aca lun fr bining herp Therapist nay tive at ‘hoy have ala, were rejected the patient Su be "etm, intrmimpairtherapia! confer oe wfeive eee Theremay bes sense among therapit the ave ‘ret thine nd elot when they expevene apes {ove termination Narlsnte injury isl compo among ‘horas. Tat therapists whose own slfestem it foaworth Pinal ection t losing pate though remstare termination, ach ae rt fejetin, ana, ‘uy iterfre with other nope othe tora’ pete onal personal stro with be herp af for Therapist Consequences for Adminsrators rom an administrative perspective, finda nd human contributes to long wating Inte. Therapists or ai so imines Consequences for Researchers can rede the bility of the study aequtel tt ‘e hypotiens Farts prematere termination ca in rome the design of «fd. Pov example, when a ran {mised fl experiences uneren premature termination of prematre termination fect how 0 ings ar Inert Tn view ofthe penal probleme aerated with most casos of patient tated pematare termination, ean Prevalence of Patient Intated Prematare Termination Reported ten of penned prmstare termination from pevebtherapy ate typially igh toa meta analyte ty, Wate and Pekar! reported an averge rte of47%, which i consistent with rate repre in previous tevisen?® Compare tte ate reporter individ, {roup, fol and coupes terepie Hats fr shore teen sr iene theape, hover maybe lower Stra? ‘Sond that the dropout rat fo hie sink dened fem ‘pent erentason lo bf tetnenearentation, Si Inn, Heder and Ton ood that only 1 of patient rectving re erp droped ut within the Set ix ont whereas 1% af pains receiving long-term her Spy droped oat within that tre pero he rate may {Deven wer fr manual timedimied therapies that porta ars for tine ted entero ther yy (CBT that was rove in cial revere i, ich sande in contrat to a reported tate of 50% for Unevnlinited CBT tat wa provided in a privat pee toe wing Maerste raer were la soporte ty Elkin nealngues rhe manetiaed formftie itedn. ‘erprsonal pychitherapy (208) and CBT SP) tat were ‘rovied inthe Nation Lntte of Mental Health IMbertve vatment uy fdpreein ven nuh the ‘tes f patient inated prenatve rmination fr ma be lower than therapies prod under oer condition, the eae rman ger than desirable a are genera: tle to only « mony of prctitners ates or priate Pracie ar genoral ines apeat to be much higher and ‘ect beret that patent nite pemature termina. pyetbersps Reston/Catses of Pain etd ‘Premature Tenination Unsoutey: hee are many fctors that contrat top ‘ent desiostaterinate erapyprematrely The cba. lenge fr sinane snd researcher baa been to ently ‘has factor. thas bo suggested ha patents mn ter ‘minnie prematurely bras he te to aoe at ‘elrng cannot are with tir tera ao eich “ld be reed tat ti trait eat Pi feet her erp operetta Drovent has not ceurred ky enogh,Oters faors ich ala of ativan, low penal mindedoe, ‘ons and unreliacexpectatine a lio been nace fs contribting to prture terminate, Reviews a he ‘reat termiation eerste ave ated eens ‘rong, coin predicors thie phenomena, bt uth Opranicaket al 59 ono spec fas ening a premaare termination ‘Conadaring the ange number offre at yb a voted in patent decion to ond Ueray premtarely, Slnician nd themaclves in ill stanton won imiking it Beene ofthe many factors invade one Strategy io equllyeeete aero al type of patients or ‘weatont eons, Rather mule trate arereuized ‘Svea! shor have atnptd deat afl se {Ger fr reducing promature termination, A coco, bat Comprehensive, spaces of then states wel bi fal rclinins, Previous eves of prevention erties ‘end to present oly ited snletion of strategies le, ‘ef, artes by Berard and Walzer ad elle) Te contrat, he oat of the present Fv tt iver. METHOD We reviened the MEDLINE, PaycINFO, and EMBASE ntatasor fr erate an seducing patient nit p= the eearch wos January 1970 to Bares 2004 The ing earch term wate wed: premaire Letina, drop Sister termination, dacntnustion, paychthsra oe pt manul search of ference in reine rie ‘Aniln that wer revel or this revow 0) were pe lhe in Bish (2) were published peer evened ou ral an 2) euslan pythosherapy for eli RESULTS We ietied 99 artes Ut epciflly dace trate he fr preventing or reducing paint nite pematare fenmination of pofcoderapy The eateies tht ae rp ‘nated nthe reieved ris ne Presid In ine {ation enhancement feitaon of erapeat sian, sed etaton of act epreion (ee text beh We re Sed these ators (esp fe the peetherpy prepare ‘Son etgor) based oo our review ofthe teratre. Typ telly, prevention statis have ben exter only 1 protherapy preparation intervention of a "sone ‘Bing eae” Autor syst to eto aegin was(60. Oprodaicaak eta Senco or Pentng os Redang a Pepin teenagers ee | Mlb edd nergy | "Eze | Cehcmmepnen | Se vonctin_, ite al | ‘wingmess tented ae there reich cr ‘rates amas | Sone Tettoanl poiteebehnes Surprisingly omy 5 of he 39 retried articles ware 12 snvestiitedpeberapy prepaestonteenigues, inves ‘Seated patenaceton nds anon vented one ‘nnageet Te rao = 28) the artes wee el deers of diferent rate. Each of he proven ‘So srnepindenesed in tire penne ely Pretheapy reparation Drctherapy preparation, tha mst Gequely dseused stegy fr preventing pte sed prematre er in, frst any rene condcted prt the com ‘ence of ray ha emp eens the patent out the prose fray and oven the pain for ‘rerking In tener. Paychsberapy i cllenging e- {ity or aimast al pacient even thse who have had pre bon experience Ani uncon and misono ‘recommorplac Apprebensio in opeclly sete ree ‘ng grep herp: Compared to he nid thera st Sn, ie peal ancited wth rete eet othe es ena of oto, india, undoranding pr neal Far any patent diel trneingohers ‘ed elting them on personal level represents Oe ‘ef therapy Borner ftechaengingtaaeftepnting fd werking in therapy efative and eet preparing Srcedues have been soney recomended, "The objecsves of petorapy preparation inde pro- ‘idig Informatio abut the rasoale and natae of py ‘Detherapy toa the ale and eigen terapit nd patent a about the diftis tht ea roe i he po- fot of treatment Such inrmtin eintende 1 ela patent misencptons alent therapy, tore ineon rence betncen pnt end therapist enpetains of ‘sn pace it the patents enbaned pancho mini doe They indicate tht prepared patente alo dp lnerensed hopeless and report a tr understanding et {he therapy proces and thelr rein Farther Rainer nd Cmpoel gue that prepared patents deveoyatstdee fd aki etacve te iovelvereat inter iding ‘nerensed wiles selfs, dacs problems td Idec with Ue tert. Anoter bent of he prep on process, when cna Wythe therapist he e ‘eloreat of erage alliance withthe pation” Tie let one Ia prbnpa one of he mone important bene of that rutaines patient rough tbe lel ary pee a Many preedars fr prethrapy preparation have been scribe. They invlve diffrent actin aed a pier Mort procadors are relatively el en hu a Jam) and are ntgrted wih ote il tack uch toning nial onsen snd dinning eaten ‘erates: Pratherapy proportion procedures have ener Sly tee extegpried int thee spe: le inetion, var feu heey protrinngand expel peetniog’™ A ommary amar freshers preparton ehigbsit provided Table Role tndction ote induction i the most commonly deserted prthor fy peparaen tecigue in the Keren. Tt provereng 9am ome ‘Pomaaa) aa Mog EN PRA FS RIS ATTN‘nstracton hat fre om educating patents aboot ter tone for therapy the antareet eh eaten rots the promos elit expects fr inponement) ar {he patent ad therapist role in herap. Rae indction ‘eat, thru letre wih grou of patents thr ‘im with an nivale romp in shies examined a indaetion techni ‘vee found signs fess Of thee thro nad Prepared patent The stir wed a 17 minste role ‘ing therapy The recorded mesa explained role xp ‘ons therapy therapy proasses:expcatos for erbal “leu pions enue by patients in peter ‘py mistonnpions about pscotheapy andthe ed far "Toe other to sade of the tree Siding se Ince pti. The study by Oars examined 0 ‘eh oelndtionvrtalnteviw and writen te Feeued on odating patient stout the porpne af er sp: therpyprocomes dificatien encounter iy ptt ‘ntheaptmisonepins abt peyeboterapy the value ‘ opennos and tony, ade iagrtaee of reeing unptaiar to drop ov. The sty fund squvsen t feta of the ewe proaches Yo ra adc The sy ‘SetcomnteKreThe feof th inbred bythe cet retdent i the cae, wat 08 te proses of ‘therapy and expect pate: beavis Tho eta aso ‘eumined peetherapyprparaon the therapy ther Seialcuen aes and congue bond shat presen in stendane as peterayy traning of patient. Trin ing bath members of « therapeutic dod Ue, th the lent and harap) wae sat more efecie, howe {han tnning only ane member of he dyad he, patient thera "he three the sts of ae induction echniqes dd ‘ot nd eins of proved tendace’™* In he stay UyrSlace and aleaguen owe diferent ehniqus were ‘mpg. Those nade (1 ang th patient ha be ‘She thuld expect fel beter afer oa month of er {i explaining the proces of peyshaterapy Ge, baw ‘epced af the heaps) ae) combining thet tech ‘ies. emplinng the pres of therapy ad teling he ‘tient tat he ose ould fel etter foue months therapy None the then esque seat i Ornednierket at. 63 rove atandane ates among pions lative tthe ‘hnrecied nm prepara, Tethetaly by Stroppand Bion. patente thera ‘im. The interview ose on providing patients wih onal sis for pgcnherapy ering th le oe ent end therapist and providing a goer eutine ofthe ure fees Te fim pistes mle paints Le mre uring aad ater receiving heap to eal wil {isle tempee Neier techie was ruil an "The tid study, condoctd by Zick and Artin, ® cxamined th we shen Th-minate pretherpyeretaen ‘oop ha descr the laiaip broom a patent find tera, ennoragedvgularattndancy, and vite ‘he tp a progress in syanpons hat ne sho expect eum pycotbenyy. Plena ne viewed oe vidstape did Vicarious Therapy Pretraiing ‘Viera therapy pretrining prvi patents with ean ples oftherapy Then exampes are seed demonstrate ‘herapetbeiviarsand apropite paint hats They realtone a lotat venta ar ly erat In therapy: Through hs prceare, the paint inrinaly ‘Eeampl of herapy canbe excerpts of cal mons or simulated setson, The evarpls ea be provided hough suditape videotape, er ween materi ‘Only one stud" investigates therapy pre dyn Ty ead wo rea Setervew The ccd part casted of idetpe of & ttmulatd pycbotherapy group mling She ale of for Patients and two erp Intra behaviors were Dodo rte conapt that had bon dacuaed prev ly nthe intervie: The tape wae tapped pera at acoso, which Frsed an making conection be ‘Soca iterations andthe cote of te estrional prin Peteining perc preesning engages patient ina simulation therapy. type condi ne oer 09 therapy: Patents often paripae nar inden i ‘erie prior to apenenia) preaning. The exprin ‘cl petrining alles the pot bh experince Sat bod wht thapy wil be lke ano atempe expectedtree "found ict ec In he eof thoe hee ‘tig he expres nterentio id not ona pra a tretnent ba during the ety sagen tera Tan byaumene oe tha the therapist that cered ne yf the cord thir A, eighth Dayo Sons teste consid of20 suas) The expecta Sessions eee 0 danlagany concerns tha! he patent srashavng aout therapy andon ensouraging him orber to ‘ican thn one ental therapy ees Ln ff the therapy poco an vas proved ih ee op ortnity to prctice howe aed recive fdack. The ty fan reduced ong pat who reve the ning 2 faurscsion experiential pretraiing intervention ™ The Intervention comin of prevding ptiens ith walt ‘meer cerl dye in advance of ero tng eos, ‘The writen masta fos on fur conapte hat were ‘pts ighlobtedhere-an row event interpersonal fr emson group proces, and member ade rations. Po tent the prsgtel in setured group eres hat ‘were intended to pro exerience enh onept one ‘reson per concept fr example, experiencing what ‘rer bromeck prod. Tested found that expert) Fecning rete i inpoved sttndnoe an depot nto thin ey the ourcestan experiential ex ned on our enept thet rere of minimal rewance To ‘the ype af soup therapy aired is Ue eine, Tove con ‘gts Hed dealing wth henson fly ay incre, over that ones family fen ed ch at "Th ary id pet he were "Children shoul be ce, fet Beard ng label wih people ad odie ve. {ston fo teas The bw experiential pein e ne ere amped ieee to determine the eltve ‘portance ef the cio (writen materia and the Interpersonal, expriental) component of the prc dure Testa oad on sin eat iforeees twee the ‘wo aporoche ta experienc pretaiing with regard 0 stendance The ding agen tha te eel a expe ‘sl perising ems to ty les on he cpative mate "land move on the terpertonal experiential roe of ‘Two. studies of experiential pretaning filed wo find sgniont fist on atondance and prematre ‘eemintion ™® The sud by Hike wn coleagoee™ ex tinedatmeparteaperienal raining ohnique Tae toc ff simlatd therapy group that demonstrated esate atin and therpit behave. Afr vicwing fee, Patentere pare in roupeoftwe and intro at Play he prof pen and tera Th tay by Latur ‘tnd Cappalie® examined aa seman experiential ter ‘ote, eh srion was ane her lng. the Sr oo ‘incnceptons thst papchoherpy were denied. The ered sun conned of a 20 mins videape demon ‘ating dsr patent beavis wich was llowed ‘proupdacarion of the vido, A handout explaining hw taive and env odbc wan alan darted The id Poe ptients wis opportunites to practi veg and ‘eiing odnek ‘Colca, te suds cages hat pethorapy prop. rato statgi ant fftoe nrg the abcd ty Ie soul be punted out tt en oe af the tier igrethrapypoparaton” was pied afer 1985. Mare (Setamprnry rvearch Ut overeree th tose Problem of many ofthe ear stds fe, eal amp ‘Seo and that est urea proparation prac ‘Sn ond Pin Seton Pant selection i aloo « frequently cused stratgy fr preventing patentnisatd prematut termina. Tt ‘nar the pres of etflly seni and choosing font rab candidate fr parila foe of ther ‘Tae argue fr hs strategy ita with aura ae Seaton and wpproprits lament threo ir atch etwocn a patent ycapacte or storie and he demands the peci frm of tea: Ths, the tte prema tare terminaten i reduce Thi ret enmon ong ‘inion, peal cusion inthe Htratare rguding ‘he sed for eae pict eaten ahs "Hecechere, have soniied veal charities tat uke ptients moat aatale for cen ome of perehotberpy—tough slaty i pial eonsdered Tr Tefeence optimal outcomes, Rarely aa teach t= Vesti ben dred a pnt slein fo he parpone ‘inning premature orminton The ew atte atave investiga he we of alent selection for that por me have provided enor Sings Bamann ard ‘oleae fund thatthe Cxpcty for Dynami Proce Talore to be lable and aceeary fr reiting td acectng ip dynanically went prchalberapic, ae ‘Sie todiferentinte patents vho competed eater and tients who terminated peesturaly Ia note a Faery and cago ropa on he dvlopmect of ‘he Nijmegen Motion Tt 2 (OMI), which ited {o asom spin iat for OB They fund that resarwey could be dings sing the NBIL2, fpsting tha he NAL could ened ysl ouabi p loved tote ot high sink or doping oot af «price lar therapy ey be ord ¢eiferent teatmeat alee rial they maybe offered a preparation Intervention {hat develope alle that ‘are bleed tobe iiorant fr Femaising nthe partcslartestment. Similan norma: ‘ln: Ertan be made ia heals soo wih sen, wich erences the probability that he Be ‘nt wil main engaged nest. For sxanpe, Ive he tapeaoal kl tat recom Sr remain: tngin, orbiting om gous paycothersp. Soils ten ey be sequel br ch ptets pif ai sion toa therapy group. Leming adaptive cca hl chs btn ale wo ete ge and rece constve tive fatiakand edo impesvonar—may enable eae tint flea the internal deme of sro Tesbould be noted tht alu paint selection is « peace that elinianeDequnty engage in tbeee Io {Se ite epi evident guide ection cons for ‘he xpi purpose of edu prometare termination, As isle" bar neta, soars yan aoe ie probly the most comple, se, ane highly alld procedure in th wile fil” Thin atecy wil eooequentiy require ‘peck moreempircal tenor a oder odelinete aac seine “TimeLimied or Short-Term Treatment Contracts ‘ure termination may be mies by sing» elite ‘ine lit on the duration af herapy o by olring shore term teatet contract Making the ending expla sei dente may lp reduc pint tendecis to ot ‘one ear boat Ring i therapy y ening ea™ Orreicmiket al. 65 Sums paots maybe more wing a peri with tet sent ey baow when i wil end. Arp of short ‘nsin a focun etablbing a ealaboratie working Intinahip, an being gle aeie—can alo cotribute to ‘pled to tino therapy rater han a ‘nace nly Oeure, wer premature terminainn rates far shoresorm therapce may ls he foncon of tne lent inshore ern therapy hate lem ppartnity (oe Se) en terminate prematoely han pit in ng tre ‘Sbortierm contacts could enable the therapist to de br internitent hai cold be arrange Alea Ce ‘erat and patient could agree to meet specie soe tier atime ited period" Bidens suppor a Ingsimesimted weatmonteonteatforreducing rematire termination cen fm a eronptve ody condo by ‘Shalge and callenguen™ who eprtad a terminate rate af 124 for sort erm therapy that ad «dee tine Li, Inebave a desis tne lini “Treatment Negotiation teennent parents ey oa nd tasks of thers) te fore formal therapy actully begins sv oni eae or ‘inimising ptent tated premature erination A ental ape of tetmentnegsatin concerns probie eect hat is eaching consent rgading the nn ‘unner Daring inn dscns wi Ue poet, Ue ‘erat sould be mina ofthe pte perspective re tdi the nature of the problem ad hie o hr pe ‘common understanding with regard t rstent parame {Gr wil help free the patente pererpton of therapy a ‘calboratve for. By the same ten, therapists ald te open to moifing thr perspectives jot a they expect tint tomo thi ‘Sucre sreatment notation al invlesdicussing tay therpitsrationae receding spate orm therapy: Explaining auch a roemmendntien i perhaps ‘eet important orsroptherep: pases haves tends) ‘eeperene arctic ijury because ey pres real av retecing the herp fret Fegan {he uniqunee of hi a er problems nal anitogralprtofressment eetiton neler seeing, bon leant, the nae os patina et in ulpe srotmente fom dierent herapte— ‘Srcllyw mater Gat area whom a pent ring(5 Opriniank ‘Susdeabetsanearethepasent permission ake om tae ith the ther heap order wo she impressions fe pte nto ake cra tat eaten gal are Compstble snd matalyranorsog’" Ae rnd nen, thi ota sen gives the teapiat an eppartyfor. ‘sure tester tentment avoid tt iso her wrk ‘Seen a valine and smprant. Bernard ogoet hat ‘ach anscanm can prevectthe development of «cmp {evel ncweo tie erp nmetine old ty the patent which con lina undermine th et "he other heap walt nceanary "Weare notrareof ny sty tht ha direct tested he etetvenen tentang ab peeontion st ‘A uber artnet ate hae od, however, ‘Cate Management Rect some authors awe ogua ta eaaeider the we tially thse tom imporeshd pal lesen, rest Ie ccumstancn and events en erore with roman ‘nein and owing tom, estment. Cae management e ‘out te blp paints del wth cele, presen ie in tent sve poems wth hoon, employment rere "en nd relationship it aly and end, Teer, Scame manager and patient an set life gal ad vite {he diferent aye int thos gon cam be achive. And ‘of han gl wuld Ye o spre the pens men {a bel which woul alee secing ad einige Invaveetexphone outed can alo snude et fee ‘mewn which can eer rgulsely ooo -nedel be Sie Acapemanager dn ot nein abn atin ther ‘attests morelibesenachwho beth patient though dou reumtancen ‘or keeping patients with nis mental lines engaged Sm eatpuint emmy ca” there has bee anasto Pecarth ont ete fo preventing premature ter ‘ination fom pejehatherapy. The oly aye ome Dy Miranda and clsgues® wih examined he an ‘see managing C3 for depressed, economy erly 50% deerweo i he ate of patented pms Appoint Reminders Anpintnent reminders are scaly recommended ‘Sip strategy for minimising patient nated prema ture termination, Other ealh ere providers eg de ‘St ptm, and emily doer fequetly Ste ap Printnent reminders aa lwo ane to ene that hedaled appointments are ended Many peseotbra- iets (piel tne working rom «pedal pr scien sited apoitnen reminders bas hey ‘vic orphans tint espns or atendance and These shows and snelane can serve a aluble ‘aera fr iaterpettion in therapy Tecan be are, weve, that nore igortnt to enmure stendanceat sesso than et rl pematore termination fer the ake of seterrtny renstant behaviors Po the there Pinte whe arientatin deen pede spinon r= Indore, they appear tobe an effet means of roduing lnc prmstretrinatin serch ave “Mosivaton Enhancement ‘en, defined a increasing a persis willing eae fat, cntoue, sed dere to specie ston Eahancedmaivaton sould ntl belp patents rain engaged in eaten, but ln nceace tho ant bene fireside eaten =" Integy koh ‘ionacem of pyeheherpy tere bas bene tention pat devlping technique by whic patents mniation {er therapy may beenbanced fe the el oaubstanc suse snd est sveders, lever motiaton encore ‘hinogl mpnent of fester ta has oes on ‘terse patents partpstin in trestent spd slb tt ahancement techies fre to e PRAQES) wd in ‘Beteestment oles and extng dardrxea be apt fie the poychabernptetretnet of patents with ther ‘mont dren. FRAMES inten fndBoc (roving hd acosng rau fom peteasmert ser eer) re Sonali (making it cea to patient that sup thes {2 die what todo aboot ther problems. adit of ng peeaonl opinion ad gldancel men of satis (proving options for ays to change empty (amon ‘etingconcern sed understanding pation diate), sod seefeoey essing that teatime i Hl tbesoca i gatintarcomate a change The compo- ‘en FRAMES ave mca commen withthe bavi not lnsiann when hey we ying ngage «pce In trent FRAMES din hat here ex planned ‘er fre epic pape of oncing te pti! nt ‘Soton fr, pl omitment engage trap. Core™ Sia Newnan have sggetad eer mitivtion ewan: ment tecniqes or paychatrpy ecleing eres hen’ minsncepsons seu pancotherag 2) erin Ieeenve or hang, (3) ting wemaivaonal a= ‘mens acknowl ndpasing te pitt cross ‘Sosieration of and step tour. change and) am ‘ng problem kaos ht they appr len orale ‘Wl important for eoarers ots the fen) ofthis promising strategy orden paint ets rate Frasitaton of Therapeatie Aliance "Ths far inhi review, ont the tage nt me have ‘ston nur before the pated erp engage n ‘nal therapy Ths min isa woction othe widely shared citon tht eat ntervenin can prevent prematare {mination Bary ferent doo not prude howert ‘hun oer repeater hry bos bag, Perhaps ‘hermet important insecin reverion seat aiessed {nthe leurs te falta oa rong teropetc a: Tice tecming erasing ar ha trons her peti alan eta! nor only fr fitting 8 p= ‘re ate, tt lo for ping the lent east in {centment*™* The alae sewed tram eel flint fray tha tas he pin tari {ho thera prepestive nthe patents sxeptance {he treatment gale Atrong lions believe elp the tint aerate wet ro he lel en ‘herapy” Some shore ang the te establabmes of « kt allance most be aroapianed within Ue Gat tree avon inorder frit aaa sgieant impact on pre ‘General rccmendiions frei tragic withthe patient nce renoming e e smite ‘esrmah, rear empathy, and geninenen Mot autre Indhentta theinterpersonaldyams ofthe eal so ‘hp horween patient td tempt be tended o huh fut therapy Communiating mt rsp or the patient Perey aod ne interes in working wit im or her (NOL help develop satisfactory levels of elaboratian and {rast A testmect progres tefl bon daling ‘withruptresin the alae The therapist shod recgniae Sol address bare and-p relionsip poems se hey or ‘rin therapy: Winget work with negtive poco Onrdaiorkst al, 67 shouldbalpenhane the alance Thetherapat wings ‘crlasoacip vate the plient epee nd aio contrite tothe pereptin of therapy a eabraie denon Fasitaton of Allee Expression Astberany proce he kine of patent ined pre ‘tessaeatnmpherein hich he patieot an work hough ‘our aca Whon pnt at expen ‘ive felingy smo thelr thorupy experience the heaps, ho group inthe cae of op sete hey fen re fort to ating them out by ling therap. Negative a {ect may seo be rated to somo eter austin uti of the rtmene:Novortelan, the patent may fe! soem {artis exprating and exploring such act in therapy Ta (poop tentment, lure wo expec gato fling ‘natbutale othe grou having devlped nome that reude ch erennn Therapists temic ‘Rate to wach acm by sifing fc ay rm ponte ‘thom they perceive se negative salen "Therapists sul acti sonarage patient toexpront ele dota and questions abot therapy. Ferhermore, ‘hropnts toald pert patients text ete {arene Understand therapists say Ue recat fo Save segntive flings dominat the ely sags et ‘mont Exporton of wh fogs omever, can and ‘nih th otenaty and contrite tthe pase under ‘Sanding thal tinge ned exerenes ante epreated ‘Mow ether appear nsciphasze he expression fogs: tiveatftt in tery Aunt fics on neato ligt nay actually be detrimental, ever partial in 209 ‘Berapy Boao ed alea™ have engi at contin. uv exprensio of agave a tne teat, arte Shiba ther whereas he expreion of paste a ‘Rctondstoierare contact and sport fom ors Th {ety be more proden fiat he exrnsion ob _negtine ad pv fle in paychatherap nan eat ‘op atents ngagedintentmene Steere uo that Patina wo reported rete ilcly expensing their ‘Seaton or who experienced ea oie fet nthe i ‘Shona treatment” were mor Nkly to sarminate py DISCUSSION Scant cai telecine gapchotherapy. The are: {ere oungete hat patent inated premature termination ‘an be vod. Wohave reviewed nine dierent eee65 Oppel ‘hac romarch or ini expres has vented may be "At divin qoetion thal flows fe thi erie i: ‘what's the best stategs to use to prveet. patent {Spee of preentin strategie hve not bon conde ‘Thos cons shat deta flaiencs cae be ‘nae som Give hut 2 maby of factor ie kly ‘are itis pba tat ie prevention ste il lkete patents trmizting premaerely. For example Felevant othe type ef ther that hey vie conduct ‘roeinducnn interview) formulate a comtac with the tint regen he ration of rete (4 wend Pointe reminderrbefore mh therapy min tnd [Shey tothe therapeatie liane throught tester, fad eamre a safe anopere that ean ft he ps {let expan of net ad patie nec. Corts ‘rai mayb npc antl in sei cent or ‘lamps in he onion of tient with chron ad per ‘sth many ofthe daly ie yobs Ce, samen) {hat leh intros with emaaing a ray ‘Seats eogsgoment with the terete, Tay bee Sona proven tatogs muy dap en ew ach 8 cat branes genuinely sted nthe aeration It ems rneeae tee tnt postive patcpesta would tlw fected by te ineretion ed thar more Hkly {0 terminae prematurely Although no ty he exanioed this se det sad by Piper and olga found ‘hatte more that patente wovked in experiential peter a gooer,remarch oo the topic of preventing pre matcetrmionton reine underdeveloped. Our review found tat aly 1 sts hee be paid in 197. ven more semarkobe i eat ly fur of thse™== en gored inthe recent earch eratare may be that Cinians and researchers bse tat the ea be eld. They may bene shat minimal popartion re “ezendane or dropping oot ang cme forma of preter {tow rgieantoBctefvater pen af petereny fare ivore o the fre of dicoverng ape methods tr ombunatins of thos af prevering pen intated rmatue termination fr area oma herapy Tht tion. We mow mianeacknowedge te tngortance ‘we thee strate in any emai or comprehensive fasion for te epi parpne of prevestingpremazie ‘erinain. Tava the mutnlmgative consequnonsoaten- inte premature termination, the igh termination rates hat continue to be pred i the erate nose ht turret prevention rates ae etdequte ad ht ch ‘worktl ead to e dane Unfortnetl, more rear is inns sogarding which strategies to ae when an ith Whom. Fo exapl, pate with severe personaly disor em ae stray isto kao gage noses, nedeympton reduction Heneing foie tate fr pio hace patent in therapy would have amor in ‘linge, Oterimporeantdrestins or esaach lade toning the fevenen af he many promising preven tion strstr aorsted by dnicana Canparatve tude Inv acon that existing rates of prevention setae {eit ptient nw name patient. Ths the xen {Grhich their eines aply othe enerl ovation pope Into toa daar Fata rscreh wil nod aro hit sions to tea doped on melpesnignees Therore of ‘hoo factor that we ci ta nt aso, he beter curunderstandingof the mechani that underietbe phe eur weshouldbrabletedeveopand employ nerves ‘hatred the umber a requene afeuh termination. Rise behopedthat our review wil malt oer cn ‘REFERENCES 1. bart JP ow trderine penalty de I Chak Maria Mone is H. Borrego 2 Peart Realname or depig at Pcaat to cate sod tito. Cn Pech2. Carter #4 De Gato A, Maro GR Dept nd a ‘terpenes Pt 197517-8 4. 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S71 42 Min Assan, a Teste ope Sone erven hoch Son 021-30 Opotncnk tat ower ini ieee gr et erat nd cs ett sais ea ‘ea ba bo to and etation nterew ee Res ID pha el ap get ance mation chang Coa eta Pra 6-0 Noite, aries Bee Ey ype ge W, Omri 8 Joe AS Pree ep yen 8 Ran AS Relat wernt nd nr! rma Cs ea 98 ie Pre Cog Su. Ha er Da ete emit ck tas Osan ei thr eta NP WE, Oped 8 aly pone Sn Soging nt fom stem oe herp een dy np Da 20803054