It is often characteristic of the mentally ill that those who are badly in need of treatment seek to avoid it. One way of avoiding treatment is by dropping out at the very point at which it is concretely presented. The patient who drops out of treatment after a few visits constitutes a challenge to our understanding of him and to our ability to provide effective treatment services. Several factors are usually presented as the basis for drop-out: resistance to treatment, lack of rapport in the initial interview, and psychopathology. In reviewing our own clinical experience, however, we encountered instances contradicting the importance of these factors. There were patients who wanted treatment and yet dropped out, and there were patients who did not want treatment and continued. Furthermore, there were patients who continued in spite of "bad" rapport with a doctor and those who dropped out in spite of a
FREEDMAN N, ENGELHARDT DM, HANKOFF LD, et al. Drop-Out from Outpatient Psychiatric Treatment: "Personality" and Situational Determinants. AMA Arch NeurPsych. 1958;80(5):657–666. doi:https://doi.org/10.1001/archneurpsyc.1958.02340110127020
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