Changes in therapists’ client dropout rates over time: Findings from a practice-research group

Research has failed to consistently show that therapists facilitate better client outcomes as they gain more experience. The present study was designed to examine changes in early client retention over the course of extended periods of time among 2591 therapists in private practice. Naturalistic data collected between 2018 and 2022 was extracted from a technology-enabled practice-research group (PRG). Therapists displayed an increase in client dropout rates as they gained more experience on the PRG. Additionally, larger caseloads on the PRG were associated with lower increases in client dropout over time. Finally, therapists working with clients paying higher out-of-pocket fees (e.g., co-pays) had higher increases in client dropout over time. These findings provide additional evidence supporting the distinction between clinical experience and expertise.