Attrition revisited

Attrition of subjects from therapeutic treatment programs, long recognized as a bane of evaluation researchers, is the focus of hundreds of studies purporting to explain, measure or correct it. This article discusses the scope and limitations of research regarding the causes of premature termination from psychotherapeutic and substance abuse programs and examines the applicability of proposed methodological remedies for assessing and countering attrition to the specific problem of research involving dropouts from treatment. By and large, research on the causes of attrition suffers from inadequate conceptualization and weak methodological designs. The researcher's anticipation and measurement of factors driving premature program termination is key to the effective assessment and correction of problematic attrition in treatment evaluations. The phenomenon of attrition from treatment requires more rigorous attention from the evaluation community.