Comparison of four operational definitions of premature termination

This investigation directly compared 4 methods for classifying clients as premature terminators: therapist judgment, failure to attend the last scheduled appointment, median-split procedure, and failure to return to therapy after the intake appointment. Premature termination rates ranged from 17.6% to 53.1% across the 4 definitions. Only 2 of the definitions (therapist judgment and missed last appointment) demonstrated adequate agreement in classifying participants as premature terminators. Overall, these findings provide empirical support for the assertion that different definitions of premature termination measure distinct constructs and cannot be used interchangeably. The authors review the advantages and disadvantages associated with each definition and present a new method for evaluating premature termination.