AI divides opinion, doesn’t it? Recently, I decided to overcome my entirely unfounded prejudices against it and put Open AI’s ChatGPT and Google’s Bard AI platforms through their paces.

Could they suggest three ways, I asked them, based on research, in which I could reduce dropout? Turns out they know their stuff – their three suggested strategies overlapped almost perfectly. See whether you agree and whether their suggestions tell you anything new or useful.

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Estimated reading time: 10 minutes

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How can I reduce my dropout rate?

I asked both platforms for three ways, based on research evidence, that I can reduce my dropout rate. Here’s my question, and their responses.

ChatGPT’s suggestions

Reducing dropout in psychotherapy is crucial for enhancing treatment effectiveness and client outcomes. Here are three evidence-based strategies to minimize dropout rates in your practice:

1. Clear Treatment Expectations and Goals: Collaboratively establish clear treatment expectations, goals, and a roadmap with your clients. Research shows that when clients have a comprehensive understanding of the therapeutic process and the anticipated outcomes, they are more likely to remain engaged and committed to therapy. Regularly revisit and adjust these goals based on client progress, fostering a sense of purpose and accomplishment.

2. Cultivate Strong Therapeutic Alliance: Develop a strong therapeutic alliance by creating a supportive, empathetic, and non-judgmental environment. Studies consistently highlight the significance of a positive therapeutic relationship in reducing dropout rates. Regularly seek feedback from clients about their experience in therapy, address any concerns promptly, and adapt your approach to align with their preferences and needs.

3. Flexible Treatment Approach: Tailor your therapeutic approach to match each client’s unique characteristics and preferences. Research demonstrates that personalized interventions are associated with higher retention rates. Utilize evidence-based practices that resonate with your client’s individual strengths and challenges. Additionally, periodically assess and discuss progress to ensure that the treatment plan remains relevant and effective.

By implementing these evidence-based strategies—clarifying treatment expectations, nurturing a strong therapeutic alliance, and offering a flexible treatment approach—you can enhance client engagement and commitment, ultimately reducing dropout rates in your psychotherapy practice. Remember that ongoing self-assessment, continuous learning, and adaptation are key to providing effective and client-centred care.

Bard’s suggestions

Sure, here are three ways you can help to reduce dropout in your psychotherapy practice that are based on research evidence:

1. Build a strong therapeutic relationship. This is perhaps the most important factor in reducing dropout. When clients feel a strong connection with their therapist and believe that they are being understood and supported, they are more likely to stay in therapy. There are many things you can do to build a strong therapeutic relationship, such as being warm, genuine, and empathic; listening attentively; and showing respect for your client’s values and beliefs.

2. Set clear expectations and goals. At the beginning of therapy, it is important to take some time to discuss with your client what they hope to achieve in therapy. This will help to ensure that you are both on the same page and that your client is motivated to continue with treatment. It is also important to set realistic goals that are achievable within a reasonable timeframe.

3. Be flexible and responsive to your client’s needs. Things come up in life that can make it difficult for clients to attend therapy sessions. If your client is unable to make a session, be understanding and work with them to reschedule. You may also need to be flexible with your approach to therapy if your client is struggling to make progress. For example, you may need to change the focus of therapy or the type of interventions you are using.

In addition to these three strategies, there are a number of other things you can do to reduce dropout in your psychotherapy practice. For example, you can provide your clients with psychoeducation about the benefits of therapy and the importance of attending all sessions. You can also offer them support and encouragement throughout the treatment process. By taking the time to build a strong therapeutic relationship, set clear expectations, and be flexible and responsive to your client’s needs, you can help to reduce dropout and improve the outcomes of your psychotherapy practice.

The first time I asked the question I didn’t specify a word count. Both platforms rattled out responses at lightning pace. Interestingly, when I specified a 250-word limit, Bard was equally fast, but ChatGPT looked like it might be about to blow a gasket, taking two or three minutes to generate a response.

Give two sources for each suggestion

As any of you who’ve undertaken research will know, a key part of the discipline involved is in reviewing the literature and citing your sources. So, I asked each platform to provide two sources for each of their three suggestions. They couldn’t have been more different.

ChatGPT

Certainly, here are two sources for each of the evidence-based suggestions mentioned:

1. Clear Treatment Expectations and Goals:

   – Kazdin, A. E., & Blase, S. L. (2011). Rebooting Psychotherapy Research and Practice to Reduce the Burden of Mental Illness. Perspectives on Psychological Science, 6(1), 21–37. doi:10.1177/1745691610393527

   – Lambert, M. J., & Barley, D. E. (2001). Research Summary on the Therapeutic Relationship and Psychotherapy Outcome. Psychotherapy: Theory, Research, Practice, Training, 38(4), 357–361. doi:10.1037/0033-3204.38.4.357

2. Cultivate Strong Therapeutic Alliance:

   – Norcross, J. C. (2011). Psychotherapy Relationships That Work: Evidence-Based Responsiveness. Oxford University Press.

   – Horvath, A. O., & Symonds, B. D. (1991). Relation Between Working Alliance and Outcome in Psychotherapy: A Meta-Analysis. Journal of Counseling Psychology, 38(2), 139–149. doi:10.1037/0022-0167.38.2.139

3. Flexible Treatment Approach:

   – Strunk, D. R., & Hollars, S. N. (2019). Cognitive therapy. In M. J. Lambert (Ed.), Bergin and Garfield’s Handbook of Psychotherapy and Behavior Change (pp. 365–408). Wiley.

   – Wampold, B. E., & Imel, Z. E. (2015). The Great Psychotherapy Debate: The Evidence for What Makes Psychotherapy Work (2nd ed.). Routledge.

Please note that these sources provide in-depth information on the respective topics and may offer further insights into the evidence supporting the strategies to reduce dropout rates in psychotherapy practice.

Bard

1. Build a strong therapeutic relationship.

Source 1: “Therapeutic alliance: A guide to research and practice” by Bruce Wampold and Colleen M. Boswell (2017). This book provides a comprehensive overview of the research on the therapeutic alliance, including its importance in reducing dropout.

Source 2: “Therapeutic relationships that work: Evidence-based practice for mental health professionals” by Leslie S. Greenberg and Robert L. Elliott (2019). This book provides practical advice on how to build strong therapeutic relationships, with a focus on evidence-based techniques.

2. Set clear expectations and goals.

Source 1: “Early withdrawal from mental health treatment: Implications for psychotherapy practice” by William T. O’Donohue, Mark A. Fisher, and James R. Hayes (2003). This article reviews the research on dropout from mental health treatment and provides recommendations for how to reduce it, including setting clear expectations and goals.

Source 2: “Therapeutic alliance and outcome in psychotherapy: A meta-analytic review” by Bruce Wampold, Mark B. Minami, and Christopher M. Tierney (2002). This article provides evidence that the therapeutic alliance is a significant predictor of outcome in psychotherapy, and that setting clear expectations and goals can help to strengthen the alliance.

3. Be flexible and responsive to your client’s needs.

Source 1: “Therapeutic flexibility: A guide to adapting psychotherapy to the individual client” by Bruce Wampold, Michael F. Lambert, and Christopher M. Tierney (2018). This book provides a comprehensive overview of the research on therapeutic flexibility, including its importance in reducing dropout.

Source 2: “Flexibility in psychotherapy: A guide to adapting treatment to the individual client” by Barry Duncan, Scott Miller, and Mark Hubble (2010). This book provides practical advice on how to be flexible and responsive to your client’s needs, with a focus on evidence-based techniques.

I hope this helps!

So, how did the platforms do?

Not having had much previous experience of using these two nor any other AI platform, my expectations were limited. For that reason I found myself reasonably impressed on two counts.

First, the strategies offered by each platform feel very much on the money in terms of how, at my best, I’d be looking to approach my work with clients. While my focus would be on promoting engagement rather than preventing dropout, these are really two sides of the same coin.

Second, in terms strategies offered by ChatGPT and Bard respectively, while they were in a different order and expressed differently, it would have been otherwise difficult to fit the metaphorical cigarette paper between them. I can’t really be fussed about the order, as I hadn’t asked for an order of priority or evidence of impact.

What I find a little puzzling is that, while the strategies are almost identical, each of the twelve sources offered in support of them is unique. The only thing I can currently conclude from this is that there’s a vast amount of evidence pointing in more or less the same direction.

Overall, stylistically I’m edging towards favouring Bard. Its responses left me feeling as if it was engaging with me directly. Just a little more personalised. I also liked the fact that Bard provided thumbnail descriptions for each of the sources that might be helpful in guiding my reading choices.

Did they provide useful learning?

Again, broadly, yes. While none of the strategies offered as helping to reduce dropout are news to me, sometimes it’s useful to be reminded. I’m not always at my best. So, while I subscribe totally to the principle that it’s important to respond flexibly to clients’ unique characteristics and preferences, for example, I may sometimes fall down in practice.

If I didn’t know my way around the evidence, however, and/or if I were relatively inexperienced, these 250 words offerings might be very helpful indeed. After all, how many of us learn this stuff in our core training?

That’s me, but what about you? Did you learn anything new from AI’s offerings? Do you agree with their strategies? Do you disagree or have better ones? There’s space below for comments….

Waking up to the possibilities of AI

It would be very easy to be snarky or dismissive about AI but based on this experience and a bit more experimentation since, I feel like I might be having an awakening as to its possibilities.

I could ask for suggestions that build on the strategies. How might I structure a conversation with a client that elicits their needs and preferences, or start using a strength-based approach with another? How could I start to introduce measures of outcome into my practice in a collaborative way?

Could I get AI to suggest five more blog topics (yes) and write them for me (yes)? Would you even notice (yes, at least I hope so). Could I get a list of suggestions for a literature review (yes, see above). Could it write my counselling qualification essays? Almost certainly.

Will AI turn out to be a force for good or otherwise? I think the answer to that question lies entirely in our hands. It is after all still a tool, albeit a pretty powerful one. Let’s hope it remains that way!

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