Date of Award


Document Type


Degree Name


Organizational Unit

Morgridge College of Education

First Advisor

Jesse N. Valdez, Ph.D.

Second Advisor

Cynthia McRae

Third Advisor

Kathy Green


Attrition, Depression, Dropout, Telehealth, Telepsychology


Telemental health interventions are currently being implemented in primary care settings in order to reduce the cost of providing treatment and increase access to services of underserved groups. Studies of the efficacy of telemental health interventions have generally demonstrated high rates of attrition. Eysenbach (2005) suggested that the reality of high attrition rates in telemental health studies prompts further investigation into the factors related to attrition. Such research should focus on identifying the characteristics of clients who drop out of treatment and at what points such clients are likely to drop out. The purpose of this study was to identify client characteristics associated with dropout from a telemental health intervention for depressed primary care patients. Clients who dropped out at different time points during the intervention were compared to determine whether they differed demographically or on certain baseline characteristics, including severity of depression, self-efficacy, acculturation, treatment expectancy, and co-morbid mental illness. In addition, differences in attrition rates between therapists were examined to determine whether observable therapist characteristics impacted retention in telemental health treatment. Results suggested that participant age and baseline depression scores, therapist age, and changes in participant depression scores over time were significant predictors of attrition from the intervention. Implications and comparisons of attrition in telemental health and traditional psychotherapy interventions are discussed.

Publication Statement

Copyright is held by the author. User is responsible for all copyright compliance.

Rights Holder

Benjamin Salazar


Received from ProQuest

File Format




File Size

108 p.


Clinical psychology