Attrition revisited

Attrition of subjects from therapeutic treatment programs, long recognized as a bane of evaluation researchers, is the focus of hundreds of studies pu rporting to explain, measure or correct it. This article discusses the scop e and limitations of research regarding the causes of premature termination from psychotherapeutic and substance abuse programs and examines the appli cability of proposed methodological remedies for assessing and countering a ttrition to the specific problem of research involving dropouts from treatm ent. By and large, research on the causes of attrition suffers from inadequ ate conceptualization and weak methodological designs. The researcher's ant icipation 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 requir es more rigorous attention from the evaluation community.