More than a third of students worldwide suffer from psychological problems - a concerning number that could rise in upcoming years. Caring Universities (CU) is an initiative of nine Dutch...Show moreMore than a third of students worldwide suffer from psychological problems - a concerning number that could rise in upcoming years. Caring Universities (CU) is an initiative of nine Dutch institutions to combat these issues. With eight evidence-based online programmes, CU strives to improve student wellbeing. The programmes include self-help, psychoeducation, and the weekly tracking of an e-coach. However, there is a large number of dropouts across programmes. Using a mixed-method design, potential reasons for dropout were investigated qualitatively, while medication and additional psychotherapy were researched quantitatively as predictors of dropout. Participants completed a demographic and dropout questionnaire on the CU platform. Results of the qualitative analysis (N = 40) showed that time pressure and a lack of motivation were the most prevalent reasons for dropping out. Experiencing stress and the lack of feedback were recurring themes of the narrative accounts. In the quantitative investigation (N = 4331), neither medication nor psychotherapy significantly affected dropout, meaning that future CU programmes will not have to correct or account for them. Limitations include the measurements based on self-report and the way dropout was defined. Future research should take into account more reasons for and predictors of dropout from eHealth programmes for students, like language.Show less
Background: Research identified psychological characteristics underlying a ‘need for psychological control’ as treatment attrition moderators for anxiety disorders in Cognitive Behavioural Therapy ...Show moreBackground: Research identified psychological characteristics underlying a ‘need for psychological control’ as treatment attrition moderators for anxiety disorders in Cognitive Behavioural Therapy (CBT) and Acceptance and Commitment Therapy (ACT). It has not yet been examined if these characteristics moderate treatment attrition for older adults with anxiety, as this age population experience greater barriers in seeking therapy. Objective: This study evaluated whether the psychological characteristics of experiential avoidance and cognitive reappraisal moderated the observed attrition in CBT, and if mindfulness and positive mental health moderated the observed attrition in ACT. Method: Dutch speaking adults, aged 55-75 (N=314) with mild to moderate anxiety, were randomized into a four session CBT or ACT protocol. In the primary analysis, treatment attrition was defined as attending at least one treatment session but not completing all four sessions. In the secondary analysis, treatment attendance was defined as the total number of completed treatment sessions Results: The observed attrition rates were significantly different between the CBT and ACT condition (ꭓ2=6.58, p=.01). The four psychological characteristics did not significantly predict treatment attrition nor the number of completed treatment sessions in CBT and ACT. Conclusions: This study found no moderation in the examined psychological characteristics on the observed ACT and CBT attrition for older adults with anxiety. These findings may be explained by age related reorientations in the need for control and methodological issues in defining treatment attrition. Methods for developing a multi-layered definition of treatment attrition are discussed, and future directions for treatment attrition moderator research are proposed.Show less
