An ecological model of dropout intention in university students during the covid-19 pandemic

Objective: To analyse the drop out intention of university students after six months of home confinement during the covid-19 pandemic using an ecological model. Method: A non-experimental cross-sectional study with an intentional sampling of 1,011 active university students during 2020. Aged between 18 and 54 years (M = 22,6; SD = 4,8; female = 438). We evaluated them with the university dropout questionnaire for students, Depression, Anxiety and Stress Scale, Fear of covid-19 Scales, covid-19 Anxiety syndrome scale, and the Satisfaction with academic changes questionnaire. We performed a descriptive and multivariate analysis of the data. Results: The model explain 28 % of drop out intention among university students during confinement by covid-19 (sensitivity = 86,8 %). Dissatisfaction with academic changes is the main predictor of the model (OR = 0,960; IC 95 % [0,950, 0,959). Other significant predictors are positive and negative interactions (i.e., in family, social, and academic environments), negative emotional symptoms, anxiety about covid-19, being older, studying at a private university, and having a family member diagnosed with covid-19. Discussions: Macrosystem changes (i.e., home confinement and online classes) during the first six months of the covid-19 pandemic modified the students' interaction with their proximal systems and new predictors of the intention to drop out emerged (e.g., anxiety about covid-19 and having a family member diagnosed with covid-19), associated with the context of confinement.

Objetivo: Analizar la intención deserción de los estudiantes universitarios tras seis meses de confinamiento en casa durante la pandemia por covid-19 a partir de un modelo ecológico. Método: Estudio transversal no experimental con un muestreo intencional de 1011 estudiantes universitarios activos durante 2020. Con edades comprendidas entre los 18 y los 54 años (M = 22,6; DE = 4,8; mujeres = 438). Los estudiantes respondieron el cuestionario de abandono universitario para estudiantes, la Escala de Depresión, Ansiedad y Estrés, la Escala de Miedo de covid-19, la Escala de Síndrome de Ansiedad de covid-19 y el cuestionario de Satisfacción con los cambios académicos. Se realizó un análisis descriptivo y multivariante de los datos. Resultados: El modelo explica el 28 % de la varianza de la intención de deserción entre los estudiantes universitarios durante el confinamiento por covid-19 (sensibilidad = 86,8 %). La insatisfacción ante los cambios académicos es el principal predictor del modelo (OR = 0,960; IC 95 % [0,950, 0,959). Otros predictores significativos son las interacciones positivas y negativas (i.e., en el entorno familiar, social y académico), los síntomas emocionales negativos, la ansiedad ante la covid-19, ser mayor, estudiar en una universidad privada y tener un familiar diagnosticado con covid-19. Conclusiones: Los cambios en el macrosistema (i.e., el confinamiento en el hogar y las clases en línea) durante los primeros seis meses de la pandemia por covid-19 modificaron la interacción de los estudiantes con sus sistemas proximales y surgieron nuevos predictores de la intención de abandono (e.g., ansiedad ante la covid-19 y tener un familiar diagnosticado con covid-19), asociados al contexto de confinamiento.

Adherencia o deserción de adolescentes en psicoterapia por agresiones sexuales: la perspectiva de sus terapeutas / Adherence or Drop Out of Adolescents in Psychotherapy Due to Sexual Abuse: their Therapist's Perspective

Resumen Un alto porcentaje de adolescentes que asisten a psicoterapia por haber sido víctimas de agresiones sexuales desertan de su tratamiento, afectando así su proceso de superación. Existe escasa investigación respecto a qué precipita la deserción o favorece la adherencia en estos casos. Objetivo: describir características del sistema consultante y del proceso psicoterapéutico de adolescentes que han sido víctimas de agresiones sexuales que adhieren y que desertan de la psicoterapia, desde la perspectiva de sus psicoterapeutas, explorando sus similitudes y diferencias. Método: se realizaron entrevistas semiestructuradas a psicoterapeutas que atendieron 16 casos de adolescentes que han sido víctimas de agresiones sexuales, 8 que desertaron de la psicoterapia y 8 que adhirieron hasta el alta. Se realizó un análisis narrativo temático de las entrevistas. Resultados: las principales similitudes identificadas fueron contextos sociofamiliares multiproblemáticos, recursos personales en los adolescentes y una relación psicoterapéutica positiva. Las diferencias se enfocaron en los adultos responsables, quienes en los casos de deserción mostraban bajo apoyo, una relación más conflictiva con el adolescente, escaso involucramiento en la psicoterapia y una relación frágil con el psicoterapeuta. Los adolescentes que desertaron presentaron motivos de consulta no asociados con la agresión sexual y se caracterizaron por ser socialmente poco integrados, a diferencia de los que adhirieron. Discusión: los fenómenos de adherencia y deserción a psicoterapia son complejos y multifactoriales. Junto con factores asociados al sistema consultante, se destacan elementos del proceso psicoterapéutico que propician la adherencia, y que, por tanto, pueden ser abordados tempranamente para favorecer la adherencia a la psicoterapia.

Abstract A high percentage of adolescents who attend psychotherapy due to sexual abuse drop out of treatment, affecting the overcoming. There is little research on what precipitates desertion or promotes adherence in these cases. Aim: describe features of the consulting system and the psychotherapeutic process of adolescents who have been sexually abused who adhere and drop out of psychotherapy, in order to explore similarities and differences from the perspective of their psychotherapists. Methods: Semi-structured interviews were conducted with psychotherapists who attended 16 cases of adolescent victims of sexual abuse, 8 who deserted from psychotherapy and 8 who continued until discharge. Thematic narrative analysis of the interviews was developed. Results: the main similarities described were multiproblematic social and family contexts, personal resources in the adolescents and a positive psychotherapeutic relationship. Differences were focused on caretakers, who in the drop out cases showed low support and a more conflictive relationship with the adolescent, little involvement in psychotherapy and a poor relationship with the psychotherapist. Adolescents who deserted had consultation purposes not related with sexual abuse and low social integration, unlike those who adhered. Discussion: the phenomena of adherence and dropout of psychotherapy are complex and multifactorial. Along with factors associated with the consulting system, elements of the psychotherapeutic process that support adherence stand out, which can be addressed early in the process.

Motivos de evasão na pós-graduação no Brasil: um instrumento de medida / Drop-out reasons of graduation in Brazil: a measurement tool

A quantidade de pessoas que iniciam e que concluem as pós-graduações é discrepante, mesmo considerando-se a duração do curso. O objetivo deste trabalho foi adaptar a Escala de Motivos de Evasão do Ensino Superior (M-ES) para a Pós-Graduação. Foram realizados dois estudos para tal finalidade. No primeiro, os itens da M-ES foram avaliados por juízes que indicaram a necessidade de criação de novos itens. No segundo, participaram 639 pessoas entre 21 e 62 anos, a maioria da pós-graduação (75%). Dos modelos testados, a versão de 7 fatores, denominados motivos interpessoais, relacionados à carreira, falta de suporte, desempenho acadêmico, produção científica, reconhecimento acadêmico e institucionais, foi a que apresentou melhor ajuste. Os valores de alfa dos fatores variaram de 0,61 a 0,97. Sabendo da importância da ciência para o desenvolvimento de qualquer nação, fez-se necessário o desenvolvimento deste estudo, a fim de garantir que os pesquisadores tenham condições adequadas para a conclusão dos cursos e para contribuição com a ciência e sociedade de uma forma geral.

The number of people starting and completing graduation is discrepant, even considering course duration. The aim was to adapt the Escala de Motivos de Evasão do Ensino Superior (M-ES) (Scale of drop-out reasons in higher education) to the graduation context. Two studies were carried out; in the first, the M-ES items were evaluated by judges, and new ones were constructed according to the new setting. In the second study, 639 people participated, aged between 21 and 62 years, most attending a graduation course (75%). The 7-factor version fitted better, being composed of interpersonal motives, related to career, lack of support, academic performance, scientific production, academic recognition and institutional reasons. Alpha values ranged from 0.61 to 0.97. Science is fundamental to the development of any nation and it is necessary to ensure that those involved in research might have appropriate conditions to conclude their courses in order to contribute to the desired development.

Funcionalidad familiar en escolares con comportamientos de riesgo psicosocial en una institución educativa de Sincelejo (Colombia) / Family function in schoolchildren with behavioral psychosocial risk in an educational institution in Sincelejo (Colombia)

Resumen Objetivo: Determinar el grado de Funcionalidad familiar y las funciones familiares de las familias de escolares que presentan comportamientos de riesgo psicosocial en una institución educativa de Sincelejo durante 2015. Materiales y métodos: Se realizó un estudio cuantitativo, de corte transversal descriptivo para conocer el grado de funcionalidad familiar y relaciones familiares en los escolares que presentaban conductas de riesgo psicosocial. Población constituida por 440 escolares; muestra de 69 escolares con conductas de riesgo psicosociales. Se recolectó la información utilizando la Prueba de Percepción del Funcionamiento Familiar (FF-SIL) y la encuesta de comportamientos agresivos y prosociales (COPRAG) para indagar las conductas de riesgo presentadas. La tabulación se realizó a través del programa sistematizado Epi Info 3.5.4; el análisis utilizó estadística descriptiva y medidas de tendencia central. Resultados: 83 % (57) de los escolares que presentaban conductas de riesgo eran del género masculino; la mayoría de 11 años de edad; la conducta más observada fue la violencia escolar, morbilidad física y psicológica. Las principales categorías que afectaban la funcionalidad familiar fueron la cohesión y la armonía; los escolares que pertenecían a pandillas, que presentaron ausentismo escolar y algún tipo de morbilidad, provenían de familias clasificadas como disfuncionales. Discusión y conclusiones: Se puede afirmar que los escolares intervinientes en el estudio provenientes de familias disfuncionales presentaron con mayor frecuencia pertenencia a pandillas, ausentismo escolar y algún tipo de morbilidad. Además, que pueden presentar varias conductas de riesgo simultáneamente.

Abstract Objetive: Establish the degree of Family Functionality and the family functions of the families of schoolchildren who present behavior of psychosocial risk in an educational institution of Sincelejo, during the year 2015 Materials and methods: A quantitative, descriptive cross-sectional study was carried out to determine the distribution of family functionality and family relationships in schoolchildren with behavioral psychosocial risk. Population constituted by 440 school children, sample of 69 school children with psychosocial risk behaviors. Data were collected using the FF-SIL Family Function Perception Test and the survey of aggressive and prosocial behaviors COPRAG the risk behaviors presented. The tabulation was performed through the Epi Info 3.5.4 system, the analysis used descriptive statistics and measures of central tendency. Results: 83 % (57) of schoolchildren who presented risky behaviors were males, most of them 11 years of age, the most observed behavior was school violence, physical and psychological morbidity. The main categories that affected family functionality were cohesion and harmony, Schoolchildren who belonged to trainees, who presented school absenteeism and some type of morbidity, came from families classified as dysfunctional. Discussion and conclusions: It can be affirmed that the students involved in the study from dysfunctional families showed more frequent gang membership, school absenteeism and some type of morbidity. In addition, they may present several risk behaviors simultaneously.

Mind the gap between high school and university! A field qualitative survey at the National University of Caaguazú (Paraguay).

Paraguay has eight public universities and 45 private universities. The National University of Caaguazú (Universidad Nacional de Caaguazú or UNCA), with its main campus located in Coronel Oviedo, is one of the most recently founded public universities, being established in 2007. The UNCA has launched a project aiming at exploring the potentiality of its educational system, as well as its gaps. In particular, the UNCA wants to assess the effectiveness of preparatory courses for preparing students for admission to the degree course in medicine (Cursos Probatorios de Ingreso or CPI), in order to identify the main strong and weak points of the system, the popularity and usefulness of CPI as perceived by the students, the students' and teachers' opinions regarding the limits of school, and their suggestions. This paper is based on a field survey and highlights the care that must be taken in order to develop conditions respectful of the wellbeing of those participating in the educational context.

Factores psicológicos y/o psiquiátricos presentes en pacientes desertores de protocolo de preparación para cirugía bariátrica / Psychological and/or psychiatric factors present in patients who abandoned the preparation protocol for bariatric surgery

Resumen: INTRODUCCIÓN: La obesidad severa es la enfermedad crónica con mayor prevalencia en el mundo, afectando la calidad de vida de los pacientes. Aunque existe una variedad de tratamientos para ella, las tasas de abandono de los mismos se encuentran entre el 40-80%. OBJETIVO: Identificar los factores psicológicos y/o psiquiátricos que presentaron en la evaluación inicial los pacientes con obesidad severa que desertaron del protocolo de preparación para la cirugía bariátrica y establecer diferencias con los pacientes que no desertaron. MÉTODO: Se llevó a cabo un estudio analítico observacional de casos (desertores) y controles (no desertores), retrospectivo, transversal, con una muestra de 286 expedientes de pacientes candidatos a cirugía bariátrica del Hospital General Dr. Manuel Gea González en la Ciudad de México, con IMC de 44.77 ± 7.47 kg/m2 y una edad de 37.45 ± 9.94 años y que fueron seleccionados por muestreo no probabilístico por conveniencia. RESULTADOS: Se encontraron diferencias significativas: género (los hombres desertan más), los pacientes desertores mostraron una mayor prevalencia en el trastorno por estrés postraumático, trastorno por déficit de atención e hiperactividad, trastorno por atracón, aislamiento, deterioro de las funciones cognitivas y mayor disfunción familiar y social que los no desertores. Un análisis multivariado sobre los mismos factores demostró que el ser hombre, tener poco apoyo social, presentar trastorno por atracón y tener un mayor número de faltas a sus citas durante el tratamiento, son factores contribuyentes para la deserción. DISCUSIÓN Y CONCLUSIÓN: Existen variables psicológicas/psiquiátricas que podrían establecerse como factores de riesgo en la deserción y como consecuencia incrementar la posibilidad de afectar el bienestar físico y emocional del paciente.

Abstract: INTRODUCTION: Severe obesity is the chronic disease with the highest prevalence around the world. It affects the life quality of patients in terms of physical and mental health. Although there are a variety of treatments for severe obesity, dropout rates are between 40% to 80%. OBJECTIVE: To identify the psychological and/or psychiatric factors presented in the initial evaluation of patients with severe obesity who deserted the preparation protocol for bariatric surgery and stablish differences between them and those who didn't defected. METHOD: An analytical observational open study of cases (deserters) and controls (non deserters), retrospective, transversal, with a sample of 286 files of patients candidates for bariatric surgery from General Hospital "Dr. Manuel Gea Gonzalez" in Mexico City selected by simple random sampling fulfilling desertion variable, with a BMI of 44.77 kg/m2 ± 7.47 and 37.45 ± 9.94 years old and were selected by non-probabilistic convenience sample. RESULTS: Significant differences were found: gender (men drop out more), deserters patients showed a higher prevalence in post-traumatic stress disorder, attention deficit hyperactivity disorder, binge eating, isolation, impaired cognitive function and greater family and social dysfunction than non-deserters. A multivariate analysis of these factors showed that being male, having little social support, present a binge eating disorder, have a greater number of absences to appointments during treatment, are factors contributing to attrition. DISCUSSION AND CONCLUSION: There are psychological/psychiatric variables that could be established as risk factors for dropping out, increasing the possibility of affecting the patient's physical and emotional well-being.

Função escolar x evasão: a falência da educação para o trabalho / School Function and pupils' drop-out: The failure of education for work

O artigo apresenta a discussão de uma pesquisa realizada numa escola da rede pública de Fortaleza-CE, como parte de uma disciplina de Psicologia Escolar. A pesquisa investigou as relações entre a função da escola e evasão escolar, pelo ponto de vista de educadores e alunos. Foi utilizado o referencial teórico foucaultiano para a análise dos dados. Como resultados, podemos apontar que há um desencontro entre a função que a escola deveria assumir na ótica dos alunos e a função que os educadores a fazem assumir ao se comprometerem com determinadas obrigações institucionais, resultando disso a massiva evasão encontrada no estabelecimento em questão. Compreendemos que o fato de a escola pública não assegurar uma vaga no mercado de trabalho especializado para seus alunos, via vestibular ou ensino técnico, contrapõe-se à função escolar de educação para o trabalho. Estando enfraquecida nessa função, a escola não consegue manter seus alunos, mesmo apelando para os mais diversos mecanismos de controle disciplinares.

The article discusses the results of a research done in a public school in Fortaleza (Brazil) as part of a School Psychology course. The research investigated the relationship between the function of school and pupils' drop-out based upon the opinions of the pupils and teachers. It was used a Foucauldian theoretical reference in order to analyze the collected data. It could be found that there is a difference between the school function perceived by the pupils and the function that teachers try to develop through institutional rules, resulting on the massive student drop-out reported in the researched school. When public schools fail to assure a better place for its pupils in the job market, through university access or technical formation, the idea of school as 'education for work' becomes contradictory. When this function is undermined, the school cannot avoid student drop-out despite the use of different disciplinary control mechanisms.

Cuestionario de Vivencias Académicas en su versión reducida (QVA-r): un análisis psicométrico / Academic Experiences Questionnaire, reduced version (QVA-r): A psychometric analysis

En el presente estudio se adaptó y validó el Cuestionario de Vivencias Académicas versión reducida (QVA-r) (Almeida, Ferreira & Soares, 2001) en una muestra de 297 estudiantes universitarios de una facultad de psicología de la ciudad de Bogotá, con una edad promedio de 20 años. La consistencia interna en todas las escalas, estimada a partir del alfa de Cronbach, fue mayor o igual a .60 y la estructura factorial obtenida explica el 40.5% de la varianza total, en una conformación similar a la reportada para el instrumento original, aunque algunos ítems se agruparon de manera diferente. Se discuten las propiedades psicométricas del instrumento y se indican algunos usos potenciales del mismo.

This study intends to adapt and validate the reduced version of the Academic Experiences Questionnaire (QVA-r) (Almeida, Ferreira & Soares,2001) in a sample of 297 university students of a Psychology Faculty in Bogotá, with an average age of 20 years. The internal consistency for all scales, estimated using Cronbach Alfa, was .60, and the resulting factorial structure explained 40.5% of total variance with a similar structure to the one reported for the original instrument, although some of the items grouped in a di6erent way. the instrument's psychometric properties are discussed and some of its potential uses are indicated.

Perfil de mulheres usuárias de álcool em ambulatório especializado em dependência química / Profile of female alcohol users in specialized outpatient clinic

Embora cresça o número de mulheres com abuso ou dependência alcoólica, elas ainda permanecem como alvo não prioritário na tomada de decisão dos gestores de políticas públicas. OBJETIVOS: Caracterizar o perfil sociodemográfico de mulheres com abuso ou dependência do álcool, identificar o consumo alcoólico, as intervenções terapêuticas realizadas e alguns fatores que poderiam estar relacionados ao abandono precoce do tratamento nesta população. METÓDOS: Foram incluídas 192 mulheres que procuraram pela primeira vez tratamento na Unidade de Pesquisa em Álcool e Drogas (UNIAD) da Universidade Federal de São Paulo (UNIFESP), no período de 2000 a 2006. As informações foram coletadas nos prontuários das pacientes, as quais foram separadas em dois grupos, usando-se como critério o abandono de tratamento. RESULTADOS: Não houve diferença significativa nas características sociodemográficas da população estudada. Em ambos os grupos houve predomínio de solteiras, com primeiro grau incompleto e situação de desemprego. O consumo diário de destilados foi significantemente maior no grupo abandono gradual (p < 0,002). O grau de dependência grave foi significantemente maior (p < 0,001) nos dois grupos em relação aos graus leve e moderado. A quantidade de álcool ingerida por semana, o uso de medicação coadjuvante e a necessidade de atendimento psiquiátrico prévio foi significantemente maior no grupo abandono gradual (p < 0,001 e p < 0,002), respectivamente. CONCLUSÃO: Mulheres usuárias de álcool que desistiram do tratamento no primeiro mês quando comparadas às não desistentes fizeram mais uso de fermentados ou a associação deste com destilados, consumiram menos unidades de álcool por semana, usaram menos medicações coadjuvantes e procuraram menos tratamentos prévios.

Although the number of women who use, abuse of and become addicted to alcohol is increasing, they are still not the main target of the health care services as their distinctive characteristics regarding psychoactive substances have not been taken into account by the public health policy decision-makers. OBJECTIVE: To characterise those women who use alcohol as well as to identify the pattern of alcohol consumption, clinical interventions, and previous treatments performed in this patient population. METHODS: This retrospective cohort study reviewed medical records of alcohol users who had sought treatments offered by UNIAD and UNIFESP between 2000 - 2006. A total of 192 patients were included in this study according to criteria for treatment dropout. RESULTS: The groups were found to have similar socio-demographic characteristics. Consumption of both fermented and distilled beverages were significantly higher in the dropout group (p = 0.002). Alcohol addiction was found to be significantly more severe in both groups (p < 0.001). Use of auxiliary medication (p < 0.001) and search for psychiatric consultation (p < 0.001) were significantly higher in the non-dropout group. CONCLUSION: Alcoholic women who abandoned the treatment during the first month, compared to those who did not, made more use of both fermented and distilled beverages, had consumed less units per week, used less auxiliary medications, and sought less treatments.

Expectativas, percepción del paciente hacia su terapeuta y razones para asistir a dos o más sesiones

resumen está disponible en el texto completo

Summary: In Mexico, patients who seek psychological therapy attend on average only three sessions, which are not enough to truly benefit from therapy One variable that might be related with dropping out is the patient's expectations. When the patient attends the first session and does not find what he expected he might not return for additional sessions. Unfortunately, contradictory evidence prevents us from fully understanding the role of patients' expectations in determining whether patients will attend additional sessions after their first interview. In addition, if the patient perceives unfavorable qualities in his therapist he may choose not to return for more sessions. This was the case in some studies but in some others the patients' perceptions of their therapists' qualities were not useful predictors of which patients would return after the first interview. In any case, every time that a patient does not return without warning his therapist the question may remain: why didn't the patient return? Thus, the aims of this study were: 1. To document the expectations subjects had before their first interview, 2. To identify whether these expectations were met, 3. To determine if there is a relationship between having one's expectations met and attending a second session, 4. To document subjects' reasons for attending two or more sessions, and 5. To compare the perceptions of the therapists' personal qualities among patients who did return or not for a second session. Method. Thirty-nine subjects who attended a psychotherapy session at any time were contacted. The average age was 32.05 years (range from 20 to 63 years), 26 were single and 13 were married. Since this was an exploratory study, an open questions interview was used. Questions included: what expectations did you have before your therapeutic interview? Were your expectations met? Did you return after your first interview? Why did you attend two or more sessions? What qualities did you perceive in your therapist? All of the answers subjects gave were encoded and frequencies were computed. The responses of subjects who attended two or more sessions were compared with answers of subjects who did not. Results. Before the first interview, subjects expected therapists would be attentive, supportive, friendly, and honest. Second, subjects expected concrete results from the first interview: they expected solutions to their problems and doubts, and to feel better in general. They also expected they would be able to confide in their therapists. Last, subjects expected that their pain would be eased, that they would be able to talk about their problems, and that they would not be afraid. When patients' expectations were met they explained that their therapists were attentive listeners. They described their therapists as kind, objective and reliable. They also felt that their therapists were able to help them, often by offering another perspective on their problems. These subjects felt better after the session. On the contrary, when patients' expectations were not met they explained that their therapists did not listen, were critical, acted as if conducting a test, and arrived late to the session. Also, subjects did not feel that they could confide in their therapists and were disappointed that they did not help them to solve their problems. After the first interview, 19 subjects returned for a second session and eight did not. Twelve of these subjects reported having their expectations met on the first interview, while 27 subjects reported that their expectations were not met. Having one's expectations met was significantly correlated with attending a second session (r = +.34, p < .05). The main reasons subjects reported when asked why they attended two or more sessions were the following: I had to continue the treatment, I wanted to feel better, I wanted to overcome my problems, I needed help, I thought the therapist would improve in the next session, and the therapist helped me. Reasons subjects gave for not attending were: the therapist did not listen to me, the therapist was not friendly, I did not like the therapist, the therapist criticized me, I learned that the best way to solve my problems is by my self, the therapy was expensive, I had to study, and I had to work. Subjects who attended a second session perceived more positive qualities in their therapists (e.g. the therapist was kind, reliable, punctual, intelligent, respectful, understanding) than negative (e.g. arrived late, unkind, authoritarian, aggressive, impulsive, incompetent). Subjects who did not attend a second session perceived more negative qualities in their therapists. Finally, those who attended a second session perceived that their therapists were more experienced than subjects who did not attend a second session. Conclusions. Having one's expectations met was significantly correlated with attending a second session, a finding that contradicts other studies. In addition, when patients perceived therapists did not listen to them, they were less likely to attend additional sessions, a finding that is consistent with other research. Finally, also in agreement with other studies, subjects who attended a second session perceived more positive qualities in their therapists than those who did not attend a second session for these perceived more negative qualities in their therapists. One problem that sometimes arises when drop out subjects are interviewed, is that they may lie because they do not want to have any problems with the institution providing them the service or because they do not want to meet their therapists again. However, it is likely that this was not the case for this research. Since interviews were not conducted in a consulting room or a psychological services setting, it is also likely that the "social desirability" was reduced. That is, subjects had the opportunity to speak the truth because the researcher did not know the therapists or institutions they were talking about. One important limitation to this study was that subjects were asked retrospectively about events that took place prior to the interview. So, it is possible that subjects' answers were distorted due to the effect of time on memory. Clearly, more research is needed in prospective studies to explore the relationship between the attendance of more than one session and patient's expectations of therapy sessions and their perceptions about therapists.