Factors related to the premature termination of individual psychotherapy by HIV-seropositive African-American women

Date of Award




Degree Name

Doctor of Philosophy (Ph.D.)


Educational Psychology

First Committee Member

Blaine J. Fowers - Committee Chair


African-American women have one of the highest AIDS rates in the United States. In addition to the health issues accompanying HIV infection, this population is confronted with the task of coping with the psychosocial stressors associated with the disease and the pre-existing stressors that they face. Effectively coping with these stressors is critical for this population because of the implications this has for disease progression and survival. Psychotherapy is one of the most promising possibilities for helping these women cope. However, this population does not seem to readily seek nor remain in therapy. The focus of this study was to determine what factors are related to the premature termination of individual psychotherapy by HIV-positive, African-American women, with the ultimate goal being to identify cases at risk for premature termination and to intervene in an effort to facilitate their retention in psychotherapy and to ultimately promote their survival.Participants were purposively sampled from a pre-existing research project evaluating how HIV-seropositive, African-American women and their families cope with psychosocial problems. The sample was divided into two groups: (a) participants who were not retained in therapy and (b) participants who were retained. Data were collected from interviews with these participants and from interviews with the therapists of these participants. Data were also collected from document reviews conducted on participant responses to psychosocial assessments administered by the pre-existing project. The final sample consisted of fifteen participants: eight Non-Retained, five Retained, and two therapists. Data were collected and analyzed according to the grounded theory method, and the results of this study suggest that there are four factors that contribute to premature termination for this population: (a) whether the participant understood Project expectations; (b) whether the participant was comfortable with disclosure; (c) whether the participant believed therapy to be necessary; and (d) the degree to which life demands interfered with the client's ability to schedule and keep therapy appointments.


Black Studies; Education, Guidance and Counseling; Psychology, Clinical

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