# Defining and reporting treatment dropout in blended therapy for mental health: scoping review and analysis

## TL;DR

This paper examines how different definitions of treatment dropout in blended mental health therapy affect reported outcomes and highlights the need for consistent reporting.

## Contribution

The study introduces a framework for operationalizing and comparing dropout definitions in blended therapy, revealing their impact on outcomes and usage patterns.

## Key findings

- Applying five synthesized dropout definitions to trial data showed variation in dropout rates and their associations with mental health outcomes.
- Cluster analysis identified distinct patterns of digital component usage among participants.
- The study emphasizes the importance of transparent reporting of dropout definitions to improve research comparability.

## Abstract

Evidence suggests that blended therapy combining face-to-face psychotherapy with digital components may reduce treatment dropout, yet definitions of dropout vary widely. This variability is particularly pronounced in blended therapy, where dropout may involve discontinuation of in-person sessions, disengagement from digital components, or both. This study aimed to identify operational definitions of treatment dropout in blended therapy and to examine how different definitions influence dropout rates, treatment outcomes, and usage patterns. A scoping review identified 14 studies reporting operational definitions of dropout. Five synthesized definitions were applied to data from a large blended therapy trial, revealing variation in dropout rates and their associations with depressive symptoms, anxiety, and life satisfaction. Cluster analysis further identified distinct digital usage patterns. These findings highlight the need for transparent and differentiated reporting of dropout definitions in blended therapy research to improve comparability and interpretation across studies.