Palmer, Riley2022-11-142022-11-142022-08https://hdl.handle.net/11299/243127University of Minnesota Ph.D. dissertation. August 2022. Major: Psychology. Advisor: Patricia Frazier. 1 computer file (PDF); 63 pages.Psychotherapy dropouts are generally considered to have poor outcomes relative to treatment completers. However, qualitative evidence has found that some dropouts benefit from therapy, and most quantitative evidence uses average-level analyses, which may obscure dropouts who improve. Furthermore, most research in this area does not conceptualize dropout as a no-show, despite this form of dropout having negative implications for others accessing treatment. To address these shortcomings in the literature, the present study used a sample of no-shows and used latent growth mixture modeling (LGMM) and latent class growth analysis (LCGA) to identify subgroups of individuals with similar distress trajectories during the course of therapy. The naturalistic sample included 2,179 no-shows at college counseling centers across the U.S. The Distress Index of the Counseling Center Assessment of Psychological Symptoms was used. I hypothesized there would be evidence for some no-shows improving to a similar degree as treatment completers. Following LGMM/LCGA, subgroups of no-shows were compared to treatment completers (N = 4,813), and predictors of group membership among no-shows were considered. A five-class LCGA model was ultimately selected, with four of the five classes showing improvement ranging from small to large (ds = 0.44-0.81). The growth parameters of some no-show subgroups had overlapping confidence intervals with treatment completers, suggesting similar trajectories. From a more subjective perspective, the groups’ trajectories were also visually similar. Predictor variables were not meaningfully associated with class membership. This study provides support for the idea that many clients who no-show to therapy without returning nevertheless benefit from the process to a meaningful degree. Limitations are discussed, as well as implications for reducing the incidence of no-shows.enDropoutNo-showOutcomePsychotherapyThesis or Dissertation