Low-Income Cancer Patients in Depression Treatment: Dropouts and Completers

  • Anjanette A. WellsEmail author
  • Lawrence A. Palinkas
  • En-Jung Shon
  • Kathleen Ell


This study aims to explore reasons for depression treatment dropout among low-income, minority women with depression and cancer. Semi-structured telephone interviews are conducted with 20, predominately Latina, patients who dropped out of depression treatment and 10 who completed. Transcripts analyzed using techniques rooted in grounded theory. Treatment completion barriers cluster according to Meichenbaum and Turk's (Facilitating treatment adherence: A practitioner's guidebook, Plenum Press, New York, 1987) five adherence dimensions: (a) Barriers to Treatment (informational, instrumental, cultural [language, discrimination]); (b) Disease Features (emotional burden of cancer/depression); (c) Cancer/Depression Treatment Regimens; (d) Provider–Patient Relationship (depression treatment dissatisfaction); and (e) Clinical Setting (hospital organizational issues). Although both groups describe multiple overlapping dimensions of barriers, completers seem more motivated and satisfied with treatment, possibly due to completers experiencing the positive treatment effects after the first several sessions. More research should be conducted to determine the most effective clinical treatment methods for this population.


Antidepressant Medication Depression Treatment Minority Cancer Patient Positive Treatment Effect Project Assistant 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



We thank Sylvia Barker, Maria Hu-Cordova, and Yvonne Parades-Alexander who helped with challenging recruitment and data collection efforts for this study; Tess Cruz, PhD, who assisted advice on the research design and data analysis; Pey-Jiuan Lee, who provided necessary data analysis reports; and Patricia Cheung, who contributed to updating the literature. I confirm all patient/personal identifiers have been removed or disguised so the patient/person(s) described are not identifiable and cannot be identified through the details of the story. This project was funded by grants from the American Cancer Society for a doctoral oncology fellowship (DSW06-219-01-SW), the National Cancer Institute for a Minority Research Supplement (3 R01 CA105269-S1) (PI: Kathleen Ell, DSW) and an NCI F31 dissertation fellowship (1 F31 CA132623).

Conflict of interest

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.


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Copyright information

© National Council for Community Behavioral Healthcare 2013

Authors and Affiliations

  • Anjanette A. Wells
    • 1
    • 4
    Email author
  • Lawrence A. Palinkas
    • 2
  • En-Jung Shon
    • 3
  • Kathleen Ell
    • 2
  1. 1.Brown School of Social WorkWashington University in St. LouisSt. LouisUSA
  2. 2.School of Social WorkUniversity of Southern CaliforniaLos AngelesUSA
  3. 3.Mandel School of Applied Social ScienceCase Western Reserve UniversityClevelandUSA
  4. 4.George Warren Brown School of Social WorkWashington University in St. LouisSt. LouisUSA

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