ORIGINAL PAPER ‘‘Almost There’’...Why Clients Fail to Engage in Family Therapy: An Exploratory Study Meng-ning Wang Æ Jonathan Sandberg Æ Amy Zavada Æ Mona Mittal Æ Anne Gosling Æ Tziporah Rosenberg Æ Aaron Jeffrey Æ Justin McPheters Published online: 7 June 2006 Ó Springer Science+Business Media, Inc. 2006 Abstract A great deal of clinical research has sought to describe and suggest remedies for the client dropout phenomenon. However, few studies have addressed the equally pervasive, yet often ignored, non-engagement problem. An exploratory study was con- ducted to understand why many clients fail to engage in family therapy services after they have completed the initial intake. The results of the study suggest that therapist gender and experience level, clinic policies regarding videotaping sessions, family concerns, and changes in the presenting problem prior to the first session, had an impact on potential clients’ decision to engage in therapy. Implications and future research are discussed. Keywords Marital and family therapy Æ Client non-engagement Æ Client dropout Æ Client recruitment Æ Mental health service The Problem of Non-engagement The failure to engage clients in therapy continues to be a major mental health services delivery problem (Evans, 1999; Masi, Miller, & Olson, 2003). When clients do not receive the services they need; they, their therapists, clinics, and eventually society at large pay a heavy cost, both in terms of human suffering and money (Pekarik, 1985). 123 Meng-ning Wang, MA, a doctoral student, and Jonathan Sandberg, PhD, a faculty member in the Marriage and Family Therapy Program at Syracuse University at Syracuse University are co-first authors. Amy Zavada, MA, Tziporah Rosenberg, MA, Aaron Jeffrey, MA, and Justin McPheters, MA, are doctoral students, and Mona Mittal, PhD, and Anne Gosling, PhD, are faculty in the same program. M. Wang Æ J. Sandberg (&) Æ A. Zavada Æ M. Mittal Æ A. Gosling Æ T. Rosenberg Æ A. Jeffrey Æ J. McPheters Department of Marriage and Family Therapy, Syracuse University, 008 Slocum Hall, Syracuse, NY 13244, USA e-mail: jgsandbe@syr.edu Contemp Fam Ther (2006) 28:211–224 DOI 10.1007/s10591-006-9001-3