Clients' Reasons for Dropping Out of Therapy: A Qualitative Study

Abstract

Aim

There has been limited research on therapy attrition from the perspective of clients who terminate. This qualitative study addresses the question, why do clients choose to terminate therapy prematurely?

Method

Twelve participants who had chosen to end in-person individual therapy were interviewed.

Findings

The most common reason for terminating was experiencing invalidation from the therapist, including not feeling heard, feeling dismissed and judged and not feeling valued. Another type of invalidation experienced was therapists' microaggressions on client identities of race, culture and sexual orientation. Inadequate problem-solving in therapy, through oversimplification of problem-solving or not receiving guidance for change, was another common reason for dropout.

Discussion

Understanding the perspectives of clients who have been dissatisfied with therapy is useful for identifying therapist behaviours that can cause ruptures. Clinicians can learn from clients' negative experiences in therapy in order to improve clinical practice.