BMC psychology · 2026
"The one that got away"- therapists' experiences when patients suddenly drop out from psychotherapy: a thematic analysis.
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Kullgard Niclas, Börjesson Melinda, Carlsson Johanna, Holmqvist Rolf, Andersson Gerhard
Аннотация
OBJECTIVE: The objective of the study was to examine how therapists in clinical practice experience sudden dropouts from psychotherapy.
METHOD: We interviewed 12 licensed psychotherapists regarding sudden dropouts. The interviews were analysed using thematic analysis (TA).
RESULTS: Three main themes and seven subthemes were identified. The first main theme was: Struggling to understand and explain the dropout. The subthemes were: "the patients' problem was too difficult", "trouble cooperating" and "problematic emotional bond". The second main theme was: Continuing when something is wrong. The subthemes were: "difficulties maintaining presence", "emotional withdrawal and sense of failure as a therapist". The last third main theme was: Therapists processing feelings after the dropout. The subthemes were: "doubting your own capacity", "to be abandoned", "sense of relief and lessons learned".
CONCLUSIONS: Sudden treatment dropouts often elicit negative emotions such as guilt, shame, and sorrow. They may also bring a sense of relief. Abrupt termination of therapy can affect therapists both professionally and personally, with the impact sometimes persisting long after the client has dropped out from therapy.
METHOD: We interviewed 12 licensed psychotherapists regarding sudden dropouts. The interviews were analysed using thematic analysis (TA).
RESULTS: Three main themes and seven subthemes were identified. The first main theme was: Struggling to understand and explain the dropout. The subthemes were: "the patients' problem was too difficult", "trouble cooperating" and "problematic emotional bond". The second main theme was: Continuing when something is wrong. The subthemes were: "difficulties maintaining presence", "emotional withdrawal and sense of failure as a therapist". The last third main theme was: Therapists processing feelings after the dropout. The subthemes were: "doubting your own capacity", "to be abandoned", "sense of relief and lessons learned".
CONCLUSIONS: Sudden treatment dropouts often elicit negative emotions such as guilt, shame, and sorrow. They may also bring a sense of relief. Abrupt termination of therapy can affect therapists both professionally and personally, with the impact sometimes persisting long after the client has dropped out from therapy.