Unbalancing the imbalance: a qualitative exploration of why patients drop out of psychoanalytic psychotherapy.

Similar to other therapeutic methods, the issue of patient dropout from psychoanalytic psychotherapy presents significant challenges for patients, therapists, and the overall mental health system. While quantitative studies in solution-focused therapies have often explored this issue, a more in-dept...

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Published in:Psychoanalytic Psychotherapy Vol. 39; no. 1; pp. 40 - 63
Main Authors: Jalali, Payvand, Zarani, Fariba, Panaghi, Leili, Shelby, R. Dennis
Format: Article
Published: Taylor & Francis Ltd Mar2025
Subjects:
Online Access:View this record in EBSCOhost
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      dt: Mar2025
      vid: 39
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      pub: Taylor & Francis Ltd
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        184106426
        10.1080/02668734.2024.2408249
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        atl: Unbalancing the imbalance: a qualitative exploration of why patients drop out of psychoanalytic psychotherapy.
      aug:
        au:
          Jalali, Payvand
          Zarani, Fariba
          Panaghi, Leili
          Shelby, R. Dennis
        affil:
          Department of Psychology, Shahid Beheshti University, Tehran, Iran
          Family Research Institute, Shahid Beheshti University, Tehran, Iran
          Emeritus, Institute For Clinical Social Work, Chicago, IL, USA
      su:
        United States
        Psychotherapy
        Psychotherapists
        Qualitative research
        Mental health
        Termination of treatment
        Interviewing
        Psychological adaptation
        Psychoanalysis
        Patient-professional relations
        Illegitimacy
        Psychosocial factors
        Patients' attitudes
        Nursing care plans
        Psychodynamic psychotherapy
        Long-term health care
        Descriptive statistics
        Treatment effectiveness
        Experimental design
        Thematic analysis
        Patient dropouts
        Mathematical models
        Research methodology
        Theory
        Patient decision making
        Therapeutic alliance
        Grounded theory
      sug:
        subj:
          Psychotherapy
          Psychotherapists
          Qualitative research
          Mental health
          Termination of treatment
          Interviewing
          Psychological adaptation
          Psychoanalysis
          Patient-professional relations
          Illegitimacy
          Psychosocial factors
          Patients' attitudes
          United States
          Offices of Mental Health Practitioners (except Physicians)
          Nursing care plans
          Psychodynamic psychotherapy
          Long-term health care
          Descriptive statistics
          Treatment effectiveness
          Experimental design
          Thematic analysis
          Patient dropouts
          Mathematical models
          Research methodology
          Theory
          Patient decision making
          Therapeutic alliance
          Grounded theory
      keyword:
        grounded theory method
        psychoanalytic psychotherapy
        psychodynamic psychotherapy
        treatment dropout
        unilateral termination
        grounded theory method
        psychoanalytic psychotherapy
        psychodynamic psychotherapy
        treatment dropout
        unilateral termination
      ab: Similar to other therapeutic methods, the issue of patient dropout from psychoanalytic psychotherapy presents significant challenges for patients, therapists, and the overall mental health system. While quantitative studies in solution-focused therapies have often explored this issue, a more in-depth understanding can be gained by approaching it qualitatively within the framework of long-term, open-ended psychoanalytic psychotherapy. Eleven patients and four therapists with direct experience of dropout participated in twenty-six in-depth interviews, guided by Corbin and Strauss's grounded theory methodology. The analysis identified the central theme of dropout as a 'departure from the imbalanced binary system', which includes contextual, action-interaction, and consequence categories. The conceptual model underscores key factors contributing to dropout, encompassing both cross-theoretical elements such as the therapeutic alliance and coping strategies, and more specific factors like perceptions of psychoanalytic therapy's legitimacy in a specific culture and patients' beliefs about its effectiveness as a therapeutic approach. These findings provide valuable insights into the complex nature of treatment dropout, offering important clinical and scientific implications.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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