What is it about?

Some people don’t get better or even feel worse after therapy, and some stop going before it's finished. To understand why this happens, researchers interviewed 24 patients who had a bad experience with face-to-face therapy recently. They found that certain things about therapists can make treatment less effective. These include negative traits like being inflexible or unempathetic, unprofessional behavior like violating boundaries or not keeping things private, lack of competence in understanding the problem or being too passive, and when the therapist and patient don't match well. To make therapy more successful, therapists need various skills like being good at building relationships, knowing their stuff, being ethical, and being involved. Some of the problems identified are more complicated and might take time for therapists to improve, while others are not okay in therapy, such as inappropriate behaviors. However, more research is needed to see how often these problems happen and how much they affect therapy.

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Why is it important?

This study is important because it sheds light on why some people don't benefit from psychotherapy or end their treatment too soon. By understanding what patients perceive as factors contributing to treatment failures, therapists can improve their effectiveness. Future investigations could help improve therapy practices and outcomes for patients.


This study's findings are incredibly valuable as they shine a light on an important aspect of psychotherapy: why some individuals don't benefit or prematurely end their treatment. Understanding patients' perspectives on what contributes to treatment failures is pivotal for therapists to enhance their effectiveness. This research uncovers critical issues related to therapist behavior and underscores that exploration and understanding is crucial in the ongoing quest to optimize therapy and its benefits for those in need.

Sven Alfonsson
Karolinska Institutet

Read the Original

This page is a summary of: Psychotherapist variables that may lead to treatment failure or termination—A qualitative analysis of patients’ perspectives., Psychotherapy, October 2023, American Psychological Association (APA),
DOI: 10.1037/pst0000503.
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