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What Went Wrong? Therapists' Reflections on Their Role in Premature Termination

Abstract
Consensual Qualitative Research methodology was used to explore how experienced therapists understood and learned from cases of premature termination. Eleven board certified therapists participated in semi-structured interviews concerning a case of a former client who had left treatment prematurely. They offered their reflections on the client’s presentation, the structure of the treatment, successful aspects of the therapy, problems in the treatment, the process of termination, and the impact on their own professional development. Core ideas were identified in each interview, and were cross-referenced to highlight the most common experiences described by the therapists. Premature terminations resulted from multiple, concurrent problems in the treatment including client un-readiness to change, therapist mistakes, and strains in the therapeutic relationship. Therapists experienced a mixture of emotions following the termination including anger, confusion, sadness, and occasional relief. Although therapists initially described premature termination as the result of client issues and psychopathology, upon reflection they acknowledged their own contributions to the premature termination. In the end, therapists remained uncertain about why their former clients left treatment because they lacked their clients’ perspectives. Recommendations for future research and implications for clinical practice are offered.
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2010-01-01
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