A qualitative exploration of therapists’ experiences as clients who prematurely terminated their therapy in England
AuthorsBonsmann, Christine F.
AdvisorsGubi, Peter M.
MetadataShow full item record
AbstractThis qualitative study explored experiences of prematurely terminating adult individual therapy from the perspectives of therapists as clients in England. The aims of the study were to gain an overview of the experience of prematurely terminating therapy; to understand the experience of dissatisfaction when this is given as a reason for prematurely terminating therapy; and to inform and thus help improve practice. Rates of premature termination from counselling and psychotherapy remain high despite a considerable body of research into possible predictors of this phenomenon. Few studies have explored clients’ experiences of premature termination in depth. Clients often report dissatisfaction as a reason for premature termination, and this experience is under-researched. From practitioners’ perspectives, little is known about indicators of dissatisfaction, and how to manage premature termination if it occurs. The study was conducted in two stages. The purposeful sample were therapists who, as clients, prematurely terminated personal therapy after attending at least two sessions. Participants self-selected as having prematurely terminated therapy. Stage one used an online qualitative survey to gain an overview of participants’ experiences of premature termination, and the 40 usable responses were analysed inductively using thematic analysis. The survey was used to recruit participants for stage two. In stage two, six semi-structured interviews were carried out with participants who had prematurely terminated therapy for reasons of dissatisfaction. The data were analysed using interpretative phenomenological analysis. Overall, the major themes created were: feeling dissatisfied; client becomes unable to continue therapy; and communication about the premature termination. The findings confirm the importance of the working alliance in therapy, and illuminate how the alliance failed to develop in experiences of dissatisfaction. It is argued that understanding clients’ experiences could enable practitioners to recognise the presence of dissatisfaction, and adapt therapy, if appropriate, to minimise avoidable premature termination. The need for therapy to ‘add value’ was also identified. The findings indicate a failure by some therapists to act in a relational way when clients prematurely terminated therapy, thereby disrupting the dominant discourse about the importance of the therapeutic relationship. Clients’ needs at the point of premature termination were identified. The findings of this study are not generalisable but may be transferable. The study concludes that therapists’ management of how therapy ends is just as important as the management of how it begins, regardless of how it ends. This has implications for practice and training. Areas for further research are identified.
CitationBonsmann, C. F. (2016). A qualitative exploration of therapists’ experiences as clients who prematurely terminated their therapy in England. (Doctoral dissertation). University of Chester, United Kingdom
PublisherUniversity of Chester
TypeThesis or dissertation
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