[Adolescent Drop-Out from Psychodynamic and Cognitive-Behaviour Psychotherapy from the Therapist's Perspective: A...

Therapy drop-outs in adolescence remain a prevalent and complex problem with inconsistent research findings: Although a number of possible predictors have been identified, such as difficult family situations and development-related autonomy efforts, the underlying mechanisms and processes are hardly explained. In this qualitative study, 24 interviews were conducted with resident child and youth psychotherapists. The therapists reported a self-chosen drop-out case from their practice. Additionally, they were asked about their views on what they consider typical for adolescent dropouts. The content analysis yielded factors relating to three topics as reasons for dropouts from the therapist's perspective. The area of therapy included themes such as setting variables or disagreement about therapy goals. The family and environment area included reasons concerning the family, e. g., lack of parental support or parents opposing therapy. Finally, reasons such as therapy being too demanding, lack of motivation or loyalty conflicts were assigned to the adolescents. To conclude, a sensitive handling seems to be necessary when trying to balance the adolescent's striving for autonomy and their therapeutic needs as well as finding the right dosage of parental involvement with parents who are often in need of treatment themselves.