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Understanding non-response in psychotherapy: A meta-synthesis
Bethany Carrington1, Rebecca Yeates1, Ciara Masterson1
1Leeds Institute of Health Sciences, University of Leeds, Leeds, UK.
Clinical Psychology Review
|September 13, 2024
Summary
Psychotherapy nonresponse affects both clients and therapists, involving difficulties in connection and openness. This experience can be harmful, highlighting the need for qualitative outcome measures.
Area of Science:
- Psychology
- Psychotherapy Research
- Qualitative Research
Background:
- Limited research exists on psychotherapy nonresponse.
- Focus has been on negative outcomes, overlooking nonresponders.
- This study addresses client and therapist experiences of nonresponse.
Purpose of the Study:
- To synthesize qualitative evidence on client and therapist experiences of psychotherapy nonresponse.
- To explore the multifaceted nature of nonresponse in psychotherapy.
- To propose a model of psychotherapy nonresponse.
Main Methods:
- Qualitative evidence synthesis.
- Searched seven databases for qualitative studies on nonresponse.
- Thematic synthesis of 24 included studies.
Main Results:
- Identified six client themes (e.g., Hopes and fears, Disconnected relationship) and four therapist themes (e.g., High expectations, Experiencing a disconnect).
- Client themes included "Therapy was not worth the investment."
- Therapist themes included "Feeling threatened."
Conclusions:
- A model of psychotherapy nonresponse is proposed.
- Nonresponse involves difficulties in connection and openness for both parties.
- Nonresponse is not an absence of effects but a range of potentially harmful experiences, especially for clients.
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