The present study used Consensual Qualitative Research methodology to explore how experienced therapists understand and learn from impactful cases of premature termination. Eleven board certified psychologists were interviewed regarding a former client who left treatment prematurely. Participants were asked to reflect on client and therapist factors that may have contributed to premature termination, and on how the termination affected their work and professional development. Results indicated that therapist reactions and mistakes may contribute to the risk of premature termination, and that therapists may experience complex and lasting personal reactions to such outcomes. While they may face considerable uncertainty, therapists can learn valuable lessons by reflecting on departed clients. Implications for research and practice are discussed.
Although the therapeutic alliance is an evidence-based psychotherapy element, scant literature exists on best practices for alliance-focused training. This qualitative study explored the perspectives of 10 psychotherapy alliance researchers on current and ideal alliance-centered training approaches. Data derived from interview transcripts of the proceedings of 2 semistructured discussions at professional conferences. Results indicated that most participants viewed current alliance training as unstructured, while also expressing an interest in developing a more structured, gold standard approach. Participants also highlighted the psychotherapist's role in alliance development and the importance of clinicians' personal improvement strategies. Little consensus emerged concerning barriers to ideal alliance-training practices.
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