Understanding psychotherapy experience from the perspective of psychologist and client: An investigation of initiation, continuation, and dropout reasons using qualitative research method

Individuals sometimes may encounter psychological difficulties in their life and may need professional help resources. Although there are various psychotherapy methods that are effective in coping with the problems of individuals, the prevalence of the tendency not to apply to psychotherapy or to drop psychotherapy makes it necessary to examine the possible obstacles in the psychotherapy process. In this context, the main purpose of this research was to provide an in-depth analysis of the facts about deciding to get psychotherapy, continuing psychotherapy, and dropping out of psychotherapy from the perspective of the psychologists and the clients. For this purpose, the phenomenological approach, one of the qualitative analysis methods, was adopted as a research method. Interview technique, which is one of the qualitative data collection methods, was used. An interview form consisting of semi-structured questions was created. The sample of the study consisted of 14 psychologists (9 females and 5 males) and 16 clients (14 females and 2 males). Descriptive and content analyses of the transcriptions of the interviews were made in the MAXQDA analysis program. Research findings consisted of three parts: "Making the Decision to Get Psychotherapy", "Who Continues to Psychotherapy?" and "Who Drops Out of Psychotherapy?". The title of "Making the Decision to Get Psychotherapy" was categorized into four themes (factors positively affecting the help-seeking intention, deciding on the source of psychological help, expectations from psychotherapy, and concerns about psychotherapy). The title of "Who Continues to Psychotherapy?" consisted of three themes in the sample of clients (client dependent factors, relationship-related factors and therapeutic interventions, and environmental/external factors). In addition to these three themes, the theme of "psychologist-related factors" was found in the sample of psychologists. Both in the client sample (dropping out due to dissatisfaction, due to feeling good, due to external/environmental factors, and dropping out for economic reasons) and in the psychologist sample (client-related factors, psychologist-related factors, relationship-related factors and therapeutic interventions, external/environmental factors), four themes were found for the title of "Who Drops Out of Psychotherapy?" Accordingly, the level of psychological distress was emphasized in deciding to get psychotherapy, and it was mentioned that accessibility and stigma were effective in psychological help-seeking. While the financial burden of the psychotherapy fee was an important variable that affects the decision to get psychotherapy, continue psychotherapy, and drop out of psychotherapy; experiencing positive developments/learning new things, the client's motivation for change, and a good therapeutic alliance found to be effective in maintaining psychotherapy. Clients stated that they dropped psychotherapy due to financial reasons, dissatisfaction, and environmental factors; psychologists also mentioned the contribution of resistance and transference. The findings were discussed within the framework of the literature, and suggestions were made for the application areas.