Psychotherapy Dropout: Using the Adolescent Psychotherapy Q-Set to Explore the Early In-Session Process of Short-Term Psychodynamic Psychotherapy.
Q-analysis
adolescence
dropout
interaction structures
psychodynamic psychotherapy
treatment process
Journal
Frontiers in psychology
ISSN: 1664-1078
Titre abrégé: Front Psychol
Pays: Switzerland
ID NLM: 101550902
Informations de publication
Date de publication:
2021
2021
Historique:
received:
11
05
2021
accepted:
20
09
2021
entrez:
8
11
2021
pubmed:
9
11
2021
medline:
9
11
2021
Statut:
epublish
Résumé
Research suggests that short-term psychodynamic psychotherapy (STPP) is an effective treatment for depression in adolescence, yet treatment dropout is a major concern and what leads to dropout is poorly understood. Whilst studies have begun to explore the role of patient and therapist variables, there is a dearth of research on the actual therapy process and investigation of the interaction between patient and therapist. This study aims to address this paucity through the utilisation of the Adolescent Psychotherapy Q-set (APQ) to examine the early treatment period. The sample includes 69 adolescents aged 16-18 years with major depressive disorder receiving STPP as part of the First Experimental Study of Transference Work-in Teenagers (FEST-IT) trial. Of these, 21 were identified as dropouts and were compared to completers on pre-treatment patient characteristics, symptomatology, functioning, and working alliance. APQ ratings available for an early session from 16 of these drop out cases were analysed to explore the patient-therapist interaction structure. Results from the Q-factor analysis revealed three distinct interaction structures that explained 54.3% of the total variance. The first described a process of mutual trust and collaboration, the second was characterised by patient resistance and emotional detachment, the third by a mismatch and incongruence between therapist and adolescent. Comparison between the three revealed interesting differences which taken together provide further evidence that the reasons why adolescents drop out of therapy vary and are multidimensional in nature.
Identifiants
pubmed: 34744869
doi: 10.3389/fpsyg.2021.708401
pmc: PMC8568886
doi:
Types de publication
Journal Article
Langues
eng
Pagination
708401Informations de copyright
Copyright © 2021 Fredum, Rost, Ulberg, Midgley, Thorén, Aker, Johansen, Sandvand, Tosterud and Dahl.
Déclaration de conflit d'intérêts
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Références
Psychother Res. 2018 Sep;28(5):708-721
pubmed: 29084488
J Consult Clin Psychol. 2012 Aug;80(4):535-46
pubmed: 22663902
J Am Acad Child Adolesc Psychiatry. 2013 Aug;52(8):863-75
pubmed: 23880496
Psychol Bull. 1979 Mar;86(2):420-8
pubmed: 18839484
Trends Psychiatry Psychother. 2013;35(3):181-90
pubmed: 25923390
Cochrane Database Syst Rev. 2014 Jul 01;(7):CD004687
pubmed: 24984083
Clin Psychol Psychother. 2018 Mar;25(2):195-209
pubmed: 29057596
Child Adolesc Ment Health. 2012 May;17(2):76-85
pubmed: 32847293
J Psychother Pract Res. 2000 Fall;9(4):190-9
pubmed: 11069131
Clin Child Psychol Psychiatry. 2019 Jul;24(3):446-461
pubmed: 30400758
J Clin Psychiatry. 1998;59 Suppl 20:22-33;quiz 34-57
pubmed: 9881538
Psychother Res. 2018 Mar;28(2):235-249
pubmed: 27232208
J Pers Assess. 2020 Sep-Oct;102(5):616-627
pubmed: 31609644
Psychol Psychother. 2006 Dec;79(Pt 4):529-38
pubmed: 17312869
Braz J Psychiatry. 2013 Oct-Dec;35(4):416-31
pubmed: 24402217
Front Psychol. 2021 Apr 27;12:662671
pubmed: 33986713
J Consult Clin Psychol. 1977 Oct;45(5):954-5
pubmed: 903458
BMC Psychiatry. 2021 Feb 17;21(1):106
pubmed: 33596856
Psychother Res. 2010 Jul;20(4):423-35
pubmed: 20560091
Eur Child Adolesc Psychiatry. 2021 Feb;30(2):183-211
pubmed: 31965309
Transcult Psychiatry. 2018 Feb;55(1):3-30
pubmed: 29035137
J Am Psychoanal Assoc. 2005 Spring;53(2):541-68; discussion 569-78
pubmed: 16045166
Psychother Res. 2019 Apr;29(3):306-319
pubmed: 30526383
J Clin Psychol. 2003 Jan;59(1):133-47
pubmed: 12508337
Psychol Psychother. 2014 Mar;87(1):15-31
pubmed: 23208997
Trials. 2012 Sep 06;13:159
pubmed: 22950546
Harv Rev Psychiatry. 2005 Mar-Apr;13(2):57-70
pubmed: 16020021
J Behav Ther Exp Psychiatry. 2000 Jun;31(2):73-86
pubmed: 11132119
J Child Psychol Psychiatry. 2015 Mar;56(3):370-93
pubmed: 25496340
J Pers Assess. 1996 Dec;67(3):588-97
pubmed: 8991972
Front Psychol. 2019 Feb 05;10:75
pubmed: 30804827
J Consult Clin Psychol. 2012 Aug;80(4):547-59
pubmed: 22506792
Lancet. 2018 Nov 10;392(10159):1789-1858
pubmed: 30496104
Psychotherapy (Chic). 2008 Jun 1;45(2):247-267
pubmed: 19838318
Br J Psychiatry. 1979 Apr;134:382-9
pubmed: 444788
Am J Psychiatry. 2017 Oct 1;174(10):943-953
pubmed: 28541091
J Consult Clin Psychol. 1993 Aug;61(4):611-9
pubmed: 8370856
Front Psychol. 2021 Apr 06;12:641770
pubmed: 33889114
Clin Med (Lond). 2015 Apr;15(2):151-4
pubmed: 25824067
Psychiatry Clin Neurosci. 2012 Apr;66(3):180-6
pubmed: 22443241
J Fam Psychol. 2006 Mar;20(1):108-16
pubmed: 16569095
Arch Gen Psychiatry. 2004 Dec;61(12):1208-16
pubmed: 15583112
J Consult Clin Psychol. 2002 Aug;70(4):1051-5
pubmed: 12182269
J Behav Ther Exp Psychiatry. 2006 Sep;37(3):247-55
pubmed: 16460667
Clin Psychol Rev. 2013 Jul;33(5):698-711
pubmed: 23742782
Psychother Res. 2009 Mar;19(2):172-80
pubmed: 19396648
J Anxiety Disord. 2012 Jun;26(5):583-9
pubmed: 22440391
Psychol Med. 2003 Feb;33(2):241-51
pubmed: 12622303
Front Psychol. 2020 Jun 17;11:1243
pubmed: 32625146
J Affect Disord. 2001 May;64(2-3):203-16
pubmed: 11313087
J Nerv Ment Dis. 2000 Jun;188(6):366-71
pubmed: 10890345
Child Adolesc Psychiatry Ment Health. 2018 Jul 30;12:39
pubmed: 30069230
Psychother Res. 2018 Sep;28(5):672-684
pubmed: 27774841
Psychother Res. 2020 May 13;:1-13
pubmed: 32404003
Pediatrics. 2016 Dec;138(6):
pubmed: 27940701
Psychotherapy (Chic). 2020 Dec;57(4):471-490
pubmed: 31928023
Clin Psychol Psychother. 2017 Mar;24(2):462-474
pubmed: 27109315
Trends Psychiatry Psychother. 2019 Jul 10;41(2):128-135
pubmed: 31291411
Clin Psychol Psychother. 2010 May-Jun;17(3):231-9
pubmed: 20013760
Int J Eat Disord. 2001 Sep;30(2):138-48
pubmed: 11449447
Health Technol Assess. 2017 Mar;21(12):1-94
pubmed: 28394249
J Am Med Inform Assoc. 1997 Nov-Dec;4(6):501-10
pubmed: 9391937