Abstract
Objectives Sometimes, clients prematurely terminate the therapy sessions before realizing the full
benefits of psychotherapy. In the present study, we aim to investigate the factors affecting Iranian clients’
premature dropout of psychotherapy and counseling from the therapists’ perspective.
Methods This is a qualitative study conducted from September 2023 to July 2024. Participants were 31
male and female counselors and therapists working in the field of mental health in Bushehr city, south
of Iran. They were selected using a purposive sampling method until theoretical saturation was reached
in semi-structured interviews. The data were coded based on Strauss and Corbin’s grounded theory.
Lincoln and Guba’s four criteria were used to assess the trustworthiness of the data. MAXQDA software,
version 2020 was used to analyze the data.
Results From the analysis of interviews, 439 open codes were first obtained and placed in 60
subcategories. Finally, nine main categories were identified which included: 1) Lack of expertise and skill
of the therapist in psychotherapy and counseling, 2) Cognitive, motivational, emotional, and behavioral
actions of the client during the sessions, 3) Biographical factors of the client, 4) Environmental factors, 5)
Structural factors, 6) Client’s personality patterns, 7) Lifestyle, personality, and emotional characteristics
of the therapist, 8) Biographical factors of the therapist, and 9) Psychiatric medications.
Conclusion There are several factors related to both patients and therapists that affect premature dropout
from psychotherapy and counseling. The identified factors in the present study can help improve the
quantitative and qualitative level of psychotherapy in Iran and reduce the rate of premature dropout