Abstract
Psychotherapy is a therapeutic approach aimed at alleviating symptoms associated with mental, personality, emotional, and behavioral disorders. Numerous studies have demonstrated its effectiveness in treating various psychological conditions (Poster et al., 2021). However, in the past decade, dissatisfaction with psychotherapy has increased, leading to a higher rate of premature dropout from psychotherapy and counseling (Syan etal., 2020). Meta-analyses indicate that the prevalence of premature dropout varies significantly, ranging from 10% to 50% depending on the study context (Fernandez et al., 2015).
Premature dropout from psychotherapy and counseling can result in substantial negative consequences, particularly for clients with severe mental disorders, affecting not only their well-being but also their families and social environments. Recognizing the high prevalence of this phenomenon, researchers have sought to identify contributing factors (Kullgard et al., 2022). Studies generally categorize determinants of therapy success or failure into three primary domains: client characteristics, therapeutic methods, and therapist-related factors (Hanevik et al., 2023).
One significant factor influencing early withdrawal is client anxiety, which impacts their ability to engage effectively in therapy (Arnow et al., 2007). Highly anxious individuals often struggle with emotional instability and difficulties in forming a strong therapeutic alliance, increasing their likelihood of premature dropout (Immel et al., 2022). Additionally, concerns regarding self-disclosure can further contribute to early withdrawal. Another influential factor is low self-esteem, which has been identified as a predictor of premature dropout from psychotherapy and counseling. Clients with low self-esteem, particularly those with conditions such as eating disorders, tend to leave therapy prematurely, before achieving treatment goals (Flückiger et al., 2011). Additionally, biographical characteristi