# “The one that got away”- therapists’ experiences when patients suddenly drop out from psychotherapy: a thematic analysis

## TL;DR

This study explores how therapists feel when patients suddenly stop therapy, revealing emotional impacts and challenges in understanding the reasons.

## Contribution

The study provides new qualitative insights into therapists' emotional and professional responses to sudden patient dropouts.

## Key findings

- Therapists often struggle to understand the reasons behind sudden dropouts.
- Negative emotions like guilt and sorrow are common, but some therapists also feel relief.
- The impact of dropouts can persist long after the patient leaves therapy.

## Abstract

The objective of the study was to examine how therapists in clinical practice experience sudden dropouts from psychotherapy.

We interviewed 12 licensed psychotherapists regarding sudden dropouts. The interviews were analysed using thematic analysis (TA).

Three main themes and seven subthemes were identified. The first main theme was: Struggling to understand and explain the dropout. The subthemes were: “the patients’ problem was too difficult”, “trouble cooperating” and “problematic emotional bond”. The second main theme was: Continuing when something is wrong. The subthemes were: “difficulties maintaining presence”, “emotional withdrawal and sense of failure as a therapist”. The last third main theme was: Therapists processing feelings after the dropout. The subthemes were: “doubting your own capacity”, “to be abandoned”, “sense of relief and lessons learned”.

Sudden treatment dropouts often elicit negative emotions such as guilt, shame, and sorrow. They may also bring a sense of relief. Abrupt termination of therapy can affect therapists both professionally and personally, with the impact sometimes persisting long after the client has dropped out from therapy.

The online version contains supplementary material available at 10.1186/s40359-026-03958-z.