Hindering events in psychotherapy with adolescents: A retrospective investigation of patients' recollection

Background: Adolescents often drop out of psychotherapy, with research indicating that almost half of adolescents abandon therapy prematurely. Authors have recommended that, in order to increase engagement and prevent dropout, it is important for clinicians to manage and maintain the therapeutic setting and the relationship. Objective: This study was designed to investigate the impact of events that hinder the therapeutic alliance in psychotherapy with adolescents, with attention to the adolescents' experiences of these events, how such events were managed within the therapeutic relationship and consequences for the course of treatment. Methods: Semi-structured interviews were conducted with adolescents and young adults who experienced negative events during their treatment. Results: Following a structured thematic analysis, four main domains of hindering events were identified: (a) the nature of problems; (b) subjective experience; (c) response to the events; and (d) consequences of these events. Conclusion: While there were some similarities between hindering events in adult psychotherapy and that undertaken with adolescents, findings indicate that working with adolescents presents specific challenges associated with limited independence that is typical of this stage of life, and this has implications for clinical practice.