Dropouts, unsuccessful therapies, and other 'stumbles' in systemic therapy.

Abstract

Within the systemic and broader psychotherapy community, there is a lack of discussion on unsuccessful therapies and patients leaving treatment prematurely, despite these being common experiences for psychotherapists. This paper aims to encourage reflecting on therapists and families' experiences of failure and dropouts, by discussing the book edited by  Alessia Cuccurullo and Federica Visone (2023), titled "Failure in psychotherapy. A systemic-relational perspective in therapy and training" (original title: “Il fallimento in psicoterapia. Una prospettiva sistemico-relazionale tra clinica e formazione”).  Definitions and prevalence of failure and dropout are examined with reference to international literature, along with an exploration of factors and clients' viewpoints on these occurrences. Moreover, the relationship between therapeutic alliance and dropout is addressed. A few clinical vignettes are commented, in the effort to highlight the complexity of these issues and how different narratives of failure or success might arise regarding the same therapy.