R.SAMBASIVAM1, E.SEOW1, S.CHANG1, M.SUBRAMANIAM1, J.A.VAINGANKAR1
Institute of Mental Health1
Psychotherapy service covers a broad range of techniques and approaches that can produce long lasting improvements in the mental health of clients. In this study we examined clients’ experiences pre, during and post therapy using a qualitative design to explore specific reasons for premature termination of outpatient psychotherapy.
In-depth interviews were conducted with 15 participants undergoing outpatient psychotherapy at a tertiary psychiatric hospital. Interview topics included experiences around reasons for seeking psychotherapy, elements of therapeutic process that clients found helpful or obstructive, and current perceived change after receiving psychotherapy. All interviews were audio-recorded and transcribed verbatim. Thematic analysis, adopting an inductive approach, was conducted to identify patterns and derive meaning within the data. A codebook was constructed, and inter-rater Cohen’s kappa coefficient was established to be 0.83.
Mental health stigma and poor understanding of psychotherapy came up as initial barriers to one seeking psychotherapy. In addition, affordability and availability of service impeded service use, while preference for non-pharmacological intervention was regarded as a key advantage. Facilitators of therapeutic alliance covered themes such as therapist attributes, application of techniques and matching of evidence-based treatment modalities with clients’ preference. Others, in post-therapy, recognised the value of being in therapy to enhance symptoms recovery and control.
The study highlighted that the overall psychotherapy experience (pre, during and post), plays an important role in facilitating the client’s decision to start and continue therapy and gain benefits post-therapy. This information can help to address common barriers and further enhance the effectiveness of psychotherapy.