Why Patients Leave Psychotherapy

Introduction Psychotherapy is assumed to be the treatment of choice for most psychiatric outpatients; yet the demand for it far exceeds the supply of psychotherapists. Neither the upsurge of new pharmacological agents, whose chief value in outpatient work seems to be to facilitate psychotherapy,1nor expanded training programs can bridge this gap in the foreseeable future. For this very practical reason, as well as for many theoretical ones, every effort must be made to deepen our understanding of the processes of psychotherapy so as to increase the efficiency of current psychotherapeutic procedures and perhaps discover more effective ones. In order to do this, a valid appraisal of current procedures is a prerequisite. Since the response to psychotherapy depends on the interaction of a particular person with a particular situation, this appraisal can be approached from two directions. One, which has received the most attention, is to describe the attributes