Long-term Group and Premature Drop out Group in Psychotherapy: Therapist’s Technique


  • boonyawee Senaboonyarit instructor


Long-term Group, Premature drop out, Therapist’s technique


Premature drop out of the group members, even with well-chosen members, is an inevitable issue in long-term group psychotherapy. It is shown that 20-60% of members usually leave the group during sessions 12 to 20. As a consequence, these immature terminations absolutely impact on the equilibrium of long-term group psychotherapy. It is challenging for psychotherapist to handle this problem in group process.  Therefore, psychotherapist should have professional characteristics include the observation skills, listening skills, perception and translation of clients’ behaviors in group. In addition, therapist need to have experiences and skills to apply therapeutic techniques such as “here and now”, therapist’s self-disclosure, catharsis, interpretation, altruism, and existential factors, and making hope. Professional therapist is also required to draw out the potential of members in group for helping each other. An effective psychotherapist does not only reduce the impacts of premature drop out in long-term group but also promote personal development of each member in group processs.


Download data is not yet available.


ทินกร วงษ์ปการันย์. (2552) จิตบำบัด: ทฤษฎีและเทคนิค. เชียงใหม่: เชียงใหม่โรงพิมพ์แสงศิลป์.

Abramowitz, S.I., & Jackson, C. (1974). Comparative effectiveness of there-and-then versus here-and-now therapist interpretations in group psychotherapy. Journal of Counseling Psychology, 21(4), 288–293. Retrieve from https://doi.org/10.1037/h0036719

Alonso, J.T. (2011). Cohesion’s relationship to outcome in group psychotherapy: A meta-analytic review of empirical research. (Doctoral dissertations, Brigham Young University, Provo, Utah, United States). ScholarsArchive. BYU Brigham Young University. Retrieved from https://scholarsarchive.byu.edu/etd/2658

Anderson, K.N. (2015). Premature Termination of Outpatient Psychotherapy: Predictors, Reasons, and Outcomes. (Doctoral dissertation, The University of Nebraska–Lincoln, USA). ProQuest Dissertations and Theses database. Retrieved from http://www.digitalcommons.unl.edu.

Anthony, M.T. & Jacob, A. F., Ryan, J. M., Yossef, S.B. (2015). Marek RJ, Ben-Porath YS, Van Dulmen MH. Premature termination from psychotherapy and internalizing psychopathology: The role of demoralization. J Affect Disord.,174, 549-555. doi.org/10.1016/j.jad.2014.12.018.

Barrett MS, Chua W-J, Christoph PC, Gibbons MB, Casiano D, Thompson D. (2009). Early withdrawal from mental health treatment: Implications for psychotherapy practice. Psychotherapy (Chic), 45(2):247-67.

Batch, A. (2018) Dropout in Group Therapy: Causes and prevention strategies. (Master’s thesis, The City University of Seattle, USA). Library & LRC CityUniversity of Seattle. Retrieved from http://www.repository.cityu.edu.

Bhikkhu B. (2001). Conditionality. Bangkok: Sukkapabjai.

Cooper, A.A., ConKlin, L.R. (2015). Dropout from individual psychotherapy for major depression: A meta-analysis of randomized clinical trials. Clin Psychol Rev 40, 57-65.

Donelson, R. F. (2017). Group dynamic (7th ed.). Boston: Cengage.

Duff, C.T. & Bedi, R. P. (2010). Counsellor behaviours that predict therapeutic alliance: From the client’s perspective. Counselling Psychology Quarterly, 23(1), 91-110.

Ghazaleh, S., Jalal, Y., Ahmad, B., & Shahla A. (2012). The effectiveness of group hope therapy on hope and depression of mothers with children suffering from cancer in Tehran. Iran J Cancer Prev, 5(4), 183-188.

Gregory, E.S., Victoria D., Rebecca H., Paul F., Evette L., Leo M., Belinda O., & James S. (2012). Early Dropout from Psychotherapy for Depression with Group- and Network-model Therapists. Adm Policy Ment Health and Ment Health Research, 39(6), 440-447.

Jensen, H.H., Mortensen, E.L., Lotz, M. (2014). Drop-out from a psychodynamic group psychotherapy outpatient unit. Nord J Psychiatry 68(8), 594-604. doi: 10:3109/08039488.2014.902499

Howard, B.R. (2000). Adverse outcomes in group psychotherapy: Risk factor, prevention, and research directions. J Psychother Pract Res, 9(3), 113-122.

Jan, V.B., Therasa, W., Ole, K., & Steinar, L. (2013). Development of group climate in short and long term psychodynamic group psychotherapy. International Journal of Group Psychotherapy, 63(3), 366-393.

Jensen, H.H., Mortensen, E.L., & Lotz, M. (2014). Drop-out from a psychodynamic group psychotherapy outpatient unit. Nord J Psychiatry, 68(8), 594-604.

Joshua, K. S. & Roger, P.G. (2015). Premature termination in psychotherapy: Strategies for engaging clients and improving outcomes. Washington DC: American Psychological Association.

Kivlighan, D.M. (2014). Three important clinical process in individual and group interpersonal psychotherapy sessions. American Psychological Association, 51(1), 20-24.

Koukourikos, K. & Pasmatzi, E. (2014). Group psychotherapy in psychotic patients. Health Science Journal, 8(3), 400-408. Retrieved From http://www.researchgate.net.

Knox, S. & Hill, C.E. (2003). Therapist self-disclosure: Research-based suggestions for practitioners. Journal of Clinical Psychology, 59(5), 529-539.

Lorentzen, S., Bakali, J. V., Hersoug, A.G., Ruud, T. & Hoglend, P. (2012). Psychodynamic group psychotherapy: Impact of group length and therapist professional characteristics on development of therapeutic alliance. Clinical Psychology & Psychotherapy, 19(5), 420-433.

Marmarosh, C. L., & Sproul, A. (2021). The psychology of groups: Group cohesion: Empirical evidence from group psychotherapy for those studying other areas of group work. Washington, DC: American Psychological Association.

Matthias, E., & Alf, G. (2014). Psychoanalytic psychotherapy: A hand book. New York: Karnac Books.

Martha, S. (2016). How does psychotherapy work. International psychotherapy institute. United States of America. Retrieved From http://www.ijp.org.uk.

Pingitore, F.R.B. (2015). Exploring the experiences of adolescents participating in interpersonal group psychotherapy. (Doctoral dissertation, The University of Rhode, Island.) Retrieve from http://core.ac.uk/download/pdf/56697369

Piper, W.E., Joyce, A.S., Weideman, R. & Rosie, J.S. (2007). Group composition and group therapy for complicated grief. Journal of Consulting and Clinical Psychology, 75(1), 116-25.

Riches, S., Schrank, B., Brownell, T., Slade, M., & Lawrence, V. (2020). Therapist self-disclosure in positive psychotherapy for psychosis. Clinical Psychology Forum, 2020 (327), 14-21. Retrieved from https://nottingham-repository. worktribe.com/output/3776787

Roos, J. & Werbart, A. (2013). Therapist and relationship factors influencing drop out from individual psychotherapy: a literature review. Psychotherapy Research, 23(4), 394-418.

Rutan, J.S., Walter, N.S. & Joseph, J.S. (2007). Psychodynamic group psychotherapy: Therapeutic factor in group psychotherapy. (4th ed.). New York: Guilford.

Sanaa, A., Samir A., Mona R, Salwa E., & Rania M. (2010). Therapeutic factor ingroup psychotherapy: A study of Egyptian drug addicts. Journal of group in addiction & recovery 5(3-4), 194-213.

Senaboonyarit, B. (2013). Learner’s awareness of Yalom’s therapeutic factors in group psychotherapy demonstration of the Thai association psychotherapists. J Psychiatr Assoc Thailand; 58(2), 197-206.

Senaboonyarit, B. & Chaowasilt, P. (2015). The Yalom’s therapeutic factor using in long term group psychotherapy after premature drop out: pilot study: Proceedings of International Symposium on Social Sciences and Management Conference (pp.494-500) Tokyo, Japan.

Senaboonyarit, B. (2016) Long-term Group and Premature Drop out Groups in Psychotherapy: Yalom’s ‘Here and Now’ Techniques. Universal Journal of Psychology, 4(5), 215-221.

Sharf, J., Primavera, L. H., & Diener, M. J. (2010). Dropout and therapeutic alliance: A meta-analysis of adult individual psychotherapy. Psychotherapy: Theory, Research, Practice, Training, 47(4), 637-645.

Sharon, Ziv-B., Giora, K., Elad, L., Patrick, S. M., & Golan S. (2016). Immediate therapist self-disclosure bolsters the effect of brief integrative psychotherapy on psychiatric symptoms and the perceptions of therapists: A randomized clinical trial. Psychotherapy Research, 27(5), 1-13. Retrieved from: http://dx.doi.org/10.1080/10503307

Shedler, J. (2010). The efficacy of psychodynamic psychotherapy. America Psychological Association, 65(2), 98-100.

Sue, A.E. (2009). Therapeutic factors in group counseling: Implications for audiologic rehabilitation. Perspectives on Aural Rehabilitation and Its instrumentation, 16 (1), 15-28.

Therapistaid.com (2016). Dealing with dropout: client retention. Retrieved from http://www. Therapistaid. Com/therapy-guide/client-dropout.

Walter, V., & Maarten, V. (2009). Let eating disorder patients decide: Providing choice may reduce early drop-out from inpatient treatment. Eur Eat Disord Rev, (17)3, 177-183. doi: 10.1002/erv.917.

Wheeler, K. (2014). Psychotherapy for the advanced practice psychiatric nurse: how to guide for evidence based practice. USA: Spinger.

Winger, S.J. (2010). Hope: The essential therapeutic factor. (Master’s thesis), The Adlerian Counseling and Psychotherapy, USA). Retrieved from http://www.alfredadler.edu.

Yalom, I.D., & Leszcz M. (2005). The theory and practice of group psychotherapy. (5th ed.) New York: Basic Books.



How to Cite

Senaboonyarit, boonyawee. (2021). Long-term Group and Premature Drop out Group in Psychotherapy: Therapist’s Technique. Journal of Nursing, Siam University, 22(42), 97–107. Retrieved from https://he01.tci-thaijo.org/index.php/nursingsiamjournal/article/view/249497