Therapist retrospective recall impasses in long-term psychotherapy: A qualitative analysis.

Abstract

Twelve experienced therapists completed a questionnaire, and 8 of the 12 were then interviewed, about their experiences with a therapeutic impasse that ended in the termination of therapy. Data were analyzed using a qualitative methodology. Results indicated that most of the clients were anxious and depressed with personality disorders and interpersonal problems. Therapists perceived impasses as having a profound negative impact on both clients and therapists. Variables associated with impasses in a majority of the cases were a client history of interpersonal problems, a lack of agreement between therapists and clients about the tasks and goals of therapy, interference in the therapy by others, transference, possible therapist mistakes, and therapist personal issues. Implications for training, practice, and research are provided. An impasse is a deadlock or stalemate that causes therapy to become so difficult or complicated that progress is no longer possible and termination occurs (Atwood, Stolorow, & Trop, 1989; Elkind, 1992; Weiner, 1974). Impasses are typically accompanied by feelings of anger, disappointment, boredom, defensiveness, and failure on the part of either or