Dropout and narcissism: an exploratory research about situational factors and personality variables of the psychotherapist

The premature interruption of psychotherapeutic treatments is a significant phenomenon, with rates that can be above 50%, although differences emerge among studies. In general, the variables related to the psychotherapists have a significant effect on the treatment and a greater extent than the situational variables. In this study a multi-method research has been conducted to test the situations of impasse ending in dropout and the relationship between these situations and the covert narcissistic dimension of the therapist. Each participant was administrated the Impasse Interview, asking the therapist to focus on a salient or recent dropout case, and the Hypersensitive Narcissism Scale. The linguistic analysis of the interviews carried out with T-Lab produced 4 thematic clusters. Furthermore, as for the covert narcissistic dimension, 11 therapists reported a score below the average (Group A) and 9 scoring in the average (Group B). Finally, the association between the four clusters and the two groups of therapists was investigated. The therapeutic alliance and the emotional reaction of the therapist, influenced by his narcissistic dimension, represent key variables for the outcome of the therapy.