CBT therapists' responses to client non-attendance and drop-out: A preliminary qualitative thematic analysis.

OBJECTIVE: Client non-attendance and drop-out are common challenges in psychotherapy, often framed as issues of client engagement. Less attention has been paid to how therapists respond to these events, particularly within cognitive behavioural therapy (CBT). This study explores CBT therapists' cognitive, emotional, and behavioural responses to client non-attendance and drop-out using qualitative methods. METHODS: CBT therapists working in NHS or private settings were interviewed using a semi-structured format. Transcripts were analysed using Braun and Clarke's thematic analysis. RESULTS: Six overarching themes were developed, detailing the personal, contextual, and systemic factors that influence how therapists respond to non-attendance and drop-out. CONCLUSION: These preliminary findings are consistent with previous literature in terms of cognitive and affective responses. A novel finding is CBT therapists' use of alternative approaches to manage their own distress. Implications for training and clinical practice are discussed.