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July 1959

Some Difficulties of Psychotherapeutic Practice

Author Affiliations

From the Division of Neuropsychiatry, Michael Reese Hospital.

AMA Arch Gen Psychiatry. 1959;1(1):3-6. doi:10.1001/archpsyc.1959.03590010019002

In recent years some attention has been focused on the long-neglected problem of patients turning down the recommendation of psychotherapy or dropping out of treatment after a few visits. Aside from Freud’s dictum that his initial difficulties in persuading patients to undergo psychoanalysis were succeeded in later years by an equal problem in inducing them to leave, this question has aroused little interest. A paper by Frank, Gliedman, and others1 stressed various significant attributes of the patients as the crucial determinants governing their staying in therapy. These patients presented good evidence that poorly motivated and severely ill patients are less likely to stay. Kohrman and co-workers2 came to similar conclusions in a study awaiting publication. Katz and Solomon3 concluded that patients who continue treatment are aware their problems are psychological and can communicate this, that continuation of therapy depends on attributes of both