Predictors, Processes, and Outcomes in Understanding Psychotherapy Non-Response and Dropout

Psychotherapy remains one of the most effective treatments for a wide range of psychological conditions. Yet, despite substantial progress in therapeutic models and clinical research a significant proportion of individuals do not benefit from treatment or disengage before achieving their intended goals. This presents a critical barrier to both individual well-being and broader mental health care effectiveness, prompting ongoing debate and investigation into the factors that drive these outcomes. Recent research highlights the complexity of psychotherapy engagement, and influence from psychological, interpersonal, and neurobiological perspectives. However, our understanding remains incomplete, particularly when aiming to isolate specific predictors or mechanisms that could guide targeted interventions and improve engagement in psychotherapy.

This Research Topic aims to address the predictors, processes, and outcomes related to psychotherapy non-response and dropout. It seeks to identify patterns of disengagement, client subgroups who may be at higher risk of disengagement or limited benefit, as well as investigating different factors that shape personalized therapeutic outcomes within clinical settings. The topic encourages research from psychological, behavioral, interpersonal, and neurobiological perspectives and welcomes studies that offer innovative predictive models or interventions. The goal is to explore why specific individuals or populations do not respond to psychotherapy, which mechanisms facilitate or impede engagement, and how emerging technologies might enhance prediction and prevention of dropout or non-response.

This collection welcomes a wide array of methodological approaches, including but not limited to:
• Large-scale quantitative studies and machine learning analyses aimed at improving predictive accuracy
• Qualitative investigations exploring therapist and client perspectives on psychotherapy, outcomes, and dropout
• Multimodal and integrative studies looking at psychometric, behavioral, and neuroimaging data
• Theoretical and review papers exploring psychotherapy, response and engagement processes
• Clinical trials or naturalistic studies testing interventions tailored to at-risk subgroups
• Investigations into neurobiological mechanisms underlying psychotherapy engagement and outcomes