The core of her argument is a structural one. Psychodynamic teaching, in many programs, is concentrated in outpatient psychotherapy clinics, where patients are stable and carefully selected for suitability. That placement is valuable for learning psychotherapy as a treatment modality, but it carries a hidden message: psychodynamic thinking matters only when you are conducting psychodynamic psychotherapy. Everything else—emergency calls, inpatient rounds, consultation-liaison work—appears to belong to a different, more scientific psychiatry. The result is a perceived split between the biological and the psychological that residents internalize early, and that curricula inadvertently reinforce by the geography of their own schedules.

Gorun contends that this split is illusory. Acute care settings, she argues, demand psychodynamic concepts just as much as the consulting room does. Understanding unconscious meaning, defenses, attachment patterns, transference and countertransference can help a psychiatrist make sense of crises, ruptures in the therapeutic alliance, impasses over medication, conflicts within the treatment team, and the varied ways patients respond to hospitalization or to a new diagnosis. On an inpatient unit, a patient’s sudden hostility toward a resident or an inexplicable refusal of medication may be legible only when read through these lenses. The psychodynamic framework, in this view, is not a niche skill reserved for selected cases but a general-purpose interpretive instrument for all of clinical psychiatry.

The timing of instruction matters as much as its location. Gorun proposes introducing psychodynamic principles in the first two postgraduate years, precisely when residents are caring for the most acutely ill patients and are most likely to be flooded by intense emotional reactions. Demoralization, helplessness, anger, rescue fantasies and avoidance are among the experiences she names—reactions that residents often interpret as personal failings or as evidence of unprofessionalism. When supervisors model how countertransference can be used as clinical information rather than suppressed as embarrassment, residents gain a vocabulary for experiences that otherwise feel isolating. Framing these reactions as data about the patient and the relationship, rather than as noise to be managed, may also reduce shame and burnout, a claim with obvious appeal in a profession struggling with trainee wellbeing.

Attitudes, however, are not shaped by timing alone. Gorun draws on Gabbard’s earlier warnings about how psychotherapy should not be taught: in ways that devalue other modalities, lean on jargon, separate psychotherapy from the rest of psychiatry, or handle the research evidence poorly—either neglecting it or overemphasizing it at the expense of clinical usefulness. Her prescription is to lead with the evidence base. Psychodynamic psychotherapy is an empirically tested treatment, and residents should learn early which patient groups benefit most, including those with complex or chronic depression, histories of childhood trauma, or comorbid personality disorders. Presenting psychodynamics as a modality with defined indications, rather than an unfalsifiable worldview, directly addresses the common assumption that it is not evidence-based.

A further barrier is the perception that psychodynamics is outdated and socially narrow. Some residents arrive in training believing it is unhelpful and inaccessible to patients from certain socioeconomic backgrounds. Gorun responds that the field’s contemporary landscape is considerably broader than its stereotype: community psychoanalysis has developed in recent years, and short-term, manualized, problem-focused psychodynamic psychotherapies have brought structure and brevity to a tradition once associated with open-ended treatment. Teaching this range of applications, she argues, is part of correcting the impression that psychodynamic work belongs only to a particular class of patient or a particular kind of practice.

The most substantive revision she proposes concerns theory itself. Contemporary psychodynamic theories describe how discrimination and structural inequalities contribute to symptom formation. Relational psychoanalytic theories emphasize that treatment always unfolds within a social and cultural context, and that the identities of both therapist and patient can powerfully influence what happens between them. Armed with this background, residents can examine—with what Gorun calls humility and curiosity—how a patient’s perception of similarities or differences in race, gender, sexuality or class, together with the resident’s perceived position of authority, shapes the therapeutic relationship. Exploring these dynamics openly with the patient, rather than leaving them unspoken, becomes a practical route to stronger alliances.

Gorun also addresses the discipline’s history directly. She notes that there is evidence the failure to acknowledge sociocultural bias within psychodynamic theory has turned promising residents away from engaging with the field altogether. Confronting that history, rather than defending against it, is presented as a necessary condition for recruiting a new generation of clinicians. She extends the point to systems: racialized dynamics in groups and institutions inevitably surface in training clinics, and a psychodynamic lens can help make them speakable, turning uncomfortable observations into opportunities for active change rather than silent attrition.

The argument, taken whole, is less a defense of classical doctrine than a rebranding of an interpretive method. What Gorun asks educators to do is make psychodynamic relevance visible: integrate psychodynamic formulation across every clinical setting rather than ghettoizing it in the psychotherapy clinic, teach concepts in experience-near language instead of technical jargon, tie theory to the real clinical dilemmas residents face with complex and challenging patients, and present contemporary theories that deepen understanding of identity and social context in the treatment relationship. Framed this way, psychodynamics becomes two things at once—a practical clinical lens that strengthens residents’ relationships with their patients, and an essential analytic tool embedded in formulation and treatment. Whether the reframing succeeds will depend on whether programs are willing to move the subject out of the clinic and into the emergency room, the inpatient ward and the supervision hour where residents actually live. The correspondence, published on 31 August 2026, arrives as a pointed challenge to the assumptions embedded in psychiatric curricula worldwide.

Subject of Research: Integrating psychodynamic concepts into contemporary psychiatry residency training

Article Title: Reframing Psychodynamics for Contemporary Psychiatry Training

Article References: Reframing Psychodynamics for Contemporary Psychiatry Training. (n.d.). https://doi.org/10.1007/s40596-026-02426-5

Image Credits: AI Generated

DOI: 10.1007/s40596-026-02426-5

Keywords: psychodynamics, psychiatry residency, psychotherapy training, countertransference, biopsychosocial formulation, therapeutic alliance, relational psychoanalysis, medical education, evidence-based psychotherapy, trainee burnout, cultural bias, acute care psychiatry

The study, conducted by Marcelo Leonel Peluso, Angela Donato Oliva, and Luiz Fellipe Dias da Rocha at the State University of Rio de Janeiro, describes the construction and content validation of the Therapist Communication Skills Inventory – Patient Version, abbreviated in Portuguese as the IHCT-P. Rather than asking therapists to rate themselves or relying on expert observers watching recorded sessions, the instrument puts the evaluation in the hands of the people with the most ecologically valid vantage point: the patients themselves. This choice reflects a growing consensus in the field that patient reports are less biased than therapist self-perceptions or observer judgments, particularly when the goal is to understand the interpersonal fabric of therapy.

The theoretical foundation of the work rests on the concept of social skills, and more specifically communication skills, which psychologists define as the linguistic and paralinguistic behaviors that make clear, positive, and attuned interpersonal relationships possible. The researchers adopt a competence-based view of psychotherapy, one that sees effectiveness not as loyalty to a theoretical tradition but as the therapist’s ability to enact specific, observable interpersonal behaviors that facilitate change. Within this framework, communication skills are not a stylistic flourish; the authors argue they are foundational mechanisms of therapeutic action, tied to the strength of the therapeutic alliance, the expression of empathy, and ultimately to treatment outcomes.

To give the construct a measurable structure, the team organized therapist communication skills into three dimensions. Verbal skills cover the therapist’s choice and structuring of words: asking and answering questions, requesting and providing feedback, opening and closing sessions, and making empathic verbalizations. Non-verbal skills encompass facial expressions, posture, gestures, eye contact, and other bodily cues that signal presence and emotional resonance. Paraverbal skills, the third dimension, involve the features of speech that sit outside the literal content: tone, pace, volume, rhythm, latency, and fluency. These channels are distinct but complementary, and empirical work on clinical communication has consistently treated them as separable yet interacting routes through which therapists convey attunement and intent.

The construction of the inventory began with a narrative review of the literature, drawing on Portuguese and English-language books and articles indexed in SciELO and Google Scholar, searching for concepts linking communication, skills, and therapy while excluding work focused on patient-directed communication or non-clinical settings. From seven reviewed sources, the authors identified recurring skill clusters and translated them into items. The preliminary version of the IHCT-P contained 40 items, with 17 covering verbal skills, 13 covering non-verbal skills, and 10 covering paraverbal skills. Each item then went through internal discussion among the authors regarding clarity, spelling, length, adequacy, and scope before facing external scrutiny.

That scrutiny came in two phases. In the first, five professionals with clinical and empirical expertise in the topic evaluated every item on three criteria: language clarity, practical pertinence, and theoretical relevance, each rated on a five-point scale. The researchers computed a Content Validity Coefficient for each criterion, applying a widely used threshold requiring values above 0.8. The results were strong across the board: 0.945 for practical pertinence, 0.930 for theoretical relevance, and 0.927 for language clarity. Even so, the judges’ comments drove substantial refinement. Three items were cut, fourteen were revised to sharpen clarity and precision, and two new items were added, leaving the instrument with 39 items. For its response format, the judges unanimously favored a five-point Likert scale ranging from ‘it does not apply at all’ to ‘it applies almost all the time.’

The second phase tested whether ordinary people, including those with limited formal education, could actually understand what the items were asking. Thirty adult participants, evenly split between women and men and aged between 19 and 42, with an average age of 28.3, assessed each item for clarity and comprehension rather than answering it. Here the coefficients were even higher: 0.980 for language clarity and 0.981 for comprehension. No items were removed at this stage, though three items fell below a 90 percent approval threshold on the need for change and were reworked in line with participants’ suggestions, while two others were modified based on feedback from both phases. The instrument’s instructions, rated at the maximum for both language and understanding, survived unchanged. The study received ethics approval from the State University of Rio de Janeiro, and informed consent was obtained from all participants.

The authors are candid about the limitations of what they have built. Although the scale was designed to be usable by people with lower educational attainment, the pilot sample was predominantly well-educated, with 63.3 percent holding complete higher education, a mismatch that could limit generalizability. Patient-reported measures also inherit the quirks of the respondent: individuals with personality disorders may struggle to form a stable alliance, coloring their judgments of the therapist’s communication, and the stage of therapy at assessment may shape perceptions. To blunt these biases, the team plans to have at least two patients per therapist complete the questionnaire in future studies, averaging out idiosyncratic views.

Why does this matter beyond psychometrics? The researchers position the IHCT-P as a practical tool with several clinical applications. Therapists can use it for self-assessment by inviting patients to complete it, gaining a window into how their communication actually lands with each individual. Because the instrument itself models a core communication skill, requesting feedback, its use reinforces collaborative empiricism and gives patients a structured, potentially less intimidating channel for critical or negative feedback than face-to-face conversation. In psychotherapy supervision, particularly during clinical internships, the scale can help trainees monitor their own practice and help supervisors spot gaps, while its items can serve as prompts for reflective discussion. It could also anchor intervention studies, since social skills training programs typically require pre- and post-intervention measurement to demonstrate gains.

The work is explicitly a first step rather than a finished product. The authors state that upcoming studies will pursue additional sources of validity evidence under the Standards for Educational and Psychological Testing, including exploratory and confirmatory factor analyses of the internal structure, convergent and divergent validity against established measures of therapeutic alliance and outcomes, and internal consistency and test-retest reliability. They also plan to develop and validate a therapist-report version, enabling comparisons between how therapists see themselves and how patients perceive them. Those studies are already underway, with completion expected within 18 to 24 months. If they succeed, the field will gain something it has long lacked in Brazil: a validated, patient-centered yardstick for one of the quiet but decisive ingredients of effective psychotherapy, the everyday communicative craft of the person in the therapist’s chair.

Subject of Research: Development and content validation of a patient-report psychometric inventory assessing therapists' communication skills in psychotherapy.

Article Title: Therapist’s Communication Skills Inventory – Patient Version: Construction and Content Validity

Article References: Peluso, M. L., Oliva, A. D., & Rocha, L. F. D. D. (2026). Therapist’s Communication Skills Inventory – Patient Version: Construction and Content Validity. Trends in Psychology. https://doi.org/10.1007/s43076-026-00531-w

Image Credits: AI Generated

DOI: 10.1007/s43076-026-00531-w

Keywords: psychotherapy, communication skills, psychometrics, content validity, therapeutic alliance, patient-reported outcomes, test construction, social skills, verbal communication, non-verbal communication, clinical psychology, Brazil

The piece, written by Roberto Tedeschi, an independent researcher based in Bologna, and Sara Di Serio of the Department of Clinical Science and Translational Medicine at the University of Rome Tor Vergata, does not report new experimental data. Instead, it is a conceptual argument, a deliberate provocation aimed at both the mindfulness research community and the rehabilitation sciences. The authors state that no datasets were generated or analysed, and the article carries no ethics approvals, consistent with its nature as a theoretical correspondence. What it offers is a framework: the proposal that the physiotherapist–patient encounter should be understood as a recurring, real-world setting where the psychological and neurobiological ingredients of mindfulness-based care are already in play, whether or not anyone labels them as such.

The argument begins with a paradox. Mindfulness has travelled an extraordinary distance from its origins in contemplative traditions to its current status as a mainstream public health intervention. Since Jon Kabat-Zinn’s landmark 1982 outpatient programme for chronic pain patients, which introduced mindfulness meditation into behavioural medicine, the field has grown into a global enterprise. Recent critical analyses in Mindfulness itself, including Oman’s 2025 agenda for mindfulness in global public health and Sutton’s organisational-psychology perspective on cultivating global health, signal an ambitious push to embed mindfulness at the population level. And yet, the authors contend, this push has concentrated on formal programmes and structured courses, while overlooking the places where embodied awareness is most frequently practised: clinical encounters involving the body itself.

Physiotherapy, the authors argue, is uniquely positioned in this respect. Unlike many medical consultations, physiotherapy is built on sustained physical contact, manual skills, guided movement, and an extended temporal relationship between practitioner and patient. Treatment sessions unfold over weeks or months, giving the therapeutic relationship time to deepen. Scoping reviews of therapeutic alliance in musculoskeletal physiotherapy and occupational therapy, such as the 2017 analysis by Babatunde and colleagues published in BMC Health Services Research, have documented that the quality of this alliance is not a peripheral nicety but a core component of practice that shapes engagement, adherence, and outcomes. In other words, the relational dimension of physiotherapy is not an optional extra layered onto exercise prescription; it is woven into the delivery of care itself.

The concept at the heart of the correspondence is therapeutic presence, a construct developed most prominently by Geller and Greenberg in their 2012 book Therapeutic Presence: A Mindful Approach to Effective Therapy, and operationalised in a 2010 measurement study by Geller, Greenberg, and Watson in Psychotherapy Research. Therapeutic presence describes a clinician’s state of being fully attentive, receptive, and embodied in the encounter with a patient—listening not only with the ears but with the whole nervous system. Presence, in this account, is not a vague bedside manner but a trainable, mindful capacity with measurable correlates in both therapist and client perception. The authors of the correspondence propose that physiotherapists, whose work demands continuous attention to bodily cues, are natural practitioners of presence, even if the term never appears in their training curriculum.

Why should this matter for outcomes? One strand of evidence comes from the science of contextual factors. In 2023, an international group led by Cook and colleagues, publishing in Frontiers in Psychology, reached a consensus definition for contextual factors: the elements of the therapeutic encounter—expectations, the clinician’s manner, the setting, the ritual of treatment—that modulate outcomes independently of the specific technique delivered. This line of research, closely tied to placebo and nocebo science, has made it increasingly difficult to dismiss the relational and cognitive environment of care as noise. In physiotherapy specifically, systematic reviews of attentional focus instructions, including the 2018 review by Piccoli and colleagues in the Journal of Functional Morphology and Kinesiology, show that the way a clinician directs a patient’s attention changes motor learning and performance in both central nervous system and musculoskeletal disorders. Attention, in other words, is a clinical variable, and a mindful clinician is one who manages it deliberately.

A second strand comes from pain neuroscience. Bushnell, Čeko, and Low’s influential 2013 review in Nature Reviews Neuroscience mapped how cognitive and emotional processes modulate pain and how these regulatory systems become disrupted in chronic pain. Pain is not a simple readout of tissue damage; it is constructed through an interaction of sensory input, attention, expectation, and affect. This is precisely why the mental state of the clinician may matter. A distracted, hurried practitioner may inadvertently amplify threat appraisals, while a present, calm one may foster the sense of safety that allows descending pain-modulatory systems to work in the patient’s favour. The correspondence frames the physiotherapy room as a place where these mechanisms can be observed, refined, and taught—not as abstract theory but as lived clinical practice.

The authors also draw on the phenomenology of body awareness. Mehling and colleagues’ 2011 inquiry into body awareness as the common ground of mind-body therapies, published in Philosophy, Ethics, and Humanities in Medicine, positioned interoception—the perception of internal bodily signals—as the shared substrate of practices ranging from meditation to massage. Price and Hooven’s 2018 work on interoceptive awareness skills for emotion regulation, through the mindful awareness in body-oriented therapy approach, translated that substrate into teachable clinical skills. More recently, Parma and colleagues’ 2024 overview in Brain Sciences charted progress on bodily awareness and interoception in neurorehabilitation research. Clinical perspectives on the notion of presence, gathered by Malet, Bioy, and Santarpia in Frontiers in Psychology in 2022, add a cross-disciplinary frame. Seen through this converging literature, the physiotherapist’s hands are not merely applying technique; they are participating in a bidirectional channel of interoceptive and proprioceptive information, one that mindfulness research has rarely examined in situ.

The public health implications of the argument are what give it its edge. If mindfulness is to fulfil the population-level ambitions set out in recent global health agendas, the authors suggest, it cannot rely solely on scaling formal eight-week courses, which carry costs, access barriers, and adherence challenges. Embedding mindful presence into existing, universally used services—rehabilitation being one of the most widely delivered—offers a complementary route. Every physiotherapy encounter becomes, in their phrase, a natural laboratory: a setting where presence, attention, touch, and body awareness interact without the artificiality of a lab-based attention task or a self-report questionnaire administered in isolation. Training physiotherapists explicitly in mindfulness and presence, the correspondence implies, could turn an enormous segment of routine healthcare into an informal delivery channel for skills already known to support emotion regulation, pain modulation, and motor learning.

The correspondence is careful in its limits. It proposes no trials, reports no measurements, and acknowledges its status as a conceptual intervention rather than an empirical one. But that is part of its strategic function. By naming the physiotherapist–patient encounter as a natural laboratory, the authors issue an invitation: to design studies that measure presence in rehabilitation settings, to test whether mindfulness training for physiotherapists alters patient outcomes, and to integrate the constructs of psychotherapy research with the biomechanics of manual therapy. If the invitation is taken up, the humble treatment table—arguably one of the most intimate interfaces in modern medicine—could become one of the most informative sites in the science of mind-body health. The next phase belongs to researchers willing to walk into the clinic and watch closely.

Subject of Research: Therapeutic presence and mindfulness in physiotherapist–patient encounters as a natural laboratory for public health practice

Article Title: Mindfulness in Public Health Practice: The Physiotherapist–Patient Encounter as a Natural Laboratory for Therapeutic Presence

Article References: Tedeschi, R., & Di Serio, S. (2026). Mindfulness in Public Health Practice: The Physiotherapist–Patient Encounter as a Natural Laboratory for Therapeutic Presence. Mindfulness. https://doi.org/10.1007/s12671-026-02991-8

Image Credits: AI Generated

DOI: 10.1007/s12671-026-02991-8

Keywords: mindfulness, public health, physiotherapy, therapeutic presence, therapeutic alliance, contextual factors, interoception, body awareness, chronic pain, rehabilitation, motor learning, patient encounter

The research team, led by Julianah Fakolade alongside Peter Kinderman, Shaima Hassan, and Anam Elahi, searched six electronic databases from 1983 through February 2026, initially identifying 12,608 records. After deduplication, screening of 8,926 titles and abstracts, and assessment of 62 full-text articles, thirteen studies met the inclusion criteria, ten from database searching and three through backward citation searching. The team used the SPIDER framework to structure the search and the Critical Appraisal Skills Programme qualitative checklist to appraise methodological rigour, which informed rather than dictated the weighting of evidence during a four-stage narrative synthesis. The included studies spanned more than four decades, from a 1985 dissertation on dropout among Black psychotherapy patients to work published in the mid-2020s, underscoring how persistent the problem has been.

The participants, comprising 138 males and 102 females with gender unreported in two studies, came from diverse backgrounds including African American, African-Caribbean, Latinx, Hispanic, Somali, Asian, and other ethnically minoritised communities. Nine studies were set in the United States and four in the United Kingdom. Most relied on interviews and purposive sampling, employing analytic techniques ranging from thematic analysis and interpretative phenomenological analysis to grounded theory-informed approaches. From this body of evidence, six interconnected themes crystallised: perspectives and expectations of therapy, cultural and societal influences, practical and accessibility barriers, the therapeutic relationship, systemic and service-level barriers, and autonomy and control in treatment engagement.

The first theme revealed that discontinuation often begins with doubt. Participants questioned whether therapy would help at all, frequently perceiving faith, conversations with family and friends, or even substance use as more effective coping strategies. Others found that treatment failed to meet their needs, or that their difficulties eased earlier than the planned course anticipated, prompting them to leave. Some participants described feeling pressured, even hounded, by services to engage, an experience of pursuit that felt coercive rather than supportive. The review situates these findings within the psychotherapy literature on outcome expectations, which consistently shows that belief in therapeutic efficacy fuels hope, engagement, and improvement, a process researchers call remoralisation. When expectations were low or misaligned with the reality of sessions, motivation drained away and dropout followed.

Cultural and societal influences emerged as perhaps the most distinctive thread for ethnically minoritised clients. Eight studies identified stigma, emanating from communities, families, and friendships, as a powerful engine of shame that discouraged continued attendance. Participants described being labelled mad or crazy, and absorbing cultural narratives that framed mental health difficulties as personal weakness or something to be confined within the family. For those holding intersecting marginalised identities, such as being both ethnically minoritised and LGBTQ+, stigma compounded, intensifying isolation and accelerating the decision to quit. Language posed a further obstacle: many participants felt they lacked the English vocabulary to articulate their distress, while others found therapists unwilling to acknowledge faith or cultural context, perceiving a lack of holistic support. This resonates with established evidence that mental health stigma robustly suppresses help-seeking and that perceived cultural competence strengthens alliance formation and retention.

Practical barriers, though not unique to minoritised populations, weighed heavily and often interacted with socioeconomic disadvantage. Transportation difficulties produced discomfort that eventually curtailed attendance; unstable housing, relocation, financial constraints, work, and childcare responsibilities competed with therapy for scarce time and energy. These logistical pressures echo decades of research identifying practical constraints as key predictors of premature termination. Crucially, the review argues that such discontinuation frequently reflects constrained access rather than diminished therapeutic interest, a reframing with direct implications for how services interpret and respond to missed appointments and early exits.

The therapeutic relationship proved decisive in eight of the thirteen studies. When therapists were perceived as inexperienced, insensitive, or biased, and when clients felt their feelings were insufficiently considered, disengagement became markedly more likely. Participants reported disliking a therapist’s style, experiencing boundary crossings, or suffering relational ruptures that went unacknowledged. Where ruptures were recognised and repaired, engagement often continued; where they were left to fester, therapy ended. This pattern aligns with rupture-repair models of psychotherapy and with meta-analytic evidence identifying the therapeutic alliance as one of the strongest predictors of retention and outcome. Some participants simply could not form a working bond, breeding doubt about whether the intervention could work at all.

Systemic and service-level barriers added another layer. Participants described under-resourced services, rushed sessions, fragmented care pathways, confusing transfers between therapists, and departures of therapists that severed hard-won relationships. Many felt poorly informed about what therapy involved and what expertise their therapist held. Others resented being labelled dropouts when, in their view, they were simply selecting the services that best met their needs. Those prescribed medication described a focus on long-term pharmacological management that left them unheard and disempowered. The final theme, autonomy, ties these threads together: participants who were pressured into treatment, denied choice of therapist, or excluded from decisions sometimes used discontinuation itself as a means of reclaiming control, a dynamic consistent with self-determination theory, which positions autonomy as a core psychological need underpinning sustained engagement.

The authors translate these findings into a multi-level agenda. Clinically, culturally adapted interventions that align therapeutic approaches with clients’ cultural, religious, and social contexts may improve engagement, particularly given that much of the evidence base for psychological therapies was developed in predominantly White populations. At the service level, distinguishing systemic dropout patterns from therapist-level variation could inform training, supervision, and evaluation, while flexible delivery models, including remote and hybrid formats with variable scheduling, could dismantle logistical barriers without compromising effectiveness. Relationally, shared decision-making, explicit goal setting, early alignment of expectations, and collaborative review of progress offer concrete tools for building alliances that survive ruptures and sustain hope.

The review is candid about its limitations. Heterogeneous methodologies, inconsistent definitions of dropout, reliance on US and UK samples, restriction to English-language studies, and the inclusion of six dissertations all constrain generalisability, as does the grouping of diverse ethnic groups that may obscure within-group differences. Yet the convergence between dissertation and peer-reviewed findings strengthens confidence in the synthesis. The core message is unambiguous: when ethnically minoritised adults leave therapy early, they are rarely disengaged or unmotivated. They are responding, often rationally, to structural barriers, culturally incongruent care, broken therapeutic relationships, and curtailed autonomy. Closing the retention gap therefore demands more than better appointment reminders; it requires culturally responsive, flexible, and genuinely collaborative models of care that confront inequality while honouring the client’s voice.

Subject of Research: Psychotherapy discontinuation experiences among ethnically minoritised adults: a systematic review and qualitative synthesis

Article Title: Understanding Psychotherapy Discontinuation Among Ethnically Minoritised Adults: A Systematic Review and Qualitative Synthesis

Article References: Fakolade, J., Kinderman, P., Hassan, S., & Elahi, A. (2026). Understanding Psychotherapy Discontinuation Among Ethnically Minoritised Adults: A Systematic Review and Qualitative Synthesis. Community Mental Health Journal. https://doi.org/10.1007/s10597-026-01720-8

Image Credits: AI Generated

DOI: 10.1007/s10597-026-01720-8

Keywords: psychotherapy discontinuation, therapy dropout, ethnic minority mental health, therapeutic relationship, cultural competence, stigma, mental health services, qualitative synthesis, therapeutic alliance, shared decision-making, health inequalities, autonomy