Mapping the associations between psychodynamic therapists’ functioning and dropout: a network analysis

Therapist-related factors play a crucial role in psychotherapy outcomes, particularly in preventing premature termination. The present study applied a network analysis approach to examine the interconnections among variables associated with therapy dropout in a sample of psychodynamic psychotherapists, by specifically focusing on insight orientation, mentalization, adult attachment, and professional self-efficacy. A sample of 213 psychodynamic psychotherapists (Mage = 49.08, SD = 11.91) participated in the study. Data were analysed through the implementation of a network analysis approach: a Gaussian graphical model with LASSO regularization was estimated to identify partial correlations among variables, and expected influence was computed to determine the relative importance of each node within the network. Dropout Rate showed both positive and negative associations, being negatively linked to Relational Attunement and positively associated with Distrust and Fearful Attachment. Insight Orientation emerged as the most central node in terms of expected influence, suggesting its potential regulatory role within the network. This research highlights the importance of reflective and relational therapist competencies in reducing the risk of dropout. The findings thus contribute to advancing process-oriented approaches to therapist development and dropout prevention.