Therapiesavoidance

Therapiesavoidance is the pattern of resisting or disengaging from psychotherapy or related therapeutic modalities. It includes reluctance to begin treatment, interruptions in ongoing care, or selective participation in therapy components. The term is used in clinical discussions to describe nonengagement with recommended psychotherapeutic plans.

Causes of therapiesavoidance are multifaceted. They include ambivalence about change, fear of stigma or vulnerability, distrust of providers, and prior negative experiences in therapy. Cultural beliefs about therapy and mental health can also deter engagement. Practical barriers such as cost, transportation, scheduling difficulties, and lack of language or cultural concordance contribute as well. Readiness for change and the strength of the therapeutic alliance influence the likelihood of avoidance.

Implications of therapiesavoidance include delayed or limited symptom improvement, persistent distress, and functional impairment. It is associated with higher rates of dropout or switching to alternative or less effective forms of care, potentially increasing the overall burden on individuals and healthcare systems.

Assessment and management aim to identify barriers and boost motivation to engage. Clinicians may use motivational interviewing, psychoeducation about what therapy involves, and collaborative goal setting. Flexible delivery methods such as teletherapy, brief or stepped-care models, and efforts to reduce practical barriers can improve engagement. Trauma- and culturally informed approaches, along with attention to stigma and trust, support a person-centered path to care.

See also: treatment engagement, therapeutic alliance, treatment dropout, patient-centered care.