Exploring the Lived Experience of Therapeutic Failure Among Patients with Chronic Depression: A Phenomenological Inquiry

Abstract

The aim of this study was to explore the lived experience of therapeutic failure among patients with chronic depression and to identify related factors and consequences. This research employed a qualitative, phenomenological approach. Data were collected through semi-structured interviews with 25 patients diagnosed with chronic depression in Tehran. Purposeful sampling continued until theoretical saturation was reached. Thematic analysis was conducted using NVivo software. Analysis of the interviews led to the identification of three main themes: emotional and cognitive experiences of therapeutic failure, interpersonal and social factors contributing to therapeutic failure, and psychological and behavioral consequences. Participants reported feelings of hopelessness, doubt about treatment efficacy, gaps between expectations and reality, psychological exhaustion, social stigma, lack of family support, and insufficient interaction with therapists. Reported consequences included decreased motivation, social withdrawal, worsening depressive symptoms, and passive acceptance of their condition. The experience of therapeutic failure in patients with chronic depression is a multilayered phenomenon influenced by individual, interpersonal, and structural factors, leading to profound psychological consequences. Addressing patients’ narratives and reducing social and structural barriers can improve the quality of mental health services and outcomes.