A Narrative Analysis of Therapeutic Failure Experiences in Cognitive-Behavioral Therapy: Encounter, Reconstruction, and Meaning

Abstract

This study aimed to explore the narrative experience of therapeutic failure in cognitive-behavioral therapy and to elucidate the dimensions of encounter, reconstruction, and meaning-making in affected clients. This qualitative study employed a narrative analysis approach. Data were collected through semi-structured interviews with 27 clients from psychotherapy centers in Tehran who had experienced failure in cognitive-behavioral therapy. Purposeful sampling was conducted until theoretical saturation was reached. Interviews were transcribed verbatim and analyzed using NVivo software. Member checking and peer debriefing were utilized to enhance the credibility of findings. The results revealed three core themes: “Encountering Failure” (hopelessness, identity crisis, negative emotional reactions, and therapy dropout), “Reconstruction after Failure” (seeking alternative treatments, re-evaluating expectations, learning from mistakes, and regaining support), and “Meaning-Making of Failure” (philosophical interpretation, psychological growth, value reappraisal, and sharing experiences). Participants redefined therapeutic failure as both a crisis and an opportunity for growth and meaning. Therapeutic failure in cognitive-behavioral approaches should not be regarded merely as a negative event; rather, it can provide an opportunity for identity reconstruction, personal growth, and increased resilience. Understanding clients’ narratives of failure can inform higher-quality psychological interventions and enhanced clinical support.