Patients’ perception of side effects in cognitive-behavior, psychodynamic, and psychoanalytic outpatient psychotherapy

Abstract

Objective To assess and compare the frequency of psychotherapeutic side effects in different psychotherapeutic approaches. Method Side effects were assessed across 17 domains through structured interviews with 45 outpatients in cognitive-behavior, psychodynamic, and psychoanalytic psychotherapy. Results Almost every patient (95.6%) reported at least one side effect, with a mean of 4.7 affected domains. Most frequent complaints were that problems were seen as more complex (60.0–80.0%), worsening of pre-existing symptoms (46.7–60%), occurrence of new symptoms (20.0–53.3%), feeling uncomfortable in treatment (33.3–40.0%), tensions with therapist (26.7–46.7%), as well as conflicts with current family and with family of origin (both 13.3–46.7%). Differences between therapeutic orientations were mostly non-significant. Conclusion Psychotherapy is regularly accompanied by side effects, independent of different theoretical orientations. Psychotherapists need to be familiar with side effects in order to inform patients about treatment-associated risks and to recognize and manage side effects.