Negative Effects Of Psychotherapy Research Articles

Few negative effects of psychotherapy in a psychiatric day hospital: a follow-up survey to a multiprofessional treatment with acceptance and commitment therapy.

While there are many studies on psychotherapy and its efficacy - in terms of desired outcomes - there is comparatively little evidence on the possible negative effects of psychotherapy. The aim of this study was to investigate the possible negative effects of a multi-professional psychiatric day hospital treatment for patients with mental health disorders based on Acceptance and Commitment Therapy (ACT), including possible confounding factors. Fifty-one patients with a range of psychiatric diagnoses were assessed three months after an ACT-based psychiatric day hospital treatment. Questionnaires were used to measure negative effects of psychotherapy (INEP), subjective quality of life (WHOQOL-BREF), and symptomatology (BDI-II and SCL-90-R). Correlational analyses and group comparisons were performed to determine the relationship between the sum of reported negative effects on the one hand and symptomology, quality of life, and sociodemographic variables (gender, age, diagnosis, education) on the other hand. At least one negative effect out of a list of 18 possible effects was reported by 45% of participants, and 10% reported more than two. The number of negative effects reported correlates positively with symptomology and negatively with quality of life. The sum of reported negative effects does not correlate with age or gender and does not vary by education level and primary diagnosis. In the light of previous findings, patients included in this study showed lower rates of negative effects, both overall and at item level. Practical implications of these findings are discussed.

Negative effects in randomized controlled trials of psychotherapies and psychological interventions: A systematic review

Background: Psychotherapy is a key evidence-based method for the treatment of mental disorders. However, little research has been published on the negative effects of psychotherapies. Aims: We examined this issue through a systematic literature review of previous systematic reviews on randomized controlled trials (RCTs). Methods: We focused on previous reviews and meta-analyses on 1) RCTs examining the effectiveness of psychotherapies and 2) previous reviews and meta-analyses specifically focusing on the negative effects of psychotherapy. We included publications published in PubMed and the Cochrane Databases from the year 2000 or later. Results: Of the 1,430 relevant publications, only a small proportion (30%) mentioned negative outcomes, mostly withdrawal. Only 57 of the extracted original studies monitored potential negative effects, and only three small-scale studies indicated negative effects. Conclusions: The systematic monitoring of negative effects in psychotherapy has not been given the same attention as has been given to the benefits of therapy.

Unexpressed Wishes and Unmet Needs: a Mixed Methods Study of Youth Negative Experiences in Psychotherapy

Unlike best practice guidelines for detecting and addressing medication side effects, there are no widely adopted guidelines to help therapists identify and address the possible negative effects of psychotherapy. Psychotherapy is a first-line evidence-based intervention for youth depression and anxiety, but the literature contains few studies of psychotherapy’s potential negative effects, and even fewer direct youth reports of their negative psychotherapy experiences. A mixed-methods study design was used to study youth with self-reported depression and/or anxiety and measure negative experiences associated with psychotherapy treatment. Youth were recruited from a larger study. Qualitative and quantitative data were collected from 45 youth with psychotherapy experience. Study design was informed by feedback from youth with lived experience of mental health challenges. Youth completed standardized measures of psychopathology, treatment effects, and detailed qualitative interviews. All youth experienced at least one negative effect during psychotherapy, and 30 youth (66.7%) attributed a negative effect as ‘caused’ by psychotherapy. While this attribution did not significantly differ based on severity of underlying current psychopathology, effect size estimates suggest moderate to large group differences regarding internalizing issues and baseline coping skills. Four major qualitative themes were identified from the interviews, summarizing the negative experiences of psychotherapy: (1) Barriers Experienced in Psychotherapy; (2) Concerns about Therapist; (3) Concerns about Therapy Itself; (4) Negative Experiences as a part of the Therapeutic Process. No youth raised any of these concerns directly with their therapists. These data support the need for validated, systematic assessment of psychotherapy’s negative effects among youth, with the aim of improving engagement and treatment outcomes.

Negative effects of psychotherapy: estimating the prevalence in a random national sample

Background Negative or adverse effects of psychological treatments are increasingly a focus of psychotherapy research. Yet, we still know little about the prevalence of these effects. Aims Starting from a representative national sample, the prevalence of negative effects and malpractice was determined in a subsample of individuals reporting psychotherapy currently or during the past 6 years. Method Out of an initial representative sample of 5562 individuals, 244 were determined to have had psychotherapy within the past 6 years. Besides answering questions related to treatment, its effects and the therapists, patients filled out the Negative Effects Questionnaire, items of the Inventory of Negative Effects of Psychotherapy reflecting malpractice and the Helping Alliance Questionnaire, and rated psychotherapeutic changes in different areas. Results Rates of positive changes related to therapy varied between 26.6% (relationship to parents) and 67.7% (improvement in depressed mood). Deteriorations were most commonly related to physical well-being (13.1%), ability to work (13.1%) and vitality (11.1%). Although patients generally reported a positive helping alliance, many of them reported high rates of negative effects (though not always linked to treatment). This was especially true of the experience of unpleasant memories (57.8%), unpleasant feelings (30.3%) and a lack of understanding of the treatment/therapist (19.3/18.4%). Indicators of malpractice were less common, with the exception that 16.8% felt violated by statements of their therapist. Conclusions This study helps to better estimate aspects of negative effects in psychotherapy ranging from deteriorations, specific effects and issues of malpractice that should be replicated and specified in future studies.

Negative effects of psychotherapy: Definition, assessment and clinical significance.

Negative effects of psychotherapy: Definition, assessment and clinical significance.

PartnerCARE—a psycho-oncological online intervention for partners of patients with cancer: study protocol for a randomised controlled feasibility trial

IntroductionCancer burdens not only the patient but also the partner to a comparable extent. Partners of patients with cancer are highly involved in the caring process and therefore often experience...

Frequencies and Predictors of Negative Effects in Routine Inpatient and Outpatient Psychotherapy: Two Observational Studies.

Negative effects of psychotherapy (NEP) include side effects, malpractice, and unethical behavior. Its setting-specific frequencies and predictors are mostly unknown. The two presented studies aim to investigate NEP and its predictors systematically across different treatment settings. In study 1, N = 197 patients of a German outpatient center were recruited, on average, 3.76 years after the termination of psychotherapy. In study 2, data from N = 118 patients of two German inpatient clinics were collected at admission (t0), discharge (t1), and 9-month follow-up (t2). All participants evaluated the negative effects of their previous out- or inpatient psychotherapy with the Inventory for the Balanced Assessment of Negative Effects in Psychotherapy and a priori hypothesized predictors. At least one side effect was reported by 37.3% of inpatients (t2) and 15.2% of outpatients. At least one case of malpractice and unethical behavior was reported by 28.8% of inpatients (t2) and 7.1% of outpatients. Inpatients reported significantly more side effects (U = 14347, z = 4.70, p < 0.001, r = 0.26) and malpractice and unethical behavior (U = 14168, z = 5.21, p < 0.001, r = 0.29) than outpatients. Rates of severe malpractice in the form of breaking confidentiality and physical and sexual abuse were less than 1% in both settings. Predictors of side effects were prior experience with psychotherapy and current interpersonal difficulties in the outpatient setting and higher motivation for psychotherapy (t0) in the inpatient setting. Predictors of malpractice and unethical behavior were younger age in the outpatient setting and poor therapeutic alliance, prior negative experience with malpractice and unethical behavior, and higher outcome expectations in the inpatient setting. NEP are common in both, in- and outpatient settings. Inpatients are at higher risk for the NEP than outpatients. To safeguard patients’ wellbeing, the systematic assessment and distinction of side effects and malpractice and unethical behavior should gain more attention in research and clinical practice.

Negative effects in psychotherapy: commentary and recommendations for future research and clinical practice.

Psychotherapy can alleviate mental distress and improve quality of life, but little is known about its potential negative effects and how to determine their frequency. To present a commentary on the current understanding and future research directions of negative effects in psychotherapy. An anonymous survey was distributed to a select group of researchers, using an analytical framework known as strengths, weaknesses, opportunities and threats. The researchers perceive an increased awareness of negative effects in psychotherapy in recent years, but also discuss some of the unresolved issues in relation to their definition, assessment and reporting. Qualitative methods and naturalistic designs are regarded as important to pursue, although a number of obstacles to using such methods are identified. Negative effects of psychotherapy are multifaceted, warranting careful considerations in order for them to be monitored and reported in research settings and routine care. None.

2843 – The problem of side effects in psychotherapy: adverse treatment reactions or unwanted events

The side effects of drugs are deemed so important that their pubblication are strictly regulated by national health agency. But no one agency requires such warnings connected to other mental health including Psychotherapy. In contrast to all pharmacotherapy studies in groups of patients, there is precious little information about the safety of psychotherapeutic interventions, which are also, in some patients and in some instances, associated with events that need to be noted. Actually empirical research on the negative effects of psychotherapy is largely insufficient, partly there is a lack of theoretical concept on how to define, classify and assess psychotherapy effects. This is a badly understudied issue, but of high clinical relevance, given that these treatments are so frequently recommended for the management of patients with psychopathological problems. And while there are many different forms of psychotherapy, virtually all of them share the matter discussed in this paper. Unfortunately, many psychotherapists won't discuss or acknowledge about side effects, despite they occour all the time. Some plausible definitions are considered as unwanted events, adverse reactions, deterioration of illness, malpractice reactions, treatment emergent reactions, treatment non response, therapeutic risks, controindications. Now that psychotherapy has become an accepted and effective option within the health care community, researchers and therapists need to do a better job of describing and examining the negative side effects of psychotherapy. Recognition of effects have to be a characteristic of good therapists and treatments, to improve the quality of care.

How to Define, Find and Classify Side Effects in Psychotherapy: From Unwanted Events to Adverse Treatment Reactions

Empirical research on the negative effects of psychotherapy is insufficient, partly because there is a lack of theoretical concept on how to define, classify and assess psychotherapy side effects. This paper proposes a model for the definition, classification and assessment of psychotherapy side effects. Definitions are provided for 'unwanted events', 'treatment-emergent reactions', 'adverse treatment reactions', 'malpractice reactions', 'treatment non-response', 'deterioration of illness', 'therapeutic risks' and 'contraindications'. We describe processes analysing the causality of negative events and the correctness of treatment. A procedural model on how to find, classify and evaluate negative events is described, the unwanted event to adverse treatment reaction (UE-ATR) checklist. Recognition of adverse treatment effects is a characteristic of good therapists and treatments. Psychotherapists should be sensitive for negative effects. This can help improve the quality of treatment. The UE-ATR checklist can be used in psychotherapy trials, quality assurance, clinical practice and training of psychotherapists.

Negative Treatment Effects in Dyadic Psychotherapy: A Focus on Prevention and Intervention Strategies

Therapy holds the potential to harm as well as help. This paper highlights approaches that may help prevent or decrease the incidence of negative effects in psychotherapy. These approaches include supervision, peer consultation, ongoing assessment of the therapeutic process, therapist-client matching, and referrals and transfers. We hope that this paper will serve as a stimulus for clinicians, psychotherapy researchers, and educators to put forth collabo-rative effort into identifying variables directly associated with adverse treat- ment outcomes and determining appropriate prevention and intervention strategies.

A tripartite model of mental health and therapeutic outcomes: With special reference to negative effects in psychotherapy.

A tripartite model of mental health and therapeutic outcomes: With special reference to negative effects in psychotherapy.

A tripartite model of mental health and therapeutic outcomes. With special reference to negative effects in psychotherapy.

Since a judgment of worse is always made in relation to a standard, which presupposes a definition of better, it is clear that the problem of what constitutes a negative effect is inextricably interwoven with a definition of mental health. Any form of psychotherapy or behavior modification is designed to move the patient toward a particular ideal or norm; the techniques used in a given form of therapy are instruments for accomplishing that purpose. Only by considering multiple perspectives will it be possible to derive a comprehensive definition of mental health and meaningful evaluations of psychotherapy outcomes. Consider the following: If, following psychotherapy, a patient manifests increased self-assertion coupled with abrasiveness, is this a good or a poor therapy outcome? If, as a result of therapy, a patient obtains a divorce, is this to be regarded as a desirable or an undesirable change? A patient may turn from homosexuality to heterosexuality or he may become more accepting of either; an ambitious, striving person may abandon pre-

Contemporary views of negative effects in psychotherapy. An integrated account.

As part of a larger investigation into negative effects in psychotherapy, we conducted a survey of researchers and practitioners in psychotherapy. We now present an integrated account of the consensus of these experts on the following issues: (1) Is there a problem of negative effects? (2) What constitutes a negative effect? (3) What factors are prominently associated with negative effects? There was an overwhelming affirmation of the reality of negative effects among the respondents. Furthermore, they urged that negative effects be subjected to systematic research scrutiny, a strategy made more feasible by the identifying criteria and possible causative factors cited by these experts. It is suggested that there is need for research into therapeutic actions and psychotherapy outcomes in general, with special reference to negative effects.

МЕТОДИ ТА МЕТОДОЛОГІЯ НАУКОВИХ ДОСЛІДЖЕНЬ У СФЕРІ ПСИХОЛОГІЧНОЇ ДОПОМОГИ

У статті здійснюється огляд методологічних вимог до наукових досліджень у сфері психологічної допомоги. Дається короткий екскурс в історію психотерапевтичних досліджень. Вказуються основні дослідницькі стратегії, серед яких – оцінювання "терапевтичного пакету", оцінювання внеску окремих і додаткових втручань в ефективність "терапевтичного пакету", оцінювання ролі окремих параметрів організації психотерапії та самого терапевтичного процесу, оцінювання характеристик клієнта і терапевта, порівняння ефективності окремих підходів. Коротко окреслюються перспективні напрямки досліджень, зокрема аналіз негативних ефектів психотерапії, її медіаторів та механізмів. Описується сучасний стандарт розвідок у сфері психічного здоров’я – експериментальні рандомізовані контрольовані дослідження, а також основні стратегії їх реалізації: нетерапевтичного контролю, порівняння терапевтичних та звичайних умов, порівняння з плацебо, контролю компонентів терапевтичного проекту, комбінації терапевтичних проектів, порівняння з альтернативами. Висвітлюються особливості застосування та базові кроки мета-аналітичних досліджень, зокрема такі, як концептуалізація, збір даних, кодування змінних, статистичний аналіз, мета-аналітичні висновки та узагальнення. Вказується на роль наукових досліджень у регуляції розвитку психотерапевтичної практики. Згадуються окремі наукові об’єднання та центри, які розвивають наукові дослідження у психотерапії.&#x0D; The overview of the methodological requirements of psychotherapy research and the brief excursion into the history of empirical base psychotherapy are presented in this article. Basic research strategies in the field of psychological help are Treatment Package Strategy, Dismantling Treatment Strategy, Constructive Treatment Strategy, Parametric treatment strategy, Comparative Treatment Strategy, Client and therapist variation strategy and process research strategy. The perspective ways of research are analysis of the negative effects of psychotherapy and investigation ofpsychotherapeutic mediators and mechanisms. Modern standard of research in the field of mental health - randomized controlled trial. Main implementation strategies of RCTs are Wait-list or no-treatment control, Treatment-as-Usual Comparison, Placebo Comparisons, Component Control Designs, Combination Treatment Designs and Comparisons With Bon а Fide Alternatives. Meta-analysis is special kind of psychotherapy research, which involves describing the results of different studies using statistical procedures. Basic steps of meta-analysis are Conceptualization, Data collection, Coding studies, Statistical procedures, Write up meta-analysis. Scientific research have significant role in the regulation of the psychotherapy practice.