Effective—and Tolerable: Acceptance and Side Effects of Intensified Exposure for Anxiety Disorders

Heinig, Ingmar; Knappe, Susanne; Hoyer, Jürgen; Wittchen, Hans‐Ulrich; Richter, Jan; Arolt, Volker; Deckert, Jürgen; Domschke, Katharina; Hamm, Alfons O.; Kircher, Tilo; Lueken, Ulrike; Margraf, Jürgen; Neudeck, Peter; Rief, Winfried; Straube, Benjamin; Ströhle, Andreas; Pauli, Paul; Pittig, Andre

doi:10.1016/j.beth.2022.11.001

Cited by 7 publications

(1 citation statement)

References 81 publications

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“…Knowledge about negative experiences with psychotherapy is crucial for several reasons. For example, to determine the treatment burden of therapies (Dobler et al 2018;Heinig et al 2022), as well as to identify patients who are at risk of (serious) adverse events, this information, along with the success rate of the therapy, is needed to enable patients to give informed consent (Blease, Lilienfeld, and Kelley 2016;Halfond, Wright, and Bufka 2021). In addition, insight into the negative effects of therapies can inspire improvement of current treatments or the development of alternatives.…”

Section: Discussionmentioning

confidence: 99%

A Scale for Measuring Positive and Negative Experiences of Psychotherapy (PNEP): First Psychometric Findings of a New Instrument for Monitoring Clients' Experiences

Dandachi‐FitzGerald,

Houben,

Broers

et al. 2024

Clin Psychology and Psychoth

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BackgroundClients' adverse experiences during psychotherapy are rarely monitored in clinical practice or research trials. One obstacle here is the lack of a measure to gauge both positive and negative experiences during psychotherapy. We developed and evaluated a new instrument for measuring such experiences.MethodThe Positive and Negative Experiences of Psychotherapy (PNEP) questionnaire was developed based on pilot data, a literature review, and two existing scales for measuring primarily adverse experiences during psychotherapy. Mental healthcare clients (N = 200) anonymously completed and evaluated the PNEP. Subsequently, a sample of professionals (N = 34) who underwent psychotherapy in the context of their training filled in the PNEP twice, with a 2‐week interval in between.ResultsThe positive and negative experiences subscales of the PNEP were found to possess excellent internal consistencies (αs ≥ 0.90). The PNEP test–retest reliability was 0.93 for the positive experiences subscale and 0.78 for the negative experiences subscale. For the positive subscale, four factors were extracted: symptom reduction and positive well‐being, high quality of therapy and therapeutic relation, personal growth and acceptance and interpersonal functioning. For the negative subscale, exploratory factor analysis suggested a three‐factor solution: escalation of symptoms and emotional distress, low quality of therapy and therapeutic relation and (self‐)stigmatization and dependency. Participants related a median of 13 positive and six negative therapy experiences to their most recent treatment. The most frequently endorsed negative experiences were having more negative thoughts and memories, feeling emotionally overwhelmed and an increase in stress due to the therapy. A minority of participants (10.5%) reported no negative treatment experiences.ConclusionsIn the field of psychotherapy, the evaluation of risks and benefits is crucial for assessing safety and effectiveness. The PNEP could be a promising instrument for achieving this objective, although further research is needed to replicate and expand upon the current findings.

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