Negative Effekte von Psychotherapie: Häufigkeit und Korrelate in einer klinischen Stichprobe

Abeling, Britta; Müller, Astrid; Stephan, Michael; Pollmann, Iris; Zwaan, Martina de

doi:10.1055/s-0043-117604

Cited by 21 publications

(23 citation statements)

References 17 publications

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“…Poor therapeutic alliance, prior negative experience with MUB, and higher outcome expectations emerged as the robust predictors in the inpatient setting, with a somewhat higher model fit. Taking into account the overall weak model fit and previous inconclusive research results (Crawford et al, 2016;Abeling et al, 2018;Moritz et al, 2019), the clinical relevance of the predictor age seems minor. In contrast, poor therapeutic alliance might represent a promising predictor of MUB.…”

Section: Discussionmentioning

confidence: 85%

“…Yet, increasing evidence for negative effects of psychotherapy (NEP) was provided over the last decade (Crawford et al, 2016;Cuijpers et al, 2018;Gawlytta et al, 2019;Moritz et al, 2019). NEP is multifaceted, including intrapersonal changes, symptom deterioration, stigmatization, and relationship problems (Ladwig et al, 2014;Abeling et al, 2018). They can arise in different treatment stages and even after termination of psychotherapy (Linden, 2013).…”

Section: Introductionmentioning

confidence: 99%

“…Conversely, a poor therapeutic alliance had a detrimental effect on symptom severity in a randomizedcontrolled trial, including participants with acute first or second episodes of a non-affective psychosis (Goldsmith et al, 2015). First studies indicate that a poor therapeutic alliance might predict the occurrence of NEP (Ladwig et al, 2014;Rozental et al, 2016;Grüneberger et al, 2017;Abeling et al, 2018). However, longitudinal or experimental data proving the causal relationship between the therapeutic alliance and the occurrence of NEP are missing.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2020

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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 ( t 0 ), discharge ( t 1 ), and 9-month follow-up ( t 2 ). 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 ( t 2 ) and 15.2% of outpatients. At least one case of malpractice and unethical behavior was reported by 28.8% of inpatients ( t 2 ) 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 ( t 0 ) 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.

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Section: Discussionmentioning

confidence: 85%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

et al. 2020

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“…Mit 78,2 % war der Großteil der Studienteilnehmer weiblich, was der Geschlechterverteilung in anderen Studien gleichkommt [4,7,17] Die Ergebnisse der Studie zeigen, dass im Mittel am häufigsten den Items der Kategorie "Mangelhafte Diagnostik/Technikanwendung" zugestimmt wurde (M = 44,31 %). Betrachtet man die Ergebnisse auf Einzelitemebene, dann wird deutlich, dass das Item "Ich hatte das Gefühl, ich mache keine Fortschritte in der Therapie."…”

Section: Diskussionunclassified

“…B. [4]) meist erfasst, ohne spezifische Aussagen darüber zu treffen, ob die negativen Effekte auf Kunstfehler zurückzuführen sind, als Nebenwirkungen zu interpretieren sind oder keinerlei Bezug zur Therapie hergestellt werden kann.…”

Section: Introductionunclassified

Unerwünschte Ereignisse durch unsachgemäß durchgeführte Psychotherapie

et al. 2019

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Zusammenfassung Ziel der Studie In einer Pilotstudie wurde das neu entwickelte Inventar zur Erfassung von Kunstfehlern und Kunstfehlerfolgen in der Psychotherapie (IKKIP) erstmals eingesetzt, um die Häufigkeit therapeutischen Fehlverhaltens aus Patientensicht zu erfassen, die resultierende Belastung zu erheben und Prädiktoren zu identifizieren. Methodik Ausgewertet wurden Daten von N = 165 Patienten mit Psychotherapieerfahrung, die an der Online-Befragung teilnahmen. Ergebnisse Die Patienten berichteten im Mittel M = 16,21 Ereignisse, die im Sinne von Kunstfehlern interpretierbar sind, und zu einer Belastung mittelmäßiger Schwere führten. Während Ereignisse der Kategorie „Mangelhafte Diagnostik/Technikanwendung“ am häufigsten berichtet wurden, gingen sexuelle Grenzverletzungen mit dem höchsten Belastungsgrad einher. Schlussfolgerung Die Ergebnisse belegen die Notwendigkeit einer differenzierten und systematischen Erfassung von Kunstfehlern und deren Folgen. Das IKKIP scheint dabei vor allem für den Forschungsbereich geeignet.

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Better Safe Than Sorry. A Scoping Review of Monitoring for Negative Effects in Preregistrations of Psychological Interventions

Jeckel,

Thiele,

Hirschfeld

et al. 2024

Clin Psychology and Psychoth

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Although negative effects of psychological interventions are suspected to be common, they are rarely investigated. Experts and international guidelines agree that monitoring for negative effects in clinical studies is needed to make psychological interventions safer and to empower patients before they give their consent to participate. Therefore, monitoring should already be considered during planning and preregistration of a study. The aim of this scoping review was to find out how frequently studies on psychological interventions monitor their negative effects according to preregistrations and to investigate reasons why monitoring is not carried out. Preregistrations of psychological interventions on ClinicalTrials.gov were scrutinized for information on monitoring of negative effects and other study characteristics. In a survey, researchers of studies where no monitoring was reported were asked for reasons for not doing so. Overall, 2231 preregistrations of psychological interventions were found; of these, only 3.4% included explicit information on monitoring for negative effects. In the survey, more researchers reported having conducted monitoring, although the type of monitoring was often inadequate. The type of monitoring varied widely, and specific monitoring measurements were rarely used repeatedly. Monitoring for negative effects was more prevalent in studies investigating treatments versus low‐threshold interventions, in studies conducted in Europe versus other continents and in more recent studies. Researchers reported lack of knowledge as the most frequent reason for not monitoring negative effects. Our results imply a lack of monitoring and inconsistent information on negative effects in preregistrations, with inconsistent use of the term monitoring and measurements, and a lack of knowledge among researchers. Improved knowledge and a standardized approach, starting with an adequate preregistration, would be helpful to routinely examine negative effects in psychological interventions to make them safer and better.

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Negative Effekte von Psychotherapie: Häufigkeit und Korrelate in einer klinischen Stichprobe

Cited by 21 publications

References 17 publications

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

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

Unerwünschte Ereignisse durch unsachgemäß durchgeführte Psychotherapie

Better Safe Than Sorry. A Scoping Review of Monitoring for Negative Effects in Preregistrations of Psychological Interventions

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