Unerwünschte Ereignisse durch unsachgemäß durchgeführte Psychotherapie

Gawlytta, Romina; Schwartze, D; Schönherr, Désirée; Schleu, Andrea; Strauß, Bernhard

doi:10.1055/a-1026-1577

Cited by 7 publications

(3 citation statements)

References 22 publications

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“…Psychotherapy is evidence-based for a wide spectrum of psychological disorders. 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).…”

Section: Introductionmentioning

confidence: 99%

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: Introductionmentioning

confidence: 99%

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

et al. 2020

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“…Much less clear is the answer to the question about the prevalence of misconduct and malpractice, including several kinds of boundary violations. One study (Gawlytta et al, 2019) estimated that some complaints (e.g., lack of progress, or therapists' bias) occur in one 10th to one fifth of the sample, whereas more severe issues (e.g., inadequate termination of therapy, breaches of confidentiality, sexual or physical assault) were less commonly reported. Clearly more empirical investigations are needed on the prevalence and impact of misconduct and malpractice, and especially in training and supervision.…”

Section: Discussionmentioning

confidence: 99%

“…The rates vary between 1.6% (Grenyer & Lewis, 2012, in Australia) and 4% to 8% (Lamb et al, 2003, in the United States). In an internet-based survey of German patients, the rate of patients reporting sexual boundary violations was 6% (Gawlytta et al, 2019). When therapists were asked if they knew about abusing colleagues (e.g., through patient reports), the number rose significantly, as shown in a study in Israel (29%, Aviv et al, 2006).…”

Section: Prevalence Of Malpractice and Boundary Violationsmentioning

confidence: 93%