Negative Effects From Psychological Treatments A Perspective

Center for Anxiety and Related Disorders, Boston University, 648 Beacon Street, 6th Floor, Boston, MA 02215, USA.
American Psychologist (Impact Factor: 6.87). 01/2010; 65(1):13-20. DOI: 10.1037/a0015643
Source: PubMed

ABSTRACT The author offers a 40-year perspective on the observation and study of negative effects from psychotherapy or psychological treatments. This perspective is placed in the context of the enormous progress in refining methodologies for psychotherapy research over that period of time, resulting in the clear demonstration of positive effects from psychological treatments for many disorders and problems. The study of negative effects--whether due to techniques, client variables, therapist variables, or some combination of these--has not been accorded the same degree of attention. Indeed, methodologies suitable for ascertaining positive effects often obscure negative effects in the absence of specific strategies for explicating these outcomes. Greater emphasis on more individual idiographic approaches to studying the effects of psychological interventions would seem necessary if psychologists are to avoid harming their patients and if they are to better understand the causes of negative or iatrogenic effects from their treatment efforts. This would be best carried out in the context of a strong collaboration among frontline clinicians and clinical scientists.

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    • "1.2. Side-effects of psychotherapy – terra incognita Despite early reports that psychotherapy can cause unwanted effects, too (Barlow, 2010), the systematic examination of adverse effects arising from psychotherapy is still in its infancy (for a review see Linden, 2013). Reasons for the apparent neglect of adverse events in psychotherapy research are multi-faceted. "
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    ABSTRACT: It is almost a matter of fact for both clinicians and patients that pharmacological agents exert wanted as well as unwanted effects. In contrast, unwanted events of psychotherapy have long been neglected.
    Journal of Obsessive-Compulsive and Related Disorders 02/2015; 5. DOI:10.1016/j.jocrd.2015.02.002 · 0.81 Impact Factor
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    • "Thus , all adverse events associated with the treatment may not have been collected . However , we believe that this rudimentary collection of adverse events provides valuable information about the possible negative effects of participating in a study such as this , especially considering that reporting negative effects in psychological treat - ment studies is rarely done ( Barlow , 2010 ) . Fourth , the addition of blinded clinician - rated outcome measure could have provided valuable additional information about the efficacy of our condi - tions . "
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    ABSTRACT: An internet-delivered cognitive behavioral treatment (ICBT) based on systematic exposure exercises has previously shown beneficial effects for patients with irritable bowel syndrome (IBS). Exposure exercises may be perceived as difficult for patients to perform because of the elicited short-term distress and clinicians may be reluctant to use these interventions. The aim of this study was to compare ICBT with the same protocol without systematic exposure (ICBT-WE) to assess if exposure had any incremental value. This randomized controlled dismantling study included 309 participants diagnosed with IBS. The treatment interventions lasted for 10 weeks and included online therapist contact. ICBT-WE comprised mindfulness, work with life values, acceptance, and encouraged reduced avoidance behaviors, while ICBT also included systematic exposure to IBS symptoms and related situations. Severity of IBS symptoms was measured with the Gastrointestinal Symptom Rating Scale – IBS version (GSRS-IBS). The between-group Cohen’s d on GSRS-IBS was 0.47 (95% CI: 0.23 to 0.70) at post-treatment and 0.48 (95% CI: 0.20 to 0.76) at 6-month follow-up, favoring ICBT. We conclude that the systematic exposure included in the ICBT protocol has incremental effects over the other components in the protocol. This study provides evidence for the utility of exposure exercises in psychological treatments for IBS.
    Behaviour Research and Therapy 04/2014; 55(1). DOI:10.1016/j.brat.2014.01.007 · 3.85 Impact Factor
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    • "However, should the condition of a participant deteriorate significantly during the treatment period, supervising clinicians may choose to end the participation prematurely and provide the participant with other healthcare services. Second, negative effects attributable to an internet intervention have previously been reported (Boettcher et al., 2014), and are assumed to exist in face-to-face treatments as well (Barlow, 2010). Consequently, this will be investigated by distributing questionnaires regarding potential adverse events weekly during the treatment period, and at post-treatment (Rozental et al., 2014). "
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    ABSTRACT: Procrastination is defined as a voluntarily delay of an intended course of action despite expecting to be worse-off for the delay, and is considered a persistent behavior pattern that can result in major psychological suffering. About one-fifth of the adult population and half of the student population are presumed having substantial difficulties due to recurrent procrastination in their everyday lives. However, chronic and severe procrastinators seldom receive adequate care due to preconceptions and the lack of understanding regarding procrastination and the treatment interventions that are assumed beneficial. Cognitive-behavioral therapy is often deemed treatment of choice, although the evidence supporting its use is scarce, and only one randomized controlled trial has been performed. The primary aim of the proposed study is therefore to test the efficacy of cognitive-behavioral therapy delivered as either a group intervention or via the Internet. Participants will consist of students recruited through the Student Health Centre at Karolinska Institutet. A randomized controlled trial with a sample size of 100 participants divided into blocks of thirty will be used, comparing an eight-week Internet-based cognitive-behavioral therapy intervention, and an eight-week group cognitive-behavioral therapy based intervention. It is believed that the proposed study will result in two important findings. First, different treatment interventions in cognitive-behavioral therapy are assumed to be helpful for people suffering from problems caused by procrastination. Second, both an Internet-based cognitive-behavioral therapy intervention and a group intervention are presumed suitable for administering treatment for procrastination, which is considered important as the availability of adequate care is limited, particularly among students. The proposed study will increase the knowledge regarding the efficacy of different treatments of procrastination, as well as enhance the overall comprehension of the difficulties related to dilatory behavior.
    04/2014; 1(2). DOI:10.1016/j.invent.2014.05.005
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