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Cited by 44Psychotherapy Techniques and ApplicationsMental Health Treatment and AccessPsychiatric care and mental health services

Rate and predictors of negative effects of psychotherapy in psychiatric and psychosomatic inpatients

Rheker, Julia, Beisel, Sylvia, Kräling, Svenja, Rief, Winfried·2017·Psychiatry Research
DOI 10.1016/j.psychres.2017.04.042
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Abstract

Studies examining the rates of negative effects of psychotherapy are rare and the reported rates differ widely. To be able to calculate adequate benefit-cost ratios in conjunction with different samples and settings, we need a deeper understanding of these effects. We therefore investigated whether different treatment settings would reveal varying rates and kinds of negative effects by recruiting patients from a psychiatric (n=93) and a psychosomatic rehabilitation (n=63) hospital. Negative effects of psychotherapy were assessed with the Inventory for the Assessment of Negative Effects of Psychotherapy post-treatment. To investigate whether patients' pre-treatment expectations have an influence on reported negative effects, patients filled in the Patient Questionnaire on Therapy Expectation and Evaluation prior to treatment begin. Patients from the psychiatric hospital reported an average 1.41 negative effects, with 58.7% reporting at least one negative effect. Those from the psychosomatic hospital reported 0.76 negative effects on average, with 45.2% of patients reporting at least one negative effect. The differences between these samples are significant. The two samples' top three reported types of negative effects are that patients had experienced more downs during or just before the end of the therapy, that patients had difficulty making important decisions without the therapist, and that patients were concerned that colleagues or friends might find out about the therapy. A regression analysis revealed that the clinical setting (psychosomatic rehabilitation hospital vs. psychiatric hospital) and expectations in the form of hope of improvement were significant predictors for negative effects of psychotherapy. Our study highlights the need to examine the negative effects of psychotherapy in different settings and samples to better evaluate the benefit-cost ratios of treatments for different patient groups. It also shows that we need guidelines for assessing and reporting negative effects.

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  • Side effects as measured with the INEP have been linked to poorer therapeutic alliance, more interpersonal difficulties, higher treatment expectations, and lower treatment satisfaction.

    “Side effects as measured with the INEP have been linked to poorer therapeutic alliance (measured with the Helping Alliance Questionnaire), more interpersonal difficulties (measured with the Inventory of Interpersonal Problems, Gerke, Meyrose, Ladwig, Rief, & Nestoriuc, 2020), higher treatment expectations (Abeling, Müller, Stephan, Pollmann, & De Zwaan, 2018;Rheker, Beisel, Kräling, & Rief, 2017)”

    From Effective—and Tolerable: Acceptance and Side Effects of Intensified Exposure for Anxiety Disorders (2023) · cites this paper as Rheker, Beisel, Kräling, & Rief, 2017

  • The most frequent side effects in this study were (fear of) treatment stigma, insurance problems, low mood, the experience to depend on the therapist and conflicts with patients' partners.

    “The most frequent side effects in this study were (fear of) treatment stigma, insurance problems, low mood, the experience to depend on the therapist and conflicts with patients' partners”

    From Effective—and Tolerable: Acceptance and Side Effects of Intensified Exposure for Anxiety Disorders (2023) · cites this paper as Rheker et al., 2017

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Authors
Rheker, J., Beisel, S., Kräling, S., & Rief, W.
Affiliations
  • Philipps University of Marburg (DE)
  • Salus Klinik (DE)
Corresponding author
Rheker, Julia
ORCID
Rief, Winfried
Venue
Psychiatry Research
Publisher
Elsevier BV
Published
2017-08
Volume
254
Pages
143-150
ISSN
0165-1781 (ISSN-L)
DOI
10.1016/j.psychres.2017.04.042
OpenAlex
W2606286922
Cited by
44
References
24
Citations by year
2026: 2 · 2025: 4 · 2024: 7 · 2023: 4 · 2022: 4 · 2021: 8 · 2020: 5 · 2019: 5 · 2018: 5
FWCI
5.09
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Psychiatry Research (publishedVersion)
  • PubMed (publishedVersion)
Funders
German Research Foundation (DFG, RI 574/ 22-2)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
Keywords
adverse effects, psychiatric inpatients, psychosomatic rehabilitation, treatment setting, patient expectations, benefit-cost ratio
MeSH terms
Adult, Mental Disorders, Female, Hospitals, Psychiatric, Humans, Male, Middle Aged, Predictive Value of Tests, Psychophysiologic Disorders, Psychotherapy, Surveys and Questionnaires, Treatment Outcome

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