CoChat
Sign Up
Cited by 216Psychotherapy Techniques and ApplicationsPsychoanalysis and Psychopathology ResearchElectroconvulsive Therapy Studies

The Elephant on the Couch: Side-Effects of Psychotherapy

Open access
Berk, Michael, Parker, Gordon·2009·Australian & New Zealand Journal of Psychiatry
DOI 10.1080/00048670903107559
Open this paper in CoChat — free accountOpen PDF

Abstract

Although we take it as a given that many psy-chotherapies are efficacious, form a cornerstone of much current practice, and are valued by many patients, there is a dissonance in the way in which physical therapies and psychotherapies are consid-ered in terms of their costbenefit ratio. Any potent intervention has both the capacity to cure and to harm. For drug-based therapeutic trials, adverse event monitoring is mandatory. By contrast, evalua-tion of psychotherapy has historically weighted the ‘benefit ’ side of the equation. For example, is a particular type of psychotherapy effective, is one psychotherapy superior to another, or does psy-chotherapy benefit a particular condition? At first pass it might appear bizarre to question

Integrity signals

Registry

Crossref · 10.1080/00048670903107559

Cites

5 of 5 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

We couldn’t retrieve this paper’s full text, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Most clinical trials focus on the average treatment outcome and the number of patients achieving clinically significant change, while ignoring that some patients might experience adverse or unwanted events.

    “Most clinical trials focus on the average treatment outcome and the number of patients achieving clinically significant change, while ignoring the fact that some patients might also experience adverse or unwanted events (Berk 2009).”

    From Psychotherapeutic treatments for depression in older adults (2024) · cites this paper as Berk 2009

  • Population interventions to prevent substance abuse in children or common mental disorders in humanitarian settings have been shown to worsen outcomes.

    “Population interventions to prevent substance abuse in children or common mental disorders in humanitarian settings have been shown to worsen outcomes 261”

    From Preventive psychiatry: a blueprint for improving the mental health of young people (2021) · cites this paper as [261]

  • Some adverse effects are expected in psychotherapy trials, including new symptoms and strains in the patient-therapist relationship, but few psychotherapy trials report data on adverse events and suicidality.

    “Some of the adverse effects would also be expected in psychotherapy trials, including the emergence of new symptoms and strains in the patienttherapist relationship, 43 however, few psychotherapy trials report data on adverse events and suicidality.44”

    From Comparative efficacy and acceptability of antidepressants, psychotherapies, and their combination for acute treatment of children and adolescents with depressive disorder: a systematic review and network meta-analysis (2020) · cites this paper as [43]

  • Factors that limit MBI trials involving UEs include difficulty obtaining a statistically significant number of participants and the type of design of these studies.

    “In addition to these possible flaws, factors that limit MBI trials involving UEs include the difficulty associated with obtaining a statistically significant number of participants and the type of design of these studies [6, 27, 28].”

    From Unwanted effects: is there a negative side of meditation? A multicentre survey (2017) · cites this paper as [27]

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Authors
Berk, M., & Parker, G.
Affiliations
  • Barwon Health (AU)
  • Black Dog Institute (AU)
Corresponding author
Berk, Michael
ORCID
Parker, Gordon
Venue
Australian & New Zealand Journal of Psychiatry
Publisher
SAGE Publications
Published
2009-01-01
Volume
43
Issue
9
Pages
787-794
ISSN
  • 0004-8674 (ISSN-L)
  • 1440-1614
DOI
10.1080/00048670903107559
OpenAlex
W2169639228
Cited by
216
References
5
Citations by year
2026: 5 · 2025: 11 · 2024: 20 · 2023: 13 · 2022: 11 · 2021: 42 · 2020: 25 · 2019: 8 · 2018: 16 · 2017: 13 · 2016: 7 · 2015: 10 · 2014: 9 · 2013: 4 · 2012: 9
FWCI
7.41
Type
journal article
Language
en
Open access
Licence
journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations
  • Australian & New Zealand Journal of Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Bristol-Myers Squibb
  • Eli Lilly and Company
  • Pfizer
  • Sanofi
  • Geelong Region Medical Research Foundation
  • Beyond Blue
  • Servier
  • H. Lundbeck A/S
  • National Health and Medical Research Council (510135, 520616)
  • Cilag
Topics
  • Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
  • Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
  • Health Sciences › Medicine › Psychiatry and Mental health › Electroconvulsive Therapy Studies
Keywords
adverse effects of psychotherapy, adverse event monitoring, psychotherapy efficacy, psychotherapy evaluation
MeSH terms
Clinical Competence, Humans, Psychology, Psychotherapy, Evidence-Based Practice

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review