Is psychotherapy for functional somatic syndromes harmful? A mixed methods study on negative effects

Area of Science:

• Psychology
• Psychiatry
• Clinical Medicine

Background:

• Concerns exist regarding negative effects of psychotherapy for functional somatic syndromes (FSS).
• These concerns may deter patients from seeking necessary treatment.
• Understanding patient-reported negative effects is crucial for improving FSS care.

Purpose of the Study:

• To investigate the occurrence and characteristics of negative effects in group-based psychotherapy for patients with severe or multiple FSS.
• To explore patient experiences of negative effects to inform clinical practice.

Main Methods:

• An explanatory sequential mixed methods design was employed.
• Data were collected using the Inventory for the assessment of Negative Effects of Psychotherapy (INEP) and semi-structured telephone interviews.
• Quantitative data were analyzed descriptively, and qualitative data underwent thematic analysis.

Main Results:

• 31% of patients reported negative effects to some extent.
• The most frequent negative effects included therapist dependence (12%), feeling down post-therapy (6%), and insurance issues (7%).
• Thematic analysis revealed three main themes: therapeutic relationships, treatment outcomes, and the transition from therapy to daily life.

Conclusions:

• Patients with FSS reported few specific negative effects, and these occurred with low frequency.
• Group-based psychotherapy was generally well-received, though some patients experienced negative effects within and outside therapy.
• Informing patients about potential negative effects before commencing psychotherapy is important.