[Negative Effects of Psychotherapy: Prevalence and Correlates in a Clinical Sample]

So far, the prevalence of negative effects of psychotherapy and their correlates have rarely been investigated in a systematic manner. The prevalence of negative effects varied between 3 studies with the Inventory for Assessing Negative Effects of Psychotherapy (INEP) with 20, 84, and 93.8% substantially. Thereby, the impact of bias effects remains unclear. In addition, reported correlates of the number of negative effects were examined and augmented with further correlates.

For the study, a clinical sample of inpatients and day-patients (N=200) evaluated their previous psychotherapy retrospectively before their current admission with the Inventory for Assessing Negative Effects of Psychotherapy (INEP). Sociodemographic and clinical data of both patients and therapists as well as time-related and methodical aspects of the evaluated psychotherapy were examined as possible correlates.

70.5% (n=141) of the patients reported at least one negative effect (M=2.11, SD=2.23). The most common negative effects were "longer periods of negative mood" (39.9%) and "being offended by statements of the therapist" (28%). Higher symptom severity, lower subjective success of the evaluated therapy, as well as unfulfilled expectations regarding therapy outcome but not the quality of the therapeutic relationship were associated with a higher number of negative effects. Also female gender of patient and therapist and a younger age of the therapist were significantly associated with more negative therapy effects.

The prevalence of negative effects was not negligible. In line with previous studies, the highest rates of negative effects were reported for "symptoms" and aspects of the "therapeutic relationship". The study confirms several correlates for the number of retrospectively assessed negative effects. Patients need to be informed about negative effects prior to psychotherapeutic treatment.