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Negative effects during multicomponent group-based treatment: A multisite study.
Martina Pourová1, Tomáš Řiháček1, Luboš Chvála1
1Department of Psychology, Faculty of Social Studies, Masaryk University, Brno, Czech Republic.
Summary
Negative effects (NEs) in group therapy, such as worsening symptoms or unpleasant memories, are common. High initial distress and poor therapeutic alliance predict NEs, but they are not required for positive change.
Area of Science:
- Psychology
- Psychotherapy Research
- Clinical Psychology
Background:
- Negative effects (NEs) in group treatments are under-researched.
- Understanding NEs is crucial for improving therapeutic outcomes.
Purpose of the Study:
- To explore the prevalence of various NEs in multicomponent group-based treatment.
- To identify predictors of NEs in this therapeutic context.
Main Methods:
- 330 patients from seven clinical sites participated.
- The Negative Effects Questionnaire (NEQ) measured NEs post-treatment.
- Structural equation modeling identified predictors of NEs.
Main Results:
- Worsening of symptoms was the most frequent NE type; resurfacing of unpleasant memories was the most frequent item.
- Predictors included distress, alexithymia, attachment avoidance, low working alliance, problem actuation, and worse outcomes.
- Psychological mindedness acted as a protective factor.
Conclusions:
- Patients with higher initial distress, a problematic group alliance, and high in-session emotional arousal are prone to NEs.
- NEs are not a prerequisite for therapeutic change.
- Findings inform strategies to mitigate negative effects in group therapy.
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