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Therapists and psychotherapy side effects in China: A machine learning-based study.

Lijun Yao1, Zhiwei Xu2,3, Xudong Zhao1

  • 1Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, Tongji University School of Medicine, Shanghai 200124, PR China.

Heliyon
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Therapist awareness of psychological states is key to identifying psychotherapy side effects. Understanding these factors helps improve patient outcomes and therapist practice.

Keywords:
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Area of Science:

  • Psychology
  • Clinical Psychology
  • Psychotherapy Research

Background:

  • Side effects in psychotherapy are recognized but often unavoidable.
  • Therapist influence on psychotherapy side effects is significant.
  • Quantitative studies on therapist mechanisms contributing to side effects are limited.

Purpose of the Study:

  • To develop and validate a tool for assessing therapists' perceptions of client side effects.
  • To identify key factors distinguishing therapists who perceive client side effects from those who do not.
  • To explore the application of machine learning in understanding therapist contributions to psychotherapy outcomes.

Main Methods:

  • Designed the psychotherapy Side Effects Questionnaire-Therapist Version (PSEQ-T).
  • Collected data online from 530 therapists via a cross-sectional analysis.
  • Employed six machine learning algorithms and SHAP values to identify predictive features for therapist categories.

Main Results:

  • A 59.6% incidence of therapists perceiving client side effects was observed, with 'making clients feel bad' being most common (49.8%).
  • A Random Forest classifier achieved the best performance (F1=0.722, AUC=0.717) in distinguishing therapist groups.
  • "Therapists' psychological activity" emerged as the most significant feature for categorization.

Conclusions:

  • Therapist awareness and management of their psychological states are critical for perceiving psychotherapy side effects.
  • Mastery of psychotherapy limitations, theory, and technology influences therapist perception of client side effects.
  • Findings highlight the importance of therapist self-awareness in mitigating potential negative impacts in psychotherapy.