madinamerica
Rebecca Troeger August 15, 2018
A study led by Dr. Schermuly-Haupt of the Psychosomatic Rehabilitation Research Group at Charité University Medicine Berlin examines the prevalence of side effects for Cognitive-Behavioral Therapy (CBT). The researchers, whose results were published in Cognitive Therapy and Research, found that 43% of CBT patients in their sample experienced side effects, which they define as “negative reactions to an appropriately delivered treatment.”
“Knowledge about the side effect profile [of psychotherapy] can improve early recognition of side effects, safeguard patients, and enhance therapy outcome,” the researchers write.
Researchers have long recognized that psychotherapy has positive as well as negative consequences. Estimates of side effect (SE) rates for psychotherapy vary from 5% to 20% of cases. One such side effect — deterioration of symptoms due to therapy — has been found to occur in 3 to 10% of patients. Psychological distress and marital/family conflict are two common side effects of treatment; others include the appearance of new symptoms, suicidality, stigmatization, and tension or changes in a patient’s social relationships.
Despite historical recognition of psychotherapy’s side effects, there is currently little data on their features and rate of occurrence. Dr. Schermuly-Haupt and colleagues sought to address this gap. They interviewed one hundred CBT therapists, asking them to describe “unwanted events” (UEs) experienced by a recent patient who had undergone 10 or more sessions of CBT.
Therapists were prompted to distinguish between unwanted events (i.e., any unwanted event that occurs during therapy, which may or may not be related to the therapy), adverse treatment reactions (i.e., an unwanted event related to treatment), and side effects (i.e. an unwanted event related to treatment that met “professional standards”) through the use of an Unwanted Events-Adverse Treatment Reactions Checklist, which differentiates between these treatment reaction categories.
The researchers found a curious discrepancy between the percentages of side effects identified by psychotherapists who were first asked for a “spontaneous report,” versus the percentage later identified during interviews when the various categories of unwanted events were “systematically evoke[d]” through use of the checklist. Initially, 74% of therapists stated that they didn’t know of any UEs or SEs that had occurred during treatment.
After the structured interview, however, therapists reported that 43% of patients experienced one or more SE (Average .57, SD = .81). This difference in reported side effects may point to a blind spot on the part of psychotherapists, which perhaps owes to difficulty recognizing one’s ability to harm, as well as a lack of training and awareness about psychotherapy’s adverse side effects.
The most commonly reported side effects included “negative well-being/distress,” “deterioration of symptoms,” and “strains in family relations.” According to qualitative data, examples of “negative well-being/distress” included crying uncontrollably in session, discomfort, and fear when engaging in interventions in session (e.g., exposure activities, role plays), difficulty discussing specific topics, and strong feelings experienced in response to the therapist (e.g. anger, tension, stress, and anxiety).
Examples of family strain that emerged as a result of treatment included a spouse who was distressed after his wife became less attentive and took more time for herself after being in therapy and a client who felt guilt and sadness after choosing to distance herself from a parent.
The authors note that there is some debate regarding whether “ordinary reactions” to CBT, such as the distress reactions and changes in patients’ social relationships described above, should be characterized as side effects, particularly since they may be essential to successful treatment outcomes. They argue that even though these responses “may be unavoidable, justified, or even needed or intended,” they should nevertheless be categorized as side effects. These side effects, although “unavoidable” and even “intended,” should be studied and should serve as motivation to develop treatments that “are better tolerated,” they write.
The authors also note that although the majority of the side effects identified in their study were rated as mild to moderate (59.6%) and not lasting (89.6%), over 40% of side effects were classified as severe or very severe, and 8.8% were persistent. Reflecting on these findings, they conclude, “Psychotherapy is not harmless.”
The study has several limitations. As psychotherapists reported side effects, reports may have been influenced by therapist bias; the authors suggest that future studies use a blend of stories from patients, therapists, and outside interviewers. The study’s sample was composed of patients with various diagnoses, and as such, results would likely be different in a more homogenous sample, or with a different form of therapy. Additionally, as approximately half of the patients whose cases were reported on in the study were taking psychotropic drugs, and it is thus impossible to rule out the effect of medication on the observed side effects.
The authors hope that the results of their study will increase psychotherapists’ awareness of treatment side effects and that this will contribute to improved care. In alignment with the recent call for an enhanced psychotherapy informed consent process, the authors also state that their data can be used to strengthen informed consent in psychotherapy, as well as to support “risk monitoring” throughout treatment.
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Schermuly-Haupt, M. L., Linden, M., & Rush, A. J. (2018). Unwanted Events and Side Effects in Cognitive Behavior Therapy. Cognitive Therapy and Research, 42(3), 219-229. (Link)
Thank You Ms Troeger and MIA, BUT, . . . .
With all due respect we Do realize people are trying to 'fix' this broken system.
It Can't be fixed.
Defund it, completely. Shut it down with a 6 week grace period for its practioners to Close up shop and quit the biz.
On Day One of week 7, write out the arrest warrants and indictments and round up everyone still engaged in it.
Showing posts with label CBT. Show all posts
Showing posts with label CBT. Show all posts
Friday, August 17, 2018
Thursday, September 11, 2014
Behavioral Science Falls Flat On Its Face Again: Specialized Counseling Approach Does Not Help With Drinking Problems: Gee, Who'd a Thunk?
September 9, 2014
A commonly-used counseling technique for people with substance abuse issues “may be of limited benefit” to youth, according to a systematic review published in The Cochrane Library. “Researchers found that an approach known as motivational interviewing did not substantially reduce drinking or alter alcohol-related behaviour,” stated a press release about the study.
The researchers reviewed evidence from 66 trials of motivational interviewing involving a total of 17,901 young people aged 25 and under. Many of the studies involved youth at high risk for alcohol-related problems, and youth attended either one individual counseling session, group sessions, or a mixture of group and individual sessions.
Four months later, “on average participants who had counselling had about 1 and a half fewer drinks per week compared to those who had no counselling. (12.2 drinks compared with 13.7),” stated the press release. “The effect of counselling on the number of drinking days was also very small: 2.57 days per week compared to 2.74 in untreated people.”
“The results suggest that for young people who misuse alcohol there is no substantial, meaningful benefit of motivational interviewing,” said lead researcher David Foxcroft of Oxford Brookes University in the press release. “The effects we saw were probably too small to be of relevance to policy or practice.”
Counselling has limited benefit on young people drinking alcohol (Oxford Brookes University Press Release on Wiley, August 20, 2014)
Motivational interviewing for alcohol misuse in young adults (The Cochrane Library (Foxcroft, David R et al. Published Online August 21, 2014. DOI: 10.1002/14651858.CD007025.pub2)
This entry was posted in Featured News, In the News, Psychotherapy, Substance Abuse/Addiction byRob Wipond. Bookmark the permalink.
Thank You Mr Wipond and MIA.
Saturday, August 23, 2014
Nontreatment Better Than CBT For Childhood Anxiety?
What have we been saying about this entire 'Therapeutic' Scam from the start? What do you Expect from the Politics/Ideations of Atheists, Communists and Nazis tarted up and trotted about as Medical Psy-ence?
via madinamerica;
Marsha Linehan: Communism's Dialectic Through Buddhism
How do you like it America?
You're certainly Paying enough for it.
via madinamerica;
August 22, 2014
Children who received no treatment for their diagnosed anxiety disorder faired better over the long term than did those who chose to take Cognitive Behavioral Therapy (CBT), according to a study inBrain and Behavior. In addition, regardless of being treated or not, about half of the people in both groups were generally fairing better at the time of the long-term follow-up.
A team of mainly University of Toronto researchers were able to follow up approximately eight years later with 120 people who at ages 8–12 had been diagnosed with anxiety disorders between 1997-2003. Half of the participants had taken a CBT program, and a comparable group of children had not. “Nontreatment” or “treatment as usual” was defined as those who declined CBT. Some participants from both groups were involved with supportive therapy, religious or spiritual guidance, or taking medication.
“A statistically significant decrease in total anxiety was found in the nontreatment group at [Long Term Follow Up],” the reseachers wrote. Conversely, “An insignificant increase in anxiety was found in the treatment group.”
The researchers described it as the first long-term study to compare youth treated for their anxiety with CBT during childhood to those who were not treated. “Our results are surprising,” they wrote. They conceded there were many limitations to this form of study, such as possible self-selection bias among the participants.
The study also identified “an inverse relationship” with self-efficacy and self-esteem. “Anxiety decreased as self-efficacy and esteem increased.” The researchers hypothesized that this finding reflected how “the meaning attributed to [the anxiety] and the belief that one has the power to cope with it [are] the differentiating factor between clinical and nonclinical groups. To the best of our knowledge, this is the first study to provide evidence for this correlation in the context of therapy.”
Eight years later: outcomes of CBT-treated versus untreated anxious children (Adler, Gili W. et al. Brain and Behavior. August 19, 2014. DOI: 10.1002/brb3.274)
This entry was posted in Anxiety, Children and Adolescents, Featured News, In the News,Psychotherapy by Rob Wipond. Bookmark the permalink.
Thank You Mr. Wipond and MIA.
Related Posts:
see also;
Suicidal Ideations By The Numbers: Counseling Is WORSE Than Zoloft.http://psychroaches.blogspot.com/2010/11/suicidal-ideations-by-numbers.html
Talk Therapy Can Cause Harm Too by Jill Littrell P.hD.
And if That doesn't do it for you, let's Really go to town with Dialectical Behavioral Therapy.Marsha Linehan: Communism's Dialectic Through Buddhism
How do you like it America?
You're certainly Paying enough for it.
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