Patients' perception of side effects in cognitive-behavior, psychodynamic, and psychoanalytic outpatient psychotherapy.

OBJECTIVE: To assess and compare the frequency of psychotherapeutic side effects in different psychotherapeutic approaches.

METHOD: Side effects were assessed across 17 domains through structured interviews with 45 outpatients in cognitive-behavior, psychodynamic, and psychoanalytic psychotherapy.

RESULTS: Almost every patient (95.6%) reported at least one side effect, with a mean of 4.7 affected domains. Most frequent complaints were that problems were seen as more complex (60.0-80.0%), worsening of pre-existing symptoms (46.7-60%), occurrence of new symptoms (20.0-53.3%), feeling uncomfortable in treatment (33.3-40.0%), tensions with therapist (26.7-46.7%), as well as conflicts with current family and with family of origin (both 13.3-46.7%). Differences between therapeutic orientations were mostly non-significant.

CONCLUSION: Psychotherapy is regularly accompanied by side effects, independent of different theoretical orientations. Psychotherapists need to be familiar with side effects in order to inform patients about treatment-associated risks and to recognize and manage side effects.