Psychotherapy, like other therapies, may have a wide range of side effects. Naturally every kind of different psychoterapies may have different not-wanted results. A good, well trained, experiencede, and emotinal well balanced therapist know how to avoid iatrogenic effects tha can rise up to the death of the patient. This makes no diffence with the use of the others main (pharmacological) therapies.

psychotherapy is a kind of intervention and like many other intervention has effects and side effects. in this therapeutic method we want to change a bad condition and push patient toward better life but some time we just start it without any progression with superimposed financial and time loss . I saw some patients who developed depression after psychoanalysis .

There is a undulatory discussion about side effects of psychotherapy, and it´s not only about sex, crime and death. 2011 I published a paper about the use of risk management in psychotherapy. It is in German but the references may help:

https://www.researchgate.net/publication/215689264_Primum_non_nocere_secundus_opinio_vulnero

Article Primum non nocere, secundus opinio vulnero

Of course, psychotherapy has side effects. There is one important aspect of psychotherapeutic approaches - as is in any other intervention offered to our patients: the patient is given the idea that there is something available that will finally help with his or her problem. Therefore any intervention regardless of whether it is empirically tested and useful or not will induce the hope of symptom relief. We must not forget the hope we are inducing in those who suffer when we talk about treatment options. On the contrary, we must be aware of the disappointment that is caused whenever an intervention fails to help.

For cognitive behavioral therapy there are several known side effects. Just two side effects that come to my mind instantly: First, patients are forced to deal with a particular problem they would otherwise cope with differently and dealing with the problem often causes temporarily a deterioration of symptoms. But we can manage those and inform the patients beforehand. Second, being successful the patient will gain more selfconfidence and self management skills which will often change interpersonal behavior. Sometimes this causes distress for those around our patients.

I totally agree with all that has been written but any scientific report of this? Any long-term assessment of negative effects of psychotherapy? Let's be clear, I support psychotherapy when correctly done but I think robust data on side effects would balance the public debate instead of the current "bad medication" vs "safe psychotherapy" sterile one.

There is a paper by Berk and Parker from 2009 Australian and New Zealand Journal of Psychiatry. PMID: 19670051

Please also refer to this previous discussion on researchgate: https://www.researchgate.net/post/What_are_the_side_effects_of_Psychotherapy_of_whatever_modality

I gave there the following references:

Barlow DH (2010): Negative Effects From Psychological Treatments: A Perspective. Am Psychol 65:13-20.

Berk M, Parker G (2009): The Elephant on the Couch: Side-Effects of Psychotherapy. Aust N Z J Psychiatry 43:787-794.

Castonguay LG, Boswell JF, Constantino MJ, Goldfried MR, Hill CE (2010): Training Implications of Harmful Effects of Psychological Treatments. Am Psychol 65:34-49.

Dimidjian S, Hollon SD (2010): How Would We Know If Psychotherapy Were Harmful? Am Psychol 65:21-33.

Hoffmann SO, Rudolf G, Strauß B (2008): Unerwünschte und schädliche Wirkungen von Psychotherapie. Psychotherapeut 53:4-16.

Linden M (2012): How to Define, Find and Classify Side Effects in Psychotherapy: From Unwanted Events to Adverse Treatment Reactions. Clinical Psychology & Psychotherapy:n/a-n/a.

Nutt DJ, Sharpe M (2008): Uncritical positive regard? Issues in the efficacy and safety of psychotherapy. Journal of Psychopharmacology 22:3-6.

I just noticed that there is an overlap with a prior reference, sorry...

Annette, thanks for these references. John

Thanks Annette for the references. I will pass them to my students. Nines

Thanks everybody for your useful comments and ref.

Again, Thank you for the interesting references. To your knowledge, are there publications which are concerned with psychotherapy side effects in patients who are somatically ill (e.g. cancer patients with a depression)? This was a major question in the pt sessions of the World Congress of Psycho-Oncology (IPOS) this year in Rotterdam.

Psychotherapy (persuasive conversation using various strategies) as suggested in previous postings can be harmful. I am interested to read the term side effect rather than harm. It suggest perhaps an unaware medical approach. But of course once gotten beyond the professional vocabulary all we do is talk with those coming for help. Conversations can be helpful or harmful but they can't like pills have side effects. In fact if you look at the latest research well discussed in a 2010 book The Heart and Soul of Change: Delivering What Works in Therapy what works is not specific technique but the relationship and the commitment and belief of the client in the therapist. But since any hoped for positive experience can go wrong people may feel that they received little , no or harmful help. As we can see by the vast numbers of clients who fail to follow up after one or two sessions.

There are different types of psychotherapies. It also depends on if a person has history of trauma. For trauma related therapies, one has to be a bit more careful.

Generally speaking cognitive behavioral therapy is safe and with no major side effects

Regarding psychodynamic oriented psychotherapy; particularly Group therapy, besides the rush for self disclosure and pressure to share with risk of being escape goat; with inexperienced therapist patients could suffer group sessions a lot. However, we learned that with less supervision - even peer supervision- and less evaluation psychotherapy could have hazards as: using patients with or without unresolved transference for therapist emotional satisfaction, development of uncontrolled psychotic flare up, replacing realistic relations by therapeutic relations as main object, dependence on therapist, break down in personal relations with more insight in pathological nature of some relations in reality, suicidal risk is sometimes warned of ; therapist also may be more defensive and hence delay his/her growth..!!!

In psychotherapy the relationship-client relationship is often confusing even for the patient- therapist. Occasionally there are invisible boundary issues. By that I mean, the patient can become dependent on the theraputic process. There have been therapist who have created the need for dependence, and continue to foster this dependency. If he the therapist chooses to accept a job,elsewhere, for more compensation, two weeks notice can have detrimental effects for the patient, especially if the therapist leaves immediately without closure because they have vacation time they have accumulated. There has also been older research that has blamed therapist for creating the notion in the patients mind that they have unresolved and they have suffered some type of abuse-usually sexual. of abuse in patients,. False accusations of prior sexual abuse that surfaced during therapy that were in later identified as being false, can rip family relationships apart.

So, yes psychotherapy has be harmful to patients, however this is not always the case. There has been wonderful relationships with the therapist that provides support during the tough moments in psychotherapy, I have heard or read that these relationships freed the patient from the pain they brought to therapy allowing the patient to move on in their kife.

I think yes in some cases