Volume 15, Issue 3 (1-2026)
Clin Exc 2026, 15(3): 52-63 |
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Pordel H, Abbasi R. Unintended Consequences of Psychotherapy: A Systematic Review. Clin Exc 2026; 15 (3) :52-63
URL: http://ce.mazums.ac.ir/article-1-915-en.html
URL: http://ce.mazums.ac.ir/article-1-915-en.html
Ph.D. in Clinical Psychology, Faculty of Humanities, Shahed University, Tehran, Iran.
Abstract: (218 Views)
Background and purpose: Although psychotherapy is considered one of the most effective interventions for mental disorders, like any clinical intervention, it may be accompanied by unintended consequences and side effects. However, the concept, prevalence, and outcomes of such adverse effects have not yet been comprehensively and systematically examined in the literature. The present study aimed to conduct a systematic review of published research on the side effects and negative experiences related to psychotherapy over the past decade.
Materials and Methods: This systematic review was conducted through a targeted search of such databases as PubMed, Google Scholar, PsycINFO, Scopus, and the Scientific Information Database (SID) for studies published between 2013 and 2025. After screening based on inclusion and exclusion criteria, 12 eligible studies were included in the final analysis. The data were analyzed with a focus on the types of adverse effects, their prevalence, possible causes, and characteristics of therapeutic approaches.
Results: The side effects of psychotherapy are diverse, multifaceted, and sometimes pronounced, including symptom exacerbation, increased anxiety and depression, cognitive disturbances, feelings of frustration, premature termination of treatment, and weakening of the therapeutic relationship. Some studies, using a broader definition of adverse experiences, have reported a prevalence of up to 95%, although the occurrence of severe or persistent effects is less common. The lack of precise conceptual definitions, limitations in measurement tools, and variability in reporting methods remain major challenges in identifying and managing these adverse effects.
Conclusion: Psychotherapy side effects represent a significant reality within the therapeutic process, yet they are often overlooked in clinical and educational systems. Developing clear conceptual and ethical frameworks, validated assessment tools, and structured training for therapists in identifying and managing such outcomes are essential steps toward enhancing psychotherapy safety.
Materials and Methods: This systematic review was conducted through a targeted search of such databases as PubMed, Google Scholar, PsycINFO, Scopus, and the Scientific Information Database (SID) for studies published between 2013 and 2025. After screening based on inclusion and exclusion criteria, 12 eligible studies were included in the final analysis. The data were analyzed with a focus on the types of adverse effects, their prevalence, possible causes, and characteristics of therapeutic approaches.
Results: The side effects of psychotherapy are diverse, multifaceted, and sometimes pronounced, including symptom exacerbation, increased anxiety and depression, cognitive disturbances, feelings of frustration, premature termination of treatment, and weakening of the therapeutic relationship. Some studies, using a broader definition of adverse experiences, have reported a prevalence of up to 95%, although the occurrence of severe or persistent effects is less common. The lack of precise conceptual definitions, limitations in measurement tools, and variability in reporting methods remain major challenges in identifying and managing these adverse effects.
Conclusion: Psychotherapy side effects represent a significant reality within the therapeutic process, yet they are often overlooked in clinical and educational systems. Developing clear conceptual and ethical frameworks, validated assessment tools, and structured training for therapists in identifying and managing such outcomes are essential steps toward enhancing psychotherapy safety.
Type of Study: Review |
Subject:
روانشناسی
Received: 2025/07/29 | Accepted: 2025/12/20 | Published: 2025/12/20
Received: 2025/07/29 | Accepted: 2025/12/20 | Published: 2025/12/20
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