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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. [ABSTRACT FROM AUTHOR]