The Taboo in Psychotherapy: A Systematic Review of Negative Effects

No matter how well-intentioned psychological treatments are planned and implemented, they have the potential to affect clients negatively or to end unexpectedly. These negative effects are represented by very different terms in the literature. It is not clear how to define negative effects, how they will be evaluated, or what to do when encountered with them. The purpose of this systematic review was to bring together the studies on the negative effects of psychotherapy and to examine how this concept is handled and what these effects can be from the perspective of therapists and clients. As a result of the systematic literature review, 58 studies on this subject were reached, and 14 articles meeting the screening criteria were examined in detail. According to the findings, the terms used for this phenomenon include negative effects, negative indicators, side effects, deterioration-worsening of symptoms and undesirable effect. The negative effects stated in these studies with different numbers of participants suffering from different disorders and various methods are defined as technical problems, problems with the therapeutic relationship, increase or worsening of symptoms, failure to meet the expectations of the client and therapist from psychotherapy. It was thought that more randomized controlled trials were needed to make a clear conclusion on this issue. It is thought that the widespread use of such research will improve mental health studies, bring awareness to therapists by focusing on this concept that seems taboo, will have effects on being more beneficial to clients and making psychotherapies more functional.