Informing patients about possible negative effects of psychological treatment: A survey of Swedish clinical psychologists’ attitudes and practices

Abstract

Objective: The present study explored Swedish clinical psychologists’ attitudes and practices of informing patients about possible negative effects of psychological treatment. Method: An anonymous online survey with closed and open-ended questions was distributed via Facebook and two mailing lists. In total, 320 clinical psychologists (age M = 38.6, SD = 10.3; 76% women; 77.3% Cognitive Behavior Therapy) completed the survey. Responses were analyzed using χ², binominal regression analysis, and thematic analysis.

Results: No significant associations were identified between demographic variables selected a priori and informing patients about possible negative effects, i.e., years in practice, therapeutic orientation, age, and male gender. The thematic analysis resulted in several positive (e.g., creating realistic expectations of treatment and increasing resilience) and negative attitudes (e.g., causing excessive worry) of sharing patients with information about possible negative effects. It also revealed various factors that prevent an open discussion on the topic, despite being seen as important.

Conclusion: The need to offer patients information about possible negative effects should be included in ethical guidelines, codes of conduct, and taught during clinical training. Lack of knowledge, fear, lack of time, and patient characteristics however seem to prevent therapists from discussing the issue during the informed consent procedure.

Keywords:

• Negative effects
• attitudes
• practice
• thematic analysis
• online survey
• psychological treatment
• informed consent

Acknowledgements

The authors would like to thank George Vlaescu for his help with the online survey, and the Swedish Psychological Assocation for providing demographic information about their members. Both the clinical division of the Swedish Psychological Association [Sveriges Kliniska Psykologers Förening], and the Swedish Association of Behaviour Therapy [Beteendeterapeutiska föreningen] are thanked for their help in advertising the present study. Author contributions: The idea behind the present study was drafted by AR, who also acted as principal investigator. FW and AR developed the survey. FW advertised the study and managed the data collection. Quantitative analyses were made by AR, while FW conducted the qualitative analyses under supervision of AR. Both FW and AR authored the manuscript.

Disclosure Statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The present study did not receive any funding.