Psychological factors related to the experience of and reaction to electroconvulsive therapy

Abstract

Background

Aside from the focus on satisfaction levels, psychological aspects of the experience of electroconvulsive therapy (ECT) have not traditionally been the focus of significant research. Given that clinical psychologists work closely with professionals involved in administering ECT, and have increasing involvement with decisions about ECT, there is a potential role for clinical psychologists in this area.

Aims

To review the diverse sources of literature regarding how patients psychologically experience, and react to, ECT.

Method

A literature search identified relevant published papers related to the patient experience of ECT. Reviewed articles included clinician and service user led research, comprising qualitative and quantitative research approaches and policy documents.

Results

Patients have multiple and diverse reactions to ECT. These can be considered under the themes of consent, fear, powerlessness, memory and identity. The experience of ECT can significantly impact on patients and this can have a negative long-term influence.

Conclusions

Clinical psychologists need to be actively involved in consent procedures, use clinical formulation to understand the perspective of patients, and empower patients to share their views of ECT with mental health professionals and service developers. Further research into how patients experience ECT, particularly using qualitative methods, is recommended.

Keywords:

• electroconvulsive therapy
• consent
• fear
• powerlessness
• memory

Notes

1. Throughout this paper the author refers to those who received ECT as ‘patients’ This is because ECT is a medical treatment performed in a hospital setting and therefore the term patient seems the most appropriate. However the word ‘client’ is used to refer to people receiving services from mental health teams.