Psychotherapy Can Make Some People Feel Worse, Study Finds

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Psychotherapy can be a vital and even life-saving treatment for people experiencing mental health issues, but it’s not always a pleasant experience. A new study in the British Journal of Psychiatry quantifies the small part of the population who actively feel worse after therapy. About one in 20 people surveyed felt lasting negative effects from psychotherapy, the study found.

UK-based researchers led by Mike Crawford of the Royal College of Psychiatrists’ Centre for Quality Improvement surveyed adult patients from 220 English therapy clinics. Out of more than 14,000 respondents—most of whom received cognitive-behavioral therapy, group therapy, or some other kind of psychological treatment—more than 5 percent said that therapy resulted in lasting negative effects.

Minorities (both ethnic minorities and sexual minorities, including those who identify as LGBT) were more likely to report that therapy had been a negative influence. And younger people were more likely to have had a bad therapy experience that stuck with them than those over 65.

While the survey didn’t specifically ask what kind of negative effects therapy had, the researchers write that subsequent interviews of those respondents indicate that therapy can cause “exacerbations of existing symptoms and emergence of new ones including anxiety, anger and loss of self-esteem.”

It’s not terribly surprising that the mental health system doesn’t serve minorities as well as it should. Therapists have the same potential for bias as the rest of us, especially if they aren’t particularly well-educated on the issues facing minority patients. A prime example: As late as 2013, the American Psychiatric Association had to apologize for listing pedophilia as a sexual orientation [PDF]. The same organization has been criticized for its unwillingness to recognize that a lifetime of experiencing racism can contribute to PTSD.

The researchers behind the study suggest that the findings might encourage more consideration of "cultural competence" in the mental health field.

[h/t BPS Research Digest]