title: How to define, find and classify side effects in psychotherapy: from unwanted events to adverse treatment reactions.
abstract: OBJECTIVE
  Empirical research on the negative effects of psychotherapy is insufficient, partly because there is a lack of theoretical concept on how to define, classify and assess psychotherapy side effects. This paper proposes a model for the definition, classification and assessment of psychotherapy side effects.
  
  
  METHODS
  Definitions are provided for 'unwanted events', 'treatment-emergent reactions', 'adverse treatment reactions', 'malpractice reactions', 'treatment non-response', 'deterioration of illness', 'therapeutic risks' and 'contraindications'. We describe processes analysing the causality of negative events and the correctness of treatment.
  
  
  RESULTS
  A procedural model on how to find, classify and evaluate negative events is described, the unwanted event to adverse treatment reaction (UE-ATR) checklist.
  
  
  CONCLUSIONS
  Recognition of adverse treatment effects is a characteristic of good therapists and treatments. Psychotherapists should be sensitive for negative effects. This can help improve the quality of treatment. The UE-ATR checklist can be used in psychotherapy trials, quality assurance, clinical practice and training of psychotherapists.
authors.affiliation: Research Group Psychosomatic Rehabilitation, Charité University Medicine Berlin, Berlin, Germany. michael.linden@charite.de
authors.forename: Michael
authors.initials: M
authors.lastname: Linden
mesh_terms: D002983:Clinical Competence; D018450:Disease Progression; D006801:Humans; D008318:Malpractice; D001523:Mental Disorders / Q000628:therapy*; D011369:Professional-Patient Relations; D011613:Psychotherapy / Q000379:methods* / Q000592:standards*; D011787:Quality of Health Care; D017211:Treatment Failure