title: Adverse effects of psychological therapy: An exploratory study of practitioners' experiences from child and adolescent psychiatry.
abstract: The scientific knowledge about adverse effects of psychological therapies and how such effects should be detected is limited. It is possible that children and adolescents are particularly vulnerable and need specific support in order to express adverse effects. In this exploratory study, we used a qualitative approach to explore practitioners' experiences of this phenomenon. Fourteen practitioners providing psychological therapy within the Child and Adolescent Psychiatric Service were interviewed. Qualitative content analysis was applied to the data. Four overarching categories brought up by the practitioners were identified: vagueness of the concept (reflecting that the concept was novel and hard to define), psychotherapist-client interaction (encompassing aspects of the interaction possibly related to adverse effects), consequences for the young person (including a range of emotional, behavioural and social consequences) and family effects (e.g. professional complications and decreased autonomy for the parent). Professional discussions on these issues could improve psychological therapy for children and adolescents. Based on our findings and previous research, we propose three basic aspects to consider when adverse effects are detected and managed in this context: typology (form, severity and duration), aetiology (hypothesis about the causes) and perspective (adverse effects seen from the points of view of different interested parties).
authors.affiliation: Department of Neuroscience, Child and Adolescent Psychiatry, Uppsala University, Sweden National Board of Health and Welfare, Sweden ulf.jonsson@neuro.uu.se.
authors.forename: Ulf
authors.initials: U
authors.lastname: Jonsson
authors.affiliation: Department of Psychology, Uppsala University, Sweden.
authors.forename: Josefin
authors.initials: J
authors.lastname: Johanson
authors.affiliation: National Board of Health and Welfare, Sweden Department of Psychology, Uppsala University, Sweden.
authors.forename: Elin
authors.initials: E
authors.lastname: Nilsson
authors.affiliation: Department of Neuroscience, Child and Adolescent Psychiatry, Uppsala University, Sweden.
authors.forename: Frank
authors.initials: F
authors.lastname: Lindblad
mesh_terms: D000293:Adolescent; D000296:Adolescent Psychiatry; D002648:Child; D002665:Child Psychiatry; D005190:Family; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000523:psychology / Q000628:therapy*; D010290:Parents; D011369:Professional-Patient Relations; D013811:Psychotherapeutic Processes; D011613:Psychotherapy; D036301:Qualitative Research
keywords: Adverse effects; child and adolescent psychiatry; psychotherapeutic processes; psychotherapy; qualitative research