Department of Psychology, Uppsala University, Uppsala, Sweden.
Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Psychother Res. 2024 Jul;34(6):709-721. doi: 10.1080/10503307.2023.2259064. Epub 2023 Sep 27.
The present study explored Swedish clinical psychologists' attitudes and practices of informing patients about possible negative effects of psychological treatment.
An anonymous online survey with closed and open-ended questions was distributed via Facebook and two mailing lists. In total, 320 clinical psychologists (age = 38.6, SD = 10.3; 76% women; 77.3% Cognitive Behavior Therapy) completed the survey. Responses were analyzed using χ, binominal regression analysis, and thematic analysis.
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.
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.
本研究探讨了瑞典临床心理学家告知患者心理治疗可能产生负面影响的态度和做法。
通过 Facebook 和两个邮件列表，以匿名在线调查的方式，向 320 名临床心理学家（年龄=38.6，标准差=10.3；76%为女性；77.3%为认知行为疗法）发放了封闭式和开放式问题的调查问卷。使用 χ²检验、二项式回归分析和主题分析对回复进行了分析。
未发现选择的人口统计学变量与告知患者可能产生的负面效果之间存在显著关联，即从业年限、治疗取向、年龄和性别（男）。主题分析得出了一些对分享患者可能产生的负面效果的信息的积极（例如，建立对治疗的现实期望和提高适应力）和消极态度（例如，引起过度担忧）。它还揭示了尽管被认为很重要，但存在各种阻碍该话题进行公开讨论的因素。
应将为患者提供有关可能产生的负面效果的信息纳入道德准则、行为准则和临床培训中。然而，缺乏知识、恐惧、缺乏时间和患者特征似乎阻止了治疗师在知情同意过程中讨论这个问题。
