Side effects of psychotherapy

Adverse and side effects of psychotherapy are a relatively new concept in psychotherapy research, despite the fact that they were first elaborated on by Allen Bergin already in 1966. In particular, Bergin wrote about the overall deterioration of clients at the symptom level (deteriation effect). His work was later followed up by other authors who addressed negative and side effects from other perspectives. We now know that there are other side effects of psychotherapy besides deterioration, such as a low-quality therapeutic relationship, deterioration of family relationships, and poor psychotherapy outcomes (and the associated demoralization). We follow this line of research with a series of qualitative and quantitative studies. For example, we are interested in what kind of events or aspects of the therapeutic process are perceived as negative by clients themselves and how side effects relate to other aspects of therapy, such as baseline severity and quality of the therapeutic relationship.


Chvála, Ľ., Řiháček, T., Polakovská, L., Vybíral, Z., & Rozental, R. (2019). Adaptation of the negative effects questionnaire into the Czech context. Psychotherapy Research, 30(4), 510-519.

Chvála, Ľ., Řiháček, T., & Vybíral, Z. (2022). A pilot study of HEXACO dimensions and therapeutic change as potential predictors of negative effects of psychotherapy. Československá psychologie, 66(5), 532-542.​

Chvála, Ľ., & Vybíral, Z. (2023). Case study: Inductive thematic analysis of negative experiences from several psychotherapies over 15 years. Československá psychologie, 67(3-4), 213-229.

Ochs, M., Caha, J., & Řiháček, T. (2024). Risks and side-effects in systemic family therapy. In K. M. Hertlein (Ed.), The Routledge international handbook of couple and family therapy (pp 374–394). Routledge.

Polakovská, L., & Vybíral, Z. (2018). Nežádoucí účinky psychoterapie. Psychoterapie, 12(2), 115-131.

Pourová, M., Řiháček, T., Chvála, Ľ., Vybíral, Z., & Boehnke, J. R. (2022). Negative effects during multicomponent group-based treatment: A multisite study. Psychotherapy Research, 33(3), 282-297.

Vybíral, Z. (2017). Psychoterapeuti chybují I: Historický přehled. Psychoterapie, 11(3), 178-189.

Vybíral, Z. (2019). Psychoterapeuti chybují II: O čem mluvíme, když mluvíme o nezamýšlených a negativních účincích psychoterapie? Psychoterapie, 13(2), 122-137.

Vybíral, Z., Ogles, B. M., Řiháček, T., Urbancová, B. & Gocieková, V. (2024). Negative experiences in psychotherapy from clients’ perspective: A qualitative meta-analysis. Psychotherapy Research, 34(3), 279-292.

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