Do No Harm:: The Impact of Experience on Reducing Adverse Effects of Psychotherapy in Older Clients

Psychotherapy can be a highly beneficial form of treatment, which has also had success among older people. However, it is increasingly recognized by psychologists that psychotherapy can have adverse side effects.<br/>This longitudinal study investigates the impact of practice on the adverse effects of psychotherapy with elderly individuals. It follows a team of psychologists through the first 100 clients in their professional careers to explore whether increased practice leads to fewer adverse effects for their clients. The psychologists routinely monitor the effects of their work using various psychometric outcome measures and receive weekly supervision. The clients, primarily elderly individuals above the age of 65, receive psychotherapy to improve their overall well-being, which is measured using the WHO-5 Well-being Index. A binomial regression analysis is conducted, by defining adverse effects as no positive change in well-being during the course of therapy. Subsequent regression analyses include an exploration of any change in standard deviations, reflecting whether psychologists become more reliable with experience. Results suggests that psychologists do not improve with experience. The results are discussed in terms of potential strategies to reduce adverse effects in psychotherapy, with measurement-based treatment highlighted as a promising approach.<br/><br/>Keywords: Elderly persons, psychotherapy, adverse effects, experience<br/>