Click here to download

Latrogenic risk in psychotherapy
Journal Title: RIVISTA SPERIMENTALE DI FRENIATRIA 
Author/s: Laura Fruggeri 
Year:  2015 Issue: 3 Language: Italian 
Pages:  12 Pg. 105-116 FullText PDF:  2186 KB
DOI:  10.3280/RSF2015-003007
(DOI is like a bar code for intellectual property: to have more infomation:  clicca qui   and here 


We speak of iatrogenic risk when we contemplate the possibility for psychotherapy to bring about adverse effects. Research puts forth a range of hypotheses on the origin of adverse effects: i.e. therapist’s incompetence; intrinsic risks inherent to certain models; non-specific results of a form of treatment; or the relational dynamics and mechanisms in a therapist-patient relationship. The author argues that iatrogenic effects are not due to technical incompetence, but stem from relational incompetence, i.e. the incapacity of the therapist to read the interactive process flow, or the therapist’s lack of awareness to do so. The author hypothesizes that iatrogenic harm appears when the therapist, faced with a deteriorating situation, instead of observing the process of co-construction of meanings, becomes inflexible and implements rigidly the technical model. Finally, the author suggests that iatrogenic risks in psychotherapy stem from the adoption of models that disregard the intertwining intrapersonal, interpersonal and social dynamics.
Keywords: Iatrogenic risk, relational competence, therapeutic alliance, sociocultural dimension.

  1. [1] Lambert MJ, Ogles BM. The efficacy and effectiveness of psychotherapy. In: Lambert MJ, ed. Bergin and Garfield’s handbook of psychotherapy and behavior change (5th ed., pp. 139–193). New York, NY: Wiley; 2004.
  2. [2] Jarrett C. When therapy causes harm. Psychologist 2007; 21:10-12.
  3. [3] Lambert MJ, Bergin AE, Collins JL. Therapist-induced deterioration in psychotherapy. In: Gurman AS, Razin AM, ed. Effective psychotherapy: a handbook of research. Oxford: Pergamon Press; 1977. [4] Bergin AE. Some implications of psychotherapy research for therapeutic practice. Int J Psychiatry 1967; 3:136-150.
  4. [5] Jervis G. Patologia iatrogena in psicoanalisi. Psicobettivo 1995; 3: 23-32.
  5. [6] Semerari AE. Se… un genio maligno costantemente mi ingannasse? Psicobiettivo 1995; 3: 33-44.
  6. [7] Berk M, Parker G. The elephant on the couch: side-effects of psychotherapy. Australian and New Zealand Journal of Psychiatry 2009; 43: 787-794.
  7. [8] MacKenzie KR. Time-Limited Group Psychotherapy. Washington, DC.: American Psychiatric Press; 1990.
  8. [9] Shadish WR, Baldwin SA. Meta-analysis of MFT interventions. Journal of Marital and Family Therapy 2003; 29: 547.
  9. [10] Sydow K, Beher S, Schweitzer J, Retzlaff R. The Efficacy of Systemic Therapy With Adult Patients: A Meta-Content Analysis of 38 Randomized Controlled Trials. Family process 2010; 49(4): 457–485.
  10. [11] Stratton P. The Evidence Base Of Systemic Family and Couples Therapy. Association for Family Therapy; UK.: 2010.
  11. [12] Friedlander ML, Escudero V, Heatherington L. Therapeutic Alliances in Couple and Family Therapy: An Empirically Informed Guide to Practice. Washington DC: American Psychological Association; 2006.
  12. [13] Friedlander M, Escudero V, Heatherington L, Diamond MG. Alliance in Couple and Family Therapy. Psychotherapy 2011; 48 (1): 25–33.
  13. [14] Fruggeri L. Servizi sociali e famiglie: dalla risposta al bisogno alla costruzione di competenze. Oikos 1991; 4: 175-190.
  14. [15] Fruggeri L. Famiglie (2° parte). Roma: Carocci Editore; 1998.
  15. [16] Bronfenbrenner U. The ecology of human development. Cambridge, Mass: Harvard University Press; 1979 (Trad. it.: Ecologia dello sviluppo. Bologna: Il Mulino; 1986).
  16. [17] Pinsof WM, Breunlin DC, Russell WP, Lebow JL. Integrative problem centered metaframeworks (IPCM) therapy II: Planning, conversing, and reading feedback. Family Process 2011; 50(3): 314-336.
  17. [18] Boscolo L, Bertrando P . La terapia individuale sistemica. Milano: Raffaello Cortina Editore; 1996.
  18. [19] Bateson G. The birth of a matrix or double bind and epistemology. In: Berger MM, ed. Beyond the double bind. New York: Brunner and Mazel; 1978, p. 41-63.
  19. [20] Fruggeri L. Different levels of psychotherapeutic competence. Journal of Family Therapy 2012; 34 (1): 91-105.
  20. [21] Roy-Chowdhury S. How is the therapeutic relationship talked into being? Journal of Family Therapy 2006; 28: 153–174.
  21. [22] Lannamann J. Interpersonal communication. Research as ideological practice. Communication Theory 1991; 3, 179-203. [23] Shotter J. Conversational realities. London: Sage; 1993.
  22. [24] Pearce B. Interpersonal communication: making social worlds. New York: Harper Collins; 1994.
  23. [25] Fruggeri L. La competenza psicoterapeutica: un costrutto multicomponenziale. Ricerca Psicoanalitica 2014; 1: 9-21.
  24. [26] Patrika P, Tseliou E. Blame, responsibility and systemic neutrality: a discourse analysis methodology to the study of family therapy problem talk. Journal of Family Therapy 2015., DOI: 10.1111/1467-6427.1207
  25. [27] James K, McIntyre D. The reproduction of families. Journal of Marital and Family Therapy 1983; 9: 119-129.
  26. [28] Goldner V. Feminism and family therapy. Family Process 1985; 24: 31-47.
  27. [29] Jones E. Gender and poverty as contexts for depression. Human Systems 1994; 5: 169-183.
  28. [30] McCarthy I, ed. Irish family studies. Selected papers. Dublin: Family Studies Center; 1995.
  29. [31] Pakman M. La micro-politica delle classi sociali nella vita familiare. Connessioni 1997; 2:24-33.
  30. [32] Bepko C, Johnson T. Gay and lesbian couples in therapy: Perspectives for the contemporary family therapist. Journal of Marital and Family Therapy 2000; 26: 409-419.
  31. [33] Falicov C. Working with transnational immigrants: expanding meanings of family, community, and culture. Family Process 2007; 46(2): 157-171.
  32. [34] Mc Carthy I, Byrne N. A Fifth Province Approach to Intra-Cultural Issues in an Irish Context: Marginal Illuminations. In: McGoldrick M, Hardy K, ed. Re-visioning Family Therapy: Race, Class, Culture, and Gender in Clinical Practice, 2nd Edition. New York: Guilford Press; 2008.

Laura Fruggeri, Latrogenic risk in psychotherapy in "RIVISTA SPERIMENTALE DI FRENIATRIA" 3/2015, pp. 105-116, DOI:10.3280/RSF2015-003007

   

FrancoAngeli is a member of Publishers International Linking Association a not for profit orgasnization wich runs the CrossRef service, enabing links to and from online scholarly content