Preventing the adverse effects of psychological therapies

New research at the University of Sheffield aims to help healthcare professionals understand and prevent the negative effects of psychological therapies.


In the AdEPT study (understanding and preventing the Adverse Effects of Psychological Therapies), researchers from the University’s School of Health and Related Research (ScHARR) and the Department of Psychology, analysed the adverse effects of ‘talking therapies’ such as counselling and cognitive behaviour therapy.

The findings of the study, which was funded by the National Institute for Health Research (NIHR) Research for Patient Benefit programme, have been used to launch a unique website which provides useful information for service managers, clinical practitioners, and patients.

Psychological therapies, which have been shown to be helpful for people with common mental health problems such as anxiety, depression, post-traumatic stress and obsessive- compulsive disorder, are recommended by the National Institute of Health and Clinical Excellence (NICE).

Today more ‘talking therapy’ is funded by the NHS than ever before – which is why it is important to understand and prevent any detrimental effects it may have on patients.

AdEPT Chief Investigator, Professor Glenys Parry from ScHARR, said: “It has been known for a long time that some people get worse during or after therapy and there has been a lot of anecdotal evidence of people feeling they have been harmed by talking treatments.

“Until now there has been very little research on understanding and preventing negative results from psychological therapy.”

Elderly handsShe continued: “From an initial scoping review we distinguished between adverse events, adverse effects, deterioration and harm. We discovered the issues that were linked to failed therapy, including therapist competence, service pressures and constraints, and problems in the therapeutic relationship.

“Although some individuals do have a bad experience of therapy, there was no overall evidence that psychological therapy was causing harm.”

Researchers found that the proportion of clients showing reliable deterioration varies a lot between therapists. However, when the research team compared the number of people who feel worse after therapy with those who feel worse anyway, without therapy, they were very similar once they accumulated evidence from a number of studies.

A variety of research methods were used during the study including surveys, quantitative study of the experience of therapists and therapy recipients of failed therapy and the analysis of data from randomised controlled trials, comparing a psychological treatment with no treatment control, to investigate risk of harm.
Professor Parry, continued: “All medical and health interventions carry potential risks as well as benefits; even everyday medications have some toxicity for some people.

“Harm from psychological therapies is fortunately rare compared with the benefit, but we need to reduce the risk of harm. It is important to remember that just because someone has become worse over the course of the treatment it does not mean that the treatment harmed them.”

She added: “The Government, through the National Institute for Health Research (NIHR), is taking patient safety in psychological therapies seriously and our research is producing useful findings to increase patient safety in talking therapies”.

“We now have a better understanding of the reasons for negative outcomes of therapy and we’ve used this research to produce a website which contains evidence-based advice for therapists and patients,” said Professor Parry.

The site, named ‘Supporting Safe Therapy’ is designed to prevent people having a negative experience and outcome of treatment by sharing a support tool kit and information on how to avoid common problems.

Additional information

For more information about Supporting Safe Therapy  visit

For more information about the study please visit

The National Institute for Health Research (NIHR)
The National Institute for Health Research (NIHR) is funded by the Department of Health to improve the health and wealth of the nation through research. Since its establishment in April 2006, the NIHR has transformed research in the NHS.

It has increased the volume of applied health research for the benefit of patients and the public, driven faster translation of basic science discoveries into tangible benefits for patients and the economy, and developed and supported the people who conduct and contribute to applied health research.

The NIHR plays a key role in the Government’s strategy for economic growth, attracting investment by the life-sciences industries through its world-class infrastructure for health research. Together, the NIHR people, programmes, centres of excellence and systems represent the most integrated health research system in the world. For further information, visit the NIHR website

University of Sheffield
With almost 25,000 of the brightest students from around 120 countries, learning alongside over 1,200 of the best academics from across the globe, the University of Sheffield is one of the world’s leading universities.
A member of the UK’s prestigious Russell Group of leading research-led institutions, Sheffield offers world-class teaching and research excellence across a wide range of disciplines.

Unified by the power of discovery and understanding, staff and students at the university are committed to finding new ways to transform the world we live in.

In 2011 it was named University of the Year in the Times Higher Education Awards and in the last decade has won four Queen’s Anniversary Prizes in recognition of the outstanding contribution to the United Kingdom’s intellectual, economic, cultural and social life.

Sheffield has five Nobel Prize winners among former staff and students and its alumni go on to hold positions of great responsibility and influence all over the world, making significant contributions in their chosen fields.
Global research partners and clients include Boeing, Rolls-Royce, Unilever, AstraZeneca, Glaxo SmithKline and Siemens, as well as many UK and overseas government agencies and charitable foundations.


For further information please contact:

Amy Pullan
Media Relations Officer
University of Sheffield
0114 222 9859