RCT too Poor

Question 1

RCT Psychotherapy- intro

Answer 1

RCTs are near the top of the ‘hierarchy of evidence’ and then we should be able to guide clinical practice.
However psychotherapy interventions have some limits eg can be biased and also do not represent and failure to assess adverse effects.
Failure to assess adverse effects- clinicians aren’t been assessed effectively and these effects aren’t been shown. Benefits vs risks

Question 2

RCT Psychotherapy- Jonsonn et al (2014)

Answer 2

Is this true? Yes
Johsonn et Al (2014) tested whey proportion of RCTs assessed adverse effects
- used data from 132 RCTs
- 28 (21%) reported info on harmful effects
-most of these monitored deterioration
-4RCT reported no adverse effects but no real detail on method of data collection
-4RCT reputed adverse events but gave full description
Maybe adverse events are rare so data collection doesn’t focus on this?

Question 3

RCT psychotherapy- Klatte et al (2023)

Answer 3

However this does not seem to be the case!
Klatte et Al (2023) summarised 85 RCTs on the frequency and characteristics of adverse effects with the most common mental health disorders
Adverse events were actually reported in 60% of the studies = 1/10 of participants
And more serious adverse events = 1/21
However, it may be that negative events are important? Maybe need to feel therefore to heal and learn to manage these feelings

Question 4

RCT psychotherapy - mortiz et al (2015)

Answer 4

Therefore we can expect to see a positive correlation between negative and positives events
mortiz et Al (2015)
Tested the idea of ‘ no pain no gain’ questions to 85p = CBT for OCD
-measured ‘wanted effects’ and ‘ unwanted effects’ however we a significant negative correlation- adverse events were common and negatively correlated with subject wellbeing