Negative effects during multicomponent group-based treatment: A multisite study.

Objective Negative effects (NEs) in group treatments remain an under-researched area. This study aimed to explore the prevalence of various types of NEs in a multicomponent group-based treatment and to determine their predictors. Method: A total of 330 patients participating in a multicomponent group-based treatment were recruited across seven clinical sites. At the end of treatment, the Negative Effects Questionnaire (NEQ) was used to measure NEs. Item-level descriptive analysis was conducted to explore the prevalence of various types of NEs, and structural equation modeling was used to determine predictors of these NEs. Results: The most frequently reported type of NEs was the worsening of symptoms, and the single most frequently reported item was the resurfacing of unpleasant memories. Predictors of NEs included the overall distress level, alexithymia, attachment avoidance, low working alliance, problem actuation, and worse outcomes; psychological mindedness was a protective factor. Conclusion: Patients who experience higher levels of distress at the beginning of treatment, who perceive the group working alliance as problematic, and who experience high in-session emotional arousal related to their problem seem to be especially prone to reporting NEs. Furthermore, the findings do not support the assumption that NEs are a prerequisite for therapeutic change.Trial registration: ISRCTN.org identifier: ISRCTN13532466.

Adaptation of the negative effects questionnaire into the Czech context.

Objective: The aim of this study was to adapt the Negative Effects Questionnaire (NEQ) into the Czech context and to assess its psychometric properties as well as the extent to which it covers important areas of the negative aspects of psychotherapy. Method: A total of 226 respondents answered an online survey. Confirmatory and exploratory factor analyses were conducted to assess the NEQ factor structure. Thematic analysis was used to analyze the open-ended NEQ item. Results: In terms of confirmatory factor analysis, the six-factor model proposed by the authors of the NEQ did not demonstrate an adequate fit. In a subsequent exploratory factor analysis, a more parsimonious, five-factor solution was proposed instead. Furthermore, a thematic analysis revealed some areas underrepresented in the NEQ, particularly clients' relationships with their relatives. Conclusions: The NEQ is a reliable instrument with a high added value for research and practice. Several directions for future development are suggested.