Beschwerden über Psychotherapie und ihre Auswirkungen auf Patienten und Patientinnen

Abstract

ZusammenfassungDie unprofessionelle Ausübung einer Psychotherapie schädigt ihr generell gutes Ansehen. Eine öffentliche Auseinandersetzung mit Kunstfehlern oder unethischem Therapeutenverhalten findet deshalb kaum statt, obgleich ein transparenter Umgang mit dem Thema auch dessen Rarität verdeutlichen und eine professionelle Handhabung mit Fehlverhalten fördern könnte. In der vorliegenden Studie wurden mittels qualitativer Inhaltsanalyse insgesamt 55 Beschwerdebriefe von Patientinnen an die Psychotherapeutenkammer Nordrhein-Westfalen aus den Jahren 2011 und 2012 analysiert. Alle Briefe wurden anonymisiert übergeben, nachdem die Bearbeitung der Beschwerde abgeschlossen war. Insgesamt wurden 149 Beschwerden über Kunstfehler und unethisches Verhalten sowie 124 Aussagen zu deren negativen Konsequenzen identifiziert. Die meisten Beschwerden über Kunstfehler betrafen die Kategorie „Verletzung therapeutischer Basisvariablen“ (40,3%), gefolgt von „Verletzung der Rahmenbedingungen“ (16,8%) und „finanzieller Missbrauch“ (12,1%). In Folge der Kunstfehler bzw. des unethischen Verhaltens berichteten 28,2% der Patientinnen eine „Veränderung ihrer Symptomatik“. Die Ergebnisse geben einen Einblick in die Bandbreite möglicher Beschwerden und deren Konsequenzen und unterstreichen die Notwendigkeit, Patientinnen und Therapeutinnen für das Thema zu sensibilisieren.

Patients’ experiences of malpractice in psychotherapy and psychological treatments: a qualitative study of filed complaints in Swedish healthcare

“…For example, Khele et al (2008) reported that the greatest number of complaints were related to "conduct which might undermine the public's confidence in counselling" (p. 128). This fits well with some of the issues presented in the current study, such as when healthcare providers clearly transgressed ethical and professional boundaries, for instance, by reaching out to the patient privately or complimenting her appearance in session, and corresponds to the findings by Scholten et al (2018). However, such conduct also involved statements and behaviors that were experienced as invalidating in relation to stressful circumstances, which seem to correspond to the subtheme Lack of empathy in the current study, including experiences of not being taken seriously or listened to, similar to findings by Ladwig et al (2014).…”

“…For this purpose, eligible cases were retrieved from IVO, an administrative authority responsible for oversight of healthcare and social services delivery in Sweden. These records cover a range of healthcare providers and are accessible to anyone, as compared to prior research where such information was mainly available within professional associations and unions for internal use, e.g., for imposing sanctions (Khele et al, 2008;Scholten et al, 2018). Our aim was to explore malpractice issues from a qualitative perspective, and from the point of view of the patient.…”

“…The opportunity to file complaints against healthcare and social services in Sweden makes it possible to ensure a minimum standard of acceptable healthcare, prevent malpractice, and create room for improvement and learning, which are vital parts of how the system builds its legitimacy (Vårdanalys, 2019). IVO's disclosure obligations also puts the organization in a relatively unique position, making it easier to explore malpractice complaints directed toward psychologist and psychotherapists in Sweden more systematically, while other countries rely on professional associations and unions for the same purpose (Khele et al, 2008;Ladwig et al, 2014;Scholten et al, 2018). The objective of the present study is to conduct the first investigation of malpractice issues directed toward psychologists and psychotherapists in Sweden.…”

“…However, given that the content of the complaints was not analyzed or presented qualitatively, the specific nature of these remains unclear. In comparison, Scholten et al (2018) used qualitative content analysis in relation to complaints that were submitted to the Psychotherapeutic Chamber of North Rhine-Westphalia, in Germany. Among 149 cases, 124 involved malpractice issues.…”