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

Abstract

Malpractice issues in psychotherapy and psychological treatments refer to the unethical behavior of a psychologist or psychotherapist toward the patient. The current study reviewed complaints directed at psychologists and psychotherapists in Sweden with regard to possible incidents of malpractice. Eligible cases were retrieved from a database managed by the Health and Social Care Inspectorate [Inspektionen för vård och omsorg (IVO)], an administrative authority responsible for the safety and quality of healthcare and social services delivery. These cases were analyzed using thematic analysis. In total, 33 complaints matched the keywords proposed by IVO, and were scrutinized in detail. The cases primarily involved psychiatric care by a psychologist in outpatient settings, although many cases comprised multiple healthcare providers responsible for the patient's care, or targeted the healthcare unit as a whole. The results demonstrated that different forms of malpractice occur, and can be classified in two general themes, Incorrect administration and implementation and Attitude and behavior, which involve organizational aspects as well as examples of malpractice and unethical behavior. Implications for clinical practice and future research include further training in ethics and malpractice, video recording or auditing sessions, routine outcome monitoring, and providing patients with information on how to file complaints.

Malpractice in psychodynamic psychotherapy—A retrospective case study

“…With regard to the possible categories of malpractice identified by Lindgren and Rozental [5], the psychoanalyst presented with each item in the attitudes and behavior category, i.e. transgressive behavior (e.g.…”

“…Lindgren and Rozental have noted that the nature of adverse events within psychotherapy and psychological treatment has remained largely unclear [5]. They therefore analyzed 33 cases of suspected psychotherapy malpractice in Sweden, noting that eight percent of all patient records involving psychiatric care described adverse events that could have been prevented.…”

Does injustice perception threaten organizational performance in the healthcare setting? A sequential mediation examination

“…MD might have negative effects on the healthcare industry. Healthcare personnel must operate in the best interests of their patients (Waqas et al , 2023), and any unethical activity might jeopardize patient safety and the standard of care (Lindgren and Rozental, 2022). Employees who engage in fraud, deception or other unethical behaviors may justify their actions by rationalizing (Skowronek, 2022) that they are not harming patients directly or that their actions are necessary to achieve some other goal.…”

Effects of talking about side effects versus not talking about side effects on the therapeutic alliance: A controlled clinical trial

“…These include all events that occur in parallel with the therapy, are qualified as undesirable by patients, therapists, or the environment. “Side effects” are then those unwanted events which are caused by the therapy, which would be unacceptable, if there were better treatments without such burdens, and which are no because of inappropriate treatment 16 …”

“…"Side effects" are then those unwanted events which are caused by the therapy, which would be unacceptable, if there were better treatments without such burdens, and which are no because of inappropriate treatment. 16 There is also a lack of clinical guidelines on how to systematically address and assess side effects during an ongoing treatment. Linden 17 recommended to periodically use a rating scale which can be answered by the patient and the therapist alike, which allows a systematic exploration of areas in which side effects may occur.…”