[Adverse effects, side effects and medical malpractice in psychotherapy].

There is ample proof for the efficacy of psychotherapy but no systematic research on unwanted effects. Cases of malpractice represent a special problem as they always result from a therapist's inadequate behaviour. Furthermore, it is especially difficult in psychotherapy to distinguish between negative life events, unavoidable and undesirable developments of the disease, side effects of psychotherapy and positive treatment effects. In psychotherapy unwanted effects (UEs) can occur in the context of diagnostic problems, selection of the wrong treatment focus, technically inadequate interventions, sensitization processes, or inadequate development of a therapeutic alliance. Examples and case vignettes will be presented for these types of UEs and conclusions will be drawn as to how UE management can be improved.