What makes a circle safe, and what goes wrong when it isn’t?
Negative effects during multicomponent group-based treatment: A multisite study
Adjacent
Patients who began group treatment more distressed, rated the group alliance poorly or were strongly stirred in sessions reported more negative effects, and those effects came with worse outcomes, not better ones.
Patients filled in the Negative Effects Questionnaire as their treatment ended. The most common kind of negative effect was symptoms getting worse, and the single item reported most often was unpleasant memories coming back. Reports were more likely among patients who started out more distressed, who had alexithymia (difficulty naming their own feelings) or avoidant attachment, who felt a weak working alliance in the group, or who were strongly aroused about their problem during sessions. Psychological mindedness protected against them. Negative effects also went with worse outcomes, and the authors find no support for the idea that people must feel worse before they get better.
That finding bears on any practice that treats being overwhelmed as part of growth.
What it doesn’t show
A clinical treatment with several components, so the group’s own part cannot be separated out, and negative effects were measured once, at the end, by the patients’ own report. Patients, not Circling participants.
Summary based on the abstract.
Directions that build on it
- Safety, facilitation and harm
Links
Cite
Pourová, M., Řiháček, T., Chvála, Ľ., Vybíral, Z., & Boehnke, J. R. (2023). Negative effects during multicomponent group-based treatment: A multisite study. Psychotherapy Research, 33(3), 282–297. https://doi.org/10.1080/10503307.2022.2095237