Les effets inattendus des psychothérapies : de notions en concepts et applications. Une approche exploratoire par l’hypnothérapie

Abstract

Background

The literature and clinical practice in the field demonstrate that conventional evaluations of psychotherapy fluctuate between restricting psychotherapeutic efficacy to changes in symptomatology/quality of life and pointing out the absence of major differences between the various approaches. Clinical practice indicates that it is patients’ expectations that define the effectiveness of psychotherapies. All this raises yet another question about the effectiveness of psychotherapy, which needs to be explored in a new way: an examination of the unexpected effects (i.e. therapeutic experiences that surprise patients’ expectations). 2. An attempt to define the “psychotherapeutically unexpected”.–Current international scientific terminology has not yet reached a consensus, and terms such as adverse effects or events, negative effects, risks, or side effects can be found in the literature. This results in confusion, pejorative representations of therapeutic effects, and serves as an impediment in research. The unexpected effects (UEs) of psychotherapy are those effects that exceed or differ from patients’ expectations and desires regarding their psychotherapeutic care. They can be beneficial or harmful and are rarely considered or explored in the field or in research. Exploring the unexpected effects of psychotherapeutic care enables us to study the full scope, consequences and impact of psychotherapy on the individual in their ecological context. 3. An original and prototypical study of unexpected effects in hypnotherapy.

Aims

To identify the frequency and scope of UEs, develop a typology of UEs, identify UE recurrences, and assess the prevalence of beneficial UEs. The study population: 164 subjects (92 women, 72 men, mean age 40) who had received hypnotherapy.

Tool and procedure

A Dimensional Exploration of Hypnotherapeutic Unexpected Effects Questionnaire (DEHUEQ) that evaluates patients’ experiences of treatment and the UEs experienced (naming, categorization, dimensionalities). The questionnaires were collected via social networks.

Results

Sixty-four people reported UEs (39% of the population), and they identified an average of two each, occurring in the hours following their last hypnotherapy session, and that exerted a strong impact on daily life and lasted for from several months to years. Hypnotherapy UEs fall into three main categories: emotional (calmness, emotional sensitivity), self-image (self-confidence, letting go) and outlook on life (hope, ability to put things into perspective). The UEs reported were interpreted as beneficial (75.4%).

Discussion

It would seem necessary to inform subjects and therapists, families and institutions about the place for and impact of UEs in hypnotherapy. Going beyond the initial therapeutic objectives represents a paradigm shift.

Conclusions or openings?

This exploratory work highlights the need to take UEs into account, to develop specific training programs to raise awareness, to expand research, and to enhance the recommendations for good practice in psychotherapy.