BACKGROUND: Psychotherapy outcomes are typically measured in terms of symptom relief. However, this method might overlook important changes from clients' perspectives when they are asked to report on them. A more client-centred approach might bring a deeper understanding of psychotherapy outcomes. We aimed to evaluate the outcomes identified by clients within qualitative psychotherapy research. METHODS: The PsycArticles, PsycInfo, and MEDLINE Complete databases were searched for English language studies published until Nov 11, 2023. Additional studies were identified through references in the primary studies and previous meta-analyses or systematic reviews. Search terms were related to psychotherapy and counselling, clients' or patients' experiences, psychotherapy outcomes and changes, post-treatment perspectives, and types of qualitative methods. Qualitative studies on client-identified outcomes of individual psychotherapy were included. Findings related to clients' perceptions of psychotherapy outcomes were extracted (by ML and checked by TR and LT) and analysed (by all authors) using the descriptive-interpretative meta-analytic approach. All authors have personally experienced psychotherapy as clients. This study was pre-registered with PROSPERO (CRD42021277330). FINDINGS: We included 177 studies in the qualitative meta-analysis, from 24 countries, including descriptions from 2908 clients. Most of the studies were of good quality; they covered a wide range of therapeutic approaches and diagnoses. The descriptions of psychotherapy outcomes were classified into 60 meta-categories and grouped into ten clusters. These clusters related to clients' relational and social functioning; their emotional functioning; self-awareness, self-understanding, and more adaptive cognitive processing; behavioural functioning; developing their own resources; clients' attitudes towards themselves; generally embracing life; symptom and problem change; and more general wellbeing. The tenth cluster was outcomes that could not be clearly attributed to psychotherapy, which was considered outside the scope of this study. INTERPRETATION: The meta-analysis showed that clients value outcome dimensions beyond symptom reduction, such as deeper self-understanding, enhanced self-agency, and greater social engagement. By examining psychotherapy outcomes across various diagnoses and therapeutic approaches, we highlight limitations in traditional outcome measures, showing the need for more comprehensive, client-centred assessment tools and the value of incorporating qualitative methods into understanding dimensions of change. FUNDING: European Union.

• MeSH
• duševní poruchy terapie   psychologie   MeSH
• kvalitativní výzkum MeSH
• lidé MeSH
• psychoterapie * metody   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• metaanalýza MeSH
• práce podpořená grantem MeSH

Medically unexplained physical symptoms (MUPS) are a frequent phenomenon. Understanding adults and adolescents' lived experience with MUPS is essential for providing adequate care, yet a rigorous synthesis of existing studies is missing. Objective: This study aimed to summarize findings from primary qualitative studies focused on adults' and adolescents' experience of living with MUPS. Design: Qualitative studies were searched in the PsycINFO, PsycARTICLES, and Medline databases and manually. A total of 23 resources met the inclusion criteria and were subjected to a qualitative meta-summary. Results: Eight themes were found across the set of primary studies, namely, the need to feel understood, struggling with isolation, 'sense of self' in strain, facing uncertainty, searching for explanations, ambivalence about diagnosis, disappointed by healthcare, and active coping. Conclusion: The eight themes represent the core struggles adults' and adolescents' with MUPS face in their lives, psychologically and socially. Although these themes appear to be universal, the analysis also revealed considerable variability of experience in terms of expectations from healthcare professionals, attitude towards formal diagnoses, ability to cope with the illness, or potential to transform the illness experience into personal growth. Addressing this diversity of needs represents a significant challenge for the healthcare system.

• MeSH
• afekt MeSH
• dospělí MeSH
• kvalitativní výzkum MeSH
• lidé MeSH
• mladiství MeSH
• pacienti bez organického nálezu * MeSH
• poskytování zdravotní péče MeSH
• somatoformní poruchy * diagnóza   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mladiství MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

Objective: The aim of this study was to adapt the Negative Effects Questionnaire (NEQ) into the Czech context and to assess its psychometric properties as well as the extent to which it covers important areas of the negative aspects of psychotherapy. Method: A total of 226 respondents answered an online survey. Confirmatory and exploratory factor analyses were conducted to assess the NEQ factor structure. Thematic analysis was used to analyze the open-ended NEQ item. Results: In terms of confirmatory factor analysis, the six-factor model proposed by the authors of the NEQ did not demonstrate an adequate fit. In a subsequent exploratory factor analysis, a more parsimonious, five-factor solution was proposed instead. Furthermore, a thematic analysis revealed some areas underrepresented in the NEQ, particularly clients' relationships with their relatives. Conclusions: The NEQ is a reliable instrument with a high added value for research and practice. Several directions for future development are suggested.

• MeSH
• faktorová analýza statistická * MeSH
• lidé MeSH
• průzkumy a dotazníky MeSH
• psychometrie MeSH
• reprodukovatelnost výsledků MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika MeSH

Kvalitativní explorativní studie zkoumala některé nežádoucí účinky psychoterapie v ČR. Vzorek tvořilo osm respondentů se zkušenostmi z psychoterapie, data byla získána z rozhovorů. Tematickou analýzou jsme identifikovali sedm hlavních témat: negativní efekty vznikající „vrtáním se v sobě“, přenechání zodpovědnosti na terapeutovi / posílení pasivity klienta, negativní reakce vyvolané terapeutem, terapie negativně zasahuje do pracovní/školní oblasti, do vztahů a každodenního života, zkušenost s terapií odrazuje od dalších sezení nebo terapií, terapie nevede ke zlepšení a terapie přispívá k negativnímu sebeobrazu. Výzkum ukázal, že v průběhu psychoterapie se objevují různě vnímané negativní dopady a že je potřeba jejich výskytu a porozumění věnovat pozornost.

This qualitative explorative study is focused on the topic of adverse effects of psychotherapy. The aim was to explore the negative effects in Czech Republic. Individual interviews were conducted with eight participants in order to get the research data. The use of thematic analysis led to identification of seven main themes, which reflect the clients' experience with negative effects: negative effects emerge from intense self-observation; leaving responsibility to therapist reinforces client's passivity; therapist elicits negative reactions in client; therapy causes difficulties at work/school, in social relationships and in everyday life; psychotherapy experience results in rejection of further treatment; therapy does not lead to improvement, and therapy contributes to building a negative self-image. The results of the study indicate that the different negative effects are needed be taken very seriously, and as a topic of further research.