A tripartite model of mental health and therapeutic outcomes: With special reference to negative effects in psychotherapy.

TLDR

The concept of a negative effect in psychotherapy is tied to how mental health is defined, as therapies aim to shift patients toward an ideal state, yet outcomes such as increased assertiveness or divorce raise questions about what constitutes improvement. The study aims to derive a comprehensive definition of mental health and meaningful evaluations of psychotherapy outcomes by integrating multiple perspectives.

Abstract

Since a judgment of worse is always made in relation to a standard, which presupposes a definition of better, it is clear that the problem of what constitutes a negative effect is inextricably interwoven with a definition of mental health. Any form of psychotherapy or behavior modification is designed to move the patient toward a particular ideal or norm; the techniques used in a given form of therapy are instruments for accomplishing that purpose. Only by considering multiple perspectives will it be possible to derive a comprehensive definition of mental health and meaningful evaluations of psychotherapy outcomes. Consider the following: If, following psychotherapy, a patient manifests increased self-assertion coupled with abrasiveness, is this a good or a poor therapy outcome? If, as a result of therapy, a patient obtains a divorce, is this to be regarded as a desirable or an undesirable change? A patient may turn from homosexuality to heterosexuality or he may become more accepting of either; an ambitious, striving person may abandon pre-