When treatment makes matters worse: Experiences with basal exposure therapy (BET)

Background and aim: Basal exposure therapy (BET) is an inpatient treatment for people with severe mental health conditions and long treatment histories in mental healthcare. Although preliminary group evaluation data for BET are positive, some patients report negative experiences with the treatment. The overall aim was to gain new knowledge about patients’ reported negative experiences of BET in order to further develop this treatment. Method: We interviewed nine former female patients and analysed the data thematically, using an inductive, semantic approach. Three researchers and two research advisors with patient experiences in BET conducted the study. Results: Participants experienced, first, that their expectations of BET did not match their actual experiences. Second, patients experienced their relationships with BET therapists as unsafe, instrumental, mechanic and lacking in human warmth. Third, patients perceived a gap between their expectations and therapists’ intentions, leading to insecurity and a heavy sense of responsibility. Fourth, they felt that their symptoms were exacerbated during BET treatment in the form of more shame, self-hatred and loneliness. Implications: Participants’ experiences showed that the intended effects of the treatment did not always match patients’ experiences. It is imperative to further investigate patients’ experiences in order to develop BET as well as other treatments for these patients. Keywords: Basal Exposure Therapy, service user involvement, specialised mental healthcare services, evaluation, patient experiences, negative experiences