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Limitations, Risks & Evidence Guide

As you’re developing your program content, please consider the questions and suggestions below for your limitations and risks discussion. This is not an exhaustive list—consider it more of a guide to help you get started. If a topic is emerging, new, or evolving, that should be clearly indicated in your presentation. Any controversy around a topic should also be disclosed.  

As a reminder, downloadable slide templates and additional resources are available under the “Program Content Requirements” section on www.pesi.com/speakerinfo.  

  • What are the most common and severe risks? 
    • Treatment failure 
    • Misunderstandings 
    • Therapeutic alliance ruptures 
    • Emergence of new symptoms 
    • Unmet expectations 
    • Others 
  • Are there contraindications for specific patient/client populations?  
  • Are there cultural considerations? 
  • Are there other therapies with more evidence available?  
  • Is the topic new and/or evolving?  
  • Is there controversy around the topic?  
  • What is the evidence for presented content? 
    • RCTs* 
    • Other research 
    • Case studies 
    • Expert opinion 
    • Testimonials  
    • Others 
  • Are there limitations to the sources themselves? 
    • Is there a small sample size? 
    • What methodology was used (comparison study, RCT)? 
    • Were appropriate statistical methods used? 
    • Did the study include a limited subject pool (e.g., only college students, females, or Caucasian participants)? 
    • Who were the research clinicians treating the subjects? 
    • Is there potential for bias? o What is the peer review policy of the publishing journal? 
  • Are negative therapeutic effects possible? 
    • Potential for discomfort or pain 
    • Exacerbation of symptoms during treatment 
    • Client dropout 
  • Is there a possibility for no benefit at all? 

All therapies have risks and limitations. As a CE provider, we’re required to ensure that a discussion of limitations and risks is part of each PESI program. Most importantly, learners deserve a discussion of limitations and risks so that they are able to make informed decisions on interventions and allow their clients to make a decision on informed consent after a full discussion of limitations, risks, and alternatives. 

*A lack of RCTs (random controlled trials) does not mean that you cannot present on a topic. Some treatments don’t lend well to RCTs, and even removing that barrier, funding is another obstacle. However, it is important that we are honest with attendees about the state of the evidence.