Clinical psychology & psychotherapy最新文献

{"title":"Contributory Factors to Self-Disclosure in Clinical Supervision: A Meta-ethnography","authors":"Alina Elena Apostol,&nbsp;Kellie Turner,&nbsp;Rosa Hoshi,&nbsp;Aimee Pudduck","doi":"10.1002/cpp.70068","DOIUrl":"https://doi.org/10.1002/cpp.70068","url":null,"abstract":"<p>Research on supervisee disclosure in clinical supervision has predominantly focused on supervisees' tendency to withhold important information (e.g., negative feelings, perceived power differentials, clinical mistakes, personal issues and countertransference), highlighting a significant gap in understanding the factors that influence supervisees' self-disclosure. Self-disclosure, which is considered essential for supervisors to provide personalised feedback and tailored guidance, plays a critical role in effective supervision but remains underexplored in terms of its facilitators and barriers. This study addresses this gap by systematically exploring the contributory factors affecting supervisee self-disclosure within the context of clinical supervision. Using the principles of meta-ethnography, this systematic review synthesised findings from eight qualitative studies involving 180 participants (the sample ranging from 3 to 110). Through a thorough process of data extraction, translation, and synthesis, a conceptual framework was developed, positioning self-disclosure as a dynamic process shaped by the interplay between supervisory dynamics, contextual factors, and supervisees' internal experiences. Key factors influencing self-disclosure included the quality of the supervisory relationship, supervisees' perception of supervisors' personal characteristics, the emotional impact of self-disclosure on supervisees and power differentials. These findings highlight the relational and systemic factors shaping supervisee self-disclosure. Implications include strategies to improve supervisory relationships, reduce power imbalances and foster supportive environments. The study informs future research, enhances supervisory practice and guides training programmes to improve clinical supervision effectiveness.</p>","PeriodicalId":10460,"journal":{"name":"Clinical psychology & psychotherapy","volume":"32 2","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cpp.70068","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143707669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Measures of Psychological Mindedness: A Systematic Review of Psychometric Properties","authors":"Joshua Eli Thompson,&nbsp;Gillian Haddock,&nbsp;Katherine Berry","doi":"10.1002/cpp.70064","DOIUrl":"https://doi.org/10.1002/cpp.70064","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Psychological mindedness has been positively associated with psychological wellbeing and positive outcomes in psychological therapy. Valid and reliable measures of psychological mindedness are needed for accurate measurement of the construct. This paper is the first to provide a comprehensive review of existing measures of psychological mindedness.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The review protocol was pre-registered and systematic with methods reported according to PRISMA criteria. The quality of studies reporting on psychometric properties of measurement tools was evaluated against the COSMIN criteria.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-three studies relating to six measures of psychological mindedness were included in the review. No measure demonstrated sufficient evidence when evaluated against all COSMIN measurement criteria. However, the Balanced Index of Psychological Mindedness (BIPM) demonstrated the most robust psychometric properties with sufficient evidence of structural validity and internal consistency demonstrated through studies of high quality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Whilst the BIPM demonstrated the most robust measurement properties, further research is needed in relation to its content validity, cross-cultural validity, and responsiveness. The BIPM also does not incorporate ‘other-oriented’ psychological mindedness. Alternative measures such as the PMS and PMAP are available to measure psychological mindedness towards others but have less sufficient evidence of psychometric rigour.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10460,"journal":{"name":"Clinical psychology & psychotherapy","volume":"32 2","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cpp.70064","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143689866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychopathological Symptoms of Individuals Recently Bereaved During COVID-19 Pandemic: Symptom Profiles, Predictive Factors and Correlations With Insomnia","authors":"Wenli Qian,&nbsp;Tong Xie,&nbsp;Renzhihui Tang,&nbsp;Xin Xu,&nbsp;Keyuan Jiao,&nbsp;Xinyan Zou,&nbsp;Jianping Wang","doi":"10.1002/cpp.70066","DOIUrl":"https://doi.org/10.1002/cpp.70066","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This study aimed to identify subgroups of individuals bereaved within the past 1 year during the COVID-19 pandemic based on symptoms of prolonged grief disorder (PGD), depression and post-traumatic stress (PTSD). Additionally, we examined class differences in socio-demographic and loss-related variables and explored the associations between class membership and insomnia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 324 individuals (72.2% female) who experienced bereavement within 12 months (M = 4.01 months, SD = 2.45) completed Inventory of Complicated Grief (ICG), Patient Health Questionnaire (PHQ-9), PTSD Checklist for DSM-5 (PCL-5) and Insomnia Severity Index (ISI). Latent class analysis (LCA) with three-step and BCH procedure was employed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Three distinct subgroups were identified: a high symptoms class (33.4%), a high PGD, moderate depression and PTSD class (35.2%) and a moderate PGD, low depression and PTSD class (31.4%), especially yearning, preoccupation, emotional pain and loneliness, were predominant. Class membership was influenced by relationship to the deceased and expectancy of death but not by time since loss. Death due to COVID-19 did not significantly differentiate class membership compared to other causes. Additionally, significant differences in insomnia severity were observed across classes (<i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Distinct psychopathological patterns emerged among recently bereaved individuals during the pandemic, with PGD symptoms being particularly prominent. Tailored strategies may help address distinct symptom profiles and co-morbid symptoms within bereavement care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10460,"journal":{"name":"Clinical psychology & psychotherapy","volume":"32 2","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143689875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uncovering the Internal Structure of the German Version of the CORE-OM: A Network Analysis","authors":"Jürgen Fuchshuber,&nbsp;Marina Zeldovich,&nbsp;Gabor Aranyi,&nbsp;Lisa Winter,&nbsp;Martin Kuska,&nbsp;Dominique Dumont,&nbsp;Elke Humer,&nbsp;Human-Friedrich Unterrainer","doi":"10.1002/cpp.70063","DOIUrl":"10.1002/cpp.70063","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The Clinical Outcomes in Routine Evaluation – Outcome Measures (CORE-OM) is a pantheoretical diagnostic instrument that has been widely used in mental health research. Nevertheless, the exploration of the factor structure of the CORE-OM yields diverse results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This study aimed to explore the internal structure of the German CORE-OM using network analysis and compare several competing factorial structures of the CORE-OM with traditional confirmatory factor analysis (CFA) to gain a more comprehensive understanding of its structural validity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>A total sample comprised 4496 (63% female) participants from an outpatient population. In a first step, we used network analysis (<i>n</i>₁ = 2248) to assess relationships between the items, followed by explorative graph analysis (EGA) to analyse community structure. Finally, we specified five competing models, including the one derived from the EGA, and used CFA in a second sample (<i>n</i>₂ = 2248) to identify the best-fitting structure of the instrument.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The estimated cross-sectional network demonstrated high correlation stability. The average item predictability was <i>R</i>² = 0.42. The EGA identified four distinct communities in the German CORE-OM (General Problems; Interpersonal Problems; Positive Resources; Self Harm Risk). Confirmatory factor analysis showed that the EGA-derived models had the most parsimonious fit.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These findings suggest a refined structure for the CORE-OM, highlighting key item relationships and offering potential improvements for scoring and clinical use.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10460,"journal":{"name":"Clinical psychology & psychotherapy","volume":"32 2","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11923399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pain Sensitivity and Depressive Triad Mediate the Relationship Between Trauma and Stress, and Symptoms of Premenstrual Disorders","authors":"Rachela Antosz-Rekucka,&nbsp;Katarzyna Prochwicz","doi":"10.1002/cpp.70062","DOIUrl":"https://doi.org/10.1002/cpp.70062","url":null,"abstract":"<div>\u0000 \u0000 <p>The aim of this study was to test if negative cognitive triad and subjective pain sensitivity mediate the relationship between known risk factors (trauma and stress) and the symptoms of premenstrual disorders (premenstrual syndrome [PMS] and premenstrual dysphoric disorder [PMDD]) measured both retrospectively and prospectively. The study was divided into two stages: a cross-sectional (<i>N</i> = 228) and a prospective diagnosis (<i>N</i> = 90) parts. Correlation and mediation analyses were performed.</p>\u0000 <p>Both variables mediated the association of trauma and stress with retrospectively measured premenstrual symptoms (mediation between trauma and premenstrual symptoms through depressive triad was full). In the sample of prospectively diagnosed individuals, again, both negative cognitive triad and pain sensitivity mediated the relationship between trauma and PMS/PMDD symptoms partially, and there was full mediation between baseline stress level and premenstrual symptomatology. However, for the mean stress level during the prospective diagnosis phase, only pain sensitivity was a significant, partial mediator.</p>\u0000 <p>The results suggest that depressive cognitive triad and subjective pain sensitivity may play an important role in the development and maintenance of premenstrual disorders. These findings can contribute to the improvement of PMDD and PMS treatment, emphasising the importance of pain management and addressing core beliefs in psychotherapy of premenstrual disorders.</p>\u0000 </div>","PeriodicalId":10460,"journal":{"name":"Clinical psychology & psychotherapy","volume":"32 2","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143645886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Interplay Between Personality and Clinical Syndromes in Eating Disorders: Implications for Personalized Treatment","authors":"Paolo Meneguzzo,&nbsp;Francesca Buscaglia,&nbsp;Anna Pillan,&nbsp;Enrica Bucci,&nbsp;Alice Garolla,&nbsp;Anna Marzotto,&nbsp;Chiara Cazzola,&nbsp;Roberta Castegnaro,&nbsp;Elisa Bonello,&nbsp;Patrizia Todisco","doi":"10.1002/cpp.70061","DOIUrl":"https://doi.org/10.1002/cpp.70061","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Eating disorders (EDs) are complex and multifactorial conditions with significant impacts on both physical and mental health. Despite advances in treatment, relapse rates remain high, highlighting the need for improved predictive models for treatment outcomes. This study aims to examine the role of personality traits and clinical syndromes, as assessed by the Millon Clinical Multiaxial Inventory-III (MCMI-III), in predicting treatment outcomes for individuals with EDs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective evaluation was conducted on 149 women diagnosed with EDs, receiving inpatient treatment at the Eating Disorder Unit of Casa di Cura Villa Margherita-KOS (Arcugnano-Vicenza) between 2020 and 2024. Participants completed the MCMI-III at treatment initiation, with the Eating Disorder Examination Questionnaire (EDE-Q) and Clinical Impairment Assessment (CIA) administered at baseline and discharge.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Regression analyses revealed that maladaptive personality traits (avoidant, dependent and histrionic) and clinical syndromes such as major depression were significant negative predictors of treatment response. In contrast, post-traumatic stress emerged as a positive predictor of improvement. Specific personality and clinical patterns were associated with changes in symptomatology, including reductions in eating concerns, shape concerns and clinical impairment. However, not all dimensions were predictive of treatment outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study underscores the importance of personalized treatment approaches that account for both personality traits and clinical syndromes in individuals with EDs. Future research should explore how these factors interact over time and inform tailored therapeutic strategies, particularly for those with comorbid traits or disorders.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10460,"journal":{"name":"Clinical psychology & psychotherapy","volume":"32 2","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cpp.70061","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Maladaptive Schemas Mediate the Relationship Between Childhood Trauma and Interpersonal Problems in Eating Disorders","authors":"Matteo Aloi,&nbsp;Marianna Rania,&nbsp;Elvira Anna Carbone,&nbsp;Renato de Filippis,&nbsp;Daria Quirino,&nbsp;Ettore D'Onofrio,&nbsp;Cristina Segura-Garcia","doi":"10.1002/cpp.70052","DOIUrl":"https://doi.org/10.1002/cpp.70052","url":null,"abstract":"<p>Recent research highlights the role of childhood trauma in the development of eating disorders (EDs), suggesting that adverse experiences can disrupt emotional and cognitive development, leading to early maladaptive schemas (EMSs) and interpersonal problems. EMSs are psychological structures encompassing cognition, emotions, images, and bodily sensations. These EMSs are hypothesized to mediate the relationship between childhood trauma and ED pathology. This study aimed to extend the investigation of how childhood trauma leads to interpersonal difficulties, mediated by EMSs.</p><p>This cross-sectional study recruited 321 patients with EDs: <i>n</i> = 77 Anorexia Nervosa–Restricting (AN-R), <i>n</i> = 26 AN–Binge/Purge (AN-BP), <i>n</i> = 94 Bulimia Nervosa (BN), and <i>n</i> = 124 Binge Eating Disorder (BED). They completed the Eating Disorder Examination (EDE), Inventory of Interpersonal Problems (IIP-32), Young Schema Questionnaire (YSQ-S3), and Childhood Trauma Questionnaire (CTQ-SF). Path analyses were conducted to examine associations between childhood trauma, EMSs, and interpersonal problems.</p><p>Results indicated that patients with BED reported the highest levels of sexual abuse. Those with BN exhibited higher scores across all EMS domains. Positive correlations were found between childhood adversities, EMS domains, and interpersonal problems, except for the relationship between sexual abuse and schema domains. Mediation analyses revealed significant indirect effects of emotional abuse on interpersonal problems through disconnection and rejection domain.</p><p>This study consolidates the notion that EMSs mediate the relationship between childhood trauma and interpersonal problems in ED patients, highlighting the importance of addressing early trauma and EMSs to improve therapeutic outcomes. Future research should focus on longitudinal analyses to better understand the temporal development of these relationships.</p>","PeriodicalId":10460,"journal":{"name":"Clinical psychology & psychotherapy","volume":"32 2","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cpp.70052","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143632863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Systematic Review of the Effectiveness of Treatments for Depression in Rural and Remote Residents","authors":"Amelia Bentley,&nbsp;Lucinda Hogan,&nbsp;Jack Howard,&nbsp;Ramnik Singh,&nbsp;Lucinda Watt,&nbsp;Alix Hall,&nbsp;Flora Tzelepis","doi":"10.1002/cpp.70058","DOIUrl":"https://doi.org/10.1002/cpp.70058","url":null,"abstract":"<p>Rural and remote populations have a high burden of depression and poorer access to mental healthcare services than their urban counterparts. This systematic review aimed to assess the effectiveness of psychological and pharmacological treatments on reducing depression specifically in rural and remote residents. Cochrane Library, Medline, PsycInfo, Embase and Scopus, and two clinical trial registries were searched. Included studies were randomised or cluster randomised trials conducted with rural and remote adult populations; examined the effectiveness of any treatment for depression; included a control group or comparator; measured depression; and were published in English. Two authors independently screened records for eligibility, extracted information from eligible studies and assessed risk of bias and certainty of evidence. Seventeen studies were included. Meta-analyses found a small benefit of behavioural activation therapy (standardised mean difference −0.43, 95% CI −0.78, −0.08, <i>I</i>² = 40%), a large benefit of group therapy (standardised mean difference −1.80, 95% CI −2.80, −0.79, <i>I</i>² = 93%) and no evidence of benefit of interpersonal therapy (standardised mean difference −0.89, 95% CI −2.30, 0.52, <i>I</i>² = 96%) and cognitive behavioural therapy (standardised mean difference −2.39, 95% CI −5.83, 1.05, <i>I</i>² = 98%) for reducing depression in rural populations. Behavioural activation and group therapy appear effective for treating depression among rural populations, although the certainty of evidence is low, and so further research is warranted. Further research on the effectiveness of psychological and pharmacological treatments on depression in rural and remote populations is needed.</p>","PeriodicalId":10460,"journal":{"name":"Clinical psychology & psychotherapy","volume":"32 2","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cpp.70058","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143602492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Scoping Review of Interventions Designed to Increase Behavioural Health Service Engagement","authors":"Sydney Erickson,&nbsp;Ayah Irbahim,&nbsp;Karrah Bowman,&nbsp;Sadona Thompson,&nbsp;Ashley J. Harrison","doi":"10.1002/cpp.70050","DOIUrl":"https://doi.org/10.1002/cpp.70050","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>A documented underutilization of behavioural health interventions with known efficacy for treating psychological disorders exists. Thus, engagement enhancement approaches (EEAs) exist to help increase individuals' use of behavioural health interventions. EEAs target a range of barriers to treatment; therefore, a wide variety of approaches exist.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>To better understand what EEA approaches exist and in which contexts they are most widely implemented, this study conducted a scoping review of existing EEAs to increase treatment engagement in effective interventions for behavioural health disorders. Specifically, the purpose of this review was to characterize EEAs by type, modality, target population, and to examine the intersection of these categories. Additionally, this review examined research rigour and cultural considerations among existing EEAs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We found that most of the identified studies targeted individual-level barriers through psychoeducation and awareness campaigns. These primarily focused on adults with substance use disorders or major depressive disorder and occurred in person at a provider location. This review identified several limitations and gaps in the literature regarding EEAs, such a shortage of scientifically rigorous studies that assess these approaches, the lack of cultural adaptations made to EEAs to specifically support minoritized individuals, the narrow focus of targeting individual-level barriers, and the limited scope of target groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This review offers clinicians and behavioural health researchers information regarding the selection of approaches to increase engagement in accessing behavioural health interventions, as well as suggestions for future research to address disparities and develop solutions to the systemic barriers of the EEAs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10460,"journal":{"name":"Clinical psychology & psychotherapy","volume":"32 2","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143594986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rumination, Hopelessness, Behavioural Avoidance and Psychopathology Symptoms After Bereavement: Serial Mediation Analyses","authors":"Maarten C. Eisma,&nbsp;Antje Janshen,&nbsp;Nienke de Haan","doi":"10.1002/cpp.70053","DOIUrl":"https://doi.org/10.1002/cpp.70053","url":null,"abstract":"<p>Bereavement can precipitate severe mental health problems, including major depressive disorder and prolonged grief disorder. Rumination is a risk factor of post-loss mental health problems, and as such, a better understanding of its working mechanisms may inform clinical practice. Rumination is theorized to take up time and increase feelings of hopelessness, leading to inactivity and social withdrawal, which in turn fuels post-loss psychopathology. Yet, these ideas have not been tested comprehensively. Therefore, we aimed to fill this gap in knowledge. A sample of bereaved adults (87% women) completed questionnaires on socio-demographic and loss-related characteristics, rumination, hopelessness, behavioural avoidance of activities, and depressive and prolonged grief symptoms. Two serial mediation analyses demonstrated that rumination may have both direct effects and indirect effects via hopelessness and behavioural avoidance on depressive and prolonged grief symptom levels. Sensitivity analyses, including reverse mediation analyses, supported the validity of the results. Findings show that hopelessness and behavioural avoidance may act as working mechanisms in the relationship between rumination and post-loss psychopathology. Therapies targeting hopelessness and social withdrawal, such as problem-solving training and behavioural activation, may be helpful in reducing rumination and depressive and prolonged grief symptoms in bereaved persons.</p>","PeriodicalId":10460,"journal":{"name":"Clinical psychology & psychotherapy","volume":"32 2","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cpp.70053","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143594843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}