Kat Novogrudsky, Janet Treasure, Øyvind Rø, Ulrike Schmidt
{"title":"A Scoping Review of Eating Disorder Clinicians' Experiences, Needs, Views and Wellbeing.","authors":"Kat Novogrudsky, Janet Treasure, Øyvind Rø, Ulrike Schmidt","doi":"10.1002/jclp.70005","DOIUrl":"https://doi.org/10.1002/jclp.70005","url":null,"abstract":"<p><strong>Background: </strong>Eating disorders (ED) are pervasive and severe mental illnesses affecting up to 15% of females and 5% of males internationally with rates sharply rising in recent decades, especially since the COVID-19 pandemic. As a result, workload pressures on ED services have surged. The impact of this on ED clinicians and their wellbeing has not recently been investigated. This scoping review examines recent literature on ED clinicians' experiences, needs, and wellbeing to identify areas for future research and intervention. The goal is to improve clinician support, quality of life, and patient outcomes.</p><p><strong>Methods: </strong>Following PRISMA guidelines, eight databases and gray literature sources were searched for studies published from 2014 to 2024. Papers were assessed for quality and risk of bias, and mixed-methods data were analyzed using narrative synthesis.</p><p><strong>Results: </strong>Sixty-three studies, encompassing 3,152 multidisciplinary ED clinicians, were included. Clinicians worked across diverse settings with patients of varied presentations. Analyzes suggest that whilst job satisfaction amongst ED clinicians is high and attitudes are generally positive, workplace demands and stressors have a negative impact on clinician wellbeing. Several areas require clearer guidance and further clinician training. Clinicians' affect is mixed, and an 'emotional rollercoaster' is experienced at work. Many clinicians mention a lack of resources as a frustrating obstacle to an optimally operating service.</p><p><strong>Conclusions: </strong>Clinicians experience working with ED patients as emotionally challenging and occasionally fatiguing, but attitudes are generally positive. However, clinicians are hindered by organizational factors and a lack of resources, including those pertaining to staffing and training.</p>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302204","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":"Psychotherapists' and Trainees' Experiences With Co-Therapy in a Training Setting: Roles, Benefits, Challenges, and Teamwork Strategies.","authors":"Jorge Valdiviezo-Oña, Martín Moreno-Oliva, Jenmaya Trujillo, Alejandro Unda-López, Nicole Ortiz-Mancheno, Clara Paz","doi":"10.1002/jclp.70006","DOIUrl":"https://doi.org/10.1002/jclp.70006","url":null,"abstract":"<p><strong>Objective: </strong>To explore therapists' and trainees' experiences using co-therapy in a university psychotherapy training service.</p><p><strong>Methods: </strong>Therapists (n = 18) and trainees (n = 19) aged 21-36 from an outpatient psychotherapy service located in Ecuador participated in the study. All participants took part in semi-structured interviews. Data were analyzed using the framework analysis approach.</p><p><strong>Results: </strong>Most therapists and trainees had not prior experience with co-therapy. Therapists' roles at this service often involved guiding trainees and fostering mutual learning and support. Trainees also highlighted the learning opportunities that co-therapy provided; however, they expressed discomfort with administrative burdens. Co-therapy was seen as beneficial for offering diverse perspectives, for collaborative discussion and for guided intervention. Challenges included communication issues and clients feeling intimidated. Both groups emphasized the need for open communication and collaborative planning.</p><p><strong>Conclusion: </strong>From therapists' and trainees' perspectives, co-therapy is a feasible approach for both training and conducting psychotherapy. It can enhance therapeutic outcomes by integrating multiple perspectives on case formulation, progress assessment, and therapeutic direction. For trainees, co-therapy provides real-world exposure to diverse therapeutic approaches, helps understand relational dynamics, and offers continuous support from a therapy partner and network. Other training services may implement structured co-therapy programs for training, prioritizing effective communication and collaboration, and providing clear guidelines to manage challenges. Co-therapy teams should consider clients' preferences and comfort levels.</p>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293780","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":"Theory of Mind and Neurocognition in Bipolar Mania Patients and Their Unaffected First-Degree Relatives.","authors":"Jing Zeng, Tie-Bang Liu, Yang-Hui Liu","doi":"10.1002/jclp.70003","DOIUrl":"https://doi.org/10.1002/jclp.70003","url":null,"abstract":"<p><strong>Background: </strong>Cognitive impairment in manic patients involves neurocognitive and theory of mind (ToM) impairments. This study aims to investigate cognitive impairment among manic patients and their first-degree relatives (FDRs).</p><p><strong>Methods: </strong>A total of 31 manic inpatients, 31 unaffected relatives, and 30 healthy controls (HCs) were investigated using the Reading the Mind in Eye Test (RMET) and Hinting Task (HT). The intelligence quotient (IQ), attention, working memory, executive functions, fluency and processing speed were also assessed.</p><p><strong>Results: </strong>Patients and their relatives scored lower than controls on Theory of Mind reasoning and several neurocognitive measures. Regression analysis of the total sample indicated that a mania diagnosis or a FDR was strongly related to lower ToM reasoning performance. The deficits in ToM among patients were related to years of education.</p><p><strong>Conclusions: </strong>Due to the comparable performance of ToM between patients and their relatives, the reasoning aspect of ToM may represent a trait marker for bipolar disorder (BD). The deficits in ToM in patients with BD are partly independent of neurocognition.</p>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266282","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":"Virtual Reality in Psychotherapy: A Three-Dimensional Framework to Navigate Immersive Clinical Applications.","authors":"Adrian Montesano, Sofia Seinfeld","doi":"10.1002/jclp.70004","DOIUrl":"https://doi.org/10.1002/jclp.70004","url":null,"abstract":"<p><p>Virtual Reality (VR) is becoming an increasingly prominent tool in psychotherapy, offering immersive and personalized experiences that can enhance therapeutic processes. However, the diversity and complexity of VR-based interventions pose challenges for clinicians and researchers seeking to understand and apply this technology effectively. This article introduces a three-dimensional conceptual framework to support the analysis, classification, and design of VR interventions in psychotherapy. The framework is organized around three axes: Strategy (the therapeutic purpose of the VR experience: exposure, training, and exploration), Focus (the psychological domain being targeted: symptoms, attitudes, and identity/flourishing), and Perspective (the point of view or identity adopted within the virtual environment: self, other, witness, and multi-perspective). Drawing on five clinical case reports, including chronic pain, PTSD, social anxiety, depression, and psychosis, this In Session issue illustrates how VR can be harnessed across diverse therapeutic aims and models (cognitive-behavioral therapy, acceptance and commitment therapy, systemic therapy, and personal construct therapy) to foster therapeutic breakthroughs. By presenting both well-established and innovative uses of VR, this issue offers valuable insights into how virtual environments can extend the boundaries of psychotherapy and address complex psychological challenges in novel, impactful, and transformative ways.</p>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248080","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":"One Simple Question Predicts Well-Being in Radiation Therapy: The Role of Desire for Psychological Intervention and Perceived Social Support.","authors":"Roni Laslo-Roth, Sivan George-Levi, Yael Galin Loncich, Myriam Sultan, Nirit Wiskop-Farkash, Eli Sapir","doi":"10.1002/jclp.23814","DOIUrl":"https://doi.org/10.1002/jclp.23814","url":null,"abstract":"<p><p>Radiation therapy (RT) is a critical part of cancer treatment often accompanied by heightened anxiety, depression, and reduced life satisfaction. Although psycho-oncological (PO) interventions and social support can alleviate distress, it is unclear whether patients' desire for PO intervention reflects temporary or ongoing distress and whether all patients benefit from social support or only those seeking help. In this study we examined whether the desire for PO intervention during the start of RT predicted anxiety, depression, and life satisfaction at the start and end of RT and whether perceived social support moderated these effects. One-hundred-and-forty-six patients completed questionnaires at three time-points (pre-treatment, first treatment, and last treatment). Results showed that patients desiring PO intervention reported higher anxiety and depression at the start and end of RT. Higher perceived social support predicted lower depression and improved life satisfaction but only for patients expressing a desire for PO intervention. Screening for psychological distress is standard in oncology but often limited by time and resources during RT. The current study findings suggest that a single, straightforward question at the start of RT could identify at-risk patients, enabling proactive intervention. Moreover, fostering perceptions of social support may help mitigate negative outcomes in the absence of professional intervention.</p>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225619","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":"Virtual Reality in Psychotherapy: A Commentary on Strategies, Interventions, and Perspectives From Five Clinical Reports.","authors":"Sofia Seinfeld, Adrián Montesano","doi":"10.1002/jclp.23813","DOIUrl":"https://doi.org/10.1002/jclp.23813","url":null,"abstract":"<p><p>Virtual reality (VR) applications have shown significant potential in enhancing psychological interventions by evoking vivid emotional reactions and creating immersive environments. This commentary provides an overview of five clinical case reports illustrating the advantages and pitfalls of VR-enhanced psychotherapy in social anxiety disorder, PTSD due to military trauma, auditory hallucinations, depression, and chronic pain. The case reports are analyzed with a dimensional framework designed to evaluate VR applications to be used in psychotherapy. The framework is based on three key dimensions: Strategy (e.g., Exposure, Training, Exploration), Focus (Symptom, Attitudes, Identity and Flourishing), and Perspective (Self, Other, Witness, Multiperspective). For example, the use of VR-based body scan exercises in chronic pain management can enable the training of body-related attentional skills helping individuals to not only focus on pain sensations, while VR exposure therapy helps clients with social anxiety or PTSD to confront feared situations, reprocess traumatic experiences, and develop coping skills. VR Avatar Therapy, on the other hand, enables individuals with auditory hallucinations to actually have a dialogue with the voices they hear since these are embodied in avatars controlled by therapists, promoting symptom externalization and self-identity exploration. Finally, the Explore Your Meanings tool enables immersive multi-perspective exploration of self-identity in 3D immersive spaces where it is easy to visualize the differences between the perceived and ideal self. The cases demonstrate VR's unique ability to provide real-time, dynamic treatment personalization, aligning with the trend toward individualized care in psychotherapy.</p>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215971","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":"Exploring Typologies of Immediacy Events in Psychodynamic Therapy: A Latent Class Analysis.","authors":"Anna Mylona, Evrinomy Avdi, Julie Vaiopoulou","doi":"10.1002/jclp.23812","DOIUrl":"https://doi.org/10.1002/jclp.23812","url":null,"abstract":"<p><p>Immediacy is a therapeutic intervention that entails the explicit discussion between therapist and client about their relationship in the here-and-now. It is considered a potentially powerful intervention that can facilitate relational processing, especially in psychodynamic psychotherapies. Τhis study aims to explore the use of immediacy in psychodynamic psychotherapy through a case-series analysis. Videos of 139 sessions, drawn from 7 psychotherapies with 2 therapists, were coded in terms of the type of immediacy used and its immediate effects, as reflected in the client's response. A total of 121 immediacy events were identified in 57 sessions, occupying 8% of the total therapy time; the majority were initiated by the therapist. A Latent Class Analysis was conducted to explore where there exist clusters of immediacy events that share patterns of immediacy type and effect. Two distinct clusters of immediacy events were identified. The most common group, which we termed 'limited engagement in immediacy', was characterised by a primarily insight-oriented agenda on the therapist's part, smooth collaboration during the immediacy event, and limited engagement on the client's part. The second cluster, termed 'mutual engagement in immediacy,' reflected more complex processes characterised by conflict, with the therapist using a range of interventions (from alliance-building to insight-oriented interventions), evidence of disruption in the therapist-client collaboration, and the client showing increased engagement and reporting improvement. The findings are discussed drawing upon the literature on the processes of repairing ruptures in the therapeutic alliance and clinical implications regarding the use of immediacy.</p>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144187139","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":"A Longitudinal Examination of the Predictive Effects of Alexithymia on Nonsuicidal Self-Injury Among Emerging Adults.","authors":"Lola Leving, Tracy K Wong, Chloe A Hamza","doi":"10.1002/jclp.23811","DOIUrl":"https://doi.org/10.1002/jclp.23811","url":null,"abstract":"<p><strong>Objectives: </strong>Emerging evidence suggests that alexithymia, a psychological construct defined by the inability to describe emotion, differentiate feelings, and think in an internally oriented way, may be relevant in understanding engagement in nonsuicidal self-injury (NSSI). However, there is a paucity of longitudinal work on alexithymia and NSSI, which is necessary to discern whether alexithymia may heighten risk for NSSI over time.</p><p><strong>Methods: </strong>In the present study, the association between alexithymia and NSSI was examined among 1125 emerging adults (Mage = 17.96, 72% female), who completed a survey at two time points 4 months apart.</p><p><strong>Results: </strong>Participants with a history of NSSI reported higher levels of alexithymia than those with no NSSI engagement. A zero-inflated negative binomial regression model revealed that higher alexithymia at Time 1 predicted greater diversity in NSSI methods (i.e., NSSI versatility), but not NSSI frequency, at Time 2, for those already engaging in NSSI (p < 0.01, controlling for NSSI history at Time 1, emotion regulation difficulties, age, and gender). Significant differences were found in NSSI functions based on alexithymia among individuals with a lifetime history of NSSI at both time points. Among participants with a history of NSSI, alexithymia was most strongly correlated with anti-dissociation, sensation seeking, self-punishment, toughness, and interpersonal boundaries NSSI functions.</p><p><strong>Conclusion: </strong>Findings underscore that alexithymia may be relevant to understanding NSSI severity.</p>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111053","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":"A Case Study on Transforming Shame: The Role of Acceptance and Commitment Therapy in Fostering Psychological Flexibility and Self-Compassion.","authors":"M Kati Lear, Jason B Luoma","doi":"10.1002/jclp.23810","DOIUrl":"https://doi.org/10.1002/jclp.23810","url":null,"abstract":"<p><p>Shame is related to a host of social and psychological problems including depression, PTSD, social anxiety, substance misuse, borderline personality disorder, eating disorders, and self-directed violence. Shame is an acutely painful emotion that motivates humans to protect the \"flawed\" or \"fragile\" self, often through withdrawal or avoidance. Consequently, many clients who frequently and intensely experience shame persistently avoid life situations where shame could be triggered and engage in frequent self-criticism geared toward self-improvement. Though well-intentioned, these repeated attempts to reduce or avoid shame can exacerbate the sense of being defective, other, or unworthy already associated with shame and prevent people from living out their values in relationship with themselves and important others. Acceptance and Commitment Therapy (ACT) is a transdiagnostic treatment approach that aims to promote psychological and behavioral flexibility in response to painful internal experiences, like shame. This case illustration depicts how ACT can be applied to target shame by incorporating a collaborative case conceptualization process and principles from affective science to help the client respond more flexibly to shame when it is cued, and take steps to cultivate a more compassionate, values-driven relationship with self and others. The client, Courtney, was an adult heterosexual cisgender white woman working in secondary education. She presented to therapy with symptoms of anxiety, depression, and self-esteem issues and underwent 20 sessions of ACT for shame. By the final session, Courtney reported significantly reduced shame and self-criticism and increased self-compassion.</p>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078356","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":"Indirect Pathways From Dysfunctional Attitudes and Attributional Style to Depressive Symptoms Through Imposter Phenomenon.","authors":"Mark A Whisman","doi":"10.1002/jclp.23807","DOIUrl":"https://doi.org/10.1002/jclp.23807","url":null,"abstract":"<p><strong>Objectives: </strong>Cognitive theories of depression focus on how cognitive vulnerabilities increase risk for depression in the context of negative life events. To complement this perspective, two studies were conducted to examine associations among cognitive vulnerabilities, imposter phenomenon, and depressive symptoms to better understand how cognitively vulnerable individuals may respond to positive life events in ways that minimize their potential benefits.</p><p><strong>Methods: </strong>Study 1 (N = 395 undergraduates) examined associations among dysfunctional attitudes, attributional style, imposter phenomenon, and depressive symptoms, whereas Study 2 (N = 443 undergraduates) examined associations among dysfunctional attitudes regarding performance evaluation and approval by others, imposter phenomenon, and depressive symptoms.</p><p><strong>Results: </strong>Dysfunctional attitudes and, to a lesser degree, negative causal attributions for positive life events, were significantly and positively associated with imposter phenomenon, which served as an indirect pathway linking cognitive vulnerabilities with depressive symptoms (Study 1). Dysfunctional attitudes regarding performance evaluation were more strongly associated with imposter phenomenon than those regarding approval by others, and imposter phenomenon served as an indirect pathway linking dysfunctional attitudes with depressive symptoms (Study 2).</p><p><strong>Conclusion: </strong>Minimizing achievements and successes in ways characterized by imposter phenomenon may be one pathway by which people with cognitive vulnerabilities, particularly dysfunctional attitudes regarding performance evaluation, are vulnerable to depression.</p>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144026690","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}