Journal of Clinical Psychology最新文献

{"title":"Mentalizing Oneself and Others in Anorexia Nervosa: From Subjective Evaluation to Performance.","authors":"Emilie Auger, Jean-Louis Nandrino, Karyn Doba","doi":"10.1002/jclp.23791","DOIUrl":"https://doi.org/10.1002/jclp.23791","url":null,"abstract":"<p><strong>Objective: </strong>The present study examined impairment in two main dimensions of mentalizing (self-other and emotional-cognitive) in patients with anorexia nervosa (AN) by combining self-reported measures with performance-based tasks.</p><p><strong>Method: </strong>Forty-five patients with AN recruited from an eating disorder unit and 45 healthy controls (HCs) recruited from the general population completed the Mentalization Scale and the Movie for Assessment of Social Cognition.</p><p><strong>Results: </strong>The results revealed that in self-reported evaluations of their mentalization process, patients with AN hypo-mentalized about themselves and others' mental states. However, they used more hyper-mentalizing than HCs when mentalizing others' emotional and cognitive mental states in performance-based tasks. Finally, the severity of eating symptoms in patients with AN was associated with higher levels of perceived hypo-mentalizing about their own mental states and lower levels of perceived hypo-mentalizing of others' mental states. No associations were found between the severity of eating symptoms and mentalizing performance.</p><p><strong>Conclusions: </strong>This study emphasizes the importance of mentalizing impairment in patients with AN, which should be considered via a multidimensional approach that considers both emotional and cognitive dimensions and the ability to assess patients' competences.</p>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663614","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":"Using Virtual Reality Social Environments to Promote Outcomes' Generalization of AVATAR Therapy for Distressing Voices: A Case Study.","authors":"Mar Rus-Calafell, Nils Ehrbar, Tobias Teismann, Silvia Schneider, Ekincan Tas, Simon Schuster, Clementine Edwards, Mark Huckvale, Thomas Craig, Philippa Garety, Thomas Ward","doi":"10.1002/jclp.23785","DOIUrl":"https://doi.org/10.1002/jclp.23785","url":null,"abstract":"<p><p>AVATAR therapy (AT) works by facilitating a 'face-to-face' dialog between the person and a digital representation (avatar) of their persecutory voice. Although there is cumulative evidence of this way of working with voices, enhancing the therapeutic focus on improved confidence and a sense of control of the voices in social situations represents a promising way to boost the generalization of therapy gains into social contexts. This paper presents a descriptive clinical case example of AVATAR_VRSocial therapy, a new augmented version of AT incorporating immersive Virtual Reality to help the person deal better with their voices in daily situations. \"Laura\" is a woman who was hearing a very distressing, threatening voice. She felt anxious and distressed when anticipating hearing it and would engage in safety-seeking behaviors to prevent hearing the voice. Laura was supported to stand up to her avatar and regain power over it by using assertive responses, both in active avatar dialog and when exposed to the avatar voice in VR scenarios, which turned into reduced distress when hearing the voice in her everyday life. Laura's dialog with her avatar evolved into a more explicit exploration of the meaning and the purpose of the voice in relation to previous trauma and personal relationships. The additional work in VR appeared to facilitate exposure to social situations while hearing the distressing voice, without performing seeking-safety behaviors, and to allow for practicing strategies to reduce the voice's interference, which evolved from the dialogic sessions with the personalized avatar.</p>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657251","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":"Understanding Autistic Young Adults' Perceptions and Experiences of Traumatic and Stressful Events.","authors":"Alliyza Lim, Robyn L Young","doi":"10.1002/jclp.23783","DOIUrl":"https://doi.org/10.1002/jclp.23783","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this study was to explore how young autistic adults experience and respond to stressful life events, and the relationship between autistic characteristics and symptoms of stress associated with these events.</p><p><strong>Methods: </strong>Using an exploratory sequential mixed-methods approach, an online qualitative survey was first administered to 50 autistic young adults asking about their perceptions of trauma and the role that autistic behaviours may play in their perceptions of and responses to traumatic events. Data were analysed using reflexive thematic analysis. To examine the generalisability of these findings, a quantitative survey was developed based on the themes generated and then administered to 150 autistic and 149 non-autistic young adults.</p><p><strong>Results: </strong>Autistic and non-autistic participants described similar perceptions of trauma. Autistic participants reported greater interpersonal trauma exposure and more symptoms of stress than non-autistic comparisons. Among participants who experienced a DSM-5-TR traumatic event, autistic traits (as measured by select items of the Social Responsiveness Scale [SRS-2]) accounted for a combined 16.2% of the variance in PTSD symptoms (as measured by the PTSD Checklist [PCL-5]). Autistic participants highlighted that a significant factor that sets their experience apart from that of non-autistic individuals is that autism is already a challenging condition to manage. Participants identified four main ways that autism and trauma interact: (1) autism increases one's vulnerability to experiencing a stressful event, (2) autism amplifies the impact of the trauma, (3) autistic behaviours can serve as healthy or unhealthy coping mechanisms, and (4) autism compounds barriers to receiving support.</p><p><strong>Conclusions: </strong>An overarching theme that permeated the narratives of autistic young adults was, \"The autistic experience of trauma is fundamentally different.\" There is thus a need for clinicians to develop thorough case conceptualisations that consider the interaction between autism and trauma when working with an autistic population.</p>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657245","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":"Deliberate Practice Supervision to Enhance the Effectiveness of Behavioral Activation for Depression: A Case Study.","authors":"Dan Sacks","doi":"10.1002/jclp.23786","DOIUrl":"https://doi.org/10.1002/jclp.23786","url":null,"abstract":"<p><p>Deliberate Practice (DP) is a model of behavioral skill acquisition structured by several key tasks. The past decade has shown a consistent growth in interest in this form of learning for psychotherapy skills, with promising research suggesting DP training is superior to traditional learning methods of psychotherapy. This paper presents a case study of a single practitioner's experience with Deliberate Practice. It follows a clinician treating a client diagnosed with Major Depressive Disorder (MDD) while learning Behavioral Activation under the guidance of a DP Supervisor. The main components of DP are presented: direct observation of performance, concrete feedback, defining learning goals, performing repeated behavioral rehearsal and the ongoing assessment of performance. Real case vignettes are used to demonstrate these components. The paper concludes with a discussion of challenges that DP supervisors commonly face, and some practical implications for clinicians.</p>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143648213","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":"Take a Look at Me Now: The Use of Virtual Reality in the Treatment of Social Anxiety Disorder.","authors":"Katharina Meyerbröker, Paul Emmelkamp","doi":"10.1002/jclp.23782","DOIUrl":"10.1002/jclp.23782","url":null,"abstract":"<p><p>In anxiety and related disorders, Virtual Reality Exposure Therapy (VRET) was one of the first steps toward integrating technology into psychological treatments. In this article, we discuss crucial therapeutical skills and provide a case conceptualisation for the treatment of social anxiety disorder with VRET. The case conceptualisation is based on evidence-based cognitive-behavioural treatment approaches. Social anxiety can be very challenging to treat with exposure in vivo, and virtual reality exposure offers the added benefit of being able to create social situations and real-time interactions within the therapeutic context. The case conceptualisation presented is worked out for a 23-year-old female with social anxiety disorder who is increasingly hindered by her anxiety in her professional and personal life. The treatment rationale of VRET, homework assignments, and progress of therapy are presented. Additionally, this paper discusses what steps to take if the first exposure experiences are not successful and how to progress in such cases. Therapeutic pitfalls are illustrated within this case and potential solutions on how to avoid these pitfalls are addressed.</p>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143582292","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":"Psychological Interventions for Sleep Problems Among Medical and Paramedical Students: A Systematic Review.","authors":"Vijandran A Mariappan, Firdaus Mukhtar","doi":"10.1002/jclp.23781","DOIUrl":"10.1002/jclp.23781","url":null,"abstract":"<p><p>Sleep problems such as poor sleep quality and insomnia are common issues among medical and paramedical students, which may lead to mental health disorders and impaired academic performance. Despite the availability of different sleep programs and psychological interventions, as well as a few reviews exploring their effects on sleep variables in college students, a systematic review comparing their effectiveness in medical students is still lacking. This systematic review aims to investigate psychological interventions to improve sleep quality and address sleep problems in medical students. Four databases (PubMed, SciDirect, Scopus, and PsycNet) were searched to retrieve original research articles written in English and published from January 1, 2000, to September 30, 2023. Outcome measures were sleep quality, insomnia, sleep behavior, sleep quantity, and sleep-related problems. A total of 19 articles met the inclusion criteria, and 4 categories of interventions were identified (1) sleep hygiene, (2) cognitive behavioral therapy (CBT), (3) a combination of sleep hygiene/CBT with other modalities, and (4) other psychotherapeutic interventions such as progressive muscle relaxation, hypnotherapy, aromatherapy yoga, and mindfulness. Ten studies were randomized control trials, two were quasi-experimental, and the remaining seven were pre- and post-intervention designs (one group only and no control). Overall, both individual CBT and sleep hygiene education led to significant improvement in sleep quality and sleep problems among medical students, but CBT was more effective with consistent positive effects on sleep quality. Nevertheless, significant improvements in sleep quality and sleep-related outcomes were observed in studies combining these psychological interventions. Effective comparisons were limited due to the substantial heterogeneity between the studies. Further research is required to elucidate the type of psychological intervention, optimal mode of delivery, duration, and number of contacts of these interventions, including the moderators to improve sleep quality among medical students.</p>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143582313","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":"Endo Belly: A Mixed Methods Exploration of Body Image, Disordered Eating, and Psychopathology in Endometriosis.","authors":"Mia L Pellizzer, Katherine Robinson, Tracey D Wade","doi":"10.1002/jclp.23779","DOIUrl":"https://doi.org/10.1002/jclp.23779","url":null,"abstract":"<p><strong>Objective: </strong>There is increasing interest in the impact of endometriosis on body image, however, there is minimal understanding of the presence and nature of disordered eating. As body image dissatisfaction is elevated in this population and a risk factor for eating disorders, it is likely that disordered eating is also elevated which has important clinical implications for prevention and intervention. The current study aimed to explore the relationships between endometriosis, body image flexibility, eating disorder psychopathology, negative affect, and self-criticism using a mixed-methods design.</p><p><strong>Method: </strong>People (n = 179) with endometriosis, over the age of 18 years, and living in Australia were recruited using social media. Quantitative measures included the Body Image Acceptance and Action Questionnaire, Eating Disorder Examination Questionnaire 7-item Short Form, Depression Anxiety and Stress Scales, and the Inadequate Self subscale of the Forms of Self-Criticising/Attacking and Self-Reassuring Scale. Participants were also asked two open-ended questions that enabled reflexive thematic analysis of the impact endometriosis has on body image and eating, using Braun and Clarke's six phase process.</p><p><strong>Results: </strong>Participants were mostly female, heterosexual, White, and had a mean age of 30. The sample demonstrated high levels of eating disorder psychopathology, negative affect, and self-criticism, and low body image flexibility. Thematic analysis yielded three main themes, that were highly consistent with quantitative findings: Body disappointment, Food as an enemy, and Stolen identity and joy.</p><p><strong>Conclusions: </strong>This study highlights the need for prevention and intervention efforts focused on reducing eating disorder psychopathology and body image concerns experienced by individuals with endometriosis.</p>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537261","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":"Using Mindfulness to Manage Moral Injury in Veterans: Feasibility and Satisfaction of a Pilot Randomized Controlled Trial.","authors":"Michelle L Kelley, Adrian J Bravo, Elizabeth E Burgin, Susan A Gaylord, Christine Vinci, Megan Strowger, Jeffrey M Gabelmann, Joseph M Currier","doi":"10.1002/jclp.23778","DOIUrl":"https://doi.org/10.1002/jclp.23778","url":null,"abstract":"<p><strong>Objective: </strong>The present study assessed program feasibility and satisfaction among recent-era veterans who participated in Mindfulness to Manage Moral Injury (MMMI), a live facilitated web-based 7-week mindfulness-based program targeting moral injury among veterans.</p><p><strong>Method: </strong>In total, 56 post-9/11 veterans were recruited with 28 randomized to the MMMI condition and 28 to the Education and Support (ES) condition. Most participants identified as being White (71.4%), male (66.1%), and had a reported mean age of 41.50 years (Median = 39.50, SD = 9.26).</p><p><strong>Results: </strong>Among the 56 participants, 82.1% attended at least one treatment session and 44.6% completed all seven sessions. There were no significant differences in the average number of sessions attended between the MMMI (M = 4.79, SD = 2.70) and the ES (M = 4.68, SD = 2.84) conditions, t(54) = 0.145, p = 0.87. Regarding randomization, there were no statistically significant differences on almost all demographic (i.e., years in military, gender, ethnicity) characteristics and baseline scores on all outcomes across treatment conditions, thus ensuring randomization was adequately met. Of the 56 who consented, 41 (73.21%) completed most study components (i.e., completed baseline and follow-up surveys, at least 1 weekly survey, and attended at least one treatment session). Regarding treatment satisfaction, individuals in the MMMI condition reported higher treatment satisfaction (Cohen's d = 0.66).</p><p><strong>Conclusions: </strong>Preliminary findings suggest MMMI is feasible and acceptable and may be able to reach veterans who may not seek traditional Veterans Affairs Medical Center care or who prefer a web-based program. Given its promise for the treatment of moral injury among veterans, MMMI warrants additional large-scale clinical-trial testing.</p>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523401","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":"Integrating Deliberate Practice Into Group Supervision: A Case Illustration.","authors":"Elisabet Rosén","doi":"10.1002/jclp.23780","DOIUrl":"https://doi.org/10.1002/jclp.23780","url":null,"abstract":"<p><p>One of many challenges in group supervision is the question of how to keep every participant engaged and fully available for learning. This paper describes a group supervision structure that uses Deliberate Practice (DP) to involve every participant in the group through the development of therapeutic skills intended to enhance the effectiveness of their work with clients. A case example illustrates how this process unfolded in the context of therapy with a specific client, conducted by a psychiatrist undergoing psychotherapy training in a deliberate practice supervision group. Analysis of video recordings of group supervision sessions and notes on solitary deliberate practice are used to illustrate how a DP structure engaged all participants in the group, while also facilitating the clinical development of the supervised psychiatrist and enhancing patient outcomes. A DP approach to group supervision enables participants to learn from each other's cases, through the deployment of flexible activities that engage all members of the group while also providing personalized skills training.</p>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143491979","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":"Rethinking Psychotherapy Training and Supervision: The Case for Deliberate Practice.","authors":"Alexandre Vaz, Julia McLeod, Helene A Nissen-Lie","doi":"10.1002/jclp.23777","DOIUrl":"https://doi.org/10.1002/jclp.23777","url":null,"abstract":"<p><p>Psychotherapy supervision research has led to mixed, often disappointing results as to its effects on clinicians' skills acquisition and final treatment outcomes. Put simply, it is unclear if traditional supervision methods reliably increase therapist effectiveness. To answer this longstanding challenge, Deliberate Practice (DP) is now increasingly being recognized by leading authors and researchers as an effective method for enhancing therapists' skills. Despite this growing agreement about the potential advantages of DP methods, there remains a shortage of research, guidelines and real-world case presentations for their implementation in clinical supervision. In this introductory paper, we present an issue of the Journal of Clinical Psychology: In Session that showcases diverse modalities and approaches through which DP can be integrated into clinical supervision. To set the stage, this paper presents the major definitions, research evidence, and potential benefits and challenges of a DP-informed psychotherapy supervision. We highlight that while available research is promising, much is still needed to elevate the promise of DP into an evidence-based learning method that reliable increases therapist's skills and outcomes. As such, we conclude with a call encouraging clinicians, trainers and researchers alike to experiment with the methods here described and contribute to this exciting new development in the field.</p>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458253","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}