Annabelle Rynerson, Summer Newell, Praful Gade, Nazanin Bahraini, Lauren M Denneson, Steven K Dobscha
{"title":"Fear of Involuntary Hospitalization Impacts Veteran Responses to Suicide Screening: Veteran and Staff Perspectives.","authors":"Annabelle Rynerson, Summer Newell, Praful Gade, Nazanin Bahraini, Lauren M Denneson, Steven K Dobscha","doi":"10.1002/jclp.70225","DOIUrl":"https://doi.org/10.1002/jclp.70225","url":null,"abstract":"<p><strong>Objectives: </strong>Veterans generally accept the rationale for suicide risk screening; however, the screening process can be affected by barriers to disclosure. The objective of this analysis was to describe veteran and staff perspectives on fears of involuntary hospitalization related to screening and how staff can help alleviate these concerns to facilitate disclosure.</p><p><strong>Methods: </strong>We used semi-structured interviews to collect qualitative data and applied thematic analysis to transcripts using a conventional/directed hybrid approach. The sample comprised 90 veterans recently screened for suicidal ideation and 53 Veterans Health Administration (VHA) clinical staff members in primary care, mental health, and emergency department settings.</p><p><strong>Results: </strong>Veterans consistently reported fear of involuntary hospitalization as a barrier to disclosing suicidal thoughts and behaviors, and staff reported experiences with veterans who expressed fear of hospitalization as a concern during suicide risk screening. Training to adequately assess suicide risk, building a trusting relationship between patients and staff, and transparent communication were considered paramount in addressing fears of hospitalization.</p><p><strong>Conclusion: </strong>Veteran and staff participants reported that fear of hospitalization was present for veterans during screening and evaluation for suicidal thoughts. Veterans and staff recognize that fear of hospitalization impacts how veterans engage with the suicide risk screening and can be affected by the staff's level of training and experience. These findings support a patient-centered approach to screening, which includes facilitating an honest conversation and involving veterans in decision-making.</p>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149061363","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}
Alexis McGhee-Dinvaut, Jennifer M Taber, Stephen Ilardi
{"title":"Do Black and White Americans Differ in Willingness to Engage in Traditional, Alternative, and Religious Treatment Modalities for Depression?: A Hypothetical Vignette Study.","authors":"Alexis McGhee-Dinvaut, Jennifer M Taber, Stephen Ilardi","doi":"10.1002/jclp.70230","DOIUrl":"https://doi.org/10.1002/jclp.70230","url":null,"abstract":"<p><p>Black Americans have lower engagement in traditional mental health treatment compared to White Americans. However, complementary and alternative medicine is widely used, can be integrated into traditional treatment, and may have fewer barriers associated with it than traditional treatment. This study examined Black and White Americans' hypothetical willingness to engage in depression treatment options across modalities (traditional vs. alternative vs. religious vs. none) as well as factors associated with reported willingness to engage in treatment (i.e., race, symptom severity, religiosity). Participants (n = 185; 92 Black Americans, 93 White Americans) were presented with four vignettes describing varying severities of depression symptomatology and indicated their likelihood of using various treatment modalities. Repeated measures ANOVAsH indicated that as symptom severity increased, participants reported greater willingness to engage in traditional treatments. Conversely, as symptom severity decreased, participants reported greater willingness to engage in alternative treatments. Overall, participants reported greater willingness to engage in alternative treatments. Treatment willingness did not differ by race, but greater religiosity-which was higher in Black participants-was associated with greater willingness to engage in religious treatment. Further research is needed concerning other factors affecting willingness to engage in alternative treatment, as is a better understanding of when and why people are more willing to seek alternative treatment.</p>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149016973","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":"Targeting Shame and Guilt in Psychotherapy: From Conceptual Understanding to Diverse Therapeutic Approaches.","authors":"James N Kirby, Deborah Lee","doi":"10.1002/jclp.70226","DOIUrl":"https://doi.org/10.1002/jclp.70226","url":null,"abstract":"<p><p>Self-conscious emotions, specifically shame and guilt, are pivotal factors in the onset, maintenance, and treatment of various mental health disorders. While shame involves a devalued sense of the global self and internal/external stigmatization, guilt typically pertains to specific behaviors and the desire for reparation, however it can become problematic when there are inappropriate and excessive attributions of control and responsibility. This virtual issue explores the complex roles these emotions play as both clinical symptoms and barriers within the therapeutic relationship. Through a series of diverse case studies, leading experts demonstrate how various modalities, including Metacognitive Interpersonal Therapy (MIT), Acceptance and Commitment Therapy (ACT), Mentalization-Based Therapy (MBT), Eye Movement Desensitization and Reprocessing (EMDR), Control-Mastery Theory (Control-Mastery Theory), and Compassion Focused Therapy (CFT), target these emotions. Each approach offers unique strategies, from shifting evolutionary \"rank\" mentalities to fostering psychological flexibility and social safeness. Collectively, these papers provide clinicians with a comprehensive framework for addressing shame and guilt to enhance therapeutic outcomes and client wellbeing.</p>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148990130","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":"Extending Safety Planning Beyond Suicide Prevention: The Clinical Utility of Self-Regulation Planning.","authors":"Morgan Robison, Tapan A Patel, Thomas E Joiner","doi":"10.1002/jclp.70229","DOIUrl":"https://doi.org/10.1002/jclp.70229","url":null,"abstract":"<p><p>Safety planning has demonstrated efficacy in reducing suicide risk. Less is known, however, about the potential adaptability of safety plans as a therapeutic tool for addressing other clinically relevant behaviors beyond suicidality. To reflect this broader applicability, we introduce an adapted Self-Regulation Plan (SRP), which emphasizes guiding in-the-moment skills use across diverse clinical contexts. This manuscript provides an overview of safety planning within suicidal crises, identifies similarities and differences between safety planning and SRPs, and proposes how SRPs may be used to structure and support adaptive responses across an array of clinical presentations. By enhancing the generalizability of these principles, future research can investigate concepts such examining the effectiveness of SRPs and broadening of the term \"safety.\"</p>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148990138","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":"Reimagining Voices: A Case-Based Exploration of Imagery-Enhanced Cognitive Behavioural Therapy for Distressing Voices (IE-CBTv).","authors":"Mikaela Bere, Georgie Paulik","doi":"10.1002/jclp.70227","DOIUrl":"https://doi.org/10.1002/jclp.70227","url":null,"abstract":"<p><p>Distressing voices (auditory verbal hallucinations) are frequently accompanied by emotional mental imagery, the nature of which often amplifies the associated distress. Mental imagery can be experienced across any of the sensory modalities and can reflect memories of past events or be fictional. Often, the themes for the content of distressing voices and associated mental imagery are driven by underlying core beliefs, or schemas, that the individual holds. Imagery-Enhanced Cognitive Behavioural Therapy for distressing voices (IE-CBTv) builds on the traditional first-line CBT approach by incorporating targeted work with associated mental imagery and using imagery techniques to address the underlying themes and core beliefs linked to the voices. This paper presents the case of a 25-year-old male voice hearer, Leo, who worked collaboratively with their therapist across ten sessions of IE-CBTv. Leo reported distressing voices with core themes of being unloved, abandoned, and not belonging. His distressing voices were associated with a clear mental image of Leo being cast aside in a social group situation. This case presentation will discuss how the therapist supported the client to make sense of his voices, using a formulation-based approach. The rationale for different imagery techniques, how they were collaboratively designed, implemented, and received, will be discussed; alongside challenges and therapist reflections. Implications for clinical practice for working with distressing voices using an IE-CBTv framework will also be discussed.</p>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148976852","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}
Iuno Z Groot, Nathan Bachrach, Anne-Sophie M M Venhuizen, Renske Wichers, Petra Frets, Silvia M M A Evers, Arnoud Arntz
{"title":"What Works in Therapy? Patients' Views on Effective Elements of Schema Therapy Versus Treatment as Usual for Cluster-C Personality Disorders.","authors":"Iuno Z Groot, Nathan Bachrach, Anne-Sophie M M Venhuizen, Renske Wichers, Petra Frets, Silvia M M A Evers, Arnoud Arntz","doi":"10.1002/jclp.70228","DOIUrl":"https://doi.org/10.1002/jclp.70228","url":null,"abstract":"<p><p>Although Schema Therapy (ST) shows promise as an intervention for cluster-C personality disorders (PD), little is known about how patients experience ST. This study explored patients' experiences with Individual ST (IST) and Group ST (GST), and exploratively compared these with specialized Treatment As Usual (sTAU). Specifically, we explored patients' experiences with regard to the format (group vs. individual), the therapeutic relationship, specific ST techniques, patients' ability to participate and practical aspects of the protocols. Thirty participants from a multicenter randomized controlled trial (RCT), comparing IST, GST, and sTAU, were interviewed after completing treatment. The data were analyzed using thematic analysis guidelines. Patients reported both facilitating and hindering factors: Patients described the group format as providing unique learning opportunities, recognition, and support, yet many patients preferred additional individual sessions for more personalized attention to treatment goals. GST participants also suggested implementing screening procedures for group therapy suitability and extending the number of sessions. Across both IST and GST, patients perceived the therapeutic relationship and specific ST techniques, such as the mode model and Imagery Rescripting, as important contributors to their recovery process. Within the therapeutic relationship, a directive yet empathic approach was appreciated, and continuity of care was considered essential for building trust and rapport. Interviewed patients suggested that ST protocols could be further improved by simplifying and tailoring the mode model, offering diverse forms of ImRs, and enhancing personalization to patients' individual needs.</p>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148968701","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}
Amy Lunn, Angie Jenkin, Alex Lau-Zhu, Lisle Scott, Megan Dunnage, John Stewart, Joanna Holliday
{"title":"\"It All Exists Within Me\": A Qualitative Study Exploring Mental Health Service Experiences in Adults With Comorbid Eating Disorders and Emotionally Unstable Personality Disorder.","authors":"Amy Lunn, Angie Jenkin, Alex Lau-Zhu, Lisle Scott, Megan Dunnage, John Stewart, Joanna Holliday","doi":"10.1002/jclp.70221","DOIUrl":"https://doi.org/10.1002/jclp.70221","url":null,"abstract":"<p><strong>Objective: </strong>Comorbidity between Eating Disorders (ED) and Emotionally Unstable Personality Disorder (EUPD) is high. This comorbidity is also linked with worse outcomes for traditional evidence-based treatments. We aimed to improve mental health service experience for adults with comorbid EUPD and ED by: (1) understanding the service-user experience of receiving and accessing care; (2) identifying areas of unmet need; and (3) creating recommendations for improving care for this population.</p><p><strong>Methods: </strong>The project comprised semi-structured interviews with nine service-users within the UK National Health Service. Reflexive Thematic Analysis was used to generate themes, which informed clinical recommendations and a framework for improving care to meet local needs, with implications beyond.</p><p><strong>Results: </strong>Service-users described long waits and disjointed care, often feeling pressured to prioritise one difficulty over another in ways that did not align with their own goals. Many reported that their needs were only recognised at crisis point, highlighting a gap between clinician understanding and personal experiences. Six themes were derived from patient interviews. Psychoeducation about the links between EUPD and ED was seen as helpful, as well as the need for more consistent individualised care that better reflects service-users' goals and needs.</p><p><strong>Conclusions: </strong>The project increased understanding of the experiences of mental health service use in adults with comorbid ED and EUPD, and produced a set of recommendations, aimed at improving care for these individuals. These included a thorough assessment of comorbidity, consideration of service-user choice, alongside appropriate service adaptations to best meet service-users' goals and needs.</p>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148955701","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}
Jacqueline Peters, Peter J de Jong, Marije Aan Het Rot
{"title":"Distant and Distressed: Interpersonal Problems in Anxiety and Depression.","authors":"Jacqueline Peters, Peter J de Jong, Marije Aan Het Rot","doi":"10.1002/jclp.70212","DOIUrl":"https://doi.org/10.1002/jclp.70212","url":null,"abstract":"<p><strong>Objectives: </strong>Interpersonal functioning has a complex, bidirectional relationship with mental disorders such as anxiety and depression. The Inventory of Interpersonal Problems (IIP) assesses aspects of interpersonal functioning, including general interpersonal distress and interpersonal styles. In this study, we aimed to better understand how these aspects relate to anxiety and depression by (1) comparing interpersonal distress and style in individuals with current, past, and no lifetime anxiety and/or depression, and (2) examining how interpersonal styles relate to the comorbidity and chronicity of anxiety and depression.</p><p><strong>Methods: </strong>Participants (N = 1800) were drawn from the 9-year follow-up of the Netherlands Study of Depression and Anxiety. Diagnostic data from baseline until the 9-year follow-up were used to determine diagnoses and chronicity. General interpersonal distress and style were derived from the IIP using the Structural Summary Method. Participants were grouped into four interpersonal style subtypes corresponding to the quadrants of the interpersonal circumplex.</p><p><strong>Results: </strong>Currently diagnosed participants reported higher general interpersonal distress and a more submissive style than those with past and no lifetime anxiety/depression. As predicted, a cold-submissive style was associated with greater comorbidity and chronicity, also after adjusting for demographics.</p><p><strong>Conclusions: </strong>This study extends prior research on how patients' interpersonal style relates to psychopathology by using longitudinal, transdiagnostic data of individuals across different symptomatic stages. Our findings indicate that a cold-submissive style is relatively common in more comorbid and chronic anxiety and depressive disorders. This highlights the clinical value of integrating interpersonal assessment into treatment planning.</p>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148955757","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}
Ilana L J Buijssen, Sam M H de Haas, Giel J M Hutschemaekers
{"title":"Towards an Integrative Perspective of the Actively Involved Person in Mental Health Care: A Concept Mapping Approach.","authors":"Ilana L J Buijssen, Sam M H de Haas, Giel J M Hutschemaekers","doi":"10.1002/jclp.70224","DOIUrl":"https://doi.org/10.1002/jclp.70224","url":null,"abstract":"<p><strong>Objective: </strong>The importance of being actively involved in dealing with mental health care problems is well-recognized. Many terms and ideas have been introduced to explicate this active involvement, but to date, there is no consensus about a definition. This study aims to create an integrative perspective that brings together different ideas about the actively involved user in mental health care.</p><p><strong>Method: </strong>Following a concept mapping procedure, we collected the statements of stakeholders involved with mental health care about this active involvement during two brainstorm sessions (total N = 12). These stakeholders included clinicians, researchers, policy makers, and users of mental health care. A larger group with the same characteristics but that also included people otherwise concerned with mental health care (N = 25) sorted and rated the statements based on perceived similarity and importance.</p><p><strong>Results: </strong>The result was a concept map with six clusters: adjustment, participation, agency, networking, self-determination, and resilience. Most clusters were deemed to be equally relevant. The spatial configuration of the clusters suggested two underlying dimensions captured by focus (changing-strengthening) and locus (self-context), which together formed four quadrants representing distinct expressions of active involvement.</p><p><strong>Conclusions: </strong>The dimensional and quadrants integrate the literature surrounding active client participation into a coherent framework and give rise to a dynamic interpretation of active involvement in which individuals gradually regain ownership over their mental health state. In doing so, this conceptualization offers a framework for understanding the different ways in how active client participation can be expressed and supported throughout treatment.</p>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148930163","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}
Helena Garrido-Hernansaiz, Manuel Martín-Fernández, Douglas J Boegaerts
{"title":"The Hospital Anxiety and Depression Scale in People Living With HIV: A Validity Study in a Hard-to-Reach Population.","authors":"Helena Garrido-Hernansaiz, Manuel Martín-Fernández, Douglas J Boegaerts","doi":"10.1002/jclp.70223","DOIUrl":"https://doi.org/10.1002/jclp.70223","url":null,"abstract":"<p><strong>Objectives: </strong>While the Hospital Anxiety and Depression Scale (HADS) is widely used in diverse populations, countries, and languages, its scores' factor structure remains under debate. Only three studies have examined this in People Living with HIV (PLWH), with none conducted in Europe, Latin America, or Spanish-speaking samples. This study aimed to test five possible structural models of the HADS scores (one-, two-, and three-factor, and bifactor models with two and three factors) in Spanish-speaking PLWH, and to examine evidence of reliability and sensitivity.</p><p><strong>Methods: </strong>A convenience sample of 580 PLWH was recruited via online dissemination and health center referrals from Spain, Mexico, Colombia, and other Latin American countries. Participants completed the HADS and provided information on sociodemographic and medical variables (e.g., gender, age, means of HIV transmission). Confirmatory factor analyses were conducted, McDonald's omega coefficients computed for internal consistency, and independent-samples t-tests performed for sensitivity analyses.</p><p><strong>Results: </strong>A bifactor solution, comprising two specific factors (Anxiety and Depression) along with a strong general Distress factor, best fitted the data (CFI = 0.99, TLI = 0.98, RMSEA = 0.03, SRMR = 0.02). The Anxiety, Depression, and Distress scales showed good internal consistency (ω = 0.89, 0.87, and 0.93, respectively) and were generally able to distinguish between groups (men-women, employed-unemployed, connected-not connected to an HIV-related group).</p><p><strong>Conclusions: </strong>The HADS scores appear multidimensional, reliable, and sensitive in Spanish-speaking PLWH. However, their ability to reliably measure anxiety and depression separately is in question and warrants further investigation.</p>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148912210","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}