Journal of Clinical Psychology最新文献

{"title":"Challenge and Support: Scaffolding the Practicing Therapist in DP Supervision.","authors":"Vidar M Husby","doi":"10.1002/jclp.23774","DOIUrl":"https://doi.org/10.1002/jclp.23774","url":null,"abstract":"<p><p>While consensus on the importance of deliberate practice (DP) in psychotherapy increases, clarification of key elements in DP supervision is yet to be seen. An international collaboration between researchers, authors, supervisors, and therapists has proposed a method for DP supervision and created a training program for DP supervisors. This has led to a six-step overview model for DP and the DP Supervisor Competency Rating Scale (Vaz, Rousmaniere and Husby, 2023). DP in the context of supervision has concrete steps and requires specific supervisor skills. This article illustrates these with a case study consisting of twelve sessions with a trained DP supervisor and a supervisee that is a seasoned clinical psychologist. Annotated session transcripts provide a step-by-step qualitative representation of the collaborative process in identifying client challenge, therapist deficit and actionable learning goals as well as the in-session behavioral rehearsal. The article presents the DP-supervision overall trajectory, as well as both supervisee's and supervisor's input on the process. It discusses the importance of integrating conceptual, conditional, and procedural knowledge in therapist development, and claims that the same is true for DP-supervisor development. Finally, the need for empirical investigation of the proposed key elements in DP supervision is emphasized.</p>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143408091","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":"Negative Body Experience in a Clinical Sample of Mental Disorders: Associations With Posttraumatic Stress Disorder, Mood Disorders, and Personality Disorders.","authors":"Minke M van de Kamp, Mia Scheffers, Claudia Emck, Pim Cuijpers, Peter J Beek","doi":"10.1002/jclp.23776","DOIUrl":"https://doi.org/10.1002/jclp.23776","url":null,"abstract":"<p><p>While body experience is a key focus of treatment in psychomotor therapy (PMT), research has largely overlooked this important topic. In this study we explored three domains of body experience-body satisfaction, body attitude, and interoceptive awareness-in individuals with mental disorders in a clinical sample receiving PMT. We expected these patients to have a more negative body experience than nonclinical controls, with PTSD, mood disorders, personality disorders, and sex negatively affecting all three domains of body experience. The study involved 235 participants aged 18-59 with various mental disorders that were referred to PMT between 2008 and 2017 at a mental health center in the Netherlands. They completed questionnaires on all three of the body experience domains of interest. One sample t-tests revealed that patients had significantly greater negative body satisfaction and body attitude than nonclinical control samples obtained from the literature, with no significant difference in interoceptive awareness. Regression analyses within the patient sample revealed that female patients and patients with mood disorders or PTSD, displayed more negative body satisfaction than patients with other mental disorders. Additionally, female patients and patients with mood disorders displayed more negative body attitude. Although the total patient group and controls had comparable interoceptive awareness, only PTSD had significantly lower interoceptive awareness. Age and personality disorders did not predict differences on any domain of body experience. This research demonstrates that body experience is disturbed in patients with mental disorders who received PMT, and that there are disorder-specific disturbances on domains of body experience domains.</p>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143408075","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":"Advocating for Life: A Hospital's Guide to Suicide Prevention.","authors":"Ronnie D Watson, Khirey B Walker","doi":"10.1002/jclp.23766","DOIUrl":"https://doi.org/10.1002/jclp.23766","url":null,"abstract":"<p><strong>Introduction: </strong>With a global increase in adolescent suicidal thoughts and behaviors (STBs), this study addresses the need for enhanced advocacy initiatives within psychiatric inpatient settings.</p><p><strong>Methods: </strong>This study, conducted in the Midwest region of the United States, sampled a diverse group of healthcare professionals from psychiatric hospitals, including nurses, nurse practitioners, therapists, techs, and psychologists. Specifically, this study used reflexive thematic analysis to gather insights into the existing state of advocacy efforts, focusing on their alignment with the needs of adolescent patients and barriers to effective implementation.</p><p><strong>Results: </strong>Preliminary findings revealed a significant gap in hospital-wide advocacy programs tailored to the needs of adolescents facing STBs. Participants stressed the need for more personalized, dynamic advocacy strategies that go beyond traditional models, suggesting a move toward integrated, patient-driven approaches.</p><p><strong>Conclusion: </strong>This study details several limitations with current psychiatric inpatient care practices, stressing the need for a paradigm shift toward more effective advocacy and suicide prevention strategies. Our results advocate for an approach that actively involves patients in their care journey.</p>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065995","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":"Common Elements and Differences Among Treatment Approaches to Complex Post-Traumatic Stress Disorder: A Commentary on Five Case Studies.","authors":"Benedetto Farina, Giancarlo Dimaggio, Dolores Mosquera","doi":"10.1002/jclp.23773","DOIUrl":"https://doi.org/10.1002/jclp.23773","url":null,"abstract":"<p><p>Treating people who have experienced deep and prolonged developmental trauma, that is, complex post-traumatic stress disorder (cPTSD), can be challenging given the complexity and severity of their presentations. The main features of complex post-traumatic stress disorder, that is, affective and behavioral dysregulation, altered self-experience and identity disturbances, relational difficulties, negative self-concepts, and negative pathogenic beliefs, are, at the same time, therapeutic goals and obstacles to treatment. Therefore, clinicians must be aware of these difficulties in order to identify them and be ready to treat them when they arise during therapy with the same client. For this reason, the clinical cases presented in this issue of the Journal of Clinical Psychology: In Session provide a very useful overview of how to deal with these manifestations from the perspective of different models of psychotherapy. This commentary, after briefly reviewing the clinical features and therapeutic difficulties of these clients, offers a critical summary of the commonalities and differences between the various approaches presented by the clinical cases in this special issue. The purpose is to help the reader navigate the key aspects of treating the pathogenetic processes involved in cPTSD and to identify the different therapeutic tools that may be applicable to the different clinical presentations.</p>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052568","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 Relationships Between Body-Related Emotion Intolerance and Restrictive Eating as a Function of Multidimensional Perfectionism.","authors":"Shauna Solomon-Krakus, Danika A Quesnel, Amanda Uliaszek, Catherine M Sabiston","doi":"10.1002/jclp.23770","DOIUrl":"https://doi.org/10.1002/jclp.23770","url":null,"abstract":"<p><strong>Objective: </strong>Emotion intolerance and perfectionism are two maintaining mechanisms to eating disorder symptomology. However, it is unclear how these mechanisms relate to one another. This study explored whether perfectionism is a vulnerability factor for facets of restrictive eating in the context of body-related emotions.</p><p><strong>Methods: </strong>Female undergraduate students (N = 148) completed questionnaires assessing baseline levels of self-critical perfectionism and personal standards perfectionism. Participants then engaged in an ecological momentary assessment protocol where body-related emotion intolerance and restrictive eating facets (cognitive restraint and behavioral restriction) were assessed over 10 consecutive days. Multilevel modeling and simple slopes analysis were used to explore these moderated relationships. Within-person (Level 1 body-related emotion intolerance) and between-person (Level 2 perfectionism dimensions) relationships were examined.</p><p><strong>Results: </strong>Based on the analyses, both self-critical and personal standards perfectionism dimensions interacted with body-related emotion intolerance to predict increases in restrictive eating facets.</p><p><strong>Conclusion: </strong>These findings indicate that personal standards perfectionism, though conceptualized as the less maladaptive dimension of perfectionism, should not be ignored when conceptualizing and intervening with restrictive eating. Recommendations are provided on how to refine treatment targets to be more attuned with situations that elicit body-related emotion intolerance.</p>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006032","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":"Enhancing Insight in Patients With Obsessive Compulsive Disorder: A Case Study on Avatar Therapy Using Virtual Reality.","authors":"Lara Wille, Luzie Lohse, Lena Jelinek, Steffen Moritz, Josephine Schultz, Swantje Borsutzky, Amir H Yassari, Lise Mariegaard, Ditte Lammers Vernal, Sanne Helene Bekker, Louise Birkedal Glenthøj, Franziska Miegel","doi":"10.1002/jclp.23772","DOIUrl":"https://doi.org/10.1002/jclp.23772","url":null,"abstract":"<p><p>Treatment efficacy for patients with obsessive-compulsive disorder (OCD) with poor insight is low. Insight refers to a patient's ability to recognize that their obsessions are irrational and that their compulsions are futile attempts to reduce anxiety. This case study presents the first application of virtual reality-assisted avatar therapy for OCD (VRT-OCD) in a patient with contamination OCD and ambivalent insight. Before treatment, the patient was not distanced from the content of his obsessions, which obstructed treatment progress. VRT-OCD aims to enhance insight by creating distance between the patient's functional self and their OCD by means of a virtual avatar, an individually designed visual representation of their OCD. The three-session therapy involved engaging with the avatar, practicing resistance to the OCD, and reinforcing self-esteem based on the patient's values. By learning that his obsessions hindered him from living life according to his values, the patient was motivated to engage in dialog with his avatar and learned to stand up for himself. After treatment, the patient had improved insight (BABS score reduced by 71%) and reduced symptoms (Y-BOCS score reduced by 51%). First results suggest that VRT-OCD may increase insight and empower patients to confront their obsessions, leading to increased motivation to resist their compulsions. This study highlights the feasibility, acceptance, and potential effectiveness of VRT-OCD as a novel therapeutic approach for individuals with OCD.</p>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023584","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 to Promote Self-Identity Reconstruction as the Main Focus of Therapy.","authors":"Alejandro Garcia-Gutierrez, Adrián Montesano, Guillem Feixas","doi":"10.1002/jclp.23771","DOIUrl":"https://doi.org/10.1002/jclp.23771","url":null,"abstract":"<p><p>Based on the repertory grid technique, we developed Explore Your Meanings (EYME), a digital platform that helps patients explore identity values and internal conflicts using virtual reality (VR). EYME was part of a research project treating depression in young adults, including 10 weekly, 1-h sessions aimed at changing personal constructs-cognitive schemas that shape how individuals interpret reality. We present the case of Mary, a 21-year-old woman diagnosed with persistent major depressive disorder and social phobia. Early sessions with EYME revealed key implicit dilemmas in Mary's worldview, such as feeling that she had to be selfish (an undesired personal characteristic) to become smarter and more self-confident (desired pole). As Mary visualized these constructs in VR, she began to recognize her identity conflicts and strengths, ultimately helping her to improve her negative self-image. Interventions focused on reframing these constructs, particularly around \"intelligence\" and introducing \"emotional intelligence,\" which helped Mary adopt a more nuanced view of herself. A key session involved a two-chair dialog between her \"critical\" and \"emotional\" selves, facilitating the integration of polarized aspects of her personality. In subsequent sessions, EYME reinforced these changes, with Mary reinterpreting behaviors like being \"selective\" as protective rather than negative. By the end of therapy, she no longer met the criteria for depression or social phobia, and her psychological distress had normalized.</p>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006035","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":"Perceptions and Use of Extended-Duration Exposure Therapy Amongst Psychologists","authors":"Rebecca Caton,&nbsp;Bronwyn M. Graham","doi":"10.1002/jclp.23767","DOIUrl":"10.1002/jclp.23767","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Extended-duration exposure therapy, in which treatment is delivered over a single prolonged session or cluster of long-duration sessions, is a highly efficacious and efficient treatment for anxiety disorders such as specific phobias. Despite this, little is known about the use of extended-duration exposure therapy in clinical practice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In the present study we investigated the perceptions and use of extended-duration exposure therapy amongst a sample of Australian psychologists via a survey, and the Therapist Beliefs about Exposure Scale. Additionally, we compared theoretical understanding of exposure therapy, and therapy delivery strategies (using a case study vignette), between psychologists who deliver exposure therapy via an extended-duration mode, versus the more traditional multi-session mode.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Extended-duration exposure therapy is widely underutilised, and this is associated with negative beliefs about exposure therapy in general, as well as several practical barriers. There were no differences in the reported theoretical mechanisms of exposure therapy between those who do and do not use extended-duration exposure therapy. However, psychologists who use extended-duration exposure therapy reported greater use of strategies with demonstrated efficacy (e.g., more intense delivery) and less use of therapy-interfering strategies (e.g., distress reduction techniques) relative to those who do not use extended-duration exposure therapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>These findings identify potential mechanisms accounting for extended-duration exposure therapy's efficiency and point to strategies that may increase the uptake of extended-duration exposure therapy in clinical practice.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":"81 4","pages":"262-273"},"PeriodicalIF":2.5,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005796","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":"Internalized Transnegativity, Self-Warmth, Self-Coldness, and Eating Disorder Symptomatology Among Transgender and Nonbinary Adults","authors":"Sarah McArthur,&nbsp;Suzanne McLaren,&nbsp;Peter D. Goldie","doi":"10.1002/jclp.23764","DOIUrl":"10.1002/jclp.23764","url":null,"abstract":"<p>Eating disorders (EDs) are highly prevalent among transgender and nonbinary (TNB) adults, and internalized transnegativity is a key risk factor for ED symptomatology. Although extant literature has established that self-compassion protects against EDs among the cisgender population, research among TNB adults is nascent. The current study sought to identify whether internalized transnegativity and components of self-compassion (i.e., self-warmth and self-coldness) were independently associated with ED symptomatology, and whether the components of self-compassion moderated the relation between internalized transnegativity and ED symptomatology. An international sample of 127 TNB adults aged between 18 and 69 years (<i>M</i> = 32.24, SD = 11.12) completed the Transgender Identity Survey, the Self-Compassion Scale, and the Screen for Disordered Eating via an online survey. Simple linear regression models were run, followed by moderation analyses. Internalized transnegativity and self-coldness were associated with ED symptomatology, but self-warmth was not. Self-warmth and self-coldness did not moderate the relation between internalized transnegativity and ED symptomatology. The results highlight that self-coldness and, to a lesser extent, internalized transnegativity account for a significant portion of the variance in ED symptomatology among TNB adults. Although these effect sizes were small, they have important clinical implications. Future research should take alternative analytical approaches to examine how self-warmth, self-coldness, and internalized transnegativity are related to ED symptomatology among TNB adults.</p>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":"81 4","pages":"249-261"},"PeriodicalIF":2.5,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jclp.23764","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006229","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":"\"It's OK for Me to Cry\": Client and Therapist Perspectives on Change Processes in SPEAKS Therapy for Anorexia Nervosa.","authors":"Cat Papastavrou Brooks, Abigail Rennick, Randeep Singh Basra, Tony Lavender, Helen Startup, Anna Oldershaw","doi":"10.1002/jclp.23769","DOIUrl":"https://doi.org/10.1002/jclp.23769","url":null,"abstract":"<p><strong>Introduction and aims: </strong>Existing therapies for Anorexia Nervosa (AN) have limited effectiveness, necessitating the development of novel therapies and interventions. Hypothesizing and targeting clear mechanisms of change within treatment offer potential opportunities to improve them. The SPEAKS program aimed to develop, trial, and evaluate a therapy which targets key emotional and social factors known to be relevant in the development and maintenance of AN. The aim of the present study is to explore therapist and client experiences of change processes during the SPEAKS intervention, and what supported or inhibited these.</p><p><strong>Method: </strong>Semi-structured interviews were conducted with sixteen female clients (in age range of 18-49) and six therapists; topic guides explored perceptions of client change processes. Thematic analysis was conducted on the data by two researchers.</p><p><strong>Results: </strong>Two themes and six sub-themes were developed from the data. These were: \"the impact on the eating disorder,\" \"change processes\" (\"emotional change\" and \"changing the self\"), and \"facilitators of and barriers to change processes\" (\"therapeutic relationship,\" \"clients' emotional engagement,\" \"online delivery,\" and \"therapist lacking flexibility\"). \"Emotional change\" involved an enhanced capacity for clients to tune-in more, acknowledge, listen to, and express how they felt, and \"Changing the self\" represented a shift in how clients related to themselves, particularly the more vulnerable parts of themselves.</p><p><strong>Discussion: </strong>The findings of the present study provide support for the hypothesized mechanisms of change inherent within the SPEAKS therapy approach. This supports the robustness and validity of the intervention and lends support for further investigation of its effectiveness.</p><p><strong>Clinical trial registration: </strong>The study was registered according to the guidelines of the International Standard Randomized Controlled Trial Number Register (ISRCTN No. 11778891).</p>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142978531","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}