Psychotherapy最新文献

{"title":"Cognitive behavioral telehealth treatment for adolescents with loss-of-control eating: A randomized controlled feasibility study.","authors":"Janet A Lydecker, Rebecca Kamody, Elise Ozbardakci, Wendy K Silverman, Marian Tanofsky-Kraff, Ralitza Gueorguieva, Carlos M Grilo","doi":"10.1037/pst0000621","DOIUrl":"10.1037/pst0000621","url":null,"abstract":"<p><p>This study aimed to develop and test the feasibility and acceptability of a telehealth treatment for adolescent loss-of-control (LOC) eating, including the feasibility of attaining clinically meaningful outcomes. LOC-eating episodes occur when experiencing a sense of LOC while eating a subjectively or objectively large amount of food. Participants were 55 adolescents (aged 12-17) with recurrent LOC-eating episodes and elevated weight (based on age and sex-normed percentiles) who enrolled in a feasibility trial of cognitive behavioral therapy (CBT). Five participants enrolled in the treatment development \"open series\" and provided feedback. Fifty participants were randomized to the subsequent randomized controlled trial and received either CBT-LOC or nutrition education. Treatment fidelity was checked. CBT-LOC for adolescents with LOC eating demonstrated treatment feasibility and acceptability. Retention (<i>M</i> = 15.3 of 16 sessions), treatment credibility (<i>M</i> = 5.26 of 6), and treatment fidelity (92%-100% of broad topics covered) were high. Treatment satisfaction was higher in CBT-LOC than nutrition education (<i>p</i>s < .001). Time × Intervention effects revealed greater improvements for CBT-LOC than nutrition education for binge eating, LOC eating, secretive eating, and global eating-disorder psychopathology. Weight change was minimal for both interventions. Among adolescents with weekly or greater baseline LOC-eating episodes, overvaluation of weight/shape and depression also improved. Overall, this feasibility randomized controlled trial testing CBT-LOC for adolescents experiencing LOC eating and elevated weight demonstrated feasibility and acceptability. Initial evidence demonstrated that it was feasible to produce clinically significant improvements in LOC-eating episodes, eating behaviors, and eating-disorder psychopathology. Few participants attained decreased weight, which may limit motivation to seek treatment from parents and adolescents. (PsycInfo Database Record (c) 2026 APA, all rights reserved).</p>","PeriodicalId":20910,"journal":{"name":"Psychotherapy","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13155366/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147842089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The best route to resolving complicated grief: Emotional sequences amplified by arousal.","authors":"Alejandro DelaTraba, Rafael Jódar, Jose Gamoneda, Carla Cunha","doi":"10.1037/pst0000619","DOIUrl":"https://doi.org/10.1037/pst0000619","url":null,"abstract":"<p><p>This study investigated emotional processes associated with change in brief emotion-focused therapy for complicated grief delivered via videoconference. We focused on emotional arousal, depth of experiencing, and the frequency with which clients first accessed primary maladaptive emotions and subsequently processed grief, a process known as the emotional transformation sequence. We also examined whether depth of experiencing and arousal during the central and final session segments moderated the effects of these sequences on therapeutic outcomes. Twenty-six clients meeting criteria for complicated grief received three emotion-focused therapy sessions. The second session, which included empty-chair work for unfinished business, was coded using the Classification of Affective Meaning States, the Client Experiencing Scale, and the Client Emotional Arousal Scale-III. Outcomes were assessed pretreatment, posttreatment, and at 2-month follow-up, including complicated grief, emotional well-being, and depressive symptoms. Depth of experiencing predicted reductions in depressive symptoms at follow-up. Emotional transformation sequences predicted improvements in well-being and depressive symptoms at follow-up. The importance of emotional transformation sequences as a mechanism of change is further supported by the finding that good-outcome cases showed more sequences than poor-outcome cases, despite similar levels of depth of experiencing and arousal. Emotional arousal further amplified the effect of transformation sequences on depressive symptoms, emotional well-being, and complicated grief, explaining an additional 30% of variance in grief outcomes at follow-up. These findings indicate that emotional transformation sequences during empty-chair work, particularly when accompanied by sufficient arousal, constitute a key mechanism of therapeutic change in brief emotion-focused therapy for complicated grief. (PsycInfo Database Record (c) 2026 APA, all rights reserved).</p>","PeriodicalId":20910,"journal":{"name":"Psychotherapy","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147623498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapist presence and client session and symptom outcomes: A longitudinal examination of their reciprocal relationships.","authors":"Xu Li, Yejin Hong, Chaihua Lin","doi":"10.1037/pst0000618","DOIUrl":"https://doi.org/10.1037/pst0000618","url":null,"abstract":"<p><p>The aim of this study was to explore how therapeutic presence predicted psychotherapy session quality (SQ) and client symptom (CS) reduction at both between-person and within-person between-session levels. The sample included 14,316 sessions involving 1,916 clients and their 173 trainee therapists in a master's level mental health counseling training program in China. Before each session, the client rated their symptom level. After every session, the therapist reported their level of therapeutic presence in the session, while the client rated their perception of the quality of the session. Analyses using latent curve model with structured residuals showed that, at the between-person level, higher therapist rating of first-session therapeutic presence predicted better initial SQ rated by the client. Further, sustained increasing presence over time was associated with continued CS relief during treatment. At the within-person between-session level, therapeutic presence led to better SQ for the session and lower CSs before the next session. Significant fluctuations (i.e., the lack of an autoregressive effect) for therapeutic presence at the session level were also found. We discussed implications for research and training, especially in the Chinese cultural context. (PsycInfo Database Record (c) 2026 APA, all rights reserved).</p>","PeriodicalId":20910,"journal":{"name":"Psychotherapy","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147575214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spiritual competency training in mental health and multicultural orientation and contemplative awareness: An evaluation of two training approaches with psychotherapists.","authors":"Daniel Gutierrez, Stephanie Dorais, Jennifer Niles","doi":"10.1037/pst0000578","DOIUrl":"10.1037/pst0000578","url":null,"abstract":"<p><p>The current literature for the various mental health professions is replete with studies demonstrating the critical importance of addressing spiritual and religious concerns in mental health treatment, yet many clinicians remain untrained in spiritual and religious competence. In recent years, researchers have developed training programs to support clinicians' understanding of how spirituality influences mental health and provided resources for how clinicians can address it with clients. The present study investigates the effectiveness of two online training programs, Spiritual Competency Training in Mental Health (SCT-MH) and a contemplative pedagogy-based program called Multicultural Orientation and Contemplative Awareness (MOCA), in enhancing spiritual and religious competence among counselors. We conducted a three-parallel-arm randomized controlled trial with a sample of practicing counselors to compare the SCT-MH (<i>n</i> = 10), MOCA (<i>n</i> = 15), and a wait-list control group (<i>n</i> = 29). We recruited our sample from state licensure boards for mental health practitioners, alumni listservs for counseling programs, and social media marketing. Additionally, the study examined the explanatory role of cultural humility on spiritual competence over time. Linear mixed modeling revealed a significant interaction between group and time, demonstrating that the SCT-MH group had a large effect and MOCA had a moderate effect in improving clinicians' total spiritual competence score compared with the control group. The findings suggest that both SCT-MH and MOCA can effectively enhance spiritual competence in counselors and cultural humility plays a significant role in this development. Implications and recommendations for implementation are discussed. (PsycInfo Database Record (c) 2026 APA, all rights reserved).</p>","PeriodicalId":20910,"journal":{"name":"Psychotherapy","volume":" ","pages":"104-114"},"PeriodicalIF":3.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Guiding connections: The role of therapist interventions in facilitating couples' vulnerability and responsiveness in enactments.","authors":"Ofra Kula, Reut Machluf Ruttner, Ben Shahar, David A Sbarra, Eran Bar-Kalifa","doi":"10.1037/pst0000615","DOIUrl":"10.1037/pst0000615","url":null,"abstract":"<p><p>The primary proposed change process in emotion-focused therapy models for couples involves partners accessing and revealing vulnerable emotions and responding to such disclosures with empathy and compassion. Therapists often use enactments (guiding partners to communicate with each other directly) to facilitate this process. However, many therapists report lacking confidence and clarity in how best to facilitate enactments, and it remains understudied which therapist interventions within enactment episodes contribute to vulnerability sharing and responsiveness expression. This preregistered study examined the role of three interventions used during enactments-systemic meaning-making (narrating), emotional engagement (experiencing), and interaction guiding (choreographing) in promoting these processes. One hundred forty enactment events from 21 treatment couples were coded and analyzed. Trained raters coded therapists' interventions and partners' behaviors. In contrast to our hypothesis, systemic meaning-making and interaction guiding were not associated, and emotional engagement was only marginally associated with greater vulnerability expression. Interaction guiding was positively associated with responsiveness. However, systemic meaning-making was negatively associated with responsiveness, and emotional engagement was not associated with responsiveness. Vulnerability expression did not predict partner responsiveness. These findings highlight the importance of tailoring therapist interventions in enactments according to their distinct contributions to facilitating vulnerability and responsiveness. (PsycInfo Database Record (c) 2026 APA, all rights reserved).</p>","PeriodicalId":20910,"journal":{"name":"Psychotherapy","volume":" ","pages":"62-69"},"PeriodicalIF":3.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146053497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"I too deserve good\": A qualitative exploration of corrective relational experiences in psychodynamic therapy for depression.","authors":"Liat Leibovich, Abigail Sadek, Tal Ben David-Sela, Yara Khoury, Michal Malka, Nick Midgley, Sigal Zilcha-Mano","doi":"10.1037/pst0000607","DOIUrl":"10.1037/pst0000607","url":null,"abstract":"<p><p>Corrective relational experiences (CREs) occur specifically within the therapeutic relationship and are perceived by patients as distinct and meaningful. Despite their potential importance in facilitating therapeutic change, CREs received limited theoretical, clinical, and empirical attention. The present study aimed to identify different types of CREs and to examine whether they suggest distinct mechanisms of change. Posttreatment semistructured qualitative interviews with 57 patients diagnosed with major depressive disorder following short-term supportive-expressive psychodynamic psychotherapy uncovered 21 CREs. Four ideal types were identified: <i>experiencing empathic engagement, experiencing nonjudgmental acceptance, experiencing new understanding or insight</i>, and <i>experiencing encouragement and empowerment</i>. All patients who reported a CRE also described intrapersonal growth, and most reported an improved relationship with their therapist following the CRE. Our findings highlight the enduring impact of these experiences, even years after the conclusion of therapy, providing a more nuanced understanding of how they may drive positive change in the treatment of individuals with major depressive disorder. (PsycInfo Database Record (c) 2026 APA, all rights reserved).</p>","PeriodicalId":20910,"journal":{"name":"Psychotherapy","volume":" ","pages":"24-32"},"PeriodicalIF":3.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146166547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are some therapists more effective when they deliver one type of therapy versus another?","authors":"Alice E Coyne, Michael J Constantino, Averi N Gaines, Frederik J Wienicke, Anuj H P Mehta, Michael Barkham, William B Stiles, Gillian E Hardy, Luciano Dias de Mattos Souza, Karen Jansen, Ricardo Azevedo da Silva, Érico Nobre Dos Santos, Jack J M Dekker, Jaap Peen, Henricus L Van, Zachary D Cohen, Ellen Driessen","doi":"10.1037/pst0000614","DOIUrl":"10.1037/pst0000614","url":null,"abstract":"<p><p>Adding nuance to the between-therapist effect on patient outcomes, research has increasingly demonstrated that a given therapist can differ in their effectiveness depending on who they treat (e.g., patients with different racial/ethnic identities) and/or what they treat (e.g., patients with different presenting problems). This preregistered study examined whether individual therapists are also more or less effective depending on how they treat their patients; that is, delivering one type of therapy versus another. We did so in the context of an individual participant data meta-analysis of clinical trials that compared classes of cognitive-behavioral therapy and psychodynamic therapy for depression. The meta-analytic sample included 30 therapists who were crossed with treatment condition and 492 patients (M = 25.08 patients per therapist; SD = 15.77). Patients completed measures of depression at baseline and posttreatment. Multilevel structural equation models revealed significant variability in the within-therapist treatment condition-outcome association (p < .001), indicating that some therapists were more effective when delivering one treatment over the other. Descriptively, 53% of therapists had similar outcomes across both groups (d < .20), whereas 47% had at least a small-sized treatment-type strength (d ≥ .20; range = 0.21-0.65). Results inform the personalization of treatment usage to the individual provider's effectiveness data. (PsycInfo Database Record (c) 2026 APA, all rights reserved).</p>","PeriodicalId":20910,"journal":{"name":"Psychotherapy","volume":"63 1","pages":"70-78"},"PeriodicalIF":3.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147326779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emotion regulation in short-term dynamic therapy: Attachment-moderated changes and bidirectional temporal associations with symptoms.","authors":"Gershom Gwertzman, Orya Tishby","doi":"10.1037/pst0000610","DOIUrl":"10.1037/pst0000610","url":null,"abstract":"<p><p>This study examined changes in emotion regulation difficulties during short-term dynamic psychotherapy and their temporal relationship with symptom change, considering attachment styles as potential moderators. Sixty-three patients with mild to moderate depression and/or anxiety underwent 16 weeks of supportive-expressive therapy. Emotion regulation difficulties, symptoms, and attachment styles were assessed using self-report measures. Contrary to hypotheses, no overall improvement in emotion regulation difficulties was observed. However, patients with high attachment avoidance showed increased emotional clarity, while those with anxious attachment demonstrated greater acceptance of negative emotions over time. A deterioration in emotion regulation strategies was observed across all patients, particularly among those with avoidant attachment. Cross-lagged panel analysis revealed complex temporal dynamics: bidirectional relationships between emotion regulation and symptoms during early sessions, decoupling in intermediate sessions, and unidirectional effects (regulation predicting symptoms) in late sessions. These findings highlight the complex phase-dependent dynamics of emotion regulation change in short-term psychodynamic psychotherapy. The results emphasize the importance of considering both treatment phase and attachment styles when addressing emotion regulation difficulties in therapy. (PsycInfo Database Record (c) 2026 APA, all rights reserved).</p>","PeriodicalId":20910,"journal":{"name":"Psychotherapy","volume":" ","pages":"13-23"},"PeriodicalIF":3.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145678494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient experiences of long-term psychodynamic psychotherapy for mood disorders: A naturalistic semistructured interview study.","authors":"Max Moser, Angela Barrett, Patrick Luyten, Ingrid Ozols, Susanna Every-Palmer, Peter Fonagy, Chloe Campbell","doi":"10.1037/pst0000609","DOIUrl":"10.1037/pst0000609","url":null,"abstract":"<p><p>Despite evidence from randomized controlled trials of long-term psychodynamic psychotherapy's (LTPP's) efficacy in treating depression, qualitative research on patient perspectives remains limited. This study aims to provide a deeper understanding of patient experiences, including perceived therapeutic mechanisms, challenges, and benefits, in LTPP. A qualitative study using naturalistic, semistructured interviews was conducted with 12 adult patients (six male, six female) from Australia and New Zealand/Aotearoa. Participants had received an average of 7.8 years of LTPP. Interviews were analyzed using reflexive thematic analysis to identify core themes related to treatment access, engagement, therapeutic change, and outcomes. Six themes were developed (a) experiences with prior treatments, (b) initial challenges in engaging with LTPP, (c) the centrality of the therapeutic relationship, (d) gaining self-insight, (e) experiences of internal change, and (f) the emotional and financial costs of long-term therapy. Participants described LTPP as a challenging yet transformative treatment, facilitating affect regulation, self-compassion, and improved interpersonal functioning. Participants attributed benefits to their LTPP treatments and emphasized the importance of a stable therapeutic relationship and insight in subjective improvement. However, they also described the process as emotionally painful and resource intensive. These findings indicate that patient experiences of LTPP are broadly consistent with psychodynamic theories of change and underscore the importance of integrating patient perspectives into psychotherapy research and policy. (PsycInfo Database Record (c) 2026 APA, all rights reserved).</p>","PeriodicalId":20910,"journal":{"name":"Psychotherapy","volume":" ","pages":"1-12"},"PeriodicalIF":3.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145565203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Young people's perceptions of therapist interpersonal skills and alliance: How distinct are they?","authors":"Mick Cooper, Tomasz Jankowski, David Saxon, Beata Zarzycka, Michael Barkham","doi":"10.1037/pst0000611","DOIUrl":"10.1037/pst0000611","url":null,"abstract":"<p><p>The aim of this study was to investigate the degree of commonality between young people's perceptions of the alliance and the therapist interpersonal skills (TIS) of empathy, unconditional positive regard, and congruence. Participants were 152 young people (aged 13-16 years old; 114 female, 70 of minoritized ethnicities) who were experiencing moderate to severe levels of emotional symptoms and participated in up to 10 sessions of school-based humanistic counseling. At 6 weeks postrandomization, TIS and the alliance were assessed using the Barrett-Lennard Relationship Inventory: Form OS-40: T-S (Student Form, Version 3) and the Working Alliance Inventory Short Form, respectively. Structural equation modeling was used to identify latent constructs. A model with two correlated second-order factors and a hierarchical model with one third-order general factor exhibited the best data fit. The general factor, which we named <i>youth-perceived relationship quality,</i> explained a substantial amount of variance for TIS (81%) and alliance (98%). TIS and alliance effects, treated independently, explained an additional 3% and 1.4% of variance in satisfaction with care and psychological difficulties after therapy, respectively, as compared with general youth-perceived relationship quality. While therapeutic relationship factors-in clinical practice, training, and research-are often considered distinct, we found a high degree of commonality in how young people perceived the alliance and TIS. Further research is warranted on youth-perceived relationship quality as an integrated variable in youth psychotherapy. (PsycInfo Database Record (c) 2026 APA, all rights reserved).</p>","PeriodicalId":20910,"journal":{"name":"Psychotherapy","volume":" ","pages":"79-90"},"PeriodicalIF":3.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145744137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}