Psychotherapy最新文献

{"title":"Cultural processes for addressing clients' spiritual and religious identities in psychotherapy: A proof-of-concept investigation.","authors":"Joseph M Currier, Sarah G Salcone, Esther Kim, Paola E Fernandez, Derek Kemp","doi":"10.1037/pst0000625","DOIUrl":"10.1037/pst0000625","url":null,"abstract":"<p><p>Limited research has examined cultural processes for addressing spirituality and/or religion (S/R) in psychotherapy. In total, 143 religious and/or spiritually oriented psychotherapy clients who preferred a spiritually integrated approach completed outcome measures (well-being, depression, anxiety, spiritual struggles) in the first month of treatment and 3 months later. Participants also completed assessments of treatment dropout and satisfaction, along with validated measures of their clinician's cultural humility for their S/R, clinicians' cultural missed opportunities for addressing their S/R, and their own concealment of S/R, at follow-up. Cultural processes related to S/R were associated with treatment outcomes, dropout, and satisfaction in anticipated directions in bivariate analyses. Findings for cultural humility fell to nonsignificant in the presence of baseline outcomes, working alliance, and other cultural processes. In contrast, adverse cultural processes emerged as robust correlates of indices for a successful course of psychotherapy in multivariate analyses. Specifically, clients' concealment of their spiritual and/or religious identities was uniquely associated with poorer outcomes (lower well-being, greater anxiety symptoms and spiritual struggles) and clinicians' missed opportunities to discuss S/R in the treatment process were uniquely linked with lower satisfaction. Cultural processes did not predict the likelihood of dropout beyond the participants' working alliance ratings. Overall, this pattern indicates the utility of attending to cultural processes associated with addressing S/R in psychotherapy with religious and/or spiritually oriented clients while also highlighting a need for rigorous research that might advance clinical training and practice along these lines. (PsycInfo Database Record (c) 2026 APA, all rights reserved).</p>","PeriodicalId":20910,"journal":{"name":"Psychotherapy","volume":" ","pages":"328-339"},"PeriodicalIF":3.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148318473","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":"The interplay of clients' role expectations with working alliance: A multilevel analysis.","authors":"Hui Xu, Zhijin Hou, Jiajia Zhu, Lan Zhang","doi":"10.1037/pst0000634","DOIUrl":"10.1037/pst0000634","url":null,"abstract":"<p><p>Research on clients' psychotherapy expectations has predominantly focused on the associations of clients' role expectations with working alliance and psychotherapy outcomes. However, limited research has examined their moderating role in multilevel alliance-outcome associations. Utilizing naturalistic data from a Chinese training clinic (6,400 observations nested within 1,016 clients and 176 therapists), the present study conducted multilevel analyses to examine the moderation effects of clients' role expectations, including expectations about client involvement, counselor expertise, and facilitative conditions, on between- and within-client alliance-outcome associations. Results provided little evidence that these expectations moderated the between-client alliance-outcome association. At the within-client level, the alliance-outcome association was stronger when clients held higher expectations regarding client involvement (β = -.16, 95% credible interval [-.35, .02], one-tailed Bayesian <i>p</i> = .043) and counselor expertise (β = -.19, 95% credible interval [-.38, -.00], one-tailed Bayesian <i>p</i> = .022). The interaction involving facilitative conditions was also in the same direction but weaker (β = -.13, 95% credible interval [-.32, .05], one-tailed Bayesian <i>p</i> = .077). These findings shed light on the interplay between clients' treatment expectations and a key process variable, clarifying when alliance improvement is associated with clinical benefit. (PsycInfo Database Record (c) 2026 APA, all rights reserved).</p>","PeriodicalId":20910,"journal":{"name":"Psychotherapy","volume":" ","pages":"304-313"},"PeriodicalIF":3.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148579875","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":"Listening and being heard during group psychotherapy: A response surface analysis of (in)congruence in communication on cohesion and interest in continued group services after the initial session.","authors":"Andrew J Seidman, Nathaniel G Wade, Meredith V Tittler","doi":"10.1037/pst0000629","DOIUrl":"10.1037/pst0000629","url":null,"abstract":"<p><p>Conversational give-and-take after members engage in self-disclosure during group psychotherapy-a form of mutual influence implicated in group cohesion and continuation of treatment-can be conceptualized dyadically as the degree to which members engage in active, empathic listening and perceive others to do the same (i.e., responsiveness). Examining the effects of group members' perception of balance between their own level of listening and other members' responding (i.e., congruence) as it relates to group process and outcome can provide insights and identify opportunities for intervention from group therapists. The present study utilized polynomial regression and response surface analysis to examine these issues among 117 college students in 26 interpersonal-process groups who, as part of a research study, reported engaging in self-disclosure. Results indicated that congruence between members' use of active listening and perceptions of other members' responsiveness was positively associated with cohesion, but not interest in continuing with group psychotherapy. There was not a main effect of incongruence between listening and responding (i.e., overall disagreement) on either outcome, but there were directional effects. When clients perceived themselves being responded to more than they listened, they rated the group as more cohesive. For interest in continuing with group psychotherapy, a positive trend-level effect for incongruence was found in the opposite direction (<i>p</i> = .053): More active listening in the context of lower responsiveness from other members tended to increase the likelihood of expressing interest. Implications for group process and leadership are discussed. (PsycInfo Database Record (c) 2026 APA, all rights reserved).</p>","PeriodicalId":20910,"journal":{"name":"Psychotherapy","volume":" ","pages":"378-385"},"PeriodicalIF":3.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148579912","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":"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":"340-351"},"PeriodicalIF":3.3,"publicationDate":"2026-09-01","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":"Early alliance growth and changes in attachment styles in psychotherapy.","authors":"Libby Igra, Oded Mayo, Yogev Kivity, Celia Faye Jacobsen, Susanne Lunn, Stig Poulsen","doi":"10.1037/pst0000622","DOIUrl":"10.1037/pst0000622","url":null,"abstract":"<p><p>This study investigated whether clients' pretreatment attachment insecurity predicted initial alliance and early alliance growth rate. Additionally, we examined whether clients' early alliance growth rate predicted change in attachment insecurity following therapy. Data from 549 clients treated by 53 therapists in a primary care setting were analyzed using multilevel modeling. Associations between attachment styles (anxiety and avoidance), initial alliance, and alliance growth rate in the first four sessions were analyzed. Additionally, the associations between early alliance growth rate and the degree of improvement in anxious and avoidant attachment following treatment were examined. Higher attachment avoidance significantly predicted lower initial alliance levels and was marginally associated with steeper early alliance growth. Attachment anxiety showed no significant associations with alliance formation. Steeper early alliance growth predicted greater improvement in attachment avoidance following therapy. No associations were found between alliance growth and changes in attachment anxiety. The findings suggest that clients with higher attachment avoidance exhibit lower initial alliance levels but may demonstrate greater alliance strengthening during early sessions. Notably, early alliance growth was associated with reductions in avoidant attachment insecurity following treatment. These results underscore the importance of identifying attachment styles in treatment planning and prioritizing alliance formation in early sessions for clients presenting with avoidant attachment. (PsycInfo Database Record (c) 2026 APA, all rights reserved).</p>","PeriodicalId":20910,"journal":{"name":"Psychotherapy","volume":" ","pages":"295-303"},"PeriodicalIF":3.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148199796","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":"Presence before alliance? Longitudinal evidence from psychotherapy trainees in China.","authors":"Manxuan Wu, Yimeng Zhang, Xu Li, Feihan Li, Shitao Chen, Chaihua Lin","doi":"10.1037/pst0000628","DOIUrl":"10.1037/pst0000628","url":null,"abstract":"<p><p>This study examined the longitudinal associations and temporal precedence between therapeutic presence and working alliance in psychotherapy. The data set comprised 14,498 sessions conducted by 208 master's-level trainee therapists with 1,587 clients in China. After each session, both therapists and clients completed standardized measures of therapeutic presence and working alliance. Results from random-intercept cross-lagged panel modeling indicated that, at the between-person level, therapist-client dyads that reported higher average therapeutic presence also tended to report higher average working alliance based on both client and therapist ratings. At the within-person, between-session level, a unidirectional temporal pathway was identified: From both client and therapist perspectives, higher therapeutic presence in a session consistently predicted higher subsequent working alliance across the course of treatment, whereas working alliance did not significantly predict subsequent therapeutic presence. These findings underscore the pivotal role of therapeutic presence as a precursor to a strong working alliance, highlighting its importance in fostering effective therapeutic relationships and positive treatment processes. (PsycInfo Database Record (c) 2026 APA, all rights reserved).</p>","PeriodicalId":20910,"journal":{"name":"Psychotherapy","volume":" ","pages":"273-283"},"PeriodicalIF":3.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148346115","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":"A qualitative investigation of motivations, experiences, and perceived outcomes among therapists administering intensive, long-term psychodynamic psychotherapy.","authors":"Yarden Lazar, Shmuel Shulman, Gaby Shefler, Ron Finkenberg, Ilan Amir, Maayan Abargil, Refael Yonatan-Leus","doi":"10.1037/pst0000631","DOIUrl":"10.1037/pst0000631","url":null,"abstract":"<p><p>This qualitative study examined therapist motivations for providing intensive, long-term psychodynamic psychotherapy to patients with complex mental disorders, their significant experiences, perceptions of treatment outcomes, and connections between motivations and perceived outcomes. Fifteen therapists (psychiatrists, clinical psychologists, and social workers) from a single public mental health project (\"Lechol Nefesh\") participated. Data were collected through semistructured interviews and analyzed using thematic analysis, supplemented by ideal-type analysis. Core motivations included professional development, deeper therapeutic engagement, working with challenging populations, and social mission; significant experiences involved profound emotional encounters and shifts beyond traditional therapeutic settings, and outcomes ranged from emotional holding and prevention of deterioration to notable changes in functioning and personality. Ideal-type analysis yielded four emergent trajectories (holding, developing-improving, socially improving, and deepening-diverse), which were derived from the data rather than predefined categories. Findings illuminate therapists' choices of demanding long-term care and emphasize that intrinsic motivations are strongly linked to professional experiences and evaluations of treatment success. The study underscores the importance of nurturing these motivational factors to support therapists in long-term dynamic therapy, highlighting the value of this intensive approach for severe mental disorders. (PsycInfo Database Record (c) 2026 APA, all rights reserved).</p>","PeriodicalId":20910,"journal":{"name":"Psychotherapy","volume":" ","pages":"366-377"},"PeriodicalIF":3.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148472519","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":"Editorial transitions: A real relationship model.","authors":"Mark Hilsenroth, Jesse Owen","doi":"10.1037/pst0000635","DOIUrl":"10.1037/pst0000635","url":null,"abstract":"<p><p>In this article, Mark Hilsenroth and Jesse Owen describe the influence of Charlie Gelso on their editorial terms. Gelso was the fifth editor of our beloved journal to be followed by Hilsenroth (sixth editor) and then Owen (seventh and current editor). Gelso provided mentorship, wisdom, grace, and patience. His service as editor of <i>Psychotherapy</i> stands as one of the many ways he has strengthened and advanced our profession. He helped us continue the positive traditions of the journal. He embodied his work on the real relationship in his mentorship. He will be greatly missed but not forgotten. (PsycInfo Database Record (c) 2026 APA, all rights reserved).</p>","PeriodicalId":20910,"journal":{"name":"Psychotherapy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866789","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":"Suppose all psychotherapies are equally effective: What then?","authors":"Bruce E Wampold, Scott D Miller","doi":"10.1037/pst0000637","DOIUrl":"https://doi.org/10.1037/pst0000637","url":null,"abstract":"<p><p>Ever since a few of Freud's disciples left the psychoanalytic inner circle and developed their own treatments, the number of \"talk\" therapies has proliferated. Much effort has been made to classify the plethora of treatments, with a focus on establishing their effectiveness via clinical trials. The problems with this strategy become apparent if all treatments examined via clinical trials for a disorder are not only found to be effective but work equally well and are not different in outcome than newly developed treatments, and the response rate to all treatments is modest-a finding recently established for the treatment of depression. In response to this situation, leading researchers have recommended that \"best practice\" is offering different treatments one after another until an adequate response is achieved. The empirical problems with this \"treatment-centric\" approach and an evidence-based alternative shown to improve the quality of care are discussed and presented. (PsycInfo Database Record (c) 2026 APA, all rights reserved).</p>","PeriodicalId":20910,"journal":{"name":"Psychotherapy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841226","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":"Identifying wishes in the core conflictual relationship theme: A mirror-image approach based on overgeneralization.","authors":"Merav Rabinovich","doi":"10.1037/pst0000636","DOIUrl":"10.1037/pst0000636","url":null,"abstract":"<p><p>The present brief report proposes a heuristic tool for identifying the wish component of the Core Conflictual Relationship Theme (CCRT). Developed by Luborsky and colleagues, the CCRT method is a systematic, evidence-based approach for formulating interpersonal transference patterns in psychotherapy research and clinical practice. The method comprises three core components: the wish, the response of other, and the response of self, with the wish component posing the greatest challenge for reliable identification because it is often implicit or unconscious. As the CCRT identifies core relational themes primarily through their recurrence across relational episodes, frequency alone may not fully capture the centrality of such wishes. Although the need for more systematic approaches to wish identification has long been recognized, no text-based heuristic has been proposed to facilitate its identification beyond recurrence across relational episodes. Drawing on earlier qualitative findings, this report introduces cognitive overgeneralization as an explicit mirror-image indicator for identifying the elusive wish. This simple, inferentially grounded heuristic may help reconcile the tension between methodological feasibility and reliable wish identification, thereby enhancing the usability and methodological rigor of CCRT-based psychotherapy research and clinical practice. (PsycInfo Database Record (c) 2026 APA, all rights reserved).</p>","PeriodicalId":20910,"journal":{"name":"Psychotherapy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148707246","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}