Psychotherapy最新文献_第3页

Preliminary investigation of an artificial intelligence-based cognitive behavioral therapy training tool. 基于人工智能的认知行为疗法培训工具的初步研究。

IF 2.6 2区心理学

Psychotherapy Pub Date : 2025-03-01 Epub Date: 2025-01-27 DOI: 10.1037/pst0000550

Sarah L Kopelovich, Roisín Slevin, Rachel M Brian, Victoria Shepard, Scott A Baldwin, Dror Ben-Zeev, Mike Tanana, Zac Imel

{"title":"Preliminary investigation of an artificial intelligence-based cognitive behavioral therapy training tool.","authors":"Sarah L Kopelovich, Roisín Slevin, Rachel M Brian, Victoria Shepard, Scott A Baldwin, Dror Ben-Zeev, Mike Tanana, Zac Imel","doi":"10.1037/pst0000550","DOIUrl":"10.1037/pst0000550","url":null,"abstract":"We developed an asynchronous online cognitive behavioral therapy (CBT) training tool that provides artificial intelligence- (AI-) enabled feedback to learners across eight CBT skills. We sought to evaluate the technical reliability and to ascertain how practitioners would use the tool to inform product iteration and future deployment. We conducted a single-arm 2-week field trial among behavioral health practitioners who treat outpatients with psychosis. Practitioners (N = 21) were invited to use the AI-enabled CBT training tool over a 2-week (15 days, inclusive) period. To enable naturalistic observation, no adjustments were made to their workloads nor were prescriptions on use provided. We conducted daily assessments and collected backend analytics for all users. At end point, we assessed acceptability, appropriateness, feasibility of implementation, perceived usability, satisfaction, and perceived impact of training. We observed four types of technical issues: broken links, intermittent issues receiving AI-enabled feedback, video replay errors, and an HTML error. Participants averaged 6.57 logins over the 2 weeks, with more than half engaging daily. Most participants (44.7%) engaged for < 30-min increments. Usability scores exceeded industry standard and satisfaction scores indicated good promotion of the tool. All participants endorsed high feasibility, acceptability, and appropriateness. Twelve participants (57%) used the AI-enabled feedback feature; those who did tended to report improved satisfaction, feasibility, and perceived impact of the training. The training tool was used by practitioners in a routine care setting, met or exceeded conventional implementation benchmarks, and may support skill improvement; however, data suggest that practitioners may need support or accountability to fully leverage the training tool. (PsycInfo Database Record (c) 2025 APA, all rights reserved).","PeriodicalId":20910,"journal":{"name":"Psychotherapy","volume":" ","pages":"12-21"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11913585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053376","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}

引用次数: 0

Temporal associations between interpersonal problems and therapeutic alliance in cognitive behavioral therapy.

IF 2.6 2区心理学

Psychotherapy Pub Date : 2025-02-27 DOI: 10.1037/pst0000566

Flavio Iovoli, Juan Martín Gómez Penedo, Wolfgang Lutz, Julian A Rubel

{"title":"Temporal associations between interpersonal problems and therapeutic alliance in cognitive behavioral therapy.","authors":"Flavio Iovoli, Juan Martín Gómez Penedo, Wolfgang Lutz, Julian A Rubel","doi":"10.1037/pst0000566","DOIUrl":"https://doi.org/10.1037/pst0000566","url":null,"abstract":"Interpersonal problems have been identified as a potential risk factor for a weaker therapeutic alliance during psychotherapy, yet their temporal relationship and underlying dynamics remain unclear. To address this, the present study explores these associations during the first 20 sessions of cognitive behavioral therapy. The data from 2,123 patients undergoing treatment in an outpatient clinic were analyzed. Interpersonal problems were assessed every fifth session with the 12-item version of the Inventory of Interpersonal Problems-12, while therapeutic alliance was measured after every session with the Session Rating Scale. Temporal associations were modeled using both a random-intercept cross-lagged panel model and an autoregressive latent trajectory model with structured residuals, as they allow the differentiation of within- and between-patient components. The random-intercept cross-lagged panel model produced more reliable and interpretable estimates. At the within-patient level, contemporaneous associations were significant, indicating that higher-than-usual interpersonal problems within a session were associated with lower-than-usual experienced therapeutic alliance at the same time point (β = -.067 to -.074, p = .005). Over time, higher-than-usual interpersonal problems negatively influenced therapeutic alliance at the next assessment (β = -.052 to -.063, p = .032), while higher-than-usual therapeutic alliance predicted reductions in interpersonal problems five sessions later (β = -.051 to -.083, p = .002). These findings suggest a reciprocal dynamic between interpersonal problems and therapeutic alliance, where improvements in one construct are associated with beneficial changes in the other over time, highlighting the importance of addressing interpersonal difficulties to strengthen the therapeutic alliance. (PsycInfo Database Record (c) 2025 APA, all rights reserved).","PeriodicalId":20910,"journal":{"name":"Psychotherapy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524053","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}

引用次数: 0

Development of an artificial intelligence-based measure of therapists' skills: A multimodal proof of concept.

IF 2.6 2区心理学

Psychotherapy Pub Date : 2025-02-03 DOI: 10.1037/pst0000561

Katie Aafjes-van Doorn, Marcelo Cicconet, Jordan Bate, Jeffrey F Cohn, Marc Aafjes

{"title":"Development of an artificial intelligence-based measure of therapists' skills: A multimodal proof of concept.","authors":"Katie Aafjes-van Doorn, Marcelo Cicconet, Jordan Bate, Jeffrey F Cohn, Marc Aafjes","doi":"10.1037/pst0000561","DOIUrl":"https://doi.org/10.1037/pst0000561","url":null,"abstract":"The facilitative interpersonal skills (FIS) task is a performance-based task designed to assess clinicians' capacity for facilitating a collaborative relationship. Performance on FIS is a robust clinician-level predictor of treatment outcomes. However, the FIS task has limited scalability because human rating of FIS requires specialized training and is time-intensive. We aimed to catalyze a \"big needle jump\" by developing an artificial intelligence- (AI-) based automated FIS measurement that captures all behavioral audiovisual markers available to human FIS raters. A total of 956 response clips were collected from 78 mental health clinicians. Three human raters rated the eight FIS subscales and reached sufficient interrater reliability (intraclass correlation based on three raters [ICC3k] for overall FIS = 0.85). We extracted text-, audio-, and video-based features and applied multimodal modeling (multilayer perceptron with a single hidden layer) to predict overall FIS and eight FIS subscales rated along a 1-5 scale continuum. We conducted 10-fold cross-validation analyses. For overall FIS, we reached moderate size relationships with the human-based ratings (Spearman's ρ = .50). Performance for subscales was variable (Spearman's ρ from .30 to .61). Inclusion of audio and video modalities improved the accuracy of the model, especially for the Emotional Expression and Verbal Fluency subscales. All three modalities contributed to the prediction performance, with text-based features contributing relatively most. Our multimodal model performed better than previously published unimodal models on the overall FIS and some FIS subscales. If confirmed in external validation studies, this AI-based FIS measurement may be used for the development of feedback tools for more targeted training, supervision, and deliberate practice. (PsycInfo Database Record (c) 2025 APA, all rights reserved).","PeriodicalId":20910,"journal":{"name":"Psychotherapy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080739","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}

引用次数: 0

Leveraging natural language processing to enhance feedback-informed group therapy: A proof of concept.

IF 2.6 2区心理学

Psychotherapy Pub Date : 2025-02-03 DOI: 10.1037/pst0000570

Martin Kivlighan, Joel Stremmel, Kun Wang, Lisa Brownstone, Baihan Lin

{"title":"Leveraging natural language processing to enhance feedback-informed group therapy: A proof of concept.","authors":"Martin Kivlighan, Joel Stremmel, Kun Wang, Lisa Brownstone, Baihan Lin","doi":"10.1037/pst0000570","DOIUrl":"https://doi.org/10.1037/pst0000570","url":null,"abstract":"Group therapy has evolved as a powerful therapeutic approach, facilitating mutual support, interpersonal learning, and personal growth among members. However, the complexity of studying communication dynamics, emotional expressions, and group interactions between multiple members and often coleaders is a frequent barrier to advancing group therapy research and practice. Fortunately, advances in machine learning technologies, for example, natural language processing (NLP), make it possible to study these complex verbal and behavioral interactions within a small group. Additionally, these technologies may serve to provide leaders and members with important and actionable feedback about group therapy sessions, possibly enhancing the utility of feedback-informed care in group therapy. As such, this study sought to provide a proof of concept for applying NLP technologies to automatically assess alliance ratings from participant utterances in two community-based online support groups for weight stigma. We compared traditional machine learning approaches with advanced transformer-based language models, including variants pretrained on mental health and psychotherapy data. Results indicated that several models detected relationships between participant utterances and alliance, with the best performing model achieving an area under the receiver operating characteristic curve of 0.654. Logistic regression analysis identified specific utterances associated with high and low alliance ratings, providing interpretable insights into group dynamics. While acknowledging limitations such as small sample size and the specific context of weight stigma groups, this study provides insights into the potential of NLP in augmenting feedback-informed group therapy. Implications for real-time process monitoring and future directions for enhancing model performance in diverse group therapy settings are discussed. (PsycInfo Database Record (c) 2025 APA, all rights reserved).","PeriodicalId":20910,"journal":{"name":"Psychotherapy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080744","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}

引用次数: 0

Therapist affect focus and patient outcomes in psychodynamic therapy: An updated systematic review and meta-analysis.

IF 2.6 2区心理学

Psychotherapy Pub Date : 2025-02-03 DOI: 10.1037/pst0000568

Marc J Diener, Mark J Hilsenroth, Evangeline Giannopoulos

{"title":"Therapist affect focus and patient outcomes in psychodynamic therapy: An updated systematic review and meta-analysis.","authors":"Marc J Diener, Mark J Hilsenroth, Evangeline Giannopoulos","doi":"10.1037/pst0000568","DOIUrl":"https://doi.org/10.1037/pst0000568","url":null,"abstract":"In this preregistered Prospero (CRD42022334071) review, the authors updated a meta-analysis review that examined the relation between therapist facilitation of patient emotional experience/expression and outcome in psychodynamic psychotherapy. Computer, manual, and backwards searches were conducted for relevant publications, and 14 independent samples of short-term dynamic psychotherapy were included in the meta-analysis. Data analysis included calculation of an overall effect size of the relationship between therapist affect focus and outcome, statistical significance, and test for homogeneity. In addition, moderator analyses were conducted to examine the potential impact of the methodological quality of individual studies. The overall weighted average r was .265, which was statistically significant, p < .001 (k = 14; 95% confidence interval [.130, .392]), indicating that therapist affect focus was associated with greater degree of patient change over the course of psychodynamic therapy. The results were not demonstrably heterogeneous, Q(13) = 14.787, p = .321, I² = 12.085, and publication bias analyses did not indicate cause for concerns regarding the results (all ps > .05). Trim-and-fill results indicated an adjusted weighted average r of .250 (decrease of 5.660%). None of the moderator analyses examining study methodology quality were statistically significant (all ps > .10). These data indicate that therapist facilitation of patient affective experience/expression is associated with patient improvement over the course of psychodynamic psychotherapy. The size of this relation was not significantly related to methodological quality. (PsycInfo Database Record (c) 2025 APA, all rights reserved).","PeriodicalId":20910,"journal":{"name":"Psychotherapy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080769","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}

引用次数: 0

Parsing the existential isolation-outcome association into its within- and between-patient components in naturalistic psychotherapy. 解析自然主义心理治疗中存在主义孤立-结果关联在患者内部和患者之间的成分。

IF 2.6 2区心理学

Psychotherapy Pub Date : 2025-01-20 DOI: 10.1037/pst0000564

Alice E Coyne, Averi N Gaines, Clara G DeFontes, Michael J Constantino, Diego I Barcala-Delgado, James F Boswell, David R Kraus

{"title":"Parsing the existential isolation-outcome association into its within- and between-patient components in naturalistic psychotherapy.","authors":"Alice E Coyne, Averi N Gaines, Clara G DeFontes, Michael J Constantino, Diego I Barcala-Delgado, James F Boswell, David R Kraus","doi":"10.1037/pst0000564","DOIUrl":"https://doi.org/10.1037/pst0000564","url":null,"abstract":"Complementing the oft-studied construct of interpersonal isolation, research has increasingly focused on existential isolation (EI), or the subjective feeling of separateness in one's experience. In the clinical realm, several studies have demonstrated that higher EI is associated with more severe mental health problems at a single cross-section of time. Moreover, one study showed that higher pretreatment EI predicted worse psychotherapy outcomes. However, it remains unknown whether an average level of EI across all of psychotherapy (a type of during-treatment \"trait\") and/or fluctuations in EI during psychotherapy (a type of during-treatment \"state\") relate to broader treatment outcomes. Addressing EI in this more nuanced and complex manner, the present study parsed the EI-outcome association in its between- (trait) and within-patient (state) components in the context of naturalistic outpatient psychotherapy (Constantino et al., 2021). Participants were 46 therapists treating 144 patients who provided enough EI and outcome data to establish average, longitudinal, and temporal associations across treatment. Using a random intercept cross-lagged panel model, the between-patient results showed that higher average EI was associated with worse average outcomes (standardized association = .60, p < .001). However, although within-patient EI demonstrated significant variability over time, such fluctuations were unexpectedly unrelated to subsequent changes in outcome-when accounting for prior EI and outcome changes (p = .617). The findings suggest that although EI seems to possess both traitlike and statelike qualities, the former component may have the greatest influence on treatment outcomes, whereas the latter may be more of an outcome in itself. (PsycInfo Database Record (c) 2025 APA, all rights reserved).","PeriodicalId":20910,"journal":{"name":"Psychotherapy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143010722","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}

引用次数: 0

The "gift of love" as a candidate mechanism of psychopathology and change in interpersonal reconstructive therapy for patients with high-acuity clinical needs. “爱的礼物”作为高急性临床需要患者人际重建治疗的心理病理和改变的候选机制。

IF 2.6 2区心理学

Psychotherapy Pub Date : 2025-01-16 DOI: 10.1037/pst0000556

Kenneth L Critchfield, Akiva Gornish, Lea Epstein, Julia E Mackaronis, Lorna Smith Benjamin

{"title":"The \"gift of love\" as a candidate mechanism of psychopathology and change in interpersonal reconstructive therapy for patients with high-acuity clinical needs.","authors":"Kenneth L Critchfield, Akiva Gornish, Lea Epstein, Julia E Mackaronis, Lorna Smith Benjamin","doi":"10.1037/pst0000556","DOIUrl":"https://doi.org/10.1037/pst0000556","url":null,"abstract":"A key mechanism of psychopathology and change proposed by the theory of interpersonal reconstructive therapy (IRT; Benjamin, 2003, 2018) is termed the \"gift of love\" (GOL). The GOL hypothesis is that wishes to receive love and acceptance from specific internalized attachment figures shape and maintain problem patterns and their associated symptoms for many patients across a wide range of psychopathology. According to IRT theory, optimal intervention is defined by therapist alignment, or \"adherence,\" to a core algorithm of principles that are tailored individually and bring awareness to (a) attachment-based yearnings for love and acceptance from internalized figures and (b) how those yearnings shape and motivate current problems and symptoms. The method then seeks to enhance choice about those relationships and their attendant feelings, hopes, and fears. The study sample includes 30 patients, referred while receiving inpatient treatment and followed on an outpatient basis, with complex, high-acuity clinical needs (i.e., histories of multiple psychiatric hospitalizations, recurrent suicidality, ineffectiveness of prior treatment, and significant personality pathology). Reliable measures were developed to track therapist adherence to IRT principles, as well as patient stages of change coming to terms with the GOL. IRT adherence was associated with retention, reduced depression and anxiety, and improved self-treatment. Mediation analyses support the proposition that change in IRT is contingent upon patient progress at grieving the losses and associated wishes linked to attachment figures. Implications for theory-guided research and practice at the level of underlying principles are discussed. (PsycInfo Database Record (c) 2025 APA, all rights reserved).","PeriodicalId":20910,"journal":{"name":"Psychotherapy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143010762","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}

引用次数: 0

A critical evaluation of psilocybin-assisted therapy protocol components from clinical trial patients, facilitators, and caregivers. 来自临床试验患者、促进者和护理人员对裸盖菇素辅助治疗方案组件的关键评估。

IF 2.6 2区心理学

Psychotherapy Pub Date : 2025-01-13 DOI: 10.1037/pst0000551

Roman Palitsky, Jessica L Maples-Keller, Caroline Peacock, Boadie W Dunlop, Tanja Mletzko, George H Grant, Charles L Raison, Sam Chao, Isabelle Shub, Michal Mendelbaum-Kweller, Liam Smolyar, Deanna M Kaplan, Barbara O Rothbaum, Ali J Zarrabi

{"title":"A critical evaluation of psilocybin-assisted therapy protocol components from clinical trial patients, facilitators, and caregivers.","authors":"Roman Palitsky, Jessica L Maples-Keller, Caroline Peacock, Boadie W Dunlop, Tanja Mletzko, George H Grant, Charles L Raison, Sam Chao, Isabelle Shub, Michal Mendelbaum-Kweller, Liam Smolyar, Deanna M Kaplan, Barbara O Rothbaum, Ali J Zarrabi","doi":"10.1037/pst0000551","DOIUrl":"https://doi.org/10.1037/pst0000551","url":null,"abstract":"Psilocybin-assisted therapy (PAT) is an experimental treatment with transformative promise. Developing standards for PAT psychotherapy protocols is a priority, but psychotherapeutic protocol components of PAT have been subjected to little rigorous research. This study was designed to assess protocol components in a trial of PAT. The Enhanced Critical Incident Technique (E-CIT) was used to identify critical incidents in the treatment, wish list items comprising components or modifications that would have improved the treatment experience, and contributing factors that influenced the treatment. Participants included patients (n = 10), facilitators (n = 7 licensed mental health clinicians and certified spiritual health clinicians), and caregivers (n = 7) in an open-label trial investigating PAT for cancer-related demoralization and chronic pain. Patients and caregivers were interviewed after their last treatment session in the trial; facilitators were interviewed at the end of the entire trial. Rapid qualitative analysis identified specific domains for improvement in the treatment protocol based on the E-CIT. Critical incidents, wish list items, and contributing factors pertained to aspects of the therapy (e.g., importance of intention-setting) and the overall protocol (e.g., navigating transitions in the treatment). Findings indicate the importance of tailoring PAT to accommodate the medical history and needs of this population, support common factors, and ensure collaborative care. Recommendations across nine topic areas were derived from the data and presented in the Discussion. The E-CIT shows promise for advancing early stage research on PAT components. (PsycInfo Database Record (c) 2025 APA, all rights reserved).","PeriodicalId":20910,"journal":{"name":"Psychotherapy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972105","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}

引用次数: 0

A systematic review on how to combine exposure and response prevention with add-ons for the treatment of obsessive-compulsive disorder. 关于如何结合暴露和反应预防与附加治疗强迫症的系统综述。

IF 2.6 2区心理学

Psychotherapy Pub Date : 2025-01-13 DOI: 10.1037/pst0000560

Divo Faustino, Rui Braga, Maria João Faria, Miguel M Gonçalves, João Tiago Oliveira

{"title":"A systematic review on how to combine exposure and response prevention with add-ons for the treatment of obsessive-compulsive disorder.","authors":"Divo Faustino, Rui Braga, Maria João Faria, Miguel M Gonçalves, João Tiago Oliveira","doi":"10.1037/pst0000560","DOIUrl":"10.1037/pst0000560","url":null,"abstract":"Exposure and response prevention (ERP) is an effective treatment for obsessive-compulsive disorder. However, ERP's distressful nature may be too demanding for some patients, resulting in low engagement with treatment or even dropout. The current review aimed to summarize and categorize the components of ERP plus add-on protocols. Studies were deemed eligible when an ERP treatment was combined with a psychological add-on in the treatment of adult obsessive-compulsive disorder patients. Nineteen studies fulfilled the inclusion criteria. Add-ons were divided into eight categories: acceptance and commitment therapy, cognitive therapy-based interventions, family accommodation, inhibitory learning theory strategies, inhibitory training, mindfulness-based techniques, and motivational interviewing. Studies were divided into two methods of combining ERP with an add-on: the additive and the integrative format. These types of protocols may offer a feasible way for clinicians to personalize, according to the patient's needs, an otherwise structured treatment, increasing its responsiveness. Future studies, besides studying the efficacy of these adaptations, should also assess whether clinicians who are reluctant to use exposure therapy are more willing to employ the technique in an ERP plus add-on protocol. (PsycInfo Database Record (c) 2025 APA, all rights reserved).","PeriodicalId":20910,"journal":{"name":"Psychotherapy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972106","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}

引用次数: 0

Dyadic working alliance, therapist insight skills, and client outcomes: Longitudinal mediation analyses. 二元工作联盟、治疗师洞察力技能和客户结果：纵向中介分析。

IF 2.6 2区心理学

Psychotherapy Pub Date : 2025-01-13 DOI: 10.1037/pst0000562

Lydia HaRim Ahn, Dennis M Kivlighan, Clara E Hill, Dan McNeish

{"title":"Dyadic working alliance, therapist insight skills, and client outcomes: Longitudinal mediation analyses.","authors":"Lydia HaRim Ahn, Dennis M Kivlighan, Clara E Hill, Dan McNeish","doi":"10.1037/pst0000562","DOIUrl":"https://doi.org/10.1037/pst0000562","url":null,"abstract":"A number of studies have shown an association between therapist skills (particularly insight skills) and the working alliance, but few studies have examined the directionality of this relationship. In addition, studies have used either the client or therapist report of the working alliance rather than a dyadic perspective. Thus, we examined whether (a) dyadic insight skills are indirectly related to client outcome through the working alliance and (b) the dyadic working alliance is indirectly related to client outcome through insight skills. The dyadic working alliance was measured as a latent, dyadic average of both the client and therapists' reports of the working alliance. Therapist use of insight skills was operationalized via the use of skills such as interpretations, immediacies, challenges, and disclosures of insight. We used dynamic structural equation modeling to analyze longitudinal data in long-term, psychodynamic treatment. Results indicated that at the within-client level, the use of insight skills was associated with the working alliance in the next session, and the working alliance was associated with therapist use of insight skills in the next session; however, there were no mediation effects. However, at the between-client level, the pathway from working alliance at T-1 to therapist use of insight skills at T-2 to client outcome at T-3 was significant but only for clients in longer term treatments. Findings reveal the importance of the working alliance as a signal for therapists to use insight skills for client improvement in long-term, psychodynamic therapy. (PsycInfo Database Record (c) 2025 APA, all rights reserved).","PeriodicalId":20910,"journal":{"name":"Psychotherapy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972107","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}

引用次数: 0