Psychotherapy最新文献

{"title":"Implementation and evaluation of the gender resilience, resistance, empowerment, and affirmation training (GREAT) pilot program.","authors":"Elliot A Tebbe, Em Matsuno, Joonwoo Lee, Sergio Domínguez, Stephanie L Budge","doi":"10.1037/pst0000552","DOIUrl":"10.1037/pst0000552","url":null,"abstract":"<p><p>This article reports program evaluation findings of the effectiveness of a pilot training program integrating key principles from the psychological framework for radical healing (French et al., 2020) and models aimed at decreasing internalized stigma (Israel et al., 2021). Our main goal of the training program was to increase psychotherapists' knowledge and skills related to competent and affirming practice with two-spirit, transgender, and nonbinary clients who are Black, Brown, and people of color adults. Pre- and posttraining qualitative and quantitative data were collected from 82 psychotherapist attendees to assess the acceptability of the training for learning goals and to provide preliminary evidence of training effectiveness for the training's learning objectives. Descriptive content analysis of qualitative data was used to assess the degree to which the training addressed psychotherapists' goals and increased knowledge and skills. Regression analyses of quantitative data found significant increases in psychotherapists' self-reported knowledge of key concepts and frameworks and confidence to apply new learning to psychotherapy practice. Program evaluation results largely support the acceptability and effectiveness of this training for increasing self-rated competency for psychotherapy practice with two-spirit transgender, and nonbinary Black, Brown, and people of color adult clients. Implications are discussed. (PsycInfo Database Record (c) 2025 APA, all rights reserved).</p>","PeriodicalId":20910,"journal":{"name":"Psychotherapy","volume":"62 1","pages":"32-43"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143650067","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":"Development and validation of a cognitive behavioral therapy for psychosis online training with automated feedback.","authors":"Sarah L Kopelovich, Rachel M Brian, Mike Tanana, Roisín Slevin, Brian Pace, Shannon K Stewart, Victoria Shepard, Dror Ben-Zeev, Scott A Baldwin, Christina S Soma, Sarah Stanco, Zac Imel","doi":"10.1037/pst0000548","DOIUrl":"10.1037/pst0000548","url":null,"abstract":"<p><p>The accessibility of training and fidelity assessment is critical to implementing and sustaining empirically supported psychotherapies like cognitive behavioral therapy for psychosis (CBTp). We describe the development of an online CBTp training tool that incorporates behavioral rehearsal tasks to enable deliberate practice of cognitive and behavioral techniques for psychosis. The development process consisted of designing content, inclusive of didactics, client profiles, and learner prompts; constructing standardized performance tasks and metrics; collecting responses to learner prompts; establishing intraclass correlation (ICC) of responses among trained raters; and training a transformer-based machine learning (ML) model to meet or surpass human ICC. Authenticity ratings of each simulated client surpassed benchmarks. CBTp trainers (<i>n</i> = 12), clinicians (<i>n</i> = 78), and nonclinicians (<i>n</i> = 119) generated 3,958 unique verbal responses to 28 unique prompts (7 skills × 4 simulated clients), of which the coding team rated 1,961. Human ICC across all skills was high (mean ICC = 0.77). On average, there was a high correlation between ML and human ratings of fidelity (<i>r_s</i> = .74). Similarly, the average percentage of human agreement was high at 96% (range = 87%-102%), where values greater than 100 indicate that the ML model agreed with a human rater more than two human raters agreed with each other. Results suggest that it is possible to reliably measure discrete CBTp skills in response to simulated client vignettes while capturing expected variation in skill utilization across participants. These findings pave the way for a standardized, asynchronous training that incorporates automated feedback on learners' rehearsal of CBTp skills. (PsycInfo Database Record (c) 2025 APA, all rights reserved).</p>","PeriodicalId":20910,"journal":{"name":"Psychotherapy","volume":"62 1","pages":"1-11"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921910/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143650064","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":"Correction to \"Defining and assessing adverse events and harmful effects in psychotherapy study protocols: A systematic review\" by Klatte et al. (2022).","authors":"","doi":"10.1037/pst0000574","DOIUrl":"https://doi.org/10.1037/pst0000574","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Reports an error in \"Defining and assessing adverse events and harmful effects in psychotherapy study protocols: A systematic review\" by Rahel Klatte, Bernhard Strauss, Christoph Flückiger, Francesca Färber and Jenny Rosendahl (&lt;i&gt;Psychotherapy&lt;/i&gt;, 2023[Mar], Vol 60[1], 130-148). Psychotherapy Study Protocols: A Systematic Review\" by Klatte et al. (2022) In the article \"Defining and Assessing Adverse Events and Harmful Effects in Psychotherapy Study Protocols: A Systematic Review\" by Rahel Klatte, Bernhard Strauss, Christoph Flückiger, Francesca Färber, and Jenny Rosendahl (Psychotherapy, 2022, Vol. 60, No. 1, pp. 130-148, https://doi.org/10 .1037/pst0000359), author contributions were corrected in the author note: Rahel Klatte served as support for methodology and project administration, and served as lead for data curation, formal analysis, and investigation, original draft, and writing, review, and editing. Bernhard Strauss served as lead for resources, contributed equally to conceptualization, funding acquisition and supervision, and served as support for methodology, validation, and writing, review, and editing. Christoph Flückiger contributed equally to supervision and served as support for methodology, validation, original draft, and writing, review, and editing. Francesca Färber served as support for data curation and writing, review, and editing. Jenny Rosendahl served as lead for methodology and project administration, contributed equally to conceptualization, funding acquisition, and supervision, and served as support for data curation, formal analysis, and investigation. (The following abstract of the original article appeared in record 2022-23289-001.) The assessment of safety data has become a standard across many clinical interventions. The aim of this systematic review is to investigate the extent to which harm is addressed within psychotherapy study protocols. The review includes study protocols of randomized controlled trials published between 2004 and 2017 investigating the effects of psychotherapy in adult patients with affective disorders, phobia, anxiety, obsessive-compulsive disorder, posttraumatic stress disorder, and/or personality disorders. We conducted a systematic search in the CENTRAL, Medline, PsycINFO, and Web of Science databases as well as in relevant journals. In total, 115 study protocols were included, examining 168 psychotherapy and 85 control conditions. These protocols differed considerably in the way they conceptualized harm: 77 explicitly addressed harm, 62 considered serious adverse events, and 39 considered adverse events. Although serious adverse events were defined somewhat consistently, adverse events were not. Our results imply that clinical researchers do not apply standardized approaches with regard to harm concepts, assessment, and management. To gather data on frequencies of harmful effects, we argue a higher degree of standardization would be useful. Feasible recommendations are provided","PeriodicalId":20910,"journal":{"name":"Psychotherapy","volume":"62 1","pages":"74"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143650058","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":"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":"<p><p>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 (<i>N</i> = 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).</p>","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}

{"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":"<p><p>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).</p>","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}

{"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":"<p><p>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).</p>","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}

{"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":"<p><p>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).</p>","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}

{"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":"<p><p>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 (<i>n</i> = 10), facilitators (<i>n</i> = 7 licensed mental health clinicians and certified spiritual health clinicians), and caregivers (<i>n</i> = 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).</p>","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}

{"title":"\"After the thrill is gone\": The role of psychotherapy in coping with romantic breakups.","authors":"Barry A Farber, David Roe, Shana Dickstein, Mossie Lierle, Rachel Cherner, Luisa Garbowit","doi":"10.1037/pst0000531","DOIUrl":"10.1037/pst0000531","url":null,"abstract":"<p><p>To investigate the perceptions of ex-romantic partners regarding the extent to which and ways in which psychotherapy facilitates coping with the consequences of the dissolution of past relationships, a multipart survey (Representations of Past Significant Others) that included Likert-type, multiple-choice, and open-ended questions about the ways in which individuals remember a past significant relationship and the ways in which they have moved toward closure from that relationship was disseminated via social media and networking. An attachment status measure (Experience in Close Relationship Scale-Short Form) was also administered. A total of 1,846 respondents, mean age 30.6 and predominantly White, heterosexual, female, and from the United States, completed the survey, 74.6% of whom attended psychotherapy post breakup. On average, respondents who engaged in therapy following their breakup found it to be moderately to very helpful; younger respondents, those in longer term relationships, and those with higher scores on the Experience in Close Relationship Scale-Short Form Anxiety subscale evaluated the helpfulness of therapy more highly. Multiple clinical interventions were perceived as helpful in coping with romantic breakups, including normalizing respondents' feelings about their experience, encouraging them to be more aware of their feelings, encouraging them to move forward with their lives, reminding them of their strengths, exploring the story of the relationship and the breakup, and challenging their self-critical thoughts or feelings. Understanding who is best served by postbreakup therapy and the specific interventions, psychotherapeutic and otherwise, that move individuals toward closure may facilitate therapists' efforts to help with this common source of client distress. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":20910,"journal":{"name":"Psychotherapy","volume":" ","pages":"324-333"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141890041","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":"Increasing outcome measurement precision: Network analysis of items on the Outcome Questionnaire-45.","authors":"Tim Kaiser, David M Erekson, Benjamin M Ogles","doi":"10.1037/pst0000546","DOIUrl":"10.1037/pst0000546","url":null,"abstract":"<p><p>Psychotherapy outcome research mainly focuses on scale-level changes and constructs that were developed using cross-sectional statistical analysis, possibly concealing important findings on the level of single items, and limiting the clinical utility of outcome scales. Our goal was to explore changes in symptoms, interpersonal problems, and level of functioning in everyday life and to establish groups of items with similar rates of change that could be used to form more coherent targets for measuring different therapeutic outcomes. Triangulated maximally filtered graphs were used to model the network structure of the Outcome Questionnaire-45 in a data set of <i>N</i> = 12,075 university counseling center patients. Dynamic exploratory graph analysis was used to establish communities of items with similar rates of change. Five item communities (anxiety, hopelessness, interpersonal problems, well-being, and work impairment) were found. Compared to the original Outcome Questionnaire-45 subscales, they showed better fit to the data. The \"hopelessness\" community, which describes the extent of a patient's demoralization before the start of therapy, had a significantly higher rate of change compared to other communities. The discerned item communities provide clinicians with theoretically grounded, precise targets for outcome tracking, thereby enhancing the responsiveness and adaptability of treatment interventions to individual client trajectories. Such granularity enriches our understanding of therapeutic change, with direct implications for tailoring intervention strategies to maximize early therapeutic gains and sustain long-term recovery. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":20910,"journal":{"name":"Psychotherapy","volume":" ","pages":"314-323"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142506820","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}