Psychotherapy最新文献

{"title":"Identification of cultural conversations in therapy using natural language processing models.","authors":"Patty B Kuo, Maitrey Mehta, Halleh Hashtpari, Vivek Srikumar, Michael J Tanana, Karen W Tao, Joanna M Drinane, Jake Van-Epps, Zac E Imel","doi":"10.1037/pst0000542","DOIUrl":"10.1037/pst0000542","url":null,"abstract":"<p><p>Researchers have historically focused on understanding therapist multicultural competency and orientation through client self-report measures and behavioral coding. While client perceptions of therapist cultural competency and multicultural orientation and behavioral coding are important, reliance on these methods limits therapists receiving systematic, scalable feedback on cultural opportunities within sessions. Prior research demonstrating the feasibility of automatically identifying topics of conversation in psychotherapy suggests that natural language processing (NLP) models could be trained to automatically identify when clients and therapists are talking about cultural concerns and could inform training and provision of rapid feedback to therapists. Utilizing 103,170 labeled talk turns from 188 psychotherapy sessions, we developed NLP models that recognized the discussion of cultural topics in psychotherapy (<i>F</i>-1 = 70.0; Spearman's ρ = 0.78, <i>p</i> < .001). We discuss implications for research and practice and applications for future NLP-based feedback tools. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":20910,"journal":{"name":"Psychotherapy","volume":" ","pages":"259-268"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142473391","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":"Physiological regulation processes differentiate the experience of ruptures between patient and therapist.","authors":"Amit Tchizick, Johann Roland Kleinbub, Shahar Bittan, Tal Bitton, Sigal Zilcha-Mano","doi":"10.1037/pst0000543","DOIUrl":"10.1037/pst0000543","url":null,"abstract":"<p><p>The empirical and clinical literature emphasizes the importance of alliance ruptures, signaling therapeutic processes occurring within and between the partners of the therapeutic dyad. However, knowledge about the underlying regulatory processes that occur amid ruptures is scarce. Identifying the underlying physiological markers may shed light on these regulatory processes. The overarching goal of the present study was to explore physiological markers of withdrawal and confrontation ruptures, within the patient and the therapist. Given the little known on the subject, we used a single-case design (94 episodic segments) to explore biologically based regulatory processes in the face of a rupture, contrasting confrontation ruptures versus withdrawal ruptures versus control episodes (emotional and neutral episodes). Findings showed that the patient and the therapist had contrasting physiological responses to the ruptures, depending on the type. During withdrawal ruptures, the patient exhibited high regulation, while the therapist did not show a clear physiological reaction. During confrontation ruptures, the patient exhibited low regulation, while the therapist exhibited high regulation. The different physiological regulation processes at times of ruptures suggest that, in withdrawal, the patient relied on intrapersonal regulation, contrasting with the interpersonal regulation observed in confrontation ruptures. Findings remained robust after controlling for speech turns and 10,000 Monte Carlo permutations to assess chance-level results. These findings provide initial evidence for the link between arousal and behavior in ruptures, offering valuable psychoeducational material for therapists to improve their handling of these challenging moments. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":20910,"journal":{"name":"Psychotherapy","volume":" ","pages":"292-303"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142506821","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 cultural adaptation of acceptance and commitment therapy with exercise for older Chinese with chronic pain and depressive symptoms: A mixed-methods study.","authors":"Dara Kiu Yi Leung, Annabelle Pui Chi Fong, Wai Wai Kwok, Angie Kwan Yu Shum, Tianyin Liu, Rachel H M Chan, Hotinpo Sky Kanagawa, Gloria Hoi Yan Wong, Terry Yat Sang Lum","doi":"10.1037/pst0000539","DOIUrl":"10.1037/pst0000539","url":null,"abstract":"<p><p>Chronic pain and depression are highly prevalent and correlated in older adults. Acceptance and commitment therapy (ACT) and exercise have been shown to be effective for both conditions, mostly in Western literature. Little is known about integrating two approaches, particularly in Asian cultures and among less well-educated people. This article describes the iterative process of developing a culturally adapted ACT with exercise intervention for older Chinese with chronic pain and depressive symptoms. A multidisciplinary expert panel codesigned a culturally adapted ACT with exercise intervention, comprising a weekly 2-hr ACT and a 1½-hr exercise program for 8 weeks, focusing on six ACT core components and low-to-moderate intensity circuit-based resistance exercise. Its feasibility was tested through a mixed-methods, pretest-posttest design with 22 older Chinese experiencing chronic pain and depressive symptoms (<i>M</i>_age = 71.5 years, <i>SD</i> = 7.5, 86% female). Participants showed significant improvements in pain intensity, pain interference, pain self-efficacy, physical performance, pain acceptance, and committed action (all <i>p</i> < .05). We identified five themes to inform protocol revision: (1) contextualizing values, (2) utilizing experiential learning, (3) using culturally appropriate metaphors, (4) establishing linkage between ACT concepts and pain, and (5) promoting application through repetition and prompts. Incorporating these findings, the final protocol emphasized three core ACT components and one set of physical exercises. This is the first study demonstrating the feasibility of a culturally adapted, person-centered tailoring ACT with exercise intervention for improving pain-related outcomes and mental wellness among older Chinese. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":20910,"journal":{"name":"Psychotherapy","volume":" ","pages":"269-281"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606145","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":"Alliance rupture and repair in adolescent psychotherapy: What clinicians can learn from research.","authors":"Antonella Cirasola, Peter Fonagy, Nick Midgley","doi":"10.1037/pst0000535","DOIUrl":"10.1037/pst0000535","url":null,"abstract":"<p><p>The collaborative relationship between a client and therapist, known as the therapeutic alliance, plays an important part in promoting engagement and symptom improvement in adolescent psychotherapy. However, research indicates that alliance strains, called ruptures, are common among this age group, emphasizing the importance of addressing and resolving them for enhanced engagement and better outcomes. Despite this, there is a dearth of age-specific guidelines for effectively fostering a positive alliance and repairing these ruptures. This review examines existing literature to (a) summarize the current understanding of alliance formation in youth psychotherapy, particularly considering the distinct characteristics of working with adolescents, and (b) provide evidence-based recommendations to assist youth therapists in building strong alliances and effectively addressing alliance ruptures with this age group. Existing evidence indicates that while guidance designed for adult therapy can be beneficial, working with adolescents poses unique challenges. These include resistance to treatment, engagement in risky behaviors, confidentiality issues, and parental involvement, which can strain the therapeutic relationship. This emphasizes the importance for youth therapists to understand the unique challenges and developmental stages adolescents face and to adapt their approach accordingly. By doing so, therapists can effectively address the needs of adolescents, fostering a strong alliance and handling any ruptures that may arise. Despite being a relatively new area of study with its inherent limitations, this review underscores the critical role of alliance research in improving therapy for adolescents and guiding the training of therapists who work with this age group. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":20910,"journal":{"name":"Psychotherapy","volume":" ","pages":"304-313"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141634332","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":"Considerations for the use of dialectical behavior therapy for individuals experiencing oppression.","authors":"Linda A Oshin, Shireen L Rizvi","doi":"10.1037/pst0000541","DOIUrl":"10.1037/pst0000541","url":null,"abstract":"<p><p>As the popularity of dialectical behavior therapy (DBT) grows, so does its use with increasingly diverse groups of clients. In this article, we demonstrate that DBT in its standard form can incorporate the sequelae of oppression as a target of treatment by providing clients with skills to identify oppression and its impact while responding effectively. To support the use of DBT with individuals experiencing emotion/behavior dysregulation and oppression, we review how each of the primary strategies of DBT can be used within the context of oppression. Specifically, we discuss how dialectical philosophy, the acceptance/change dialectic, communication strategies, and case management strategies can be viewed through an oppression lens. A brief review of DBT research with historically oppressed populations and common pitfalls in treating oppressed individuals is presented. As research in examining and adapting DBT for minoritized groups continues to catch up to clinical need, guidance is presented here for researchers and clinicians interested in using this empirically supported treatment in communities that experience oppression. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":20910,"journal":{"name":"Psychotherapy","volume":" ","pages":"282-291"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12025291/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142073750","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":"Questioning the status quo: Latino community members as researchers in the study of health equity.","authors":"Manuel Gutierrez Chavez, Katherine J W Baucom, Ana Sanchez-Birkhead, Jeannette Villalta, Sara Carbajal-Salisbury, Nidia Zavala Gonzalez, Leila Tatarevic, Anu Asnaani","doi":"10.1037/pst0000545","DOIUrl":"https://doi.org/10.1037/pst0000545","url":null,"abstract":"<p><p>Latinos experience disproportionate rates of obesity and related conditions like type 2 diabetes, which are projected to increase (Mohebi et al., 2022). Standard interventions for these issues often fall short due to individual-focused approaches and the lack of culturally sensitive definitions of health that include emotional, physical, political, and social domains (Gutierrez Chavez et al., 2022; Ritchie et al., 2020). Multilevel and multidimensional research efforts, integrating social justice-informed orientations, psychotherapy science, and behavioral medicine, are crucial for addressing these health inequities (Asnaani, 2023; Collins et al., 2018; Rodriguez Espinosa & Verney, 2021). Additionally, critically analyzing researcher and participant roles is essential to avoid perpetuating systemic racism (Cook et al., 2023). This article highlights the need for a paradigm shift in psychotherapy research by (a) describing Latino families' eating patterns and coping strategies for emotional distress through focus groups in the community and (b) illustrating the process behind the community-partnered development of a culturally responsive mindfulness-based health intervention. Importantly, this research approach emphasizes liberation psychology theory in the exploration of structural influences affecting health (Martín-Baró, 1996). While mindfulness techniques are feasible in this population (Cotter & Jones, 2020), Latino communities may not be amenable to the current presentation of mainstream psychological science interventions. Our research paradigm informed the conceptualization of mindfulness techniques through both clinical science and critical lenses. Thus, this study argues for reconceptualizing the definition of a successful psychotherapy study to include community engagement and liberatory principles, making the potential for big needle jumps in addressing health inequities incalculable. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":20910,"journal":{"name":"Psychotherapy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142506822","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":"State and trait characteristics of attachment as predictors of outcome in inpatient psychotherapy.","authors":"Simone Jennissen, Matthias Volz, Henning Schauenburg, Ulrike Dinger","doi":"10.1037/pst0000529","DOIUrl":"10.1037/pst0000529","url":null,"abstract":"<p><p>Attachment has mostly been investigated as a stable characteristic of individuals, although theoretical considerations and recent empirical findings suggest that attachment styles are also subject to change. When attachment is investigated as a treatment factor in psychotherapy, state and trait characteristics need to be differentiated, as they warrant different conclusions. This study examined the trait- and statelike characteristics of attachment styles over the course of inpatient psychotherapy as predictors of treatment outcome. A total of <i>N</i> = 419 patients provided weekly measurements of attachment styles and symptoms for up to 8 weeks of inpatient psychotherapy. Data were analyzed in multilevel longitudinal models controlling for rolling admissions and weekly changes in group membership. Over the course of treatment, patients' attachment styles became more secure and less fearful-avoidant. Trait attachment security as well as gains in attachment security predicted better outcomes, while trait preoccupied and fearful-avoidant attachment as well as increases in attachment preoccupation and anxiety predicted worse outcomes. Findings imply that attachment security may grow during a relatively short inpatient treatment period and both trait attachment styles as well as changes in attachment styles predict outcome. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":20910,"journal":{"name":"Psychotherapy","volume":" ","pages":"212-221"},"PeriodicalIF":2.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141082289","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":"Preventing dropout in spiritually integrated psychotherapies: What are the effective methods of attending to clients' spirituality?","authors":"Joseph M Currier, Joshua K Swift, Peter Sanders, P Scott Richards","doi":"10.1037/pst0000530","DOIUrl":"10.1037/pst0000530","url":null,"abstract":"<p><p>The purpose of this study was to examine associations between clinicians' use of varying types of spiritual interventions in the first session of spiritually integrated psychotherapies (SIPs) and clients' likelihood of returning for a second session. In total, 154 practitioners of SIPs from 33 settings in a practice-research network reported on their implementation of different methods for addressing clients' religion/spirituality on an after-session summary checklist. Roughly 80% or more of the clinicians implemented at least one spiritual intervention in the first session; on average, clinicians used 3.26 (<i>SD</i> = 3.66) of the interventions on the checklist. Occurring with 20% or more of the 1,094 clients, the most commonly used spiritual interventions included listening to spiritual issues, discussing compassion and hope, affirming clients' divine worth and attempts to trust God. In total, nearly one in five clients did not return for a second session. Focusing on interventions that were empirically linked with clients' engagement in a second session in bivariate analyses, discussion of spiritual dimensions of clients' problems and solutions was associated with a 118% greater probability that clients engaged in SIPs; in contrast, discussion of hope was linked with a 40% decrease in treatment engagement. In conclusion, findings highlight the potential opportunities and risks for implementing interventions that attend to clients' spirituality and/or religious faith at the start of SIPs. Research is needed to understand factors associated with the effective use of spiritual interventions and methods of training clinicians accordingly. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":20910,"journal":{"name":"Psychotherapy","volume":" ","pages":"184-190"},"PeriodicalIF":2.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141180500","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":"Pathological narcissism's impact on psychodynamic group therapy for perfectionism.","authors":"Sabrina Ge, Paul L Hewitt, Samuel F Mikail, Gordon L Flett, David Kealy","doi":"10.1037/pst0000528","DOIUrl":"10.1037/pst0000528","url":null,"abstract":"<p><p>Several decades of theory suggest that pathological narcissism (PN) may limit psychotherapy success, but empirical evidence for such theories is limited and mixed. In addition, it has been proposed that individuals with high levels of PN may benefit more from supportive compared to interpretive psychodynamic therapies, but no studies thus far have investigated this question empirically. As such, our study aimed to extend past research by investigating (a) whether higher levels of pretreatment PN predict poorer treatment outcome and (b) whether the type of psychodynamic therapy (supportive or interpretive therapy) moderates these findings, in a sample of patients undergoing group psychodynamic psychotherapy for perfectionism. The sample was drawn from the University of British Columbia Perfectionism Treatment Study II (Hewitt et al., 2023) and consisted of 80 treatment-seeking adults with elevated perfectionism. Contrary to expectations, multilevel and multiple regression analyses showed that pretreatment PN did not significantly predict posttreatment changes in symptom severity, life satisfaction, or work and social impairment. We also did not find that either grandiose or vulnerable narcissism predicted likelihood of patient dropout. Finally, treatment type did not moderate the relationship between pretreatment PN and treatment outcome, suggesting that, contrary to our hypotheses, PN does not impact treatment outcome regardless of the interpretive nature of the psychodynamic group therapy. These results, taken together with past findings, suggest that PN may not be associated with poorer psychotherapy outcomes in certain contexts, such as in the case of supportive or interpretive psychodynamic group psychotherapy for perfectionism. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":20910,"journal":{"name":"Psychotherapy","volume":" ","pages":"234-240"},"PeriodicalIF":2.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140899510","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":"Sexual Orientation Microaggression Rating Scale (SOMRS): Development and association with alliance ruptures.","authors":"Joey Sergi, Anna Babl, Jonathan T Warren, John E Pachankis, Catherine F Eubanks","doi":"10.1037/pst0000536","DOIUrl":"10.1037/pst0000536","url":null,"abstract":"<p><p>Sexual minority clients report experiencing frequent microaggressions during therapy, however, therapists may not recognize those microaggressions or may be reluctant to self-report them. The main aim of the present study was thus to develop an observational measure of in-session therapist-committed microaggressions related to the sexual orientation of sexual minority individuals (e.g., those who identify as lesbian, gay, bisexual, or queer). The present study further examined the association between therapist-committed sexual orientation microaggressions and ruptures in the therapeutic alliance. We hypothesized that clinically significant microaggressions would be positively associated with withdrawal ruptures in the alliance. The sample consisted of 44 gay and bisexual men who participated in a cognitive behavioral treatment designed to reduce depression, anxiety, human immunodeficiency virus-transmission-risk behaviors, and substance use. An observer-based coding measure designed for this study, the Sexual Orientation Microaggression Rating Scale (SOMRS), was utilized to capture sexual minority microaggressions in the initial sessions of treatment. Good interrater reliability was achieved for the SOMRS. Microaggressions were coded in 34% of the sessions. Within the subset of sessions with coded microaggressions, a significant association was found between withdrawal ruptures and microaggression significance ratings. The SOMRS holds potential for supporting research on microaggression as well as future efforts to help clinicians recognize and repair in-session behaviors that negatively impact sexual minority clients. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":20910,"journal":{"name":"Psychotherapy","volume":"61 3","pages":"191-197"},"PeriodicalIF":2.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11315359/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141902729","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}