PsychotherapyPub Date : 2025-09-01Epub Date: 2025-02-03DOI: 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":"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":"315-325"},"PeriodicalIF":3.9,"publicationDate":"2025-09-01","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}
PsychotherapyPub Date : 2025-09-01Epub Date: 2025-07-10DOI: 10.1037/pst0000586
Stephanie A Wiebe, Susan M Johnson, Robert Allan, T Leanne Campbell, Paul S Greenman, David R Fairweather, Mariam Ismail, Giorgio A Tasca
{"title":"A randomized controlled trial of emotionally focused individual therapy (EFIT) for depression and anxiety.","authors":"Stephanie A Wiebe, Susan M Johnson, Robert Allan, T Leanne Campbell, Paul S Greenman, David R Fairweather, Mariam Ismail, Giorgio A Tasca","doi":"10.1037/pst0000586","DOIUrl":"10.1037/pst0000586","url":null,"abstract":"<p><p>Emotionally focused individual therapy (EFIT; Johnson, 2019) is a newly developed therapeutic modality. In this study, we used a randomized controlled trial (Clinical Trial Registration NCT04719780) intent-to-treat design to examine the effects of 15 sessions of EFIT in comparison with a 15-week wait-list control on general symptom distress and symptoms of depression and anxiety. Eighty-eight participants who met the diagnostic criteria for major depressive disorder and comorbid anxiety, as determined by the Anxiety and Related Disorders Interview Schedule for the <i>Diagnostic and Statistical Manual of Mental Disorders, fifth edition</i>, were randomized to an EFIT treatment group (<i>n</i> = 44) or to a wait-list control group (<i>n</i> = 44). Average age was 35.73 years (<i>SD</i> = 12.28). Sixty-three percent identified as women, and 37% identified as male. In terms of ethnicity, 73% identified as White, 1.3% as Black, 7.7% as Southeast Asian, 7.7% as East Asian, 3.8% as Latinx, and 2.6% as First Nation. Participants completed the Outcome Questionnaire-30.2, the Patient-Reported Outcomes Measurement Information System (PROMIS)-Depression scale, and the PROMIS-Anxiety scale. Multilevel modeling results confirmed a significant difference in growth curves between the treatment group and controls on all measures. Follow-up analyses demonstrated significant reductions in symptom distress (Outcome Questionnaire-30.2) and symptoms of depression and anxiety (PROMIS-Depression and PROMIS-Anxiety) across 15 weeks. Overall, the results of this study suggest that EFIT leads to significant symptom reduction among people with depression and anxiety. (PsycInfo Database Record (c) 2025 APA, all rights reserved).</p>","PeriodicalId":20910,"journal":{"name":"Psychotherapy","volume":" ","pages":"414-423"},"PeriodicalIF":3.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609246","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}
PsychotherapyPub Date : 2025-09-01Epub Date: 2024-02-01DOI: 10.1037/pst0000519
Simon B Goldberg, Michael Tanana, Shaakira Haywood Stewart, Camille Y Williams, Christina S Soma, David C Atkins, Zac E Imel, Jesse Owen
{"title":"Automating the assessment of multicultural orientation through machine learning and natural language processing.","authors":"Simon B Goldberg, Michael Tanana, Shaakira Haywood Stewart, Camille Y Williams, Christina S Soma, David C Atkins, Zac E Imel, Jesse Owen","doi":"10.1037/pst0000519","DOIUrl":"10.1037/pst0000519","url":null,"abstract":"<p><p>Recent scholarship has highlighted the value of therapists adopting a multicultural orientation (MCO) within psychotherapy. A newly developed performance-based measure of MCO capacities exists (MCO-performance task [MCO-PT]) in which therapists respond to video-based vignettes of clients sharing culturally relevant information in therapy. The MCO-PT provides scores related to the three aspects of MCO: cultural humility (i.e., adoption of a nonsuperior and other-oriented stance toward clients), cultural opportunities (i.e., seizing or making moments in session to ask about clients' cultural identities), and cultural comfort (i.e., therapists' comfort in cultural conversations). Although a promising measure, the MCO-PT relies on labor-intensive human coding. The present study evaluated the ability to automate the scoring of the MCO-PT transcripts using modern machine learning and natural language processing methods. We included a sample of 100 participants (<i>n</i> = 613 MCO-PT responses). Results indicated that machine learning models were able to achieve near-human reliability on the average across all domains (Spearman's ρ = .75, <i>p</i> < .0001) and opportunity (ρ = .81, <i>p</i> < .0001). Performance was less robust for cultural humility (ρ = .46, <i>p</i> < .001) and was poorest for cultural comfort (ρ = .41, <i>p</i> < .001). This suggests that we may be on the cusp of being able to develop machine learning-based training paradigms that could allow therapists opportunities for feedback and deliberate practice of some key therapist behaviors, including aspects of MCO. (PsycInfo Database Record (c) 2025 APA, all rights reserved).</p>","PeriodicalId":20910,"journal":{"name":"Psychotherapy","volume":" ","pages":"292-300"},"PeriodicalIF":3.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11291704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139651585","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}
PsychotherapyPub Date : 2025-09-01Epub Date: 2025-05-05DOI: 10.1037/pst0000580
Averi N Gaines, Alice E Coyne, Ashleigh N Frank, Michael J Constantino, James F Boswell, David R Kraus
{"title":"Actor-partner outcome expectation-alliance associations in naturalistic psychotherapy.","authors":"Averi N Gaines, Alice E Coyne, Ashleigh N Frank, Michael J Constantino, James F Boswell, David R Kraus","doi":"10.1037/pst0000580","DOIUrl":"10.1037/pst0000580","url":null,"abstract":"<p><p>Meta-analyses indicate that patient outcome expectation (OE) and therapeutic alliance quality each correlate positively with improvement across diverse psychotherapies. Moreover, research demonstrates that these constructs relate to one another, including higher OE correlating with better subsequent alliance. However, notable gaps in this area remain. First, most studies that have examined the <i>OE-alliance association</i> have done so from the patient perspective only, despite both constructs having dyadic properties. Second, few studies have examined the connection between these two constructs longitudinally to capture their dynamic interrelations. Third, few studies have parsed OE-alliance links into their within- and between-dyad components, masking interpretability. Finally, most studies derive from controlled trials for specific diagnoses, limiting generalizability. Addressing these gaps, we tested the dyadic, dynamic, and statistically parsed associations among patient and therapist OE and alliance in naturalistic psychotherapy. Patients and therapists rated OE and alliance quality across up to 16 weeks of treatment. For dyads with the requisite data (<i>N</i> = 111 patients nested within 37 therapists), we used a multilevel actor-partner interdependence model that simultaneously tested all within- and between-dyad actor and partner effects of OE on alliance quality. At the within-dyad level, there were no significant actor or partner effects. At the between-dyad level, there were no significant partner effects, but there was a positive OE-alliance actor effect for both patients and therapists. Results suggest that community-based therapists may consider attending most to each participant's <i>average</i> level of OE across therapy (vs. <i>fluctuations</i>) when forecasting its influence on their own overall relationship experience. (PsycInfo Database Record (c) 2025 APA, all rights reserved).</p>","PeriodicalId":20910,"journal":{"name":"Psychotherapy","volume":" ","pages":"387-396"},"PeriodicalIF":3.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012391","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}
PsychotherapyPub Date : 2025-09-01Epub Date: 2025-04-07DOI: 10.1037/pst0000571
RaeAnn E Anderson, Nili Gesser, Victoria-Jane Welk, Kimberly Tom, Samantha C Holmes
{"title":"Promoting recovery and prevention simultaneously through peer providers to reduce the impact of childhood sexual abuse: Acceptability, feasibility, and fidelity of an integrated intervention model.","authors":"RaeAnn E Anderson, Nili Gesser, Victoria-Jane Welk, Kimberly Tom, Samantha C Holmes","doi":"10.1037/pst0000571","DOIUrl":"10.1037/pst0000571","url":null,"abstract":"<p><p>Childhood sexual abuse (CSA) affects approximately 30% of American children assigned female at birth. CSA often has a negative impact on survivors, leading to poorer mental health and an increased risk of subsequent sexual victimization. The current proof-of-concept study sought to examine the acceptability, feasibility, and fidelity of a peer-facilitated, online, one-time group intervention model to simultaneously promote recovery and prevent further victimization. We developed a brief intervention model drawing from components of previously tested protocols (i.e., expressive writing, interpersonal skills). Undergraduate students were trained as facilitators. We conducted online group sessions via Zoom with -three to seven participants per group (<i>n</i> = 40 in <i>k</i> = 10 groups). Participants were women (95.7%) or assigned female at birth nonbinary (4.3%) aged 17-30 who had experienced CSA. They were surveyed pre- and postintervention regarding acceptability. Qualitatively, feedback on the group intervention was very positive. Quantitatively, participants reported feeling more comfortable asking someone to stop sexual advances (<i>M</i> = 4.32/5.0), reported a desire to continue using skills learned (<i>M</i> = 4.56/5.0), and felt comfortable working with the peer providers (<i>M</i> = 4.63/5.0). From the participant-feasibility perspective, 100% of participants reported some level of postintervention skill practice during the one-week follow-up. The average, dichotomous, fidelity rating was 84.9%. Our findings indicate that an online group intervention facilitated by peers to improve health after CSA is acceptable, feasible, and meets minimal fidelity standards. Further development and refinement of this intervention model are warranted. (PsycInfo Database Record (c) 2025 APA, all rights reserved).</p>","PeriodicalId":20910,"journal":{"name":"Psychotherapy","volume":" ","pages":"363-375"},"PeriodicalIF":3.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12356083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804195","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}
PsychotherapyPub Date : 2025-09-01DOI: 10.1037/pst0000582
Michael J Constantino, Alice E Coyne, James F Boswell
{"title":"Big needle jumps in psychotherapy research.","authors":"Michael J Constantino, Alice E Coyne, James F Boswell","doi":"10.1037/pst0000582","DOIUrl":"10.1037/pst0000582","url":null,"abstract":"<p><p>The field of psychotherapy research has come a long way since its inception. In addition to foundational data on psychotherapy's general efficacy and effectiveness, there has been steadily mounting evidence to answer questions, such as how, for which patients, when delivered by which therapists, and under what conditions does psychosocial treatment work? Moreover, there have been key methodological and data analytic developments over time, which have supported or catalyzed, respectively, more nuanced or new psychotherapy knowledge. Nonetheless, given the field's relatively young age, as well as the need for greater replication of results, better science-practice integration, and higher consensus on psychotherapy's core and consensual scientific principles, the field arguably remains somewhat immature and in need of more empirical advancements to meet the ever-rising need for effective mental health care. Such progressions will often come in incremental steps; however, \"big needle movements\" are also needed to embody or set the stage for more revolutionary changes in how we study, understand, and practice psychotherapy. To this end, the articles in the present special section exemplify such innovations through their big-impact results and/or promising proof-of-concept methods. In this introduction to the section, we summarize the sizeable potential of the nine included articles to influence and inspire the field of psychotherapy. (PsycInfo Database Record (c) 2025 APA, all rights reserved).</p>","PeriodicalId":20910,"journal":{"name":"Psychotherapy","volume":"62 3","pages":"263-266"},"PeriodicalIF":3.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144966503","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}
PsychotherapyPub Date : 2025-09-01Epub Date: 2025-07-21DOI: 10.1037/pst0000588
Gianina Frediani, Mart De Henau, Isabelle De Pooter, Peter Rober, Siebrecht Vanhooren
{"title":"Maintaining therapeutic presence and empathy when engaging with a client's existential concerns.","authors":"Gianina Frediani, Mart De Henau, Isabelle De Pooter, Peter Rober, Siebrecht Vanhooren","doi":"10.1037/pst0000588","DOIUrl":"10.1037/pst0000588","url":null,"abstract":"<p><p>Research shows how therapists struggle to stay present with their clients' existential concerns. Our goal was to explore what hinders and enables therapists to stay present and engaged when existential concerns surface in the session. We invited 22 therapists (12 novice and 10 experienced) to engage in a role-play with a client expressing her existential concerns using a standardized script. Subsequently, the therapists were interviewed using a videotape-assisted recall procedure. Data were analyzed according to the descriptive-interpretive qualitative research approach. When confronted with existential themes in the session, novice therapists experienced overwhelming feelings of powerlessness and uncertainty, blocking their ability to remain open to the client's existential experiences. Lack of knowledge and encountering their own existential vulnerability were mentioned as triggers. For experienced therapists, the main challenge was to stay present while feeling impacted by the existential topic, which they managed by grounding and reanchoring themselves. Our findings support the idea that embracing one's own existential issues and being at ease with existential themes may be essential conditions for staying present and fostering an authentic therapeutic encounter. Furthermore, our findings suggest that gaining knowledge about the existential process and learning to ground and reanchor oneself are essential for therapists. (PsycInfo Database Record (c) 2025 APA, all rights reserved).</p>","PeriodicalId":20910,"journal":{"name":"Psychotherapy","volume":" ","pages":"376-386"},"PeriodicalIF":3.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675537","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}
PsychotherapyPub Date : 2025-06-01Epub Date: 2024-12-16DOI: 10.1037/pst0000544
Edmund W Orlowski, Myrna L Friedlander, Lee N Johnson, Shayne R Anderson
{"title":"Contribution of attachment insecurity to the role and outcome expectations of romantic partners entering couple therapy.","authors":"Edmund W Orlowski, Myrna L Friedlander, Lee N Johnson, Shayne R Anderson","doi":"10.1037/pst0000544","DOIUrl":"10.1037/pst0000544","url":null,"abstract":"<p><p>We investigated insecure attachment in relation to how actively romantic partners expect to participate in couple therapy (role expectations for self and partner) and, consequently, how much they expect to benefit from doing so (outcome expectations). Specifically, we used the mediated actor-partner interdependence model (Ledermann et al., 2011) with archived data from 297 heterosexual couples in a research-practice network (L. N. Johnson et al., 2017) who completed the Experiences in Close Relationships Scale-Short Form (Wei et al., 2007) and the Expectations and Preferences Scales for Couple Therapy (Friedlander, Muetzelfeld, et al., 2019) before their first session. Results showed acceptable model fit and a complex, dynamic interplay between gender, anxious, and avoidant attachment to partner, and pretherapy role and outcome expectations. For example, both members of the couple had lower expectations for the participation of partners who reported higher levels of attachment avoidance. Women with higher attachment anxiety also had lower role expectations for their male partners, as well as more negative outcome expectations. Whereas men with higher avoidant attachment reported lower expectations for their own role in the therapeutic process, highly anxious men expected their relationship to improve due to their own participation in the process rather than due to their partner's participation. Taken together, these results suggest that when romantic partners' interactions or descriptions of one another's behavior in the first session suggest a high level of attachment insecurity, particularly high avoidance, therapists should explain how their joint, active participation in the therapeutic process can help improve their relationship. (PsycInfo Database Record (c) 2025 APA, all rights reserved).</p>","PeriodicalId":20910,"journal":{"name":"Psychotherapy","volume":" ","pages":"243-252"},"PeriodicalIF":3.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829792","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}
PsychotherapyPub Date : 2025-06-01Epub Date: 2024-11-21DOI: 10.1037/pst0000553
Daniel Teplow, Daniella Spencer-Laitt, Laura J Long, Audrey J Hey, Julián D Moreno, Todd J Farchione
{"title":"Strengths use and emotional disorder symptom reduction during a transdiagnostic cognitive behavioral therapy: A random-intercept cross-lagged panel model study.","authors":"Daniel Teplow, Daniella Spencer-Laitt, Laura J Long, Audrey J Hey, Julián D Moreno, Todd J Farchione","doi":"10.1037/pst0000553","DOIUrl":"10.1037/pst0000553","url":null,"abstract":"<p><p>Strengths use, the engagement of positive character traits in everyday contexts, is associated with both positive functioning and symptom reduction. The present study examined longitudinal relationships between strengths use and emotional disorder symptoms (anxiety, stress, and depression) during a randomized clinical trial of the Digital Unified Protocol, a transdiagnostic cognitive behavioral therapy. Participants (N = 120) completed assessments at four major time points during treatment and at 3-month follow-up. We specified three random-intercept cross-lagged panel model to capture within-person, bidirectional, time-lagged relationships between strengths use and anxiety, stress, and depression, respectively. Prospective increases in strengths use were associated with significant decreases in anxiety at all time points (β = -0.26 to -0.49), while prospective decreases in anxiety were associated with significant increases in strengths use at most time points (β = -0.25 to -0.36). Prospective increases in strengths use were associated with significant decreases in stress at most time points (β = -0.23 to -0.54), while prospective decreases in stress were associated with significant increases in strengths use at Week 4 (β = -0.21) and at follow-up (β = -0.41). Prospective increases in strengths use were associated with significant decreases in depression at Week 8 (β = -0.63) and at posttreatment (β = -0.67), while prospective decreases in depression were associated with significant increases in strengths use at most time points (β = -0.34 to -0.47). Clinical implications of findings are discussed, including the potential role of strengths use as a treatment target. (PsycInfo Database Record (c) 2025 APA, all rights reserved).</p>","PeriodicalId":20910,"journal":{"name":"Psychotherapy","volume":" ","pages":"220-234"},"PeriodicalIF":3.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142688547","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}
PsychotherapyPub Date : 2025-06-01Epub Date: 2025-03-27DOI: 10.1037/pst0000569
Gideon Diamond, Bartosz Wlodek, Stephen Arthey, Stephen Parker
{"title":"A systematic review of deliberate practice in psychotherapy: Definitions, operationalization, and preliminary outcomes.","authors":"Gideon Diamond, Bartosz Wlodek, Stephen Arthey, Stephen Parker","doi":"10.1037/pst0000569","DOIUrl":"10.1037/pst0000569","url":null,"abstract":"<p><p>Deliberate practice has been introduced to psychotherapy training to improve therapist performance. The emerging empirical evidence supporting the positive impacts of deliberate practice is complicated by confusion regarding how deliberate practice should be operationalized and applied in the psychotherapy context and wider debate about its role in developing expertise. This systematic literature review aimed to appraise and synthesize the preliminary evidence available regarding the role of deliberate practice in improving psychotherapy outcomes. We searched MEDLINE, EMBASE, APA PsycInfo, CINAHL, Web of Science, reference lists of articles, and other sources (last checked June 2023). Quantitative English language studies that examined deliberate practice interventions in psychotherapy contexts were included. Two authors independently extracted study data and assessed quality using the relevant Joanna Briggs Institute critical appraisal checklist. Randomized controlled trials were further appraised using the Cochrane risk of bias tool. Discrepancies were resolved through discussion with a third author (Stephen Arthey). Twenty studies were included. There was wide variability in how deliberate practice had been operationalized, and only three studies met the contemporary definition that experts in the field have clarified. Significant methodological limitations impacted the reliability of studies, and the evidence was too preliminary to support or refute its use. Further research is required to establish whether deliberate practice is an effective means of improving psychotherapy outcomes. This should include increased fidelity to contemporary operationalizations, more robust methodology, and more reliable measures of long-term client outcomes. (PsycInfo Database Record (c) 2025 APA, all rights reserved).</p>","PeriodicalId":20910,"journal":{"name":"Psychotherapy","volume":" ","pages":"113-131"},"PeriodicalIF":3.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731434","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}