Research in Psychotherapy-Psychopathology Process and Outcome最新文献

{"title":"DBT-informed treatment in a partial hospital and intensive outpatient program: the role of step-down care.","authors":"Kirk D Mochrie,&nbsp;John Lothes Ii,&nbsp;Eric Guender,&nbsp;Jane St John","doi":"10.4081/ripppo.2020.461","DOIUrl":"https://doi.org/10.4081/ripppo.2020.461","url":null,"abstract":"<p><p>Few studies to date have examined Partial Hospital (PH) and Intensive Outpatient (IOP) programs that utilize a Dialectical Behavior Therapy (DBT)-informed model. Preliminary findings suggest that DBT-informed PH programs are effective in reducing clinical symptoms; however, less is known about IOP programs as well as step-down care models. The present study utilized clinically relevant outcome indices and included a heterogeneous clinical sample. Specifically, the present study assessed pre-post data to examine changes in symptoms of depression, anxiety, hopelessness, and overall degree of suffering from intake to discharge in DBT-informed PH and IOP programs as well as a step-down condition (PH to IOP). Participants included 205 adults (ages <i>M</i> = 35.28, <i>SD</i> = 12.49). The sample was predominantly female (N = 139, 67.8%) and Caucasian (N = 181, 88.3%). The sample was divided into three distinct groups: PH program patients, PH to IOP program step-down patients, and IOP patients. Findings indicated significant symptom reduction from intake to discharge for all three conditions. There were no significant differences in mean change scores in symptom reduction between the three groups. Severity of depression symptoms at intake predicted program placement. However, type of program did not predict significant changes in symptoms from intake to discharge. This DBT-informed PH and IOP program was successful at reducing various psychiatric symptoms in the sample. Clinicians might consider the advantages of placing patients with higher symptoms of depression into PH programs with the intention of transitioning to step-down care through IOP programs that utilize DBT.</p>","PeriodicalId":44262,"journal":{"name":"Research in Psychotherapy-Psychopathology Process and Outcome","volume":"23 2","pages":"461"},"PeriodicalIF":2.7,"publicationDate":"2020-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4081/ripppo.2020.461","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38462522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Giving words to emotions: the use of linguistic analysis to explore the role of alexithymia in an expressive writing intervention.","authors":"Alesia Renzi,&nbsp;Rachele Mariani,&nbsp;Michela Di Trani,&nbsp;Renata Tambelli","doi":"10.4081/ripppo.2020.452","DOIUrl":"https://doi.org/10.4081/ripppo.2020.452","url":null,"abstract":"<p><p>Expressive writing techniques are methods focusing on written emotional expression that require people to write about traumatic or difficult experiences, with the objective of promoting an elaboration of these events. The general aim of the study is to investigate the influence of alexithymia, a deficit in emotional regulation processes, on the effects of an expressive writing intervention, analyzing the writing protocols through the use of the Linguistic Inquiry and Word Count (LIWIC) and Referential Process (RP) linguistic measures via IDAAP software. Thirty-five women undergoing an assisted reproductive treatment participated in the study and filled out a sociodemographic questionnaire, the 20-item Toronto Alexithymia Scale. They also underwent three session of writing, following a request that they write about their emotions regarding their current situation. The women enrolled were divided into two groups: low alexithymia and high alexithymia, comprising individuals with a TAS-20 total score lower or higher than the mean, respectively. Analyses within the groups during the three writing sessions revealed that the women with low alexithymia reported a greater number of words expressing affectivity, sadness and future perspective, whereas no significances in the high alexithymia group emerged. Moreover, when analysing differences between the groups, high-alexithymia women reported lower scores in RP indexes and fewer words expressing sadness, future perspectives and we verbal. In conclusion, these preliminary findings may confirm the hypothesis that alexithymia affects the effectiveness of expressive writing through a difficulty in becoming involved in the writing process and a lack of symbolizing processes.</p>","PeriodicalId":44262,"journal":{"name":"Research in Psychotherapy-Psychopathology Process and Outcome","volume":"23 2","pages":"452"},"PeriodicalIF":2.7,"publicationDate":"2020-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4081/ripppo.2020.452","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38462518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Panic disorder: attack of fear or acute attack of solitude? Convergences between affective neuroscience and phenomenological-Gestalt perspective.","authors":"Gianni Francesetti,&nbsp;Antonio Alcaro,&nbsp;Michele Settanni","doi":"10.4081/ripppo.2020.421","DOIUrl":"https://doi.org/10.4081/ripppo.2020.421","url":null,"abstract":"<p><p>There is consensus among scientists in considering Panic Attack (PA) as an exaggerated fear response triggered by intense activation of the amygdala and related Fear brain network. Current guidelines for treatment (<i>e.g</i>. National Institute for Clinical Excellence, NICE, 2011), that are based on this view, do not achieve satisfactory results: one-third of all treated patients report persistent PAs and other Panic Disorder (PD) symptoms, and several meta-analyses report the high likelihood of relapse. Here we review findings from Affective Neuroscience and clinical insights from a phenomenological-Gestalt perspective, putting into question the link between PD and activation of the Fear brain network. We propose an alternative hypothesis about PD etiology: PD is mainly connected to the Panic system, that is activated in situations of separation from affective support and overexposure to the environment. In our view, PA can be understood as an acute attack of solitude which is not adequately recognized by the patient due to the intervention of a dissociative component that makes it impossible to integrate all neuro-physiological responses activated by the Panic/Separation brain system within a coherent emotional feeling. This perspective can explain many evidences that otherwise remain isolated elements without a comprehensive frame: <i>i.e</i>., the association with agoraphobia, the onset of PD during adolescence and young adult life, the need to be accompanied, the connection with air hunger and other respiratory anomalies, the efficacy of antidepressants and the lack of activation of the Hypothalamic-Pituitary-Adrenal (HPA) axe. We discuss future steps to test this hypothesis and the consequences for psychotherapeutic treatment.</p>","PeriodicalId":44262,"journal":{"name":"Research in Psychotherapy-Psychopathology Process and Outcome","volume":"23 1","pages":"421"},"PeriodicalIF":2.7,"publicationDate":"2020-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4081/ripppo.2020.421","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38463914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using exercise to protect physical and mental health in youth at risk for psychosis.","authors":"Joseph Firth, Felipe Schuch, Vijay A Mittal","doi":"10.4081/ripppo.2020.433","DOIUrl":"10.4081/ripppo.2020.433","url":null,"abstract":"<p><p>A large body of literature has demonstrated that exercise interventions can improve a broad range of outcomes in people with established schizophrenia, including reducing psychiatric symptoms, increasing cognitive functioning, and improving physical health. Furthermore, these benefits seem just as pronounced in first-episode psychosis. However, there have been few clinical studies to date examining the effects of exercise in those found to be 'at-risk' of psychosis, particularly for those meeting the criteria for 'Clinical High Risk' (CHR) state (a classification which includes both those meeting the 'ultra-high risk for psychosis' criteria and/or those with 'atrisk mental states'). This is surprising, as a proportion of those in the CHR state go on to develop psychotic disorders, and a growing body of evidence suggests that early interventions in this period have significant potential to improve the course of illness. In this article, we shall review the existing literature for i) exercise as an adjunctive intervention for those treated for psychosis; ii) exercise as a standalone intervention in CHR groups; and iii) the rationale and supportive evidence for widescale use of exercise to preserve physical and mental health in those identified as at risk for psychosis. From this, we will put forth how the CHR phase represents an under-researched but highly-suitable timepoint for administering structured exercise interventions, in order to improve physical, psychological and neurocognitive outcomes; while also potentially reducing the odds of transition to full-threshold psychotic disorders. Following this, directions, recommendations and considerations around both the clinical implementation and future research around exercise in CHR individuals will be discussed.</p>","PeriodicalId":44262,"journal":{"name":"Research in Psychotherapy-Psychopathology Process and Outcome","volume":"23 1","pages":"433"},"PeriodicalIF":1.6,"publicationDate":"2020-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b6/cb/ripppo-23-1-433.PMC7451351.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38366269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical profile, conversion rate, and suicidal thinking and behaviour in children and adolescents at ultra-high risk for psychosis: a theoretical perspective.","authors":"Maria Pontillo,&nbsp;Maria Cristina Tata,&nbsp;Roberto Averna,&nbsp;Prisca Gargiullo,&nbsp;Silvia Guerrera,&nbsp;Stefano Vicari","doi":"10.4081/ripppo.2020.455","DOIUrl":"https://doi.org/10.4081/ripppo.2020.455","url":null,"abstract":"<p><p>Over the past years there has been substantial growing interest in the prodromes of psychosis to identify individuals at risk for psychosis prior to their first psychotic episode. Researchers have proposed criteria to detect young adults at Ultra-High Risk (UHR) for psychosis, and these criteria have also been applied to children and adolescents, though few clinical studies have examined this population. This theoretical perspective presents some of the crucial issues in the assessment and treatment of UHR children and adolescents: the presence of a specific clinical profile (<i>i.e</i>., different to that of healthy controls and UHR young adults), the predictive value of UHR criteria, and the presence and clinical significance of suicidal thinking and behaviour. In UHR children and adolescents, like UHR young adults, the presence of Attenuated Psychotic Symptoms (APS) is the most frequently reported inclusion criterion at baseline, with a prevalence of approximately 89-100%. In addition, there are frequently non-psychotic comorbid diagnoses of depressive and anxiety disorders. In contrast to the UHR adult population, UHR children and adolescents demonstrate a lower conversion rate to frank psychosis, most likely due to their high rate of APS. Finally, UHR adolescents report a high prevalence of suicidal ideation and self-injurious behaviour (67.5%), as well as a significantly greater frequency of attempted suicide, relative to adolescents with frank psychosis. On this basis, UHR children and adolescents report a clinical complexity that should be carefully monitored and considered for specific and targeted therapeutic interventions to be planned and developed.</p>","PeriodicalId":44262,"journal":{"name":"Research in Psychotherapy-Psychopathology Process and Outcome","volume":"23 1","pages":"455"},"PeriodicalIF":2.7,"publicationDate":"2020-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4081/ripppo.2020.455","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38366275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical presentation and need for treatment of a cohort of subjects accessing to a mental illness prevention service.","authors":"Marco Solmi,&nbsp;Mara Campeol,&nbsp;Federica Gentili,&nbsp;Angela Favaro,&nbsp;Carla Cremonese","doi":"10.4081/ripppo.2020.434","DOIUrl":"https://doi.org/10.4081/ripppo.2020.434","url":null,"abstract":"<p><p>Outreaching activities decrease prognostic accuracy of at-risk mental state defining tools, over-attracting subjects who are not at increased risk of mental illness. The setting was a mental illness primary indicated prevention outpatients service embedded within the Psychiatry Unit of Padua University Hospital, Italy. Help-seeking patients accessing the service between January 2018 and December 2018 were evaluated with validated tools assessing functioning, at-risk mental state, schizotypal personality features, depressive and anxious symptoms, together with medical and family history collection. The primary outcome was the prevalence of drop in functioning at presentation according to the Social and Occupational Functioning Assessment Scale (SOFAS). Secondary outcomes were diagnoses according to DSM-5 criteria and meeting criteria for at-risk mental state. Fifty-nine patients accessed the service, mean age was 18.8 (2.12) years old, 54.2% were females. Virtually all subjects (97.7%) had a drop in functioning. Baseline primary diagnoses were depressive episode in 33%, anxiety disorder in 21%, personality disorder in 17%, adjustment disorder 9%, conduct disorder 7%, schizophrenia spectrum disorder 5%, bipolar disorder 5%, eating disorder in 1.7%, dissociative disorder 1.7%. Overall, 59.1% met at-risk mental state criteria. Lower functioning was associated with anxious symptoms (p=0.031), a family history of mental illness (p=0.045) and of suicide (p=0.042), and schizotypal personality traits (p=0.036). Subjects accessing a prevention service embedded within the mental health department already present a trans-diagnostic drop in functioning, mainly due to a non-psychotic mental disorder, with at-risk mental state in one patient out of two, and schizophrenia or bipolar disorder already present in only 10% of subjects. Prevention service within mental health facility setting appears to properly detect subjects in need of treatment with a drop in functioning, at risk of developing severe mental illness, without any outreaching activity in the general population.</p>","PeriodicalId":44262,"journal":{"name":"Research in Psychotherapy-Psychopathology Process and Outcome","volume":"23 1","pages":"434"},"PeriodicalIF":2.7,"publicationDate":"2020-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4081/ripppo.2020.434","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38366270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anxiety sensitivity dimensions in young individuals with at-risk-mental states.","authors":"Andrea Pozza,&nbsp;Anna Meneghelli,&nbsp;Maria Meliante,&nbsp;Luisa Amato,&nbsp;Davide Dèttore","doi":"10.4081/ripppo.2020.431","DOIUrl":"https://doi.org/10.4081/ripppo.2020.431","url":null,"abstract":"<p><p>Anxiety Sensitivity (AS) is a transdiagnostic risk factor involved in the development and maintenance of different psychopathological conditions including anxiety disorders and psychosis. It consists of Physical Concerns (<i>e.g</i>., the belief that palpitations lead to a cardiac arrest), Social Concerns (the belief that observable anxiety reactions will elicit social rejection), and Cognitive Concerns (the belief that cognitive difficulties lead to mental incapacitation). No study investigated whether specific AS dimensions are related to At-Risk Mental States (ARMS). This study compared AS dimensions between young individuals with ARMS, patients after a recently occurred First-Episode Psychosis (FEP) and matched community controls. Based on models of ARMS and previous evidence, it was hypothesized that ARMS individuals have higher physical, social and cognitive concerns than FEP patients and controls. Thirty individuals with ARMS and 30 with FEP and 30 controls recruited from the general population completed the Anxiety Sensitivity Index-3 (ASI-3) and Penn State Worry Questionnaire. ARMS and FEP individuals had higher scores than controls on ASI-3 Cognitive Concerns [<i>F₍</i> _2,87)= 11.48, <i>p</i><.001]. Individuals with ARMS had higher ASI-3 Physical Concerns scores than FEP patients [<i>F₍</i> _2,87)= 5.10, <i>p</i><.01] and at a marginal significance level than controls. No between-group difference was found on Social Concerns. Higher ASI-3 Physical Concerns scores [<i>B</i> = -.324, Wald's <i>χ²</i> ₍₁₎ = 8.29, <i>p</i> < .01] and psychiatric comorbidities [<i>B</i> = -2.726, Wald's <i>χ²</i> ₍₁₎ = 9.33, <i>p</i> < .01] were significantly related to ARMS than FEP. Higher ASI-3 Social Concerns scores were related to FEP, despite at a marginal significance level [<i>B</i> =.213, Wald's <i>χ²</i> ₍₁₎ = 3.79, <i>p</i> = .052]. Interventions for AS Cognitive/Physical Concerns could be incorporated in the treatment of ARMS. A replication of the findings is required. Future longitudinal studies should examine whether Cognitive Concerns predict development of FEP in ARMS to improve early detection and prevention strategies.</p>","PeriodicalId":44262,"journal":{"name":"Research in Psychotherapy-Psychopathology Process and Outcome","volume":"23 1","pages":"431"},"PeriodicalIF":2.7,"publicationDate":"2020-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4081/ripppo.2020.431","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38463915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychometric properties of the Italian version of the Experience in Close Relationship Scale 12 (ECR-12): an exploratory structural equation modeling study.","authors":"Agostino Brugnera,&nbsp;Cristina Zarbo,&nbsp;Benedetto Farina,&nbsp;Angelo Picardi,&nbsp;Andrea Greco,&nbsp;Gianluca Lo Coco,&nbsp;Giorgio A Tasca,&nbsp;Samantha Carlucci,&nbsp;Adalberto Auteri,&nbsp;Francesco Greco,&nbsp;Angelo Compare","doi":"10.4081/ripppo.2019.392","DOIUrl":"https://doi.org/10.4081/ripppo.2019.392","url":null,"abstract":"<p><p>The Experiences in Close Relationship Scale (ECR) is one of the most commonly used self-report instruments of adult attachment and has been widely adopted in psychotherapy research. Composed of two subscales, namely Attachment Avoidance and Anxiety, the ECR was recently shortened to a 12-items version, called the ECR-12. Given the importance of extending knowledge on its applicability in understudied populations, our aim was to validate the ECR-12 in a large sample of Italian native-speakers. A total of 1197 participants (73.2% females; mean age=28.53±11.37 years) completed the ECR-12. Each participant also completed other measures of attachment, psychopathology, interpersonal distress, coping strategies, and well-being. An Exploratory Structural Equation Modeling analysis showed an excellent fit of the data, providing support for the two-dimensional orthogonal structure of the ECR-12. In addition, the measurement model was invariant across genders. Both attachment anxiety and attachment avoidance subscales demonstrated good internal reliability, with McDonald's Omegas and Cronbach's Alphas above the suggested 0.8 cut-off. Finally, the Italian version of ECR-12 showed adequate convergent, concurrent, and divergent validity. Highly anxious individuals reported the highest levels of maladaptive interpersonal functioning and coping strategies, resulting in lower well-being. Interestingly, both attachment insecurity dimensions predicted higher levels of psychopathology, even after controlling for demographic variables and levels of self-reported relational difficulties. Given the good psychometric properties of the ECR-12, researchers and practitioners in Italy are encouraged to adopt the ECR-12 in their future research on adult attachment in psychotherapy.</p>","PeriodicalId":44262,"journal":{"name":"Research in Psychotherapy-Psychopathology Process and Outcome","volume":"22 3","pages":"392"},"PeriodicalIF":2.7,"publicationDate":"2019-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4081/ripppo.2019.392","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38366405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transference interpretations as predictors of increased insight and affect expression in a single case of long-term psychoanalysis.","authors":"Yasemin Sohtorik İlkmen,&nbsp;Sibel Halfon","doi":"10.4081/ripppo.2019.408","DOIUrl":"https://doi.org/10.4081/ripppo.2019.408","url":null,"abstract":"<p><p>Improved insight and affect expression have been associated with specific effects of transference work in psychodynamic psychotherapy. However, the micro-associations between these variables as they occur within the sessions have not been studied. The present study investigated whether the analyst's transference interpretations predicted changes in a patient's insight and emotion expression in her language during the course of a long-term psychoanalysis. 449 thematic units from 30 sessions coming from different years of psychoanalysis were coded by outside raters for analyst's use of transference interpretations using Transference Work Scale, and patient's insight, positive emotions, anger and sadness were calculated using the Linguistic Inquiry and Word Count System. Multilevel modeling analyses indicated that transference interpretations positively predicted patient's insight and positive emotion words and negatively predicted anger and sadness. The qualitative micro-analyses of selected sessions showed that the opportunity to explore negative emotions within the transference relationship reduced the patient's avoidance of such feelings, generated insight into negative relational patterns, and helped form more balanced representations of self and others that allowed for positive feelings. The findings were discussed for clinical implications and future research directions.</p>","PeriodicalId":44262,"journal":{"name":"Research in Psychotherapy-Psychopathology Process and Outcome","volume":"22 3","pages":"408"},"PeriodicalIF":2.7,"publicationDate":"2019-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4081/ripppo.2019.408","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38366409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An unavoidable bump: A meta-synthesis of psychotherapists' experiences of navigating therapy while pregnant.","authors":"Carrie Way,&nbsp;Carolien Lamers,&nbsp;Renee Rickard","doi":"10.4081/ripppo.2019.386","DOIUrl":"https://doi.org/10.4081/ripppo.2019.386","url":null,"abstract":"<p><p>Despite psychotherapists' pregnancy being a common occurrence with recognised impacts for both clients and clinicians, there remains a dearth of empirical qualitative investigations into the lived experiences of these health professionals. This meta-synthesis therefore aims to generate novel insights and understandings of the experiences of 157 pregnant therapists by integrating the research findings of thirteen qualitative studies exploring the experiences of pregnant and newly post-partum psychotherapists. Utilising Noblit and Hare's (1988) meta-ethnographic approach, papers were analysed with a view to capturing shared experiences across studies, alongside points of divergence. Analysis led to the development of four key concepts: Identity Changes, Pregnancy necessitates Disclosure, Therapeutic Challenges and Guilt. Pregnancy was related to a multitude of personal and professional challenges, with the impact being most pronounced in the accounts of primiparous, child and trainee therapists. Key clinical implications include the need for continued exploration of the therapeutic impact of pregnancy in both supervision and therapy, revisions to supervisory working practices, prompt disclosure of therapist pregnancy and subsequent reductions to therapeutic fidelity. Future research directions are discussed within.</p>","PeriodicalId":44262,"journal":{"name":"Research in Psychotherapy-Psychopathology Process and Outcome","volume":"22 3","pages":"386"},"PeriodicalIF":2.7,"publicationDate":"2019-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4081/ripppo.2019.386","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38366404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}