AMERICAN JOURNAL OF PSYCHOTHERAPY最新文献

{"title":"Residential Intensive Short-Term Dynamic Psychotherapy, Part 2: Long-Term Follow-Up in the Treatment of Personality Disorders.","authors":"Kees L M Cornelissen, Joel M Town, Anna Bartak, Marijke A de Haan, Sten P Willemsen, Jan J V Busschbach","doi":"10.1176/appi.psychotherapy.20240019","DOIUrl":"https://doi.org/10.1176/appi.psychotherapy.20240019","url":null,"abstract":"<p><strong>Objective: </strong>Intensive short-term dynamic psychotherapy (ISTDP) has been shown to be effective with patients with common mental disorders, including personality disorders. In the Netherlands, a 6-month residential version (R-ISTDP) of this traditionally outpatient therapy for patients with treatment-resistant personality disorders was developed and tested. This study focused on changes that occurred directly after treatment and 1-10 years after discharge.</p><p><strong>Methods: </strong>All patients admitted to the R-ISTDP program between 1995 and 2005 were assessed at admission, discharge, and a variable follow-up of 1-10 years. In this single-arm trial, treatment outcome was measured in terms of symptom severity (with the Symptom Checklist-90-R [SCL-90-R]), general functioning (with the Global Assessment of Functioning [GAF] Scale), employment status, social welfare benefits, and living situation. Demographic variables and psychopathology indicators were included as predictors. Because of the variable distribution of length of follow-up, outcome data from 155 patients were evaluated by using mixed-models analysis.</p><p><strong>Results: </strong>From admission to discharge, significant and large improvements were seen in SCL-90-R total scores (d=1.2) and GAF scores (d=0.9). From discharge over the course of 10-year follow-up, SCL-90-R total scores remained stable, and GAF scores further improved (d=1.5). At follow-up 1-10 years after discharge, more patients had returned to work compared with pretreatment. No statistically significant association between any of the predictors and outcome was found.</p><p><strong>Conclusions: </strong>Patients with treatment-resistant personality disorders showed substantial improvements at discharge from R-ISTDP. Although several limitations of this naturalistic study design must be considered, these findings are important in demonstrating stable long-term improvement after R-ISTDP.</p>","PeriodicalId":46822,"journal":{"name":"AMERICAN JOURNAL OF PSYCHOTHERAPY","volume":" ","pages":"appipsychotherapy20240019"},"PeriodicalIF":2.3,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Residential Intensive Short-Term Dynamic Psychotherapy, Part 1: Accelerating the Treatment of Personality Disorders.","authors":"Kees L M Cornelissen, Anna Bartak, Marijke A de Haan, Joel M Town","doi":"10.1176/appi.psychotherapy.20240020","DOIUrl":"https://doi.org/10.1176/appi.psychotherapy.20240020","url":null,"abstract":"<p><p>Intensive short-term dynamic psychotherapy (ISTDP) delivered in an individual therapy (vs. group) format has proved to be an effective treatment option for a broad range of patients with treatment-resistant mental health conditions. A novel residential program based on ISTDP was designed for patients whose personality disorders were treatment resistant (N=155), meaning that patients did not benefit from outpatient psychotherapy. The authors proposed that a specific treatment approach-residential ISTDP-can be a treatment option for patients with personality disorders. This article describes the ideas and characteristic features of how ISTDP was integrated within an innovative residential treatment program to accelerate change processes and reduce health care consumption.</p>","PeriodicalId":46822,"journal":{"name":"AMERICAN JOURNAL OF PSYCHOTHERAPY","volume":" ","pages":"appipsychotherapy20240020"},"PeriodicalIF":2.3,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Considerations for Cross-Cultural Adaptations and Implementation of Interpersonal Psychotherapy: A Review.","authors":"Victoria Papke, Shanze Hayee, Hopewell Hodges, Tori Simenec, Kristina Reigstad, Meredith Gunlicks-Stoessel, Bonnie Klimes-Dougan","doi":"10.1176/appi.psychotherapy.20240017","DOIUrl":"https://doi.org/10.1176/appi.psychotherapy.20240017","url":null,"abstract":"<p><strong>Objective: </strong>Strong social relationships are among the best predictors of mental health, physical health, and longevity, regardless of race or culture. Problems with interpersonal relationships are associated with depression, yet few interventions for depression focus on enhancing social capital. Interpersonal psychotherapy (IPT) and its adaptation for adolescents (IPT-A) are effective, evidence-based treatments for depression aimed at mitigating depressive symptoms by strengthening an individual's interpersonal functioning. Although IPT's efficacy has been established with largely White and middle- and high-income samples, this review highlights studies using IPT and IPT-A to treat depression or depressive symptoms among those affected by marginalization or health disparities around the world. Extensive consideration is given to cultural and contextual adaptations, as well as changes in implementation of the intervention, that the studies may have employed.</p><p><strong>Methods: </strong>A literature search was conducted in three databases. The studies included in the review examined IPT as a treatment for depression and depressive symptoms in communities for whom IPT was not originally validated and who may experience health care disparities (e.g., marginalized communities and low- and middle-income countries).</p><p><strong>Results: </strong>Forty-nine studies that adapted or adjusted implementation processes of IPT and related therapies across cultures were identified and included. Common adaptations and implementations included culturally appropriate changes to language or vernacular, treatment location, and therapist characteristics. Studies generally supported IPT for individuals facing health care disparities.</p><p><strong>Conclusions: </strong>Although initially developed and validated with predominantly White, middle- to high-income samples, IPT and IPT-A may be effective and adaptable interventions across cultural settings, requiring culturally and contextually informed adaptations and adjustments to implementation for optimal success.</p>","PeriodicalId":46822,"journal":{"name":"AMERICAN JOURNAL OF PSYCHOTHERAPY","volume":" ","pages":"appipsychotherapy20240017"},"PeriodicalIF":2.3,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing Suicide Rates for Cognitive Processing Therapy Versus Prolonged Exposure Therapy for Posttraumatic Stress Disorder.","authors":"Jenna A Park, Daniel J Gottlieb, Bradley V Watts, Vincent Dufort, Jamie L Gradus, Brian Shiner","doi":"10.1176/appi.psychotherapy.20240035","DOIUrl":"10.1176/appi.psychotherapy.20240035","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to compare suicide mortality rates for patients receiving two evidence-based psychotherapy (EBP) protocols for posttraumatic stress disorder (PTSD): cognitive processing therapy (CPT) and prolonged exposure (PE).</p><p><strong>Methods: </strong>Suicide mortality was measured among U.S. Department of Veterans Affairs patients with PTSD who received EBP from 2009 through 2019. Regional variation in delivering CPT versus PE was leveraged as an instrumental variable (IV) to compare suicide mortality by using standard adjustment and IV-based analyses.</p><p><strong>Results: </strong>In total, 62,686 patients received EBP for PTSD; 82.4% were male, and the mean±SD age was 46.9±14.4. Patients were followed for a median of 6 years, and there were 136 deaths by suicide (38.3 and 32.4 per 100,000 person-years among the CPT and PE groups, respectively). The regional rate of CPT versus PE delivery was a strong IV that had greater explanatory power for the type of EBP received than all patient factors combined. The standard adjustment model for CPT produced a hazard ratio of 1.25, whereas the reduced-form IV produced a hazard ratio of 1.22. The probit IV, in which relevant covariates were updated annually, produced an odds ratio of 0.99. The time-to-event IV produced a hazard ratio of 1.20. The differences were not significant.</p><p><strong>Conclusions: </strong>No statistically significant difference was found between CPT and PE in the outcome of death by suicide. More effective interventions that result in higher remission rates would likely need to be developed to achieve a relative decrease in suicide risk through PTSD treatment.</p>","PeriodicalId":46822,"journal":{"name":"AMERICAN JOURNAL OF PSYCHOTHERAPY","volume":" ","pages":"96-102"},"PeriodicalIF":2.3,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12167692/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606626","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":"The Private Loss of Dr. M.","authors":"Anita Kumar Chang","doi":"10.1176/appi.psychotherapy.20240058","DOIUrl":"10.1176/appi.psychotherapy.20240058","url":null,"abstract":"","PeriodicalId":46822,"journal":{"name":"AMERICAN JOURNAL OF PSYCHOTHERAPY","volume":" ","pages":"79-80"},"PeriodicalIF":2.3,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143415821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Repairing Cultural Ruptures in Psychotherapy: Strategies to Enhance the Therapeutic Alliance.","authors":"Nicholas Boswell, Ruby Barghini, Seamus Bhatt-Mackin, Aimee Murray, David Topor, Alyson Nakamura, Laurel Pellegrino, Anne E Ruble","doi":"10.1176/appi.psychotherapy.20240045","DOIUrl":"10.1176/appi.psychotherapy.20240045","url":null,"abstract":"<p><p>Ruptures to the therapeutic alliance are an inevitable part of therapy. The ability to repair these ruptures is an essential therapist skill. Racial, ethnic, and cultural differences between therapists and patients can increase the likelihood of rupture to the therapeutic alliance, potentially leading to unilateral treatment termination by patients. Therapists therefore need skills to work effectively with patients who have diverse, intersectional identities. In this article, the authors give therapists tools to help protect against ruptures and to repair ruptures when they occur by integrating three complementary models: taking a stance of cultural humility to decrease assumptions, identifying and directly broaching cultural topics, and implementing a six-stage cultural repair model. A case example is used to illustrate these tools and techniques in practice. These skills can improve collaboration and decrease the inherent power imbalance in the therapeutic relationship.</p>","PeriodicalId":46822,"journal":{"name":"AMERICAN JOURNAL OF PSYCHOTHERAPY","volume":" ","pages":"119-123"},"PeriodicalIF":2.3,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How to Cope in 2025: Advice From a Holocaust Survivor.","authors":"Holly A Swartz","doi":"10.1176/appi.psychotherapy.20250029","DOIUrl":"https://doi.org/10.1176/appi.psychotherapy.20250029","url":null,"abstract":"","PeriodicalId":46822,"journal":{"name":"AMERICAN JOURNAL OF PSYCHOTHERAPY","volume":"78 2","pages":"77-78"},"PeriodicalIF":2.3,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychodynamic Psychopharmacology and Christianity: Understanding Patients' Relationships With Medications.","authors":"Spencer M Gardner, Breyauna M Spencer","doi":"10.1176/appi.psychotherapy.20240006","DOIUrl":"10.1176/appi.psychotherapy.20240006","url":null,"abstract":"","PeriodicalId":46822,"journal":{"name":"AMERICAN JOURNAL OF PSYCHOTHERAPY","volume":" ","pages":"128-129"},"PeriodicalIF":2.3,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Practical Psychosocial Management for Patients With Bipolar Disorder.","authors":"David J Miklowitz, Michael J Gitlin","doi":"10.1176/appi.psychotherapy.20240028","DOIUrl":"10.1176/appi.psychotherapy.20240028","url":null,"abstract":"<p><p>The broad acceptance of evidence-based psychosocial interventions as adjuncts to pharmacotherapy for bipolar disorder has been inhibited by the extensive training, supervision, and fidelity requirements of these approaches. Interventions that emphasize evidence-based strategies drawn from these modalities-rather than the full manualized protocols-may broaden the availability of psychotherapy for patients with bipolar disorder. In this article, psychosocial risk factors relevant to the course of bipolar disorder (stressful life events that disrupt social rhythms, lack of social support, family criticism and conflict, and lack of illness awareness or literacy) are reviewed, along with evidence-based psychosocial interventions (e.g., interpersonal and social rhythm therapy, cognitive-behavioral therapy, family-focused therapy, and group psychoeducation) to address these risk factors. The results of a component network meta-analysis of randomized psychotherapy trials in bipolar disorder are discussed. Manualized psychoeducation protocols-especially those that encourage active skill practice and mood monitoring in a family or group format-were found to be more effective, compared with individual psychoeducation or routine care, in reducing 1-year recurrence rates. Cognitive restructuring, regulation of daily and nightly routines, and communication skills training were core components associated with stabilization of depressive symptoms. The authors describe a novel psychoeducational approach-practical psychosocial management (PPM)-that integrates these core strategies into the personalized care of patients with bipolar disorder to reduce recurrences and enhance mood stability. PPM is designed to be implemented, without time-intensive training and oversight, by physician or nonphysician clinicians. Evaluating the efficacy and coverage of PPM will require implementation trials in community settings.</p>","PeriodicalId":46822,"journal":{"name":"AMERICAN JOURNAL OF PSYCHOTHERAPY","volume":" ","pages":"81-87"},"PeriodicalIF":2.3,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dialectical Behavior Therapy for Adolescents: Examining Preliminary Pretreatment Expectations and Preferences.","authors":"Hilary B Vidair, Jill H Rathus, Chani Goldfeder, Erika Rooney, Katerina Levy, Alexander Dorfman","doi":"10.1176/appi.psychotherapy.20230058","DOIUrl":"10.1176/appi.psychotherapy.20230058","url":null,"abstract":"<p><strong>Objective: </strong>Dialectical behavior therapy for adolescents (DBT-A) is an evidence-based treatment for adolescents with multiple emotional and behavioral problems. Research has demonstrated the posttreatment acceptability of DBT-A by parents and adolescents. However, no study has systematically explored the expectations and preferences of adolescents before beginning DBT-A treatment. The goals of this study were to investigate adolescents' pretreatment expectations for DBT-A by developing the Adolescent Expectancies for Therapy Scale (AETS), adapted from the Parent Expectancies for Therapy Scale, and to explore their preferences regarding treatment delivery format.</p><p><strong>Methods: </strong>Participants were 21 adolescents (ages 13-18) with varying race-ethnicities who were referred for DBT-A in either a group private practice or a community mental health clinic. Participants completed the AETS and the Preferences Rating Form, which examined the extent to which participants preferred each of seven treatment modifications or preferred to keep DBT-A as is.</p><p><strong>Results: </strong>Findings indicated that, before beginning DBT-A, adolescents had moderate expectations for the outcome and process of the therapy, and approximately half reported that they preferred to be separate from their parents during multifamily skills group sessions (for at least part of the time) and to add weekly teen-only support groups to DBT-A. The AETS had adequate internal consistency (Cronbach's α=0.88).</p><p><strong>Conclusions: </strong>Understanding adolescents' pretreatment expectations and preferences for the format in which DBT-A is delivered can help clinicians better engage adolescents during the intake and orientation process.</p>","PeriodicalId":46822,"journal":{"name":"AMERICAN JOURNAL OF PSYCHOTHERAPY","volume":" ","pages":"88-95"},"PeriodicalIF":2.3,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}