AMERICAN JOURNAL OF PSYCHOTHERAPY最新文献

{"title":"Exploring Therapeutic Outcomes Through Dyadic Interactions: The Role of Patient-Avatar Dynamics in Avatar Therapy.","authors":"Alexandre Hudon, Sabrina Quilliam, Kingsada Phraxayavong, Stéphane Potvin, Alexandre Dumais","doi":"10.1176/appi.psychotherapy.20240016","DOIUrl":"10.1176/appi.psychotherapy.20240016","url":null,"abstract":"<p><strong>Objective: </strong>Despite the efficacy of current therapies, a significant proportion of patients with schizophrenia, a complex mental disorder marked by both positive (present) and negative (absent) symptoms, are considered to have treatment-resistant schizophrenia. Avatar therapy (AT) allows patients to interact with a three-dimensional representation of their most distressing voices in a virtual reality setting. The therapy shows promise in reducing impairments and improving quality of life through the establishment of a therapeutic alliance and the exploration of dyadic interactions (verbal exchanges) between patients and their avatar. The purpose of this study was to investigate differences in dyadic interactions throughout the immersive sessions of AT and to clarify the relationship between these interactions and therapeutic success by analyzing dyads as predictive indicators of positive outcomes in AT.</p><p><strong>Methods: </strong>Mean frequencies for the 10 most prevalent dyads identified in previous AT research were reported for 35 patients. A logistic regression model was implemented, and these dyads were used to predict variances in Psychotic Symptom Rating Scales-auditory hallucination scores 1 month after the completion of AT.</p><p><strong>Results: </strong>Variances in mean frequencies were reported for the dyads. A positive relation between the avatar (provocation)-patient (self-affirmation) dyad and the therapeutic outcome was found to be significant (OR=2.29, p=0.049).</p><p><strong>Conclusions: </strong>This research is pioneering in its in-depth examination of therapeutic interactions in AT, with a particular focus on dyadic interactions. Future studies should prioritize the quality rather than quantity of these interactions to more accurately forecast their effects on potential indicators of positive outcomes in AT.</p>","PeriodicalId":46822,"journal":{"name":"AMERICAN JOURNAL OF PSYCHOTHERAPY","volume":" ","pages":"238-243"},"PeriodicalIF":2.5,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142839966","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":"Psychotherapy for Delusional Disorder: Theoretical Models and Therapeutic Techniques.","authors":"Timothy Le, Mark L Ruffalo","doi":"10.1176/appi.psychotherapy.20240061","DOIUrl":"10.1176/appi.psychotherapy.20240061","url":null,"abstract":"<p><p>Delusional disorder is a challenging mental health condition given its resistance to conventional treatment with antipsychotic medications. Although patients with delusional disorder often retain good functioning outside of their delusional theme, they often become functionally impaired as delusional ideas become more central in their lives. Psychotherapy represents an important treatment modality for these patients, in that it may be the most effective treatment option to date. Theorists from both the psychodynamic and cognitive-behavioral schools have offered frameworks for understanding and treating delusions and delusional disorder, and both models appear to be useful in working with this difficult-to-treat condition. In this Psychotherapy Tools article, the authors briefly review delusional disorder, assess current research data on its psychodynamic and cognitive-behavioral treatment, and offer practical suggestions for integrating these models from a unified biopsychosocial perspective.</p>","PeriodicalId":46822,"journal":{"name":"AMERICAN JOURNAL OF PSYCHOTHERAPY","volume":" ","pages":"251-255"},"PeriodicalIF":2.5,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267612","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":"Toward Transdisciplinary Quality Measures of Competence in Psychotherapy: Measures to Identify \"Good Enough\" Therapists.","authors":"Joel Yager","doi":"10.1176/appi.psychotherapy.20240054","DOIUrl":"10.1176/appi.psychotherapy.20240054","url":null,"abstract":"<p><strong>Objectives: </strong>Mental health providers who profess competence in psychotherapy include people with M.D.s, Ph.D.s, and Psy.D.s; an assortment of master's-level providers; and advanced practice registered nurses (APRNs). Training requirements and individual training experiences in psychotherapy vary widely across and within these specialties. In this article, the author aims to identify practical approaches that employers and patients can use to identify competent practitioners and weed out those who are ineffective or dangerous.</p><p><strong>Methods: </strong>To supplement clinical observations, a narrative review was conducted that examined systematic and scoping reviews and other articles that have addressed the assessment of competence and quality in psychotherapy practice.</p><p><strong>Results: </strong>Existing measures of competence and quality in psychotherapy practice have largely been developed within, rather than across, mental health disciplines. Psychiatrists have been less involved in these efforts in the 21st century than in prior years, and few studies have explicitly involved APRNs. Most published measures have been based on assorted logs, self-reports, and observations of simulated or actual therapy sessions. After initial development, few have been deployed as ongoing measures for the purpose of screening applicants for psychotherapy positions or quality assurance. All have significant limitations.</p><p><strong>Conclusions: </strong>No available measure of psychotherapy competence has achieved gold-standard status. Several published measures could contribute to quality-assurance efforts. Practically speaking, to assess therapist competence, employers and patients must still largely rely on an assortment of certifications, personal references, and patients' accounts of experiences with their therapists. All these sources are increasingly accessible, thanks to web-based technologies.</p>","PeriodicalId":46822,"journal":{"name":"AMERICAN JOURNAL OF PSYCHOTHERAPY","volume":" ","pages":"216-223"},"PeriodicalIF":2.5,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144875937","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":"The Matryoshka.","authors":"Jonathan Hunter","doi":"10.1176/appi.psychotherapy.20250024","DOIUrl":"10.1176/appi.psychotherapy.20250024","url":null,"abstract":"","PeriodicalId":46822,"journal":{"name":"AMERICAN JOURNAL OF PSYCHOTHERAPY","volume":" ","pages":"258-259"},"PeriodicalIF":2.5,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973549","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":"Acceptance and Commitment Therapy for Posttraumatic Psychopathology: A Group-Based Telehealth Intervention.","authors":"Jordan L Thomas, Julia S Yarrington, Tiffany Chen, Rosalita Benedicto, Jennifer A Sumner, Danielle Keenan-Miller","doi":"10.1176/appi.psychotherapy.20240030","DOIUrl":"10.1176/appi.psychotherapy.20240030","url":null,"abstract":"<p><strong>Objective: </strong>Transdiagnostic treatments are needed to address the diverse manifestations and effects of trauma-related psychopathology. Acceptance and commitment therapy (ACT) is a promising intervention, although little is known about its application among trauma-exposed civilians. A single-arm pilot study evaluated outcomes of a virtual, group-based ACT intervention for trauma delivered through a training clinic.</p><p><strong>Methods: </strong>Five female clients (mean age=42.6 years) with a history of criterion A trauma completed an 11-week skills group and repeated measures assessing posttraumatic and related psychopathology symptoms (e.g., depression, anxiety, posttraumatic stress disorder [PTSD]), emotion regulation, quality of life, posttraumatic growth, and experiential avoidance. Paired-samples t tests were used to assess pre- to postintervention effects.</p><p><strong>Results: </strong>All clients completed the intervention, suggesting high acceptability. Analyses of pre- to postintervention effects demonstrated significant reductions in depression (d<i>=</i>1.16, p=0.03) and anxiety (d=0.95, p=0.05) symptoms but not in PTSD symptoms; effect sizes for significant changes were large. Significant and large increases in effective use of emotion regulation strategies (d<i>=</i>1.02, p=0.04) and posttraumatic growth (d<i>=</i>1.18, p=0.03) were also observed. Experiential avoidance, a hypothesized treatment mechanism in ACT, decreased from pre- to postintervention (d<i>=</i>1.22, p=0.03).</p><p><strong>Conclusions: </strong>Findings provide initial evidence for acceptability and beneficial clinical outcomes of a virtual, group-based ACT intervention to address the transdiagnostic consequences of traumatic stress.</p>","PeriodicalId":46822,"journal":{"name":"AMERICAN JOURNAL OF PSYCHOTHERAPY","volume":" ","pages":"231-237"},"PeriodicalIF":1.7,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12671481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812578","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 Role of Inpatient Psychotherapy in the Treatment of Depression.","authors":"Rachel Bigley","doi":"10.1176/appi.psychotherapy.20240048","DOIUrl":"10.1176/appi.psychotherapy.20240048","url":null,"abstract":"","PeriodicalId":46822,"journal":{"name":"AMERICAN JOURNAL OF PSYCHOTHERAPY","volume":" ","pages":"256-257"},"PeriodicalIF":2.5,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030081","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":"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":"194-215"},"PeriodicalIF":2.5,"publicationDate":"2025-12-15","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":"A Tribute: Habib Davanloo, M.D.","authors":"Alan Beeber, Gerda Gottwik, Sandro Rosseti","doi":"10.1176/appi.psychotherapy.20240055","DOIUrl":"10.1176/appi.psychotherapy.20240055","url":null,"abstract":"","PeriodicalId":46822,"journal":{"name":"AMERICAN JOURNAL OF PSYCHOTHERAPY","volume":" ","pages":"135-136"},"PeriodicalIF":2.5,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606625","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 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":"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":"153-159"},"PeriodicalIF":2.5,"publicationDate":"2025-09-15","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":"Intensive Short-Term Dynamic Psychotherapy for Complex, Chronic, and Treatment-Resistant Conditions.","authors":"Allan Abbass, Joel Town","doi":"10.1176/appi.psychotherapy.20240024","DOIUrl":"10.1176/appi.psychotherapy.20240024","url":null,"abstract":"<p><p>Over the past 50 years, intensive short-term dynamic psychotherapy (ISTDP) has been developed, implemented, and evaluated with respect to the treatment of a broad spectrum of complex, chronic, and treatment-resistant conditions. This therapy was developed specifically to treat a range of patients, including those who are highly defensive, those who experience the repression of emotions, and those who have cognitive-perceptual disruptions along with primitive defenses. These three groups of patients are characterized by patterns of attachment trauma and deficits related to neglect. Among the many categories of mental illness with these features that ISTDP can treat, personality disorders, treatment-resistant depression, and somatic symptoms have been the most frequently studied. In this article, the authors provide an overview of the ISTDP treatment method with regard to complex, chronic, and treatment-resistant conditions and summarize evidence for its effectiveness for diverse patient populations. On the basis of the available evidence, ISTDP warrants consideration as a tool for the management of diverse populations who have chronic and complex conditions and have not responded to other treatments.</p>","PeriodicalId":46822,"journal":{"name":"AMERICAN JOURNAL OF PSYCHOTHERAPY","volume":" ","pages":"160-166"},"PeriodicalIF":2.5,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061099","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}