AMERICAN JOURNAL OF PSYCHOTHERAPY最新文献

{"title":"Childhood Trauma and Panic Disorder: The Impact of History of Child Abuse on Illness Severity and Treatment Response.","authors":"Sarah J Kay, John R Keefe, Barbara L Milrod, Jacques P Barber","doi":"10.1176/appi.psychotherapy.20230060","DOIUrl":"10.1176/appi.psychotherapy.20230060","url":null,"abstract":"<p><strong>Objective: </strong>Patients who have experienced child abuse often have complex clinical presentations; whether a history of child abuse (HCA) affects psychotherapy outcomes is unclear. The authors examined relationships between HCA, clinical baseline variables, and change in these variables after three different psychotherapies for panic disorder (PD).</p><p><strong>Methods: </strong>Two hundred adults with PD (with or without agoraphobia) were randomly assigned to one of three treatments across two sites: panic-focused psychodynamic psychotherapy (PFPP), cognitive-behavioral therapy (CBT), or applied relaxation training (ART). Differences in demographic and clinical variables between those with and without HCA were compared. The primary analysis addressed odds of meeting clinical response criteria on the Panic Disorder Severity Scale (PDSS) between treatments, as moderated by HCA. This effect was examined via continuous outcomes on the PDSS and psychosocial functioning (Sheehan Disability Scale).</p><p><strong>Results: </strong>Compared with patients without HCA (N=154), patients with HCA (N=46) experienced significantly more severe symptoms of PD (d=0.60), agoraphobia (d=0.47), and comorbid depression (d=0.46); significantly worse psychosocial impairment (d=0.63) and anxiety sensitivity (d=0.75); greater personality disorder burden (d=0.45)-particularly with cluster C disorders (d=0.47)-and more severe interpersonal problems (d=0.54). HCA significantly moderated the likelihood of clinical response, predicting nonresponse to ART (B=-2.05, 95% CI=-4.17 to -0.30, OR=0.13, z=-2.14, p=0.032) but not CBT or PFPP. HCA did not interact with treatment condition to predict slopes of PDSS change.</p><p><strong>Conclusions: </strong>The results of this study highlight the importance of HCA in formulating treatment recommendations. Increased awareness of HCA's effects on severity of PD and treatment responsiveness among patients with PD may improve outcomes.</p>","PeriodicalId":46822,"journal":{"name":"AMERICAN JOURNAL OF PSYCHOTHERAPY","volume":" ","pages":"112-118"},"PeriodicalIF":2.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141894534","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":"Compassion-Focused Therapy for the Treatment of <i>ICD-11</i>-Defined Complex Posttraumatic Stress Disorder.","authors":"Michaela B Swee, Allison G Corman, Jessica M Margolis, Alexandra M Dick","doi":"10.1176/appi.psychotherapy.20230019","DOIUrl":"10.1176/appi.psychotherapy.20230019","url":null,"abstract":"<p><p>The most effective treatments for <i>ICD-11</i>-defined complex posttraumatic stress disorder (CPTSD) remain unknown. Further research is needed to determine whether such treatments for CPTSD are the same as or different from-or require integration with-existing gold standard treatments for posttraumatic stress disorder (PTSD). Individuals with CPTSD experience the hallmark symptoms of PTSD (i.e., reexperiencing symptoms, avoidance symptoms, and the pervasive sense of perceived threat) and pervasive disturbances in self-organization, including affective dysregulation, negative self-concept, and difficulties with interpersonal relationships. Compassion-focused therapy (CFT) is a transdiagnostic approach that was originally developed to treat shame and self-criticism. CFT helps individuals learn how to regulate their emotions, shift their emotional response style from shaming and self-critical to wise and understanding, and engage in more compassionate and rewarding patterns of relating to self and others. This article describes CFT's possible application in the treatment of CPTSD and delineates areas for future research.</p>","PeriodicalId":46822,"journal":{"name":"AMERICAN JOURNAL OF PSYCHOTHERAPY","volume":" ","pages":"135-140"},"PeriodicalIF":2.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140853135","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":"Should Psychotherapy Be Approved and Prescribed Like a Drug?","authors":"Holly A Swartz, Lauren M Bylsma Ph D","doi":"10.1176/appi.psychotherapy.20240015","DOIUrl":"https://doi.org/10.1176/appi.psychotherapy.20240015","url":null,"abstract":"","PeriodicalId":46822,"journal":{"name":"AMERICAN JOURNAL OF PSYCHOTHERAPY","volume":"77 2","pages":"43-45"},"PeriodicalIF":2.5,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141321797","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":"Telehealth-Delivered Radically Open Dialectical Behavior Therapy for Adolescents (RO DBT-A): A Pilot Mixed-Methods Study.","authors":"Molly Fennig, Uchechukwu Agali, Melinda Looby, Kirsten Gilbert","doi":"10.1176/appi.psychotherapy.20230025","DOIUrl":"10.1176/appi.psychotherapy.20230025","url":null,"abstract":"<p><strong>Objective: </strong>Disorders related to overcontrol frequently first appear during adolescence, are highly comorbid, and show limited treatment response, necessitating the adaptation of radically open dialectical behavior therapy (RO DBT; a transdiagnostic treatment targeting overcontrol) for adolescents (RO DBT-A). This study tested the preliminary efficacy of telehealth-delivered RO DBT-A in a heterogeneous clinical sample of youths.</p><p><strong>Methods: </strong>The sample consisted of 20 female participants ages 13-21 with elevated overcontrol; most were White (75%) and non-Hispanic/Latino (80%). RO DBT-A was provided over 20 weeks via skills group and individual sessions (N=13 participants). Participants seeking other treatment or no treatment formed the control group (N=7). Outcomes included self-reported symptoms and overcontrol. Follow-up interviews were analyzed by using inductive, contextualist thematic analysis to examine participant perceptions and reasons for dropout.</p><p><strong>Results: </strong>The RO DBT-A group showed significant improvements in depression (t=-1.78, df=10, p=0.011) and quality of life (QOL; Wilcoxon W=75, p=0.021) compared with the control group. From baseline to posttreatment, youths receiving RO DBT-A demonstrated significant improvements in maladaptive overcontrol (t=2.76, df=12, p=0.043), anxiety (t=2.91, df=12, p=0.043), depression (Wilcoxon signed rank V=82.5, p=0.043), and QOL (t=-3.01, df=12, p=0.043). Qualitative analysis revealed themes related to treatment barriers, facilitators, and timing.</p><p><strong>Conclusions: </strong>The findings provide preliminary evidence supporting telehealth-delivered RO DBT-A in targeting overcontrol, decreasing symptomatology, and improving QOL in a heterogeneous clinical sample of youths. Qualitative follow-ups highlighted that dropout was driven by barriers related to therapy (e.g., structure- and therapist-related issues) and the timing of RO DBT-A compared with other treatments.</p>","PeriodicalId":46822,"journal":{"name":"AMERICAN JOURNAL OF PSYCHOTHERAPY","volume":" ","pages":"46-54"},"PeriodicalIF":2.3,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11325626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140177157","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":"Psychotherapies at a Glance: Consensus Guideline-Recommended Psychotherapies for Adults With Psychiatric Disorders.","authors":"Paula Ravitz, Luis E Flores, Danielle Novick, Priya Watson, Holly A Swartz","doi":"10.1176/appi.psychotherapy.20230004","DOIUrl":"10.1176/appi.psychotherapy.20230004","url":null,"abstract":"<p><p>Clinical decision making by psychiatrists and informed consent by patients require knowledge of evidence-based psychotherapies (EBPs) and their indications. However, many mental health professionals are not versed in the empirical literature on EBPs or the consensus guideline recommendations derived from this literature. The authors compared rigorous national consensus guidelines for EBP treatment of <i>DSM</i>-defined adult psychiatric disorders-derived from well-conducted randomized controlled trials and meta-analyses and from expert opinions from the United States, United Kingdom, and Canada-to create the Psychotherapies-at-a-Glance tool. Recommended EBPs are cognitive-behavioral therapy, family therapy, contingency management, dialectical behavior therapy, eye movement desensitization reprocessing, interpersonal psychotherapy, mentalization-based treatment, motivational interviewing, peer support, problem-solving therapy, psychoeducation, short-term psychodynamic psychotherapy, and 12-step facilitation. The Psychotherapies-at-a-Glance tool summarizes the indications, rationales, and therapeutic tasks that characterize these differing psychotherapies and psychosocial treatments. The tool is intended for use in clinical teaching, treatment planning, and patient communications.</p>","PeriodicalId":46822,"journal":{"name":"AMERICAN JOURNAL OF PSYCHOTHERAPY","volume":" ","pages":"79-87"},"PeriodicalIF":2.3,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140132800","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":"Let's Stay Together: The Case for Keeping Couples and Family Therapy in the Training Curriculum.","authors":"Natalie Szykowny, Csilla Lippert, Dexter Louie, Kayla Jimenez, Douglas Rait","doi":"10.1176/appi.psychotherapy.20230017","DOIUrl":"10.1176/appi.psychotherapy.20230017","url":null,"abstract":"","PeriodicalId":46822,"journal":{"name":"AMERICAN JOURNAL OF PSYCHOTHERAPY","volume":" ","pages":"99-100"},"PeriodicalIF":2.3,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140029273","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":"Addressing Dissociated Representations of Self and Others in the Treatment of Posttraumatic Syndromes.","authors":"Fredric N Busch","doi":"10.1176/appi.psychotherapy.20230028","DOIUrl":"10.1176/appi.psychotherapy.20230028","url":null,"abstract":"","PeriodicalId":46822,"journal":{"name":"AMERICAN JOURNAL OF PSYCHOTHERAPY","volume":" ","pages":"95-98"},"PeriodicalIF":2.5,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139730730","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":"Differential Effectiveness of Open Versus Closed Psychotherapy Groups: A Systematic Review.","authors":"Meike Südmeier, Beate Muschalla Prof Dr","doi":"10.1176/appi.psychotherapy.20230026","DOIUrl":"10.1176/appi.psychotherapy.20230026","url":null,"abstract":"<p><strong>Objective: </strong>This systematic review aimed to provide an overview of the state of research on the effectiveness of open versus closed psychotherapy groups, from the beginning of empirical research on these groups to the present.</p><p><strong>Methods: </strong>A literature search in seven databases and a supplementary search of the reference lists of 23 relevant articles were conducted between August 2022 and October 2023. Seventy-two articles were identified and screened for eligibility.</p><p><strong>Results: </strong>Twenty-seven articles met the inclusion criteria and were included in the review. Outcomes are reported by study design (randomized controlled trial, quasi-experimental, descriptive). Information on each study's sample, setting, types of groups, process versus outcome measures, and outcome evaluation is provided. Findings suggest that open and closed psychotherapy groups have the same effect on reducing symptoms of mental disorders. Perception of group cohesion was phase dependent in closed group therapies, whereas cohesion was perceived as more constant in open group therapies.</p><p><strong>Conclusions: </strong>The question of how group therapy format may affect therapeutic outcomes and processes has been posed over the past 50 years, but trials are heterogeneous and robust conclusions cannot be made. Systematic research on the differential effectiveness of open versus closed psychotherapy groups is scarce. On the basis of empirical findings to date, no global superiority of either open or closed group therapy exists. Open and closed group therapies are equally effective, presumably because of different effect factors. An indication for open or closed group therapy must be made according to clinical requirements on a case-by-case basis.</p>","PeriodicalId":46822,"journal":{"name":"AMERICAN JOURNAL OF PSYCHOTHERAPY","volume":" ","pages":"55-70"},"PeriodicalIF":2.3,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140917204","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":"Rapid-Access Focused Treatment: Clinical Considerations for Brief Psychotherapy in Outpatient Psychiatry.","authors":"Christina Wilkens Laird, Amy Sholler Dreier","doi":"10.1176/appi.psychotherapy.20230030","DOIUrl":"10.1176/appi.psychotherapy.20230030","url":null,"abstract":"<p><p>Demand for mental health treatment surged after the COVID-19 pandemic intensified existing issues of limited access to care and long wait times. Programs that deliver high-quality treatment in a brief format are appealing in that they could reduce wait times for care and increase the number of patients served. The Rapid-Access Focused Treatment (RAFT) program was developed with the overarching goals of delivering brief, evidence-informed interventions in a timely and patient-centered manner, reducing wait times, and improving access to psychiatric specialty services. In this article, the authors describe the pilot implementation of the RAFT program in an outpatient psychiatry clinic, provide guidelines for identification of appropriate patients, and discuss lessons learned from two case examples that illustrate variations in the trajectory of brief treatment. Recommendations for the effective implementation of brief therapy models in an outpatient setting are provided.</p>","PeriodicalId":46822,"journal":{"name":"AMERICAN JOURNAL OF PSYCHOTHERAPY","volume":" ","pages":"88-94"},"PeriodicalIF":2.3,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141065845","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":"Microlevel Clinical Decision Making: Challenges and Suggestions to Support Early-Career Clinicians Across Care Contexts.","authors":"Benjamin M Isenberg, Katherine Venturo-Conerly","doi":"10.1176/appi.psychotherapy.20230005","DOIUrl":"10.1176/appi.psychotherapy.20230005","url":null,"abstract":"","PeriodicalId":46822,"journal":{"name":"AMERICAN JOURNAL OF PSYCHOTHERAPY","volume":" ","pages":"39-41"},"PeriodicalIF":2.5,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49693083","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}