Counselling & Psychotherapy Research最新文献

{"title":"What is the Role of Crisis Pregnancy Counselling in Ireland Post-Liberalisation of Abortion Law?","authors":"Éadaoin M. Butler,&nbsp;Meg Ryan,&nbsp;Kate Antosik-Parsons,&nbsp;Frédérique Vallières,&nbsp;Catherine Conlon","doi":"10.1002/capr.70029","DOIUrl":"https://doi.org/10.1002/capr.70029","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims/Background</h3>\u0000 \u0000 <p>The Regulation of Information (Services Outside the State for Termination of Pregnancies) Act 1995 stipulated that information about abortion services available outside Ireland had to be provided in the context of one-to-one counselling alongside information about parenting and adoption. Provision of this information fell largely to crisis pregnancy counselling (CPC) services. However, little attention has been paid to the role of CPC since the liberalisation of Irish abortion law in 2019.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design/Methods</h3>\u0000 \u0000 <p>The present study entails secondary analysis of data gathered from two qualitative interview-based studies (one with 58 people accessing abortion care in Ireland post-2019 and one with seven counsellors with experience of providing CPC pre- and post-2019) and asks ‘What is the role of CPC in Ireland post-liberalisation of Irish abortion law?’.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The accounts of CPC providers demonstrated a belief that public perception of the service was that it was solely related to abortion. People accessing abortion care viewed CPC as primarily associated with decision-making support, support largely perceived as unnecessary. Nonetheless, they also identified value in CPC both for themselves and others. Perspectives on future directions for CPC were offered.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>While counsellors view CPC as having moved away from pregnancy resolution decision-making, this perception remains prevalent among abortion service users. Greater public awareness efforts are required to communicate to potential service users that CPC is client-led, and not solely focused on abortion-related decision-making. Stronger referral systems between community-based CPC services and hospital-based abortion care are needed. Implications for policy and practice are discussed.</p>\u0000 </section>\u0000 </div>","PeriodicalId":46997,"journal":{"name":"Counselling & Psychotherapy Research","volume":"25 2","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/capr.70029","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144315319","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":"A Profile Analysis of University Counselling Service Dropout and Non-Dropout Students: The Role of Epistemic Trust and Personality Traits","authors":"Costanza Franchini,&nbsp;Gaetano Maria Sciabica,&nbsp;Mara Morelli,&nbsp;Antonio Chirumbolo,&nbsp;Silvia Andreassi,&nbsp;Anna Maria Speranza,&nbsp;Alexandro Fortunato","doi":"10.1002/capr.70027","DOIUrl":"https://doi.org/10.1002/capr.70027","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>University counselling services are a strategic resource for supporting students' psychological well-being. Despite evidence of their effectiveness, little is known about the psychological factors contributing to premature dropout from this kind of intervention. The current study aimed to explore the role of students' maladaptive personality traits and epistemic stances in influencing dropout from a counselling intervention.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>The total sample included 605 university students (<i>M</i>_age = 22.6; SD_age = 3.34) who referred to a university counselling centre. Of these, 174 students (29%) prematurely discontinued the intervention. At intake, participants' maladaptive personality traits and epistemic stances were assessed. A multivariate analysis of covariance (MANCOVA) was conducted to compare psychological profiles of dropouts and non-dropouts, controlling for gender and degree programme.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Dropout students reported significantly higher scores on all five maladaptive personality traits (negative affectivity, detachment, antagonism, disinhibition and psychoticism), as well as on epistemic mistrust and credulity. No significant differences were found in epistemic trust, and no interaction effects emerged between dropout status and gender or degree programme.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>These findings suggest that heightened maladaptive traits and difficulties in epistemic stance may impair engagement with brief counselling. Specifically, mistrust, credulity, and maladaptive traits may reflect relational vulnerabilities that predispose individuals to disengage. Early identification of at-risk profiles could help clinicians tailor interventions to promote engagement and reduce dropout. To this end, addressing personality and epistemic challenges early in the process may foster trust and enhance commitment—even within the time constraints of short-term counselling formats.</p>\u0000 </section>\u0000 </div>","PeriodicalId":46997,"journal":{"name":"Counselling & Psychotherapy Research","volume":"25 2","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144300041","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":"Perceptions of Directive and Nondirective Therapy Statements","authors":"Olivia G. Glasgow,&nbsp;Jeffrey S. Berman","doi":"10.1002/capr.70026","DOIUrl":"https://doi.org/10.1002/capr.70026","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Therapist communication style is one of many factors that may influence the outcome of psychotherapy. Some published research exists on the influence of whether the therapist is using a more or less directive form of speech; however, much of what is available is outdated. The present study assesses directive and nondirective therapist responses to recordings of client concerns.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Participants were randomly assigned to view two stimuli including the different therapist response types and were then asked to rate the therapists on perceived empathy and skill. A repeated-measures analysis of variance was performed to assess differences between perceptions of directive and nondirective therapist responses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The results indicate that male therapists using directive statements were perceived as more skillful and empathic than those using nondirective statements.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The findings of the current study encourage male therapists to utilise directive statements when discussing client concerns, such as providing skill suggestions or therapy homework.</p>\u0000 </section>\u0000 </div>","PeriodicalId":46997,"journal":{"name":"Counselling & Psychotherapy Research","volume":"25 2","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144197260","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":"English as an Additional Language Counsellor Trainees' Experiences and Coping Strategies of Foreign Language Anxiety: A Phenomenological Study","authors":"Yiying Xiong,&nbsp;Liwei Zhao,&nbsp;Japman Kaur Kandola,&nbsp;Linyi Zhang","doi":"10.1002/capr.70021","DOIUrl":"https://doi.org/10.1002/capr.70021","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>With growing linguistic and cultural diversity in the United States, there is a critical need to train counsellors who can provide linguistically and culturally responsive services. English as an Additional Language (EAL) counsellor trainees possess the potential to offer multilingual counselling but frequently experience Foreign Language Anxiety (FLA), which can hinder their counselling self-efficacy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methodology</h3>\u0000 \u0000 <p>This study employed a phenomenological approach to explore the lived experiences of EAL counsellor trainees who encounter FLA. Semi-structured interviews were conducted with 20 participants to understand how these trainees perceive and manage their language-related anxiety within counselling settings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>The analysis revealed four key themes: (1) trainees' appraisal of their FLA experiences, (2) the reframing of FLA by emphasising the advantages of bilingual/multilingual identities, (3) the use of specific coping strategies to manage anxiety, and (4) the outcomes of these strategies on their confidence and professional growth.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Findings highlight the complex emotional and cognitive processes EAL trainees undergo when navigating FLA. Implications are discussed for counselling programmes, educators, and supervisors to better support EAL trainees through culturally attuned training practices that foster resilience and multilingual competence.</p>\u0000 </section>\u0000 </div>","PeriodicalId":46997,"journal":{"name":"Counselling & Psychotherapy Research","volume":"25 2","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144074486","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":"Building the Australian Counselling Profession's Research Capacity for the Future: A Collaborative Strategic Approach","authors":"Nathan Beel,&nbsp;E. A. Cocodia,&nbsp;Katrina Andrews,&nbsp;Stephani Stephens,&nbsp;Sonam Pelden,&nbsp;Shannon Hodges","doi":"10.1002/capr.70022","DOIUrl":"https://doi.org/10.1002/capr.70022","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This paper presents an analysis of the current research landscape within the Australian counselling profession, identifying key challenges and proposing a strategic approach to building research capacity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Problem Statement</h3>\u0000 \u0000 <p>Written by a taskforce of educational leaders, it reports their perceptions and experiences of the multifaceted challenges hindering research development. These challenges encompass the limited pipeline of future doctoral-trained counselling educators, the barriers to promotion opportunities for current counsellor educators, and the impact these deficits may have on the profession overall.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Proposed Solutions</h3>\u0000 \u0000 <p>To address these challenges, the paper proposes a series of targeted strategies aimed at stakeholders across the research ecosystem.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The intention of disseminating these strategies is to support counselling professionals in other regions who may be interested in further development of their own research capacity.</p>\u0000 </section>\u0000 </div>","PeriodicalId":46997,"journal":{"name":"Counselling & Psychotherapy Research","volume":"25 2","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/capr.70022","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143939032","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":"Working Alliances in Counselling and Psychotherapy Incorporating Horse Interactions","authors":"Emma Leigh Pasiuk,&nbsp;Katy Schroeder,&nbsp;Anastasia C. Stellato","doi":"10.1002/capr.70025","DOIUrl":"https://doi.org/10.1002/capr.70025","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The relational bond between client and therapist in mental healthcare, referred to as the working alliance, can influence treatment effectiveness and clinical outcomes. Counselling and psychotherapy that incorporates horse interactions and equine specialists (ES) introduces complex relational dynamics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>To investigate working alliances in these settings, we developed and tested a survey instrument to collect working alliance scores with each team member (mental health provider [MHP], ES, and therapy horses), demographic characteristics, and other service-related variables (e.g., facilitators' working relationship). We used the Working Alliance Inventory—Short Revised (WAI-SR) to measure the working alliance between participants and their MHP and ES and the bond domain with their horse. Items were modified and created to assess the unique roles of ES and horses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A Wilcoxon signed-rank test revealed no significant differences in bond scores between MHP and ES (<i>p</i> = 0.52). Linear regressions indicated that working alliance scores with each team member were positively associated with participants' perceptions of their facilitation team working relationship.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Future research should explore the validity of the instrument and how clients' perceptions of team member relationships influence therapeutic outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":46997,"journal":{"name":"Counselling & Psychotherapy Research","volume":"25 2","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143939033","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":"What Stories Does Routine Outcome Monitoring Tell? Contrasting Psychological Distress Scores With In-Therapy Narratives","authors":"Samantha Zurita-Calderón,&nbsp;Jorge Valdiviezo-Oña,&nbsp;Chris Evans,&nbsp;Clara Paz","doi":"10.1002/capr.70023","DOIUrl":"https://doi.org/10.1002/capr.70023","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The use of outcome measures in psychotherapy has grown substantially as a method for tracking change. However, the exclusive reliance on quantitative measures may neglect contextual and relational factors affecting client experiences. This study explored how therapist perceptions and contextual factors may play a role in the interpretation of routine outcome monitoring (ROM) scores. The aim was to critically examine two therapy cases where ROM scores indicated no reliable change, yet clients demonstrated narrative improvements from the therapist's view.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This naturalistic study was conducted in a university-affiliated psychotherapy centre. Two clients undergoing narrative therapy completed the CORE-OM before therapy and CORE-10 session-by-session to monitor psychological distress. The Reliable Change Index (RCI) was used to assess the statistical significance of CORE-10 score changes. These outcomes were contrasted with information derived from therapist observations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Neither client showed statistically significant or reliable change in psychological distress across therapy. However, the therapist's analysis of clients' narratives revealed significant improvements in self-concept and relational dynamics. Themes such as expected family roles, sociocultural expectations and gender norms were key in shaping clients' experiences of psychological distress.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>ROM scores can be useful for tracking clients' change, but their potential is amplified when integrated within a broader monitoring framework that includes therapist observations, and an understanding of the influence of systemic factors on psychological distress. We advocate for multimodal monitoring in psychotherapy research and practice to address the heterogeneity and diversity of change in therapy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":46997,"journal":{"name":"Counselling & Psychotherapy Research","volume":"25 2","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/capr.70023","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143930247","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":"Feasibility of a Telehealth Intervention for Dementia Carers: Therapist Perspectives","authors":"Alison Walter,&nbsp;Kaylene Kilham,&nbsp;Briony Dow,&nbsp;Penny Rapaport,&nbsp;Gill Livingston,&nbsp;Michelle Kelly","doi":"10.1002/capr.70024","DOIUrl":"https://doi.org/10.1002/capr.70024","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The STrAtegies for RelaTives (START) programme was designed in the United Kingdom to support informal dementia carers. This study was designed to assess therapists' perspectives on the feasibility of START in the Australian healthcare context in terms of its acceptability to therapists (i.e., confidence in delivery, perceived client rapport, and perceived change in client outcomes), its adaptation for delivery via telehealth, and integration with telehealth technologies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Fourteen therapists were randomly allocated to deliver START or cognitive behavioural therapy (CBT) and commenced treatment with 18 carers (START: <i>n =</i> 13 overall, <i>n</i> = 7 via telehealth; CBT: <i>n =</i> 5 overall, <i>n</i> = 3 via telehealth). Mixed methods surveys were used to collect therapists' perspectives on acceptability and integration. Quantitative comparisons were made using independent sample <i>t</i>-tests, and qualitative responses were analysed using a theoretical semantic approach.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Postsession confidence in intervention delivery, but not client rapport or perceived change in client outcomes, was higher for START than CBT (<i>p</i> = 0.034). Postsession change in client outcomes, but not therapist confidence or client rapport, was lower for telehealth delivery (<i>p</i> = 0.043). START was a beneficial experience for therapists, with content fostering carer engagement; however, concerns included a high volume of programme content. While technological issues were thought to have a negative impact on client rapport, telehealth enabled access to care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>START was acceptable to therapists and can be effectively delivered via telehealth. Recourse to telephone-only-based care may reduce the impact of technological issues on acceptability outcomes for therapists.</p>\u0000 </section>\u0000 </div>","PeriodicalId":46997,"journal":{"name":"Counselling & Psychotherapy Research","volume":"25 2","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/capr.70024","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143930235","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":"Dialectical Behaviour Therapy Skills Training and Group Cognitive Behavioural Therapy for Hashimoto's Disease: Data on Quality of Life, Stress and Related Variables From a Randomised Controlled Trial","authors":"Kadriye Slocum,&nbsp;F. Isil Bilican","doi":"10.1002/capr.70020","DOIUrl":"https://doi.org/10.1002/capr.70020","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Recent research suggests that there are aspects of Hashimoto's disease (HD) for which medical treatment may be limited. Medical treatment of HD involves returning thyroid hormone levels to the normal reference range, a condition called euthyroidism. Poor quality of life (QOL), low psychological well-being, depression, anxiety, and stress are among the factors associated with symptoms that persist despite being euthyroid.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Considering these findings, the present study investigated the effects of dialectical behaviour therapy skills training (DBT-ST), group cognitive behavioural therapy (CBT) and a waitlist group on QOL, stress, and related variables in euthyroid HD women (<i>N</i> = 62). Data was collected pre-intervention, post-intervention, and at two-month follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Results demonstrated that the DBT-ST intervention provided statistically significant benefits, while no significant changes occurred in the group CBT and waitlist group. Among the outcome variables, DBT-ST was found to significantly increase the general health domain of QOL, the environmental mastery subscale of psychological well-being, the persistence subscale of emotional reactivity, and the tolerance subscale of distress tolerance, and significantly decrease levels of depression, anxiety, stress, and difficulties in emotion regulation. Economic status was identified as a covariate for anxiety and stress, and body mass index for general health. Considering the effects of covariates, DBT-ST explained the decrease in stress by 10.1%, an additional 2.7% compared to economic status, which explained 7.4% (<i>p</i> &lt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Future research in line with the recommendations of this study may further contribute to the development of HD treatment guidelines.</p>\u0000 </section>\u0000 </div>","PeriodicalId":46997,"journal":{"name":"Counselling & Psychotherapy Research","volume":"25 2","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143925935","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":"Who has the Right to Know? Negotiating Epistemic Authority in Constructionist Therapies","authors":"Ioanna Moraitou,&nbsp;Eleftheria Tseliou","doi":"10.1002/capr.70015","DOIUrl":"https://doi.org/10.1002/capr.70015","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Constructionist therapies challenged therapists’ authority and advocated the non-hierarchical participation of all members of the therapeutic system in the therapeutic dialogue. However, therapy is institutionally constructed as an asymmetrical process, with the therapist being assigned epistemic authority, that is, the right to know, as compared to clients. Accordingly, clients may evoke therapists’ expertise by asking for advice or straightforward diagnostic assessment. Within such a context, a normative conversational pattern is the therapist being the one formulating questions and the client being the one answering such questions. However, clients may deviate from such a pattern by formulating their own questions to the therapist. The present study's aim was to investigate how participants negotiate epistemic authority, in instances where such deviations occur.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Drawing from discursive psychology and conversation analysis, we analysed 19 audiotaped therapy sessions, conducted by 3 therapists following the post-Milan systemic approach.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>By focusing on a conversational pattern where clients address questions to therapists and therapists respond with questions, analysis illustrates the dilemmatic ways in which therapists and clients challenge and affirm epistemic asymmetry. By addressing a question to the therapist, clients appear to resist asymmetry, while at the same time they invoke therapists’ authority, thus challenging therapists’ adherence to constructionist premises. On the other hand, therapists, by replying with questions, seem to restore the normative order of therapeutic conversation, but also resist such an invoking by not responding from a position of authority.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our findings highlight the dilemmatic aspects of epistemic authority negotiation in constructionist therapies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":46997,"journal":{"name":"Counselling & Psychotherapy Research","volume":"25 2","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/capr.70015","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143908979","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}