Psychotherapy Research最新文献_第2页

Exploring poor outcome cases in emotion-focused therapy-a mixed-method study. 探讨以情绪为中心的治疗的不良结果案例-一项混合方法研究。

IF 3 1区心理学

Psychotherapy Research Pub Date : 2026-04-15 DOI: 10.1080/10503307.2026.2656706

Jan Reidar Stiegler, Elisabeth Schanche

{"title":"Exploring poor outcome cases in emotion-focused therapy-a mixed-method study.","authors":"Jan Reidar Stiegler, Elisabeth Schanche","doi":"10.1080/10503307.2026.2656706","DOIUrl":"https://doi.org/10.1080/10503307.2026.2656706","url":null,"abstract":"Objective: Poor outcome cases in psychotherapy are prevalent, costly, and understudied. In this study, we wanted to contribute to a better understanding of poor outcome cases in Emotion-Focused Therapy by doing an in-depth exploratory analysis of therapist and client contributions.Methods: Six cases drawn from a randomized clinical study on depression were selected and analyzed using both quantitative process measures, self-report measures, and qualitative investigations. We investigated the working alliance, clients' emotional processing qualities, therapist adherence in applying the model, as well as a qualitative clinical assessment of possible contributions to poor outcome.Results: The results suggest that in five out of six cases, there were unaddressed challenges in the alliance, when it came to defining a clear goal and agreement on tasks. Also, adherence measures suggest that the therapists had difficulties with developing meaningful case formulations and helping clients deepen emotional processes. In the same five out of six cases, clients showed difficulties with emotional processing.Conclusion: It seems like difficulties with establishing an idiosyncratic, meaningful therapeutic project hindered sufficient emotional engagement and processing, contributing to poor outcome. Possible reasons for these challenges, as well as suggestions for what might have mitigated them, are discussed.","PeriodicalId":48159,"journal":{"name":"Psychotherapy Research","volume":" ","pages":"1-17"},"PeriodicalIF":3.0,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Is there an allegiance bias on the efficacy of systemic therapy? A three-level meta- regression analysis. 对全身治疗的疗效是否存在忠诚偏见？三水平元回归分析。

IF 3 1区心理学

Psychotherapy Research Pub Date : 2026-04-13 DOI: 10.1080/10503307.2026.2654029

Niels Braus, Christoph Flückiger, Robin Gräfenkämper, Christian Frankman, Johanna Wichmann, Christina Hunger-Schoppe

{"title":"Is there an allegiance bias on the efficacy of systemic therapy? A three-level meta- regression analysis.","authors":"Niels Braus, Christoph Flückiger, Robin Gräfenkämper, Christian Frankman, Johanna Wichmann, Christina Hunger-Schoppe","doi":"10.1080/10503307.2026.2654029","DOIUrl":"https://doi.org/10.1080/10503307.2026.2654029","url":null,"abstract":"Objective: Allegiance bias affects the reproducibility of psychotherapy outcomes, but its impact in systemic therapy (ST) remains largely unexplored.Method: Two meta-analyses were conducted: Study 1 with 42 RCTs (364 effect sizes) for children and adolescents, as well as Study 2 with 30 RCTs (161 effect sizes) for adults. Allegiance was measured using a comprehensive rating scale across researcher, therapist, trainer, and supervisor levels. Furthermore, risk of bias (RoB) was assessed using the adapted tool for psychotherapy. Three-level meta-regressions were performed, controlling for dosage.Results: No significant moderating effect of the overall allegiance score was found in either study, Study 1: F(2, 361) = .88, p = .42, k = 364, s = 42; Study 2: F(2, 158) = 2.35, p = .10, k = 161, s = 30 . Researcher allegiance predicted higher treatment efficacy in Study 1 (β = .14, p = .02) but not in Study 2 (β = .02, p = .82). A significant moderating effect of RoB emerged in Study 2 (F(8, 151) = 3.02, p = .004, k = 161, s = 30), indicating that higher RoB was associated with larger effects favoring ST. This pattern was absent in Study 1 (F(8,355) = 1.04, p = .41, k = 364, s = 42).Conclusion: The findings underscore the role of researcher allegiance investigating ST for children and adolescents and RoB in ST for adults, highlighting the need for transparent methods and replication efforts.","PeriodicalId":48159,"journal":{"name":"Psychotherapy Research","volume":" ","pages":"1-10"},"PeriodicalIF":3.0,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147677835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Improvement of emotional dysregulation, aggression, and self-harm among people treated within outpatient personality disorder mental health services. A large longitudinal, observational, multi-centre study. 在门诊人格障碍心理健康服务中治疗的人的情绪失调、攻击和自我伤害的改善。一项大型纵向、观察性、多中心研究。

IF 3 1区心理学

Psychotherapy Research Pub Date : 2026-04-10 DOI: 10.1080/10503307.2026.2650154

D A Ulvestad, A Ekberg, J V Bakali, I U-M Eikenæs, J Fjermestad-Noll, E Hjermann, B Hummelen, K T E Morken, E Oftedal, K E Zahl, M Øvrebø, G Pedersen, T Wilberg, E H Kvarstein

{"title":"Improvement of emotional dysregulation, aggression, and self-harm among people treated within outpatient personality disorder mental health services. A large longitudinal, observational, multi-centre study.","authors":"D A Ulvestad, A Ekberg, J V Bakali, I U-M Eikenæs, J Fjermestad-Noll, E Hjermann, B Hummelen, K T E Morken, E Oftedal, K E Zahl, M Øvrebø, G Pedersen, T Wilberg, E H Kvarstein","doi":"10.1080/10503307.2026.2650154","DOIUrl":"https://doi.org/10.1080/10503307.2026.2650154","url":null,"abstract":"Objective: Psychotherapy research addressing emotional dysregulation and personality disorders (PDs) is mainly limited to borderline PD (BPD). This longitudinal study aimed to investigate dysregulation for a broader range of patients treated within PD treatment services and its associations with psychosocial impairment.Method: Quality register data included initial PD status and repeated assessment of emotional dysregulation and psychosocial functioning. Main statistical analyses were based on linear mixed models.Results: In a sample of mixed personality pathology (N = 848, 82% with PD, mean number of criteria 11, SD 6), 75% reported emotional dysregulation, 57% verbal aggression, 49% physical aggression (objects: 31%, people: 19%), and 33% self-harm. Improvement of dysregulation was significant during treatment (mean d = 0.7). BPD, schizotypal PD, and paranoid PD were associated with more severe initial dysregulation and higher improvement rates (BPD mean d = 1.0). Avoidant PD was associated with less initial dysregulation and modest change (mean d = 0.5). Antisocial PD was associated with severe initial dysregulation and little change over time. Poorer psychosocial functioning was at all time points associated with more severe dysregulation.Conclusion: High clinical relevance of emotional dysregulation was demonstrated across PD conditions, including considerable pretreatment problems, strong associations with psychosocial impairment, and significant improvements during treatment.","PeriodicalId":48159,"journal":{"name":"Psychotherapy Research","volume":" ","pages":"1-18"},"PeriodicalIF":3.0,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147655248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Establishing empirically derived non-inferiority margins for large-scale trials: An umbrella review of meta-analytic comparisons of bona fide psychological therapies. 建立大规模试验的经验性非劣效性边际：对真正的心理治疗的meta分析比较的综合回顾。

IF 3 1区心理学

Psychotherapy Research Pub Date : 2026-04-09 DOI: 10.1080/10503307.2026.2653992

Christoph Flückiger, Michael Barkham, Juan Martín Goméz Penedo

{"title":"Establishing empirically derived non-inferiority margins for large-scale trials: An umbrella review of meta-analytic comparisons of bona fide psychological therapies.","authors":"Christoph Flückiger, Michael Barkham, Juan Martín Goméz Penedo","doi":"10.1080/10503307.2026.2653992","DOIUrl":"https://doi.org/10.1080/10503307.2026.2653992","url":null,"abstract":"Objective: Setting non-inferiority margins has been problematic with decision making often appearing to be arbitrary. A pragmatic approach is to use the existing literature to provide empirical reference values for these margins. The current meta-analytic umbrella review estimates empirically derived non-inferiority margins for direct psychological therapy comparisons meeting bona fide conditions.Methods: A systematic search identified meta-analytic estimates of bona fide comparisons for primary and secondary outcomes. We conducted multilevel meta-analyses of these estimates to obtain generalizable empirically derived point-estimate non-inferiority margins.Results: Most patients included in the analyses represented populations commonly expected in outpatient psychological therapy settings. Overall, 46 meta-analytic standardized mean differences (SMD) nested in 19 meta-analyses (mean of 15.6 primary studies and 1302 participants in each meta-analysis) were identified to estimate generalizable non-inferiority margins. The estimated homogeneously distributed margins for the primary outcomes were SMD = -.17 (95% CI = -.21, -.13) and for secondary outcomes SMD = -.16 (95% CI = -.20, -.11), respectively.Discussion: This study provides empirically derived estimates for non-inferiority margins that are generalizable to large-scale trials to differentiate between small but nuanced effects and negligible non-inferior effects. Research on bona fide psychological therapy that accepts working on small effects needs careful consideration of confounding effects.","PeriodicalId":48159,"journal":{"name":"Psychotherapy Research","volume":" ","pages":"1-12"},"PeriodicalIF":3.0,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147646947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Beyond early termination: Predicting quality-related vs. quality-neutral dropout during the active phase of outpatient cognitive behavioral therapy. 超越早期终止：在门诊认知行为治疗的积极阶段预测质量相关vs质量中性退出。

IF 3 1区心理学

Psychotherapy Research Pub Date : 2026-04-09 DOI: 10.1080/10503307.2026.2653994

Bonnie Röhrig, Michael Witthöft, Frank Petrak

{"title":"Beyond early termination: Predicting quality-related vs. quality-neutral dropout during the active phase of outpatient cognitive behavioral therapy.","authors":"Bonnie Röhrig, Michael Witthöft, Frank Petrak","doi":"10.1080/10503307.2026.2653994","DOIUrl":"https://doi.org/10.1080/10503307.2026.2653994","url":null,"abstract":"AbstractObjective: This study examined predictors of dropout during the active phase of outpatient CBT, distinguishing between quality-related and quality-neutral dropouts. The focus was on patient, process, and therapist variables, including the therapeutic alliance and early treatment courses.Method: Routine data from 590 outpatient psychotherapy patients were analyzed. Dropouts were classified as quality-related (dissatisfaction or lack of progress) or quality-neutral (external reasons). Logistic regression models identified predictors of quality-related dropout. Symptom improvement differences between dropout and regular completion were calculated using t-tests.Results: 24.2% of patients discontinued therapy for quality-related reasons, while 10.8% dropped out for quality-neutral reasons. Significant predictors were lower treatment satisfaction (OR = 1.07) and a weaker therapeutic alliance (OR = 0.86). Quality-related dropouts occurred between the 10th and 15th sessions, while quality-neutral dropouts were between the 20th and 25th sessions. Early deterioration was a marginal predictor of quality-related dropout, while 58.6% of early responders in the quality-related dropout group showed significant improvement before discontinuing therapy.Conclusion: Lower treatment satisfaction and a weaker therapeutic alliance predicted quality-related dropout. Some early dropouts still showed improvement, suggesting that discontinuation does not always reflect treatment failure. Differentiating between quality-related and quality-neutral dropouts clarifies dropout patterns and improves interpretation of treatment outcomes.","PeriodicalId":48159,"journal":{"name":"Psychotherapy Research","volume":" ","pages":"1-20"},"PeriodicalIF":3.0,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Mentalization-based-treatment techniques across psychodynamic, cognitive and MBT therapies. 基于心理动力学、认知和MBT治疗的心理治疗技术。

IF 3 1区心理学

Psychotherapy Research Pub Date : 2026-04-08 DOI: 10.1080/10503307.2026.2654792

Antonello Colli, Salvatore Gullo, Giulia Gagliardini, Guia Pandolfi, Anthony Bateman, Peter Fonagy

{"title":"Mentalization-based-treatment techniques across psychodynamic, cognitive and MBT therapies.","authors":"Antonello Colli, Salvatore Gullo, Giulia Gagliardini, Guia Pandolfi, Anthony Bateman, Peter Fonagy","doi":"10.1080/10503307.2026.2654792","DOIUrl":"https://doi.org/10.1080/10503307.2026.2654792","url":null,"abstract":"Objective: This study examined whether therapists from orientations that do not explicitly target mentalizing-namely psychodynamic therapy (PDT) and cognitive behavioural therapy (CBT)-use interventions consistent with Mentalization-Based Treatment (MBT), and how their use compares with MBT-oriented therapy.Methods: Seventy-five verbatim transcripts were randomly selected from audio-recorded psychotherapy sessions involving patients with personality disorders or subclinical personality difficulties. Therapist orientation was determined by self-identification (MBT = 25, CBT = 25, PDT = 25). Sessions were independently rated using the MBT Adherence and Competence Scale (MBT-ACS) and the Reflective Functioning (RF) Scale.Results: MBT-consistent techniques were observed in PDT and CBT sessions, though at lower levels than in MBT. MBT therapists showed higher MBT-ACS scores, particularly in maintaining a not-knowing stance and identifying non-mentalizing modes. Across orientations, higher MBT-ACS scores were associated with lower mean session-level RF, but also with greater within-session RF increases.Conclusion: Mentalizing-oriented techniques appear across therapeutic orientations and may represent trans-theoretical process elements. Their association with both lower average RF and greater within-session change suggests they may be more frequently used in clinically challenging moments, supporting the restoration or enhancement of mentalizing.","PeriodicalId":48159,"journal":{"name":"Psychotherapy Research","volume":" ","pages":"1-13"},"PeriodicalIF":3.0,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Between- and within-client associations of working alliance with therapeutic outcomes in non-western contexts: Multilevel evidence from China and a comparison with the United States. 非西方环境下工作联盟与治疗结果的客户之间和客户内部关联：来自中国的多水平证据以及与美国的比较。

IF 3 1区心理学

Psychotherapy Research Pub Date : 2026-04-08 DOI: 10.1080/10503307.2026.2653995

Hui Xu, Zhijin Hou, Jiajia Zhu, Lan Zhang

{"title":"Between- and within-client associations of working alliance with therapeutic outcomes in non-western contexts: Multilevel evidence from China and a comparison with the United States.","authors":"Hui Xu, Zhijin Hou, Jiajia Zhu, Lan Zhang","doi":"10.1080/10503307.2026.2653995","DOIUrl":"https://doi.org/10.1080/10503307.2026.2653995","url":null,"abstract":"Objective: Working alliance is widely regarded as a central process variable across therapeutic orientations. However, alliance research remains predominantly informed by findings from Western contexts. Thus, the current study aimed to elucidate the multilevel roles of working alliance (client-rated) in non-Western settings. Method: Utilizing naturalistic data from a Chinese master's training program alongside a comparable US training program, this study conducted multilevel analyses to investigate both between-client alliance-outcome associations and within-client alliance-outcome associations in China, while also comparing these findings to those from the US. Results: The findings indicated that client-contributed alliance negatively predicted subsequent symptom levels in China (β = -.31, 95% CI [-.39, -.24], p < .001), and session-by-session alliance variations negatively predict subsequent symptom levels in China (β = -.04, 95% CI [-.07, -.00], p = .028). Additionally, the between- and within-client predictions of alliance for outcomes in China were equivalent to those observed in the US. Conclusions: This study contributes cross-cultural insights into the multilevel roles of alliance in individual therapy and enriches the discourse surrounding state- and trait-like aspects of alliance.","PeriodicalId":48159,"journal":{"name":"Psychotherapy Research","volume":" ","pages":"1-13"},"PeriodicalIF":3.0,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Autobiographical memory specificity to attachment-related cues improves in major depression during initial psychodynamic treatment. 在最初的心理动力学治疗中，重性抑郁症患者对依恋相关线索的自传体记忆特异性得到改善。

IF 3 1区心理学

Psychotherapy Research Pub Date : 2026-04-05 DOI: 10.1080/10503307.2026.2650153

Jonathan Raphael Nowak, Ede Nagy, Maximilian Orth, Hans-Christoph Friederich, Christoph Nikendei

{"title":"Autobiographical memory specificity to attachment-related cues improves in major depression during initial psychodynamic treatment.","authors":"Jonathan Raphael Nowak, Ede Nagy, Maximilian Orth, Hans-Christoph Friederich, Christoph Nikendei","doi":"10.1080/10503307.2026.2650153","DOIUrl":"https://doi.org/10.1080/10503307.2026.2650153","url":null,"abstract":"Objective: Patients with depression tend to retrieve fewer specific autobiographical memories, a phenomenon linked to insecure attachment and emotion regulation. This study examined changes in autobiographical memory (AM) specificity in response to attachment-related cues during the initial phase of psychodynamic psychotherapy, as early change is predictive of later outcome and central psychodynamic processes occur at this stage.Method: Seventy-four outpatients with major depression were assessed twice during early psychodynamic psychotherapy (baseline and after M = 10.5 sessions, range = 7-21). A modified Autobiographical Memory Test with attachment-related cues was used alongside measures of depression (BDI-II), anxiety (STAI), perseverative thinking (PTQ), attachment (ECR), and emotion regulation (EAQ). Robust regression analysis examined variables associated with change in attachment-cued AM (AC-AM).Results: Patients recalled more specific AC-AMs after early treatment. Depression, anxiety, and perseverative thinking decreased. Higher baseline attachment anxiety was associated with less improvement in AC-AM specificity, whereas higher baseline attachment avoidance and greater reductions in affective suppression were associated with greater improvement.Conclusion: During early psychodynamic treatment, patients with depression showed increased AC-AM specificity. Early gains appeared moderated by attachment style and affective suppression, suggesting that memory specificity improvement reflects emerging psychodynamic change processes related to attachment and affect regulation.","PeriodicalId":48159,"journal":{"name":"Psychotherapy Research","volume":" ","pages":"1-14"},"PeriodicalIF":3.0,"publicationDate":"2026-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147624331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Psychometric evaluation of the emotion-focused therapy version of person-centered and experiential psychotherapy scale: A measure of therapist adherence and competence. 以人为本的体验性心理治疗量表中以情绪为中心的治疗版本的心理测量学评价：治疗师依从性和能力的测量。

IF 3 1区心理学

Psychotherapy Research Pub Date : 2026-04-01 Epub Date: 2025-07-15 DOI: 10.1080/10503307.2025.2522386

Marina Monteiro, Robert Elliott, Daniela Nogueira, Edgar Mesquita, Carla Cunha

{"title":"Psychometric evaluation of the emotion-focused therapy version of person-centered and experiential psychotherapy scale: A measure of therapist adherence and competence.","authors":"Marina Monteiro, Robert Elliott, Daniela Nogueira, Edgar Mesquita, Carla Cunha","doi":"10.1080/10503307.2025.2522386","DOIUrl":"10.1080/10503307.2025.2522386","url":null,"abstract":"Objective: This study evaluated the psychometric properties of the Person-Centered and Experiential Psychotherapy Scale for Emotion-Focused Therapy: Adherence and Competence Observer Rating (PCEPS-EFT-9). It includes its reliability, discriminant validity between emotion-focused therapy (EFT) and person-centered therapy (PCT), and its predictive validity for therapeutic outcomes.Method: Data were drawn from a pilot study comparing EFT and PCT in treating social anxiety. Recordings of 22 EFT and 14 PCT sessions from early and mid-therapy phases were coded using the PCEPS-EFT-9. Discriminant validity was assessed by comparing scores between therapies and predictive validity through correlations with residual symptom changes.Results: The PCEPS-EFT-9 showed strong inter-rater reliability (intraclass correlation coefficients = .90-.93). Internal consistency was high for EFT (Cronbach's alpha > .97) and moderate for PCT (Cronbach's alpha = .65). EFT therapists scored significantly higher than PCT therapists (p < .001), supporting discriminant validity.Conclusion: The PCEPS-EFT-9 demonstrated robust reliability and validity, supporting its use in evaluating therapist adherence and competence in EFT. Higher adherence and competence were linked to improved outcomes, highlighting the importance of monitoring treatment fidelity in psychotherapy research.","PeriodicalId":48159,"journal":{"name":"Psychotherapy Research","volume":" ","pages":"717-731"},"PeriodicalIF":3.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144643894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The problematic impressions of therapy scale: a transtheoretical measure of negative patient experience in psychotherapy. 治疗量表的问题印象：心理治疗中负面患者体验的跨理论测量。

IF 3 1区心理学

Psychotherapy Research Pub Date : 2026-04-01 Epub Date: 2025-07-24 DOI: 10.1080/10503307.2025.2528031

James McCollum, Xu Li, George Silberschatz, David Kealy, Juan Martin Gomez Penedo

{"title":"The problematic impressions of therapy scale: a transtheoretical measure of negative patient experience in psychotherapy.","authors":"James McCollum, Xu Li, George Silberschatz, David Kealy, Juan Martin Gomez Penedo","doi":"10.1080/10503307.2025.2528031","DOIUrl":"10.1080/10503307.2025.2528031","url":null,"abstract":"Objective: Although negative experiences in psychotherapy are commonly reported by patients, these phenomena are understudied. The present study introduces the Problematic Impressions of Therapy Scale (PITS), a new measure designed to assess distressing in-session experiences.Methods: In two large samples of psychotherapy patients (N = 541 and N = 545), we conducted exploratory factor analysis followed by exploratory structural equation modeling to determine the underlying factor structure and psychometric properties of the PITS.Results: Results supported a 21-item, two-factor model reflecting therapist \"errors of commission\" (e.g., pressuring disclosure, expressing judgment) and \"errors of omission\" (e.g., failing to provide support or direction). Both subscales demonstrated acceptable internal consistency and good model fit across U.K.- and U.S.-based samples. In tests of concurrent validity, higher PITS scores showed moderate-to-strong negative associations with measures of the working alliance (Working Alliance Inventory) and perceived therapist responsiveness (Patient's Experience of Attunement and Responsiveness), suggesting that more frequent or distressing negative experiences correlate with weaker alliances. Further, errors of omission uniquely predicted poorer ratings of both bond and task dimensions of the alliance.Conclusion: These findings support the reliability and construct validity of the PITS as a tool for identifying and quantifying negative or hindering experiences in psychotherapy.","PeriodicalId":48159,"journal":{"name":"Psychotherapy Research","volume":" ","pages":"689-701"},"PeriodicalIF":3.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0