Psychotherapy Research最新文献

{"title":"Associations between therapists' verbal techniques and patient-rated therapeutic alliance, insight, and problem solving.","authors":"Antje Gumz, Anne Daubmann, Rainer Erices, Jelka Berger, Laurence Reuter, Denise Kästner","doi":"10.1080/10503307.2024.2327443","DOIUrl":"10.1080/10503307.2024.2327443","url":null,"abstract":"<p><strong>Objective: </strong>To investigate associations between common factors (alliance, insight, problem solving) and therapists' techniques. We expected a positive association between (1) supportive techniques and the alliance, (2) interpretative techniques and insight, and (3) a stronger association between interpretative techniques and insight for patients with more severe baseline symptoms. Other associations were analyzed in an exploratory way.</p><p><strong>Method: </strong>Sixty sessions from 15 adult female patients diagnosed with personality disorder were analyzed using the Psychodynamic Interventions List (verbal techniques, observer-rated transcripts), and the Session Questionnaire for General and Differential Individual Psychotherapy (common factors, patient-rated after each session). Multilevel modeling was applied.</p><p><strong>Results: </strong>A greater use of supportive techniques was related to a higher therapeutic alliance (<i>b </i>= .28, 95% <i>CI</i>: .01-.55, <i>p </i>= .042). Neither the positive association between interpretative techniques and insight nor the moderating effect of baseline symptom severity could be confirmed. Exploratory analyses revealed associations between problem-solving and different verbal techniques.</p><p><strong>Conclusion: </strong>Therapists' use of supportive techniques seems to influence the therapeutic alliance positively in patients with personality disorders. The effect of interpretative techniques might depend on other factors like patient characteristics. In general, there seem to be differential and specific associations between different therapists' verbal techniques and common factors.</p>","PeriodicalId":48159,"journal":{"name":"Psychotherapy Research","volume":" ","pages":"589-600"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140289212","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}

{"title":"Therapist cultural humility in early psychotherapy: A catalyst for improved client functioning at treatment termination.","authors":"Lushna M Mehra, Alexander M Kallen, Miracle Potter, Nikhila S Udupa, Chloe P Bryen, Therese S Kemper, Natalie J Sachs-Ericsson, Thomas E Joiner","doi":"10.1080/10503307.2025.2481268","DOIUrl":"https://doi.org/10.1080/10503307.2025.2481268","url":null,"abstract":"<p><strong>Objective: </strong>Several studies have identified therapist cultural humility as an important predictor of client psychotherapy outcomes, yet most have been conducted cross-sectionally, retrospectively, and/or with inconsistent assessment of other related therapy process constructs. Here, we bridge this gap by examining early treatment ratings of therapist cultural humility, multicultural competence, working alliance, and client-centered treatment approaches as prospective predictors of client functioning in an active community clinic.</p><p><strong>Method: </strong>Fifty participants (56% women, 10% gender diverse; 44% ethnoracially diverse), aged 18-69, rated these factors within 12 weeks of intake in a community mental health clinic. Therapists assessed client functioning at pre-treatment screening, diagnostic feedback, and treatment termination.</p><p><strong>Results: </strong>Multilevel modeling analyses indicated clients rating higher therapist cultural humility in early treatment had the largest improvements in therapist-rated functioning from pre-treatment to termination. Notably, the association between therapist cultural humility and client functioning at termination was moderated by ethnoracial status, with higher cultural humility ratings predicting better client functioning at termination solely for ethnoracially diverse clients.</p><p><strong>Conclusion: </strong>These findings underscore the importance of integrating cultural humility instruction in training programs and therapeutic standards to promote mental health equity.</p>","PeriodicalId":48159,"journal":{"name":"Psychotherapy Research","volume":" ","pages":"1-21"},"PeriodicalIF":2.6,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701755","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}

{"title":"Harnessing implementation science to integrate ambulatory assessment data into clinical practiceComment on: Ralph-Nearman, Rae, and Levinson (2024) https://www.tandfonline.com/doi/full/10.1080/10503307.2024.2360445?src=#d1e278.","authors":"Saskia Scholten, Julian Burger, Mila Hall, Miriam Hehlmann, Marilyn L Piccirillo","doi":"10.1080/10503307.2025.2477556","DOIUrl":"https://doi.org/10.1080/10503307.2025.2477556","url":null,"abstract":"","PeriodicalId":48159,"journal":{"name":"Psychotherapy Research","volume":" ","pages":"1-3"},"PeriodicalIF":2.6,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659096","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}

{"title":"Machine learned text topics improve drop-out risk prediction but not symptom prediction in online psychotherapies for depression and anxiety.","authors":"Sanna Mylläri, Suoma Eeva Saarni, Grigori Joffe, Ville Ritola, Jan-Henry Stenberg, Tom Henrik Rosenström","doi":"10.1080/10503307.2025.2473921","DOIUrl":"https://doi.org/10.1080/10503307.2025.2473921","url":null,"abstract":"<p><p><b>Objective:</b> Internet-delivered cognitive behavior therapies (iCBT) are effective and scalable treatments for depression and anxiety. However, treatment adherence remains a major limitation that could be further understood by applying machine learning methods to during-treatment messages. We used machine learned topics to predict drop-out risk and symptom change in iCBT. <b>Method:</b> We applied topic modeling to naturalistic messages from 18,117 patients of nationwide iCBT programs for depression and generalized anxiety disorder (GAD). We used elastic net regression for outcome predictions and cross-validation to aid in model selection. We left 10% of the data as a held-out test set to assess predictive performance. <b>Results:</b> Compared to a set of reference covariates, inclusion of the topic variables resulted in significant decrease in drop-out risk prediction loss, both in between-patient and within-patient session-by-session models. Quantified as partial pseudo-R², the increase in variance explained was 2.1-6.8 percentage units. Topics did not improve symptom change predictions compared to the reference model. <b>Conclusions:</b> Message contents can be associated with both between-patients and session-by-session risk of drop-out. Our topic predictors were theoretically interpretable. Analysis of iCBT messages can have practical implications in improved drop-out risk assessment to aid in the allocation of additional supportive interventions.</p>","PeriodicalId":48159,"journal":{"name":"Psychotherapy Research","volume":" ","pages":"1-16"},"PeriodicalIF":2.6,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659098","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}

{"title":"Practices of personalized treatment selection among German psychotherapists: A preregistered mixed methods study.","authors":"Robin Anno Wester, Tobias Steinbrenner, Sofie Hanraths, Johannes C Ehrenthal, Flavio Iovoli, Jessica Fritz, Julian Rubel","doi":"10.1080/10503307.2025.2473931","DOIUrl":"https://doi.org/10.1080/10503307.2025.2473931","url":null,"abstract":"<p><p><b>Objective:</b> Despite growing interest in personalized psychotherapy research, little is known about therapists' current practice of personalizing psychotherapy. This study aimed to examine the extent to which psychotherapists engage in personalized treatment selection (PTS), i.e., recommending the presumably best-fitting treatment package to a patient, as one way of personalizing psychotherapy. <b>Method:</b> This is a pre-registered study using open- and closed-ended questions in an online survey among German psychotherapists (<i>N </i>= 557 started, <i>N </i>= 392 (70.4%) completed). We applied logistic regression analyses to investigate predictors of PTS and qualitative analyses to investigate therapists' subjective reasoning for and against PTS. <b>Results:</b> 78.7% (N = 437) of the therapists stated that they had practiced PTS in the past. Therapists trained in psychodynamic approaches were more likely to engage in PTS than cognitive-behavioral therapists. Therapists named a variety of patient characteristics that can lead to the recommendation of specific treatment approaches, most notably diagnostic factors and patient preferences. Therapists not engaging in PTS most often referred to the effectiveness of their own approach as explanation. <b>Conclusion:</b> The majority of psychotherapists provide personalized treatment recommendations to their patients. In light of our findings, we discuss challenges for the implementation of data-driven clinical support tools for PTS.</p>","PeriodicalId":48159,"journal":{"name":"Psychotherapy Research","volume":" ","pages":"1-14"},"PeriodicalIF":2.6,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606681","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}

{"title":"Associations between interpersonal synchrony and clients' perception of session quality are moderated by depression severity.","authors":"Dana Stolowicz-Melman, Dana Atzil-Slonim, Adar Paz, Eran Bar-Kalifa, Eva Gilboa-Schechtman, Ruth Feldman","doi":"10.1080/10503307.2025.2462150","DOIUrl":"https://doi.org/10.1080/10503307.2025.2462150","url":null,"abstract":"<p><strong>Objective: </strong>Previous research has identified a complex relationship between client-therapist synchrony and therapy outcomes. We investigated the ways in which depression severity influences this relationship.</p><p><strong>Method: </strong>The sample was comprised of 30 clients undergoing a 16-session supportive-expressive dynamic therapy for depression. Client-therapist interpersonal synchrony was assessed using the Client-Therapist interpersonal Synchrony (CIB) coding system during five pre-selected sessions. After each session, the clients evaluated their satisfaction with the session. We employed multi-level modeling (MLM) to analyze the data.</p><p><strong>Results: </strong>Sessions characterized by higher levels of interpersonal synchrony were associated with better session quality, both within and between dyads. Depression severity moderated this association, such that the correlation between interpersonal synchrony and session outcome was weaker in dyads where clients reported greater depression severity.</p><p><strong>Conclusions: </strong>These findings suggest that to facilitate effective synchrony it is important to consider the clients' level of depression.</p>","PeriodicalId":48159,"journal":{"name":"Psychotherapy Research","volume":" ","pages":"1-11"},"PeriodicalIF":2.6,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574366","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}

{"title":"Trauma-focused cognitive-behavioral therapy for long-term posttraumatic stress disorder, major depressive disorder and anxiety disorders in victims of terrorism: A randomized clinical trial.","authors":"Clara Gesteira, Maria Paz Garcia-Vera, Jesus Sanz, James M Shultz","doi":"10.1080/10503307.2025.2467380","DOIUrl":"https://doi.org/10.1080/10503307.2025.2467380","url":null,"abstract":"<p><strong>Objective: </strong>A parallel randomized clinical trial evaluated the efficacy of Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) for victims of terrorist attacks with long-term psychopathology. <b>Method:</b> 120 adult Spanish victims, who met the criteria for current posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and/or anxiety disorders related to exposure to terrorist attacks that occurred 18 years ago, on average, were randomly assigned to 16 weekly sessions of TF-CBT (<i>n</i> = 60) or waiting list control conditions (<i>n</i> = 60). <b>Results:</b> Participants who completed TF-CBT (<i>n</i> = 25) experienced significant pre-post decreases in diagnostic rates and in posttraumatic stress, depression, and anxiety symptoms. Pre/post effect sizes for the TF-CBT-treated participants were large (<i>g_PCL-S</i> = 1.25; <i>g_BDI-II</i> = 1.03; <i>g_BAI</i> = 1.16), and between-groups effect sizes were medium-large (<i>g_PCL-S</i>=  0.94, <i>g_BDI-II</i> = 0.72, <i>g_BAI</i> = 0.95). Most TF-CBT completers (78.3% to 91.7%) achieved sub-syndromal symptom levels by post-treatment. The benefits persisted to the 6-month follow-up (<i>n</i> = 22). Modified intention-to-treat analyses (<i>n</i> = 35 vs. <i>n</i> = 50) confirmed the significance of the findings for PTSD and were significant but less robust for MDD and anxiety disorders. <b>Conclusion:</b> TF-CBT appears to be efficacious when applied to victims of terrorism with long-term psychopathology.</p><p><strong>Clinical or methodological significance of this article: </strong>TF-CBT was efficacious when applied to victims of terrorism with long-term PTSD. Results were significant but less robust for long-term MDD and anxiety disorders.</p>","PeriodicalId":48159,"journal":{"name":"Psychotherapy Research","volume":" ","pages":"1-16"},"PeriodicalIF":2.6,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568559","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}

{"title":"A mixed-methods evaluation of long-term outcomes after trauma-focused cognitive behavioural therapy for children subjected to family violence.","authors":"M Onsjö, U Axberg, O Hultmann, J Strand","doi":"10.1080/10503307.2025.2469256","DOIUrl":"https://doi.org/10.1080/10503307.2025.2469256","url":null,"abstract":"<p><strong>Objective: </strong>Exposure to family violence in childhood significantly increases the risk of developing severe psychiatric and physiological illnesses. Trauma-focused cognitive behavioural therapy (TF-CBT) effectively addresses trauma-related symptoms and improves overall well-being. However, knowledge of the persistence of these positive effects over time, facilitating factors, and why some children are not benefited remains limited. Furthermore, little attention has been paid to exploring children's subjective experiences. This study aimed to investigate long-term changes in trauma-related symptoms among children and youths who underwent TF-CBT due to family violence. Nine participants (<i>M</i> age = 16,6 years, range = 14-23; 7 girls and 2 boys) were assessed and interviewed four to five years after TF-CBT treatment.</p><p><strong>Methods: </strong>The study adopted a mixed-method approach, integrating quantitative and qualitative methods.</p><p><strong>Results: </strong>While most participants still reported being affected by the violence, most had benefited from treatment, with improvements lasting over the years. However, for those who did not report decreased symptoms, trauma symptoms persisted, accompanied by additional severe mental health problems.</p><p><strong>Conclusions: </strong>The findings underscore the importance of providing effective trauma-focused treatments such as TF-CBT and highlight the need for enhanced safety measures and parental interventions for children who do not benefit from treatment.</p>","PeriodicalId":48159,"journal":{"name":"Psychotherapy Research","volume":" ","pages":"1-15"},"PeriodicalIF":2.6,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568558","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}

{"title":"A theory-building case study of resolving epistemic mistrust and developing epistemic trust in psychotherapy with depressed adolescents.","authors":"Elizabeth Li, Nick Midgley, Chloe Campbell, Patrick Luyten","doi":"10.1080/10503307.2025.2473927","DOIUrl":"https://doi.org/10.1080/10503307.2025.2473927","url":null,"abstract":"<p><strong>Objective: </strong>Patients with epistemic mistrust struggle to view others as trustworthy sources of knowledge and often default to negative appraisals in social communication. The three communication systems theory posits that resolving epistemic mistrust involves three systems: the epistemic match, improving mentalizing, and the re-emergence of social learning outside therapy. This study aimed to empirically examine the theory to understand how epistemic trust develops in psychotherapy.</p><p><strong>Method: </strong>Using a theory-building case study approach, we analyzed therapeutic processes in six depressed adolescents (<i>M</i>age = 16.58, SD = 1.17) with varying treatment outcomes. Sixty-six audiotaped psychotherapy sessions were reviewed to compare good- and poor-outcome cases, identifying patterns within therapeutic interactions.</p><p><strong>Results: </strong>Findings provide the first empirical evaluation of the three communication systems theory, offering concrete examples of how it unfolds in clinical practice and suggesting refinements in therapist and patient processes to build epistemic trust. Additional insights into the theory highlight an early \"window of opportunity\" to foster epistemic openness, the influence of environmental factors outside therapy, and the interactive nature of therapist-patient dynamics.</p><p><strong>Conclusion: </strong>This study refines the theoretical understanding of epistemic trust in psychotherapy, revealing specific therapist and patient behaviors that may facilitate its development. Implications for clinical practice and future research directions are discussed.</p>","PeriodicalId":48159,"journal":{"name":"Psychotherapy Research","volume":" ","pages":"1-19"},"PeriodicalIF":2.6,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544170","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}

{"title":"Therapist interpersonal responsiveness: Being interpersonally flexible in response to client collaboration.","authors":"Mira An, Carol A Jauquet, Sangida Akter, Dennis M Kivlighan","doi":"10.1080/10503307.2025.2457395","DOIUrl":"https://doi.org/10.1080/10503307.2025.2457395","url":null,"abstract":"<p><p><b>Objective:</b> We assessed a new methodological and analytical approach for examining how therapist moment-to-moment interpersonal flexibility and responsiveness influence subsequent client collaboration. Therapist interpersonal flexibility was conceptualized as one of the crucial components of interpersonal responsiveness and operationalized as adjustments in therapists' interpersonal behaviors between speaking turns. To uncover the context-dependent nature of the responsiveness, the study also explored how these turn-to-turn adjustments, in relation to previous client collaboration, influence subsequent client collaboration. <b>Method:</b> This study involved 1107 speaking turns nested in 12 sessions nested within three therapist-client dyads. Three raters assessed therapist interpersonal behaviors in dominance-submission and approach-avoidance dimensions for each therapist speaking turn and the level of client collaboration for each client speaking turn. Distance scores and Dynamic Structural Equation Modeling (DSEM) were used to explore the hypothesized effects at a within-session level. <b>Results:</b> We found when therapists adjusted their interpersonal styles to a moderately high degree, clients were more collaborative than usual. We also found therapist turn-to-turn adjustments had a significantly positive effect on subsequent client collaboration only when clients were not collaborative before such adjustments were made. <b>Conclusion:</b> Overall, this study offers a methodological advancement in the study of therapist responsiveness by demonstrating the nuanced clinical insights offered by use of sophisticated analyses (i.e., within-session moment-to-moments responsiveness, Euclidean distance scores, Dynamic Structural Equation Modeling [DSEM]). Findings suggest a moderate level of turn-to-turn interpersonal adjustment may benefit subsequent client collaboration. Findings also suggest that a therapist's turn-to-turn adjustment in response to previous low client collaboration may facilitate subsequent client collaboration. Strengths, methodological limitations, and clinical implications are discussed.</p>","PeriodicalId":48159,"journal":{"name":"Psychotherapy Research","volume":" ","pages":"1-17"},"PeriodicalIF":2.6,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606683","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}