Psychotherapy Research最新文献

{"title":"Session-by-session client feeling and clarification processes over the course of emotion-focused therapy.","authors":"Ueli Kramer, Marielle Sutter, Julian Rubel, Lars Auszra, Imke Herrmann, Setareh Ranjbar, Martin Grosse Holtforth","doi":"10.1080/10503307.2026.2724935","DOIUrl":"https://doi.org/10.1080/10503307.2026.2724935","url":null,"abstract":"<p><strong>Background: </strong>Emotion-Focused Therapy (EFT) is an effective form of psychotherapy for a range of psychological problems. While earlier research demonstrated the effect of in-session processes as being central for explaining the effects of EFT, it is unclear what the role of clients' self-reported quality of emotional processing assessed right after each therapy session is for the prediction of therapy outcome. Specifically, we are assuming that session-by-session trajectories of clients' self-assessed clarification processes and treatment outcome are moderated by their self-reported post-session feelings.</p><p><strong>Methods: </strong>A total of <i>N</i> = 48 clients with a variety of psychological problems and undergoing EFT within a naturalistic context have been included in the present study. Symptom change was assessed using CORE-10 after each therapy session, in addition to pre- and post-therapy. After each session, the client self-assessed a range of session feelings and the quality of clarification experienced in the session. Longitudinal trajectory analyses with moderation effects and exploratory dynamic network analyses were conducted.</p><p><strong>Results: </strong>The post-session client experience of sadness or grief and joy moderate the trajectory of clarification depth over the course of EFT. Post-session feelings influenced the trajectory of symptom levels over the course of therapy (clarification was non-significant in the model). Specific emotion-based dynamic pathways to clarification and symptom load were explored.</p><p><strong>Conclusions: </strong>The session-by-session interplay between session feelings (sadness and joy), as self-rated by the client after each session, was a moderator of self-rated clarification and symptom-level trajectories across Emotion-Focused Therapy. This study adds to the understanding of the client's self-perceived mechanisms of change in EFT as it is conducted in a naturalistic context.</p>","PeriodicalId":48159,"journal":{"name":"Psychotherapy Research","volume":" ","pages":"1-11"},"PeriodicalIF":3.8,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882364","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":"Predicting treatment process and outcome using temporal dynamics of supervisory working alliance.","authors":"Yun Lu, Dennis M Kivlighan","doi":"10.1080/10503307.2026.2634084","DOIUrl":"10.1080/10503307.2026.2634084","url":null,"abstract":"<p><strong>Objective: </strong>This study examined the temporal dynamics of supervisor- and supervisee-rated supervisory working alliance (SWA) and their relations to treatment process and outcome.</p><p><strong>Method: </strong>The sample included 28 supervisory dyads participating in a total of 1709 weekly supervision sessions and rating SWA at each session. Meanwhile, 261 community clients attended psychotherapy with the supervisees, providing session evaluation and alliance ratings at each session and the Outcome Questionnaire-45 (OQ) every eighth session. We used a longitudinal actor partner interdependence model. Responsiveness was operationalized as the paths from one partner's SWA to the other partner's SWA in the following week<i>. In-phase</i> responsiveness is a positive path, where dyadic SWA perceptions change in the same direction. <i>Anti-phase</i> responsiveness is a negative path, indicating that dyadic SWA perceptions fluctuate around an equilibrium. SWA rupture and repair was operationalized as SWA variability.</p><p><strong>Results: </strong>Clients had greater OQ improvement when the supervisory dyads exhibited greater <i>anti-phase</i> responsiveness. Clients had higher session evaluation and greater OQ improvement when the supervisory dyads had greater SWA variability.</p><p><strong>Conclusion: </strong>Supervisors who maintain a dynamic equilibrium in response to their supervisees' SWA changes may help offer a constructive consultant perspective. SWA variability may reflect in-depth work.</p>","PeriodicalId":48159,"journal":{"name":"Psychotherapy Research","volume":" ","pages":"1291-1305"},"PeriodicalIF":3.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147445581","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":"Developing facilitative interpersonal skills: A randomized controlled study of an apprenticeship training for first-year clinical psychology students.","authors":"Steffen André Fagerbakk, Heidi Brattland, Nina Jakhelln Laugen, Katrine Høyer Holgersen, Patrick A Vogel, Truls Ryum","doi":"10.1080/10503307.2026.2615393","DOIUrl":"10.1080/10503307.2026.2615393","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate whether apprenticeship training could enhance facilitative interpersonal skills (FIS) in first-year students enrolled in a six-year integrated clinical psychology study program, compared to training-as-usual.</p><p><strong>Method: </strong>A total of 108 students were recruited and randomly assigned to either training-as-usual or training-as-usual plus apprenticeship. Students in the apprenticeship group participated in one weekly therapy session with different therapists over 10 weeks. FIS were assessed using a performance-based observer-rated test before and after the intervention.</p><p><strong>Results: </strong>The apprenticeship group showed a significant improvement in FIS from pre- to post-intervention (<i>d</i> = 0.43, 95% CI [0.19, 0.67], <i>p</i> = .001), while the control group showed a small, non-significant improvement (<i>d</i> = 0.16, 95% CI [-0.06, 0.39], <i>p</i> = .16). The between-group difference was not statistically significant but showed a small effect in the expected direction (<i>d</i> = 0.24, 95% CI [-0.09, 0.58], <i>p</i> = .15). The largest gains were seen in the skills Alliance Bond Capacity and Alliance Rupture Repair Responsiveness.</p><p><strong>Conclusion: </strong>While the between-group difference was not significant, the within-group improvement and the small observed effect favoring the apprenticeship group suggest that apprenticeship may be a valuable supplement to traditional training methods typically employed in early training.</p>","PeriodicalId":48159,"journal":{"name":"Psychotherapy Research","volume":" ","pages":"1277-1290"},"PeriodicalIF":3.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146054285","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":"Facing the fog: barriers and facilitators to communicating uncertainty among psychologists.","authors":"Lize Booy, Elly Quinlan, Catherine Deans, Kimberley Norris, Mandy Matthewson","doi":"10.1080/10503307.2025.2569036","DOIUrl":"10.1080/10503307.2025.2569036","url":null,"abstract":"<p><strong>Objective: </strong>Uncertainty is an unavoidable aspect of healthcare service provision, particularly for psychologists who often navigate complex ambiguous clinical scenarios, which can evoke negative responses and increase risk of adverse outcomes. This study explores the willingness of Australian psychologists to communicate uncertainty to clients, identifying facilitators and barriers to this process.</p><p><strong>Method: </strong>We surveyed 70 Australian psychologists providing direct client care. The survey focused on barriers and facilitators to communicating uncertainty through responses to a vignette depicting a common therapeutic scenario featuring uncertainty. Thematic analysis was undertaken using Nvivo.</p><p><strong>Results: </strong>Key themes describing barriers included psychologist's internalization of uncertainty as personal and professional inadequacy, fear of negative client reactions, and a lack of skills in effectively communicating uncertainty. Conversely, facilitators included comfort with uncertainty, external professional supports, and strong therapeutic relationships.</p><p><strong>Conclusions: </strong>The findings underscore the need for enhanced training of psychologists in uncertainty communication, focusing on developing adaptive responses and effective communication strategies. Addressing uncertainty is crucial given its inevitability, psychologist's pervasiveness discomfort with uncertainty and barriers to its communication. Future research should explore the nuanced experiences of psychologists in diverse practice settings working within a range of therapeutic modalities, and the impact of uncertainty on the therapeutic relationship.</p>","PeriodicalId":48159,"journal":{"name":"Psychotherapy Research","volume":" ","pages":"1219-1231"},"PeriodicalIF":3.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287219","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":"Clients' perceptions of therapist dishonesty.","authors":"Catherine Crumb, Barry A Farber, Hannah Ades","doi":"10.1080/10503307.2025.2561887","DOIUrl":"10.1080/10503307.2025.2561887","url":null,"abstract":"<p><strong>Objective: </strong>Although honesty is valued highly within psychotherapeutic work, therapists, like individuals in any interpersonal situation, are occasionally dishonest. The primary objective of this study was to explore clients' perceptions of therapist dishonesty, including their views on whether and under what circumstances therapist dishonesty is acceptable.</p><p><strong>Methods: </strong>Participants (N = 566) were clients currently engaged in psychotherapy who completed an online Qualtrics survey (Clients' Assessment of Tact, Concealment, and Honesty; CATCH) and the Working Alliance Inventory.</p><p><strong>Results: </strong>Most clients perceived their therapists to have been somewhat dishonest at least once during their treatment and believed it acceptable for their therapists to be dishonest about several topics, including their frustration or disappointment in clients. Clients who had a stronger working alliance perceived less therapist dishonesty and were more likely to view dishonesty as acceptable; these findings did not vary significantly by age, gender, race, or education level.</p><p><strong>Conclusion: </strong>Clinical education on the varied nature and ethics of therapist dishonesty is indicated and ought to include discussion of instances in which less-than-complete honesty may be advisable, as well as its potential detrimental effects. Clinical training might well focus on beginning therapists' awareness of how their occasional dishonesty, including therapeutic tact, affects clients.</p>","PeriodicalId":48159,"journal":{"name":"Psychotherapy Research","volume":" ","pages":"1193-1206"},"PeriodicalIF":3.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187273","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":"MATCH: client-therapist matching with machine learning.","authors":"Seth M Peacock, Ian H Goodin, Ryan K Wood, Connor J McBride, Ammon C Brock, David M Erekson, Zachary M Boyd","doi":"10.1080/10503307.2025.2599248","DOIUrl":"10.1080/10503307.2025.2599248","url":null,"abstract":"<p><strong>Objective: </strong>Therapist assignment can have a profound impact on the success of counseling. Accordingly, we present a framework that combines archival data and computer science algorithms to match clients to therapists so that client outcomes are, on average, better than assignment to the next available therapist while respecting each therapist's availability.</p><p><strong>Methods: </strong>We estimated the association between therapists and clients' outcomes using high-dimensional data from CCAPS-62 and OQ-45 surveys from 2014 to 2019, obtained at a clinic of a large private university (exactly 10,100 courses of therapy). These predictions informed constrained client-therapist matches. We evaluated the method using simulations and statistical tests.</p><p><strong>Results: </strong>Our model's predictions identified therapist-client pairs that are associated with an average improvement of client outcomes-0.145-3.65 OQ-45 points higher (<i>d</i> = 0.11) than usual, with 95% confidence, evaluated using out-of-sample data. Accounting for constraints on the availability of therapists (largely unconsidered in prior literature), our method could aid in improving outcomes with minimal impact on client wait times and few administrative changes necessary.</p><p><strong>Conclusions: </strong>Improving client outcomes given therapist constraints through data-driven client-therapist matching might still retain a sizable portion of the benefit of data-driven matching.</p>","PeriodicalId":48159,"journal":{"name":"Psychotherapy Research","volume":" ","pages":"1179-1192"},"PeriodicalIF":3.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145764044","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":"The most vulnerable are prone to use AI therapists: The role of attachment, epistemic trust, and mental health symptoms in acceptance of digital mental health interventions.","authors":"Vera Békés, Katie Aafjes-van Doorn","doi":"10.1080/10503307.2026.2615388","DOIUrl":"10.1080/10503307.2026.2615388","url":null,"abstract":"<p><strong>Objective: </strong>Digital mental health interventions (DMHIs) offer scalable solutions to traditional barriers in mental healthcare. Acceptability of DMHIs might differ among patients with differing level of symptoms and relational difficulties. This study investigated how a person's psychological profile, including their level of mental health symptoms, epistemic trust, and attachment security, predicts their acceptance of AI-based interventions (avatars, chatbots) versus human-delivered teletherapy.</p><p><strong>Method: </strong>Using cluster analysis on survey data from 1,612 (potential) patients and clinicians recruited via Prolifc, we identified three distinct psychological profiles: \"Avoidant-not trusting,\" \"Secure-trusting-healthy,\" and \"Young-anxious-ambivalent-symptomatic.\"</p><p><strong>Results: </strong>Results showed a paradoxical pattern: Individuals in the two most vulnerable clusters (\"Avoidant-not trusting\" and \"Young-anxious-ambivalent-symptomatic\") demonstrated significantly higher acceptance of AI-based DMHIs. In contrast, the psychologically healthier \"Secure-trusting-healthy\" cluster showed the lowest AI-based DMHI acceptance and the highest acceptance of teletherapy. Also, having therapy experience as provider or patient was associated with lower AI acceptance in general.</p><p><strong>Conclusion: </strong>These findings suggest that AI-based interventions may be uniquely suited to reach individuals who struggle with human-to-human therapeutic relationships, thereby serving as a critical entry point to care for those who need it most. However, those vulnerable people might also miss out on the relational learning that takes place in human-based therapies.</p>","PeriodicalId":48159,"journal":{"name":"Psychotherapy Research","volume":" ","pages":"1318-1332"},"PeriodicalIF":3.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145998920","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":"\"Now we can think about it together\" - A thematic analysis of what characterizes (in)effective supervision sessions for novice CBT supervisees.","authors":"Tatjana Paunov, Florian Weck, Franziska Kühne","doi":"10.1080/10503307.2025.2569042","DOIUrl":"10.1080/10503307.2025.2569042","url":null,"abstract":"<p><strong>Objective: </strong>Clinical supervision is considered an important aspect of therapist training. However, little is known about which elements of supervision impact on therapist skills. The current study used a qualitative approach to identify patterns of (in)effective supervision sessions for novice CBT supervisees.</p><p><strong>Method: </strong>Sixteen supervision sessions were selected, based on deviant case sampling from a larger randomized controlled trial investigating the effect of clinical supervision for psychology students. Nine effective and seven ineffective supervision sessions were chosen, based on changes in independently assessed competence and alliance scores from pre- to post-supervision. Transcripts of these sessions were analyzed using thematic analysis.</p><p><strong>Results: </strong>The analysis yielded four themes, each structured into two sub-themes: <i>Shaping Supervision through Supervisee Agency, The Supervisor as a Tailor, Co-Constructing Supervision</i>, and <i>Creating a Space to Learn</i>. Effective supervision sessions were characterized by supervisees working actively on their individual goals, the use of a variety of supervisory techniques tailored to the supervisees' needs, a collaborative exchange at eye level, and a supportive and empowering atmosphere.</p><p><strong>Conclusion: </strong>Our analysis identified theoretically and clinically relevant processes in supervision that may foster novice CBT supervisees' skills. It emphasizes the potential of personalized approaches, building on a supportive atmosphere.</p>","PeriodicalId":48159,"journal":{"name":"Psychotherapy Research","volume":" ","pages":"1264-1276"},"PeriodicalIF":3.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245601","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":"From fear toward confidence: Understanding change in clinical concerns and self-efficacy in couple and family therapy students.","authors":"Allen K Sabey, Erin Shanahan, Erin J Strahan, Adele Lafrance","doi":"10.1080/10503307.2025.2572795","DOIUrl":"10.1080/10503307.2025.2572795","url":null,"abstract":"<p><p><b>Objective:</b> Given their professional developmental stage, couple and family therapy (CFT) students are likely to have clinical concerns or fears about potential negative experiences that could occur in their clinical work as they progress through their training. A recently developed self-report measure was used to increase awareness of these clinical concerns and ultimately decrease the potential of their negative impact during clinical care.<b>Method:</b> 71 CFT students (mostly female, 87.3%, and White, 70.4%) completed this measure and other potentially relevant measures (e.g., clinical self-efficacy, attachment security) at bi-monthly intervals throughout their clinical training.<b>Results:</b> Results suggest that clinical concerns decreased over the course of their training and that increases in clinical self-efficacy led to a greater decrease in clinical concerns over time.<b>Conclusion:</b> This study has important practical implications for clinical training programs, particularly for ways through which supervisors can support clinicians in growing awareness of potential clinical concerns, and their impact on care delivery.</p>","PeriodicalId":48159,"journal":{"name":"Psychotherapy Research","volume":" ","pages":"1249-1263"},"PeriodicalIF":3.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145349341","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":"Monitoring power in context: A hermeneutic exploration of relational dynamics in counseling and psychotherapy supervision.","authors":"Onur Özmen, Gülşah Kemer","doi":"10.1080/10503307.2025.2610380","DOIUrl":"10.1080/10503307.2025.2610380","url":null,"abstract":"<p><p><b>Objective:</b> This study explored relational dynamics within a supervisory relationship, focusing on power, multicultural considerations, and parallel processes. <b>Method:</b> Guided by Gadamerian philosophical hermeneutics, the exploration relied on an iterative, reflexive engagement with eight recorded supervision sessions to interpret how these dynamics unfolded across time. Reflexive thematic analysis was used within a hermeneutic framework to identify relational patterns, and the Shedler-Westen Assessment Procedure served as an additional interpretive layer, providing the supervisor's professional perspective on supervisee personality tendencies. <b>Results:</b> Findings highlighted consistently fluctuating power negotiations, relationally embedded meanings shaping safety and disclosure, and tentative parallel processes that reflected patterns described in the supervisee's site supervision and client work. These dynamics appeared as interpretive layers rather than fixed mechanisms, emerging through the dialogical flow of supervision. <b>Conclusion:</b> The study offers process-level insights into how relational dynamics take shape within lived supervision, illustrating the value of hermeneutic inquiry for understanding supervision as an unfolding interpersonal experience. Implications for supervisors include attending to relational patterns as tentative cues for deeper inquiry.</p>","PeriodicalId":48159,"journal":{"name":"Psychotherapy Research","volume":" ","pages":"1232-1248"},"PeriodicalIF":3.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145935725","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}