Psychotherapy Research最新文献

{"title":"Mapping the relation between trials methodology and practice-based evidence in the real world of smaller effects: Generalizability and research recommendations.","authors":"Michael Barkham, David Saxon, Gillian E Hardy, Jaime Delgadillo, Wolfgang Lutz","doi":"10.1080/10503307.2025.2541710","DOIUrl":"https://doi.org/10.1080/10503307.2025.2541710","url":null,"abstract":"<p><strong>Objective: </strong>To address the generalizability of results from trials (evidence-based practice) to routine practice (practice-based evidence), focusing on smaller therapist effects and differential treatment effects.</p><p><strong>Method: </strong>We utilized data from a pragmatic trial comparing cognitive behavioral therapy (CBT) and person-centered experiential therapy (PCET) as well as routine outcome data from all patients in the clinical organization in which the trial was embedded. We constructed four datasets starting with the trial assessment data and progressively extended the inclusion criteria for therapists and patients to the point of capturing the whole routine outcome dataset across the clinical organization. We applied multilevel modeling to datasets to address the stated objectives.</p><p><strong>Results: </strong>In the trial data, non-significant therapist effects became significant as a function of increasing inclusivity in the routine practice datasets, while non-significant treatment effects favoring PCET in the trial at 6 months came to favor CBT in all routine datasets. In all four datasets, shorter treatments favored PCET (≈ 6-8 sessions) and longer treatments favored CBT.</p><p><strong>Conclusion: </strong>Embedding trials within routine practice that uses the same outcome measures enables direct tests of trial generalizability. Recommendations enhancing transparency in trial reporting are made to aid generalizability of trial results to routine practice.</p>","PeriodicalId":48159,"journal":{"name":"Psychotherapy Research","volume":" ","pages":"1-16"},"PeriodicalIF":3.0,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144974608","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":"Prediction of adolescent psychotherapy outcomes using youth- and caregiver-reported symptoms data.","authors":"Craig E Henderson, Grace S Woodard, Melanie Simmonds-Buckley, Maxwell Christensen, Amanda Jensen-Doss, Susan Douglas, Jaime Delgadillo","doi":"10.1080/10503307.2024.2394187","DOIUrl":"10.1080/10503307.2024.2394187","url":null,"abstract":"<p><strong>Objective: </strong>We used longitudinal youth- and caregiver-reports of adolescent psychological symptoms from three samples of youth receiving mental health services in routine treatment settings to derive expected change trajectories and identify cases at risk for treatment failure.</p><p><strong>Method: </strong>Participants were 1906 youth (1053 caregivers) receiving treatment in community mental health settings, merged across three samples. The Symptoms and Functioning Severity Scale (SFSS) was used as an indicator of weekly clinical change. Multilevel modeling methods were used to develop expected change trajectories and identify cases at risk for treatment failure (not on track; NOT). Logistic regression was used to predict client improvement as a function of NOT status.</p><p><strong>Results: </strong>The SFSS was a reliable indicator of therapeutic change according to youth-reported symptoms. Caregiver reports were not as robust. Whereas predictive accuracy of NOT status yielded moderately high sensitivity in detecting improvement according to youth report, caregiver reports were not as predictive.</p><p><strong>Conclusions: </strong>The youth-reported version of the SFSS-based algorithm seems appropriate for implementation in clinical care. Future studies should search for similarly predictive measures for caregivers.</p>","PeriodicalId":48159,"journal":{"name":"Psychotherapy Research","volume":" ","pages":"1185-1197"},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11868464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142113449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shared or different pathways to change? Clients' experiences of change in cognitive behavioral therapy and emotion-focused therapy for depression.","authors":"Hanna Aardal, Aslak Hjeltnes, Elisabeth Schanche, Yngvild Sørebø Danielsen, Petter Franer, Jan Reidar Stiegler","doi":"10.1080/10503307.2024.2445662","DOIUrl":"10.1080/10503307.2024.2445662","url":null,"abstract":"<p><strong>Objective: </strong>Cognitive behavioral therapy (CBT) and Emotion-focused therapy (EFT) are empirically supported models for treating depression. Comparisons of the models regarding outcome exist, but no comparison of the clients' experiences of change. This study explored and compared experiences of change in CBT and EFT for major depression.</p><p><strong>Method: </strong>We conducted a comparative thematic analysis of the experiences of 28 clients after 12-18 sessions of either CBT (<i>n </i>= 14) or EFT (<i>n </i>= 14).</p><p><strong>Results: </strong>The analysis resulted in five themes reported across treatments: (1) Changing the understanding of my problems; (2) Finding a new way to relate to inner experiences; (3) Changing how I see myself; (4) Challenging problematic ways of being with others; (5) Bringing changes into everyday life. Across treatment modalities, the clients experienced the same types of changes. Compared to EFT clients, more CBT clients emphasized the importance of practicing new strategies when facing adversity in their change process. Reversely, more EFT clients emphasized getting in touch with, tolerating, and listening to their inner experiences.</p><p><strong>Conclusion: </strong>Our findings suggest that clients undergoing CBT and EFT describe changes in the same domains but show differences in how they emphasize various pathways leading to their change.</p>","PeriodicalId":48159,"journal":{"name":"Psychotherapy Research","volume":" ","pages":"1121-1135"},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030093","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":"Unraveling the optimal balance of problem-related affective experiences and need satisfaction in cognitive-behavioral therapy: A response surface analysis.","authors":"Nicolas Wrede, Nils F Töpfer, Gabriele Wilz","doi":"10.1080/10503307.2024.2385436","DOIUrl":"10.1080/10503307.2024.2385436","url":null,"abstract":"<p><p><b>Objective:</b> Although therapists are encouraged to balance emotionally involving work on the patient's problems with need satisfaction in therapy sessions, effects of this balance have rarely been studied empirically. Hence, we examined congruence effects between problem-related affective and need-satisfying experiences in cognitive-behavioral therapy (CBT). <b>Method</b>: 165 distressed family caregivers rated problem-related affective experiences, need-satisfying experiences comprising self-esteem, positive interpersonal, and control experiences, as well as coping experiences after 12 CBT sessions. We examined within-person congruence effects of problem-related affective and need-satisfying experiences on subsequent coping in multilevel response surface analysis. Further, we included between-person problem-related affective and need-satisfying experiences and pretreatment depression and anxiety as moderators of within-person effects. <b>Results</b>: A slight predominance of self-esteem over problem-related affective experiences as well as exact correspondence between problem-related affective and both interpersonal and control experiences was most predictive of coping. Between-person moderators supported a cross-level balance heuristic of problem-related affective and self-esteem experiences. Finally, a stronger emphasis on self-esteem and interpersonal over problem-related affective experiences proved more beneficial for patients with high anxiety and low depression. <b>Conclusions</b>: The findings highlight the importance of balancing problem-related affective and need-satisfying experiences in CBT and provide insights into how balancing may be tailored to specific patients.</p>","PeriodicalId":48159,"journal":{"name":"Psychotherapy Research","volume":" ","pages":"1087-1102"},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141907952","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":"Correction.","authors":"","doi":"10.1080/10503307.2025.2455207","DOIUrl":"10.1080/10503307.2025.2455207","url":null,"abstract":"","PeriodicalId":48159,"journal":{"name":"Psychotherapy Research","volume":" ","pages":"i-iv"},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030162","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":"Association between nonverbal synchrony, alliance, and outcome in psychotherapy: Systematic review and meta-analysis.","authors":"Simone Jennissen, Julia Huber, Beate Ditzen, Ulrike Dinger","doi":"10.1080/10503307.2024.2423662","DOIUrl":"10.1080/10503307.2024.2423662","url":null,"abstract":"<p><strong>Objective: </strong>Research on nonverbal synchrony (NVS) as a core element in the therapeutic relationship has substantially increased and suggests that NVS influences therapeutic alliance and outcomes.</p><p><strong>Method: </strong>Studies on NVS regarding body movements, vocal pitch, peripheral physiological measures, and hormonal states were included. A random-effects multilevel meta-analysis was performed on 23 publications from 13 trials.</p><p><strong>Results: </strong>There was no significant overall association between NVS and alliance/outcome (<i>r</i> = .03, <i>p</i> = .644). Across modalities, there was a marginally significant association between higher NVS and smaller interpersonal problems (<i>r</i> = .10, <i>p</i> = .084) and a nonsignificant effect for the association between NVS and alliance (<i>r</i> = .06, <i>p </i>= .316), symptomatic outcome (<i>r</i> = -.06, <i>p</i> = .320), and other outcomes (<i>r</i> = .07, <i>p</i> = .255). There was significant heterogeneity between studies (<i>I</i>² = 56.47). Moderator analyses revealed that vocal pitch synchrony was negatively associated with alliance/outcome (<i>r</i> = -.20, <i>p</i> = .011), while NVS of peripheral physiological parameters was positively correlated with alliance/outcome (<i>r</i> = .32, <i>p</i> = .006).</p><p><strong>Conclusion: </strong>Findings suggest that specific modalities of NVS show specific associations with outcomes. More research is needed to investigate whether NVS across modalities reflects a unified underlying construct.</p>","PeriodicalId":48159,"journal":{"name":"Psychotherapy Research","volume":" ","pages":"1213-1228"},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717358","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":"Affect integration, metacognitions, and early maladaptive schemas as predictors of outcome in cognitive and metacognitive therapies for social anxiety disorder.","authors":"Jan Vegard Bakali, Ole André Solbakken, Asle Hoffart, Hege Brækhus, Elfrida Kvarstein, Sverre Urnes Johnson","doi":"10.1080/10503307.2024.2443499","DOIUrl":"10.1080/10503307.2024.2443499","url":null,"abstract":"<p><strong>Objective: </strong>Few reliable patient characteristics have emerged as significant predictors of outcomes for Social Anxiety Disorder (SAD). This study aimed to explore whether affect integration, metacognitions, and maladaptive schemas could serve as predictors of therapeutic outcomes for patients with SAD. Relationships between these psychological constructs and baseline SAD symptomatology were also examined.</p><p><strong>Methods: </strong>Eighty-eight patients across three sites participated in Cognitive Behavioral Therapy (CBT) or Metacognitive Therapy (MCT) for SAD in inpatient or outpatient clinics. Measures of predictors and SAD symptomatology were repeatedly assessed. Statistical analyses included longitudinal, multilevel modeling.</p><p><strong>Results: </strong>Difficulties with affect integration, metacognitions and early maladaptive schemas clearly related to higher levels of SAD symptoms at baseline but were not generally predictive of changes in SAD symptoms during therapy. However, examining sub-domains revealed that difficulties with the integration of jealousy and tenderness, and the maladaptive schema of defectiveness/shame, predicted poorer outcomes. In contrast, initial difficulties with the integration of sadness, a greater lack of cognitive confidence, and the maladaptive schema of dependence/incompetence were associated with greater symptom improvement.</p><p><strong>Conclusion: </strong>Identifying issues of affect integration and core self-other beliefs prior to therapy may enhance patient selection and allow for a more individualized treatment.</p>","PeriodicalId":48159,"journal":{"name":"Psychotherapy Research","volume":" ","pages":"1149-1161"},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899231","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":"Correction.","authors":"","doi":"10.1080/10503307.2024.2439714","DOIUrl":"10.1080/10503307.2024.2439714","url":null,"abstract":"","PeriodicalId":48159,"journal":{"name":"Psychotherapy Research","volume":" ","pages":"v"},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142789755","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":"Examining within- and between-member cohesion and working alliance effects on group members' motivation: a preliminary actor-partner interdependence study.","authors":"Kun Wang, Lisa Brownstone, Martin Kivlighan","doi":"10.1080/10503307.2024.2385399","DOIUrl":"10.1080/10503307.2024.2385399","url":null,"abstract":"<p><strong>Objective: </strong>Informed by the person-environment fit theory, this preliminary study examined if a fit between a group member's treatment experience and their working therapy context (other group members' aggregated treatment experiences) were related to their level of motivation within a group treatment for healing from internalized weight stigma.</p><p><strong>Method: </strong>We examined the relationship between two types of within-member and between-member's group cohesion, working alliance, and motivation. Specifically, we utilized the Actor-Partner Interdependence Model to operationalize the impact of actor's within-member cohesion and alliance (personal changes over time) and between-member cohesion and alliance (individual differences) as well as partner's within-member cohesion and alliance (contextual changes over time) and between-member cohesion and alliance (contextual differences) on group members' motivation. This study utilized self-report data from 26 group members who participated in three online weight stigma psychotherapy groups.</p><p><strong>Results: </strong>For cohesion, results suggested that the relationship between partner within-member cohesion and motivation was larger for members who reported low cohesion across all the sessions compared to the other members of their group. Additionally, an individual group member who perceived a group session more cohesive than they did on average, reported increased motivation in that session, and this relationship was stronger for members who on average perceived their group less cohesive than other group members. Lastly, session-level alliance was more strongly associated with an individual member's motivation in that session when the other group members reported higher group alliance on average.</p><p><strong>Conclusions: </strong>These findings underscore the significance of member-group fit in group therapy and the reciprocal impact of individual members and the group on each other's therapy outcomes.</p>","PeriodicalId":48159,"journal":{"name":"Psychotherapy Research","volume":" ","pages":"1261-1274"},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141894620","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":"Emotional and interpersonal states following dialectical behavioral therapy in adolescent borderline personality disorder: A proof-of-concept ecological momentary assessment outcome study.","authors":"Julian Koenig, Sibille Steiner, Corinna Reichl, Marialuisa Cavelti, Ronan Zimmermann, Klaus Schmeck, Michael Kaess","doi":"10.1080/10503307.2024.2385396","DOIUrl":"10.1080/10503307.2024.2385396","url":null,"abstract":"<p><p><b>Objective:</b> The effects of Dialectical Behavioral Therapy for Adolescents (DBT-A) on emotional and interpersonal instability were explored in adolescents exhibiting Borderline Personality Disorder (BPD) features, using ecological momentary assessment (EMA) to reduce recall bias.<b>Method:</b> <i>N</i> = 28 help-seeking female adolescents were enrolled, meeting ≥ 3 DSM-IV BPD criteria. BPD criteria, non-suicidal self-injury (NSSI), and depressive symptoms were examined pre- and post-DBT-A treatment (<i>mean</i> duration: 42.74 weeks, <i>SD</i> = 7.46). Participants maintained e-diaries pre- and post-treatment, hourly rating momentary affect, attachment to mother and best friend, and self-injury urges.<b>Results:</b> Interview-rated BPD symptoms decreased (χ²(1) = 5.66, <i>p</i> = .017), alongside reduced self-rated depression severity (χ²(1) = 9.61, <i>p</i> = .002). EMA data showed decreased NSSI urges (χ²(1) = 9.05, <i>p</i> = .003) and increased mother attachment (χ²(1) = 6.03, <i>p</i> = .014). However, mean affect, affective instability, mean attachment to the best friend, and attachment instability showed no significant change over time.<b>Conclusion:</b> DBT-A yielded limited evidence for altering momentary affective states and instability in adolescents based on EMA. Nevertheless, significant effects were observed in reducing NSSI urges and enhancing interpersonal dynamics during treatment, as assessed via EMA.</p>","PeriodicalId":48159,"journal":{"name":"Psychotherapy Research","volume":" ","pages":"1175-1184"},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141898679","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}