Psychotherapy Research最新文献

{"title":"Therapeutic techniques and session impact: A practice-research network study in private practice.","authors":"Louis G Castonguay, Soo Jeong Youn, James F Boswell, J Ryan Kilcullen, Henry Xiao, Andrew A McAleavey, Mary A Boutselis, Melora Braver, Nancy R Chiswick, Neal A Hemmelstein, Jeffrey S Jackson, Richard A Lytle, Marolyn E Morford, Heather S Scott, Catherine S Spayd, Mary O'Leary Wiley","doi":"10.1080/10503307.2023.2262099","DOIUrl":"10.1080/10503307.2023.2262099","url":null,"abstract":"<p><p><b>Objective:</b> This study investigated the relationship between therapeutic techniques and session impact, by examining the replicability of findings observed in a university-based training clinic (Boswell et al., 2010) in another practice-oriented setting: private practice.</p><p><p><b>Method:</b> <i>N</i> = 8 therapists completed session-level assessments of their technique use for <i>N</i> = 38 clients. The same client sample completed session-level assessments of session outcome. Technique-outcome associations were examined with multilevel models.</p><p><p><b>Results:</b> As in Boswell et al., common factors were associated with positive session impact. For clients who received higher average common factor techniques (relative to their own therapist's caseload), session impact was the poorest in sessions with higher behavioral change techniques use (relative to the client's own average). Moreover, clients with the lowest average common factor techniques (relative to their therapist's caseload) reported better session impact in sessions that involved a higher degree of session-level behavioral change techniques (relative to their own average).</p><p><p><b>Conclusion:</b> In line with Boswell et al., therapists should be mindful of the consistency of their routine technique use between- and within-clients, and this can be aided through collection of their own practice-oriented data.</p>","PeriodicalId":48159,"journal":{"name":"Psychotherapy Research","volume":" ","pages":"845-857"},"PeriodicalIF":2.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72015646","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 resistance management skill from psychotherapy experience, intellectual humility and emotion regulation.","authors":"Alyssa A Di Bartolomeo, Udi Alter, David A Olson, Max B Cooper, Tali Boritz, Henny A Westra","doi":"10.1080/10503307.2023.2280240","DOIUrl":"10.1080/10503307.2023.2280240","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;i&gt;Objective&lt;/i&gt; Resistance management in psychotherapy remains a foundational skill that is associated with positive client outcomes (Westra, H. A., & Norouzian, N. (2018). Using motivational interviewing to manage process markers of ambivalence and resistance in cognitive behavioral therapy. &lt;i&gt;Cognitive Therapy and Research&lt;/i&gt;, &lt;i&gt;42&lt;/i&gt;(2), 193-203). However, little is known about which therapist characteristics contribute to successful management of resistance. Research has suggested that psychotherapy performance does not improve with experience (Goldberg, S. B., Rousmaniere, T., Miller, S. D., Whipple, J., Nielsen, S. L., Hoyt, W. T., & Wampold, B. E. (2016). Do psychotherapists improve with time and experience? A longitudinal analysis of outcomes in a clinical setting. &lt;i&gt;Journal of Counseling Psychology&lt;/i&gt;, &lt;i&gt;63&lt;/i&gt;(1), 1-11), that psychotherapists lack humility (Macdonald, J., & Mellor-Clark, J. (2015). Correcting psychotherapists' blindsidedness: Formal feedback as a means of overcoming the natural limitations of therapists. &lt;i&gt;Clinical Psychology & Psychotherapy&lt;/i&gt;, &lt;i&gt;22&lt;/i&gt;(3), 249-257), and that difficult therapeutic moments may dysregulate therapist emotions (Muran, J. C., & Eubanks, C. F. (2020). &lt;i&gt;Therapist performance under pressure: Negotiating emotion, difference, and rupture&lt;/i&gt;. American Psychological Association). This study aimed to 1) identify whether psychotherapy experience (i.e., training versus no training and number of years of psychotherapy experience) was associated with resistance management skill, and 2) identify whether humility and difficulties regulating emotions among trained individuals were each associated with resistance management. &lt;b&gt;Method:&lt;/b&gt; A sample of 76 trained and 98 untrained participants were recruited for the present study. All participants completed the Comprehensive Intellectual Humility Scale (CIHS, Krumrei-Mancuso, E. J., & Rouse, S. V. (2016). The development and validation of the comprehensive intellectual humility scale. &lt;i&gt;Journal of Personality Assessment&lt;/i&gt;, &lt;i&gt;98&lt;/i&gt;(2), 209-221), the Difficulties in Emotion Regulation Scale (DERS; Gratz, K. L., & Roemer, L. (2004). Multidimensional assessment of emotion regulation and dysregulation: Development, factor structure, and initial validation of the difficulties in emotion regulation scale. &lt;i&gt;Journal of Psychopathology and Behavioral Assessment&lt;/i&gt;, &lt;i&gt;26&lt;/i&gt;(1), 41-54), and the Resistance Vignette Task (RVT; Westra, H. A., Nourazian, N., Poulin, L., Hara, K., Coyne, A., Constantino, M. J., Olson, D., & Antony, M. M. (2021). Testing a deliberate practice workshop for developing appropriate responsivity to resistance markers: A randomized clinical trial. &lt;i&gt;Psychotherapy&lt;/i&gt;, &lt;i&gt;58&lt;/i&gt;, 175-185 ) which was used to assess resistance management skill. &lt;b&gt;Results:&lt;/b&gt; Trained individuals performed significantly better on resistance management than untrained individuals; however, years of experience within the trained sample were","PeriodicalId":48159,"journal":{"name":"Psychotherapy Research","volume":" ","pages":"885-898"},"PeriodicalIF":2.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"107592481","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":"Moments of change: Clients' immediate experiences when sharing emotions in psychotherapy.","authors":"Gøril Solberg Kleiven, Aslak Hjeltnes, Heidi Brattland, Christian Moltu","doi":"10.1080/10503307.2023.2260938","DOIUrl":"10.1080/10503307.2023.2260938","url":null,"abstract":"<p><strong>Objective: </strong>In-session processing of emotions is important in facilitating psychotherapeutic change. This study explores how clients in active treatment experience inner changes when sharing emotions in psychotherapy sessions. The aim was to retrieve in-depth knowledge about clients' moment-by-moment experiences of change in a naturalistic psychotherapy context.</p><p><strong>Method: </strong>Two psychotherapy sessions (session 3 or 4 and session 7 or 8) were videotaped and immediately followed by semi-structured interviews with clients (<i>n</i> = 11) in the format of Interpersonal Process Recall (IPR). Interviews were analysed using thematic analysis.</p><p><strong>Results: </strong>Four themes resulted from analysis: (1) reaching a new clarity about inner struggles; (2) a shift in how I approach and experience my feelings; (3) grieving losses and gaining a more positive understanding of myself; (4) feeling relief and liberation when allowing difficult emotions.</p><p><strong>Conclusion: </strong>The resulting themes took into account the importance of the felt quality of change experiences within sessions, which appears to be important in making micro-processes of change salient. Across themes, we found accounts of shifts in awareness and self-compassion, which we discuss as micro-outcomes that clients can ideally be guided to dwell with.</p>","PeriodicalId":48159,"journal":{"name":"Psychotherapy Research","volume":" ","pages":"872-884"},"PeriodicalIF":2.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41104933","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":"Short-term psychoanalytic psychotherapy with depressed adolescents: Comparing in-session interactions in good and poor outcome cases.","authors":"Guilherme Fiorini, Yushi Bai, Peter Fonagy, Nick Midgley","doi":"10.1080/10503307.2023.2270140","DOIUrl":"10.1080/10503307.2023.2270140","url":null,"abstract":"<p><p><b>Objective:</b> To identify and describe in-session interaction patterns between psychoanalytic therapists and adolescents diagnosed with major depressive disorder, comparing good and poor outcome cases. <b>Method:</b> Audio recordings for 100 psychotherapy sessions from 10 Short-Term Psychoanalytic Psychotherapies were analysed using the Adolescent Psychotherapy Q-Set (APQ). The cases and sessions were evenly divided into two groups (poor outcome and good outcome, 5 patients and 50 sessions per group). Interaction patterns were analysed with an Exploratory Factor Analysis (EFA), while group differences were assessed through <i>t</i>-tests. <b>Results:</b> The EFA revealed three factors: (1) \"Open, engaged young person working collaboratively with a therapist to make sense of their experiences\", (2) \"Directive therapist with a young person fluctuating in emotional state and unwilling to explore\", (3) \"Young person expressing anger and irritation and challenging the therapist\". Factor 1 was significantly more prominent in the good outcome cases, while factor 3, on the contrary, was more significantly related to the poor outcome cases. Factor 2 was equally present in both groups. <b>Conclusion:</b> Besides reinforcing to researchers and clinicians the association between a collaborative psychotherapy process with good outcomes, our findings also provide empirical data regarding the role of anger in adolescent depression and the psychotherapy process.</p>","PeriodicalId":48159,"journal":{"name":"Psychotherapy Research","volume":" ","pages":"991-1004"},"PeriodicalIF":2.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72015736","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":"Empirical examination of long-term and intensive psychodynamic psychotherapy for severely disturbed patients.","authors":"Gaby Shefler, Maayan Abargil, Refael Yonatan-Leus, Ron Finkenberg, Ilan Amir","doi":"10.1080/10503307.2023.2263810","DOIUrl":"10.1080/10503307.2023.2263810","url":null,"abstract":"<p><p><i>Objectives</i> This study examines the effectiveness and efficiency of intensive psychodynamic psychotherapy for severely impaired patients. <b>Method:</b> 104 patients in four public mental health centers underwent intensive psychodynamic psychotherapy. The number and duration of psychiatric hospitalizations were monitored for these patients from one year before therapy to eight years after. Several outcome variables were measured every six months, six times in total over two and a half years, using a longitudinal design. A multi-level analytic approach was applied to account for repeated measurements and missing data. <b>Results:</b> Significant improvement was found in all three symptomatic outcome measures (SCL-90, OQ-45, BDI) throughout treatment. The numbers of psychiatric hospitalizations and psychiatric hospitalization days decreased significantly from the level they were in the year before the start of psychodynamic treatment to three years after the start of treatment. These results were maintained for at least up to eight years. After capitalization, the overall cumulative 127.47-day decrease in hospitalization days equals savings of 115,850 NIS. The average cost of treatment after capitalization was 26,770 NIS. The insurer's estimated direct savings is 89,080 NIS (24,054 $). <b>Conclusion:</b> These findings support the hypothesis that psychodynamic psychotherapy is clinically effective and economically efficient for severely impaired patients.</p>","PeriodicalId":48159,"journal":{"name":"Psychotherapy Research","volume":" ","pages":"925-940"},"PeriodicalIF":2.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41139881","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 relationship between general psychopathology in young people with family functioning and engagement with psychotherapy.","authors":"Vera Regina Röhnelt Ramires, Guilherme Fiorini, Fernanda Munhoz Driemeier Schmidt, Camila Piva Da Costa, Elenice Deon, Rob Saunders","doi":"10.1080/10503307.2023.2281549","DOIUrl":"10.1080/10503307.2023.2281549","url":null,"abstract":"<p><strong>Objective: </strong>to examine whether an underlying general psychopathology factor (p factor) existed in children and adolescents attending psychodynamic psychotherapy and whether this general psychopathology factor was associated with family functioning and engagement with psychotherapy.</p><p><strong>Method: </strong>Participants were 1976 children and adolescents, and their families, who sought psychodynamic psychotherapy from a community-based clinic in Southern Brazil. The Child Behavior Checklist and the Family Adaptability and Cohesion Evaluation Scales for assessing symptoms and family functioning were used, with treatment engagement data available through linked records. Confirmatory factor analytic methods examined psychopathology and regression models were constructed to examine associations.</p><p><strong>Results: </strong>A general psychopathology factor and specific internalizing and externalizing factors were identified. Higher general psychopathology scores at assessment were associated with an increased likelihood of dropout and poorer attendance compared to completing treatment. Father's educational level, living with both parents, lack of family adaptability and cohesion, and maltreatment experience were related to increased p factor severity.</p><p><strong>Conclusion: </strong>General psychopathology severity seems to contribute to child and adolescent psychotherapy outcomes, increasing the risk of non-adherence and dropout. Family difficulties and traumatic experiences may increase p factor severity. Identifying general psychopathology routinely can be crucial for developing effective treatment plans.</p>","PeriodicalId":48159,"journal":{"name":"Psychotherapy Research","volume":" ","pages":"957-971"},"PeriodicalIF":2.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138048204","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":"Secret-keeping in therapy by clients who are sexually attracted to children.","authors":"Sara Jahnke, Nicholas Blagden, Ian V McPhail, Jan Antfolk","doi":"10.1080/10503307.2023.2265047","DOIUrl":"10.1080/10503307.2023.2265047","url":null,"abstract":"<p><p><i>Objective</i> This study investigated the reasons why pedohebephilic clients disclose their sexual attraction to children in therapy and the experiences associated with this decision among English-speaking samples. <b>Method</b>: The pre-registered online survey combined (1) quantitative correlational data of self-reported improvement, alliance, therapist reaction to disclosure, and the belief that mandatory reporting laws were in place, and (2) qualitative data about reasons for disclosure or no disclosure as well as perceived consequences. The sample consisted of pedohebephilic people who have been clients in therapy and have disclosed (<i>n</i> = 96) or not disclosed (<i>n</i> = 40). <b>Results:</b> While the disclosure and no disclosure groups did not differ in improvement or beliefs about mandatory reporting, those who had disclosed reported a stronger alliance. Clients who did not perceive the therapist's reaction as supportive reported less improvement than the no disclosure group. Thematic analysis of qualitative data identified three themes concerning motives for disclosing or not disclosing and a fourth regarding differential impacts of disclosure. <b>Discussion</b>: This study indicates that disclosing pedohebephilia does not in and of itself lead to improvement but is contingent on a therapist's reaction.</p>","PeriodicalId":48159,"journal":{"name":"Psychotherapy Research","volume":" ","pages":"941-956"},"PeriodicalIF":2.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41239933","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":"Practice-based insights from specialized clinicians into youth suicide risk assessment and psychotherapy: A qualitative study.","authors":"Di Simes, Ian Shochet, Kate Murray, Duncan J Gill","doi":"10.1080/10503307.2023.2253360","DOIUrl":"10.1080/10503307.2023.2253360","url":null,"abstract":"<p><p><i>Objective:</i> The experience of frontline clinicians is an underutilized source of knowledge about improving youth suicide intervention. This qualitative study explored the perspectives of highly experienced, specialized mental health clinicians on the practical application of risk assessment, stabilization, and treatment and their experience of working in this practice area.<i>Method:</i> Data were collected from seven focus groups with 28 clinicians and analyzed using consensual qualitative research methods.<i>Results:</i> Four domains emerged, describing 1) youth suicide intervention as relationally focused and attachment-informed, 2) the need for flexible and tailored care balancing individual and family intervention in the context of family complexity and fractured relationships, 3) a nuanced, therapeutic approach to managing the complexity and uncertainty of adolescent suicide risk, and 4) working in youth suicide intervention as emotionally demanding and facilitated or hampered by the organizational and systems context.<i>Conclusion:</i> The importance of harnessing family systems and attachment-informed approaches to alliance, risk assessment, and treatment was emphasized, along with the parallel need for systemic clinician support and consideration of the potential negative consequences of administrative and risk management protocols.</p>","PeriodicalId":48159,"journal":{"name":"Psychotherapy Research","volume":" ","pages":"972-990"},"PeriodicalIF":2.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41152393","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":"\"Picking up the pieces\": Patients' retrospective reflections of rupture resolution episodes during treatment.","authors":"Tal Ben David-Sela, Liat Leibovich, Yara Khoury, Clara E Hill, Sigal Zilcha-Mano","doi":"10.1080/10503307.2023.2245128","DOIUrl":"10.1080/10503307.2023.2245128","url":null,"abstract":"<p><p><i>Objective:</i> Although theorists and researchers have stressed the importance of rupture resolution episodes for successful treatment process and outcome, little is known about patients' retrospective reflections about rupture resolution. <b>Aim:</b> The overarching goal of the present study was to use a mixed-method approach to examine patients' retrospective reflections on the frequency, types, and consequences of rupture resolution episodes and the association between rupture resolution episodes and patients' attachment orientation and treatment outcome. <b>Method:</b> Thirty-eight patients diagnosed with major depressive disorder (MDD) were interviewed, on average three years after termination, about their experiences of ruptures in short-term dynamic psychotherapy. <b>Results:</b> Thirty patients reported having experienced at least one rupture, with patients who showed less improvement in depressive symptoms more likely to report having had a rupture. Ruptures were judged as having been successfully resolved for 13 of these patients; suggesting that patients with a high level of attachment anxiety were less likely to be judged as having had a successful resolution. Patients whose ruptures were successfully resolved with the therapist's help reported better treatment process and outcome than patients whose ruptures were not successfully resolved. <b>Conclusion:</b> Results highlight the importance of hearing patients' perspectives on ruptures, rupture resolution, and treatment outcome.</p>","PeriodicalId":48159,"journal":{"name":"Psychotherapy Research","volume":" ","pages":"858-871"},"PeriodicalIF":2.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10021315","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 meaning and feeling of the time and space between psychotherapy sessions and everyday life: Client experiences of transitions.","authors":"Andrzej Werbart, Ulf Rådberg, Isa Holm, David Forsström, Anne H Berman","doi":"10.1080/10503307.2023.2274061","DOIUrl":"10.1080/10503307.2023.2274061","url":null,"abstract":"<p><strong>Objective: </strong>To explore how clients in psychodynamic or psychoanalytic psychotherapy, conducted in the traditional in-person setting, experience the transitions in time and space between psychotherapy sessions and everyday life.</p><p><strong>Method: </strong>Twelve semi-structured interviews were analyzed with inductive experiential thematic analysis, focusing on how the participants experience and make sense of the phenomenon in focus.</p><p><strong>Results: </strong>The participants described therapy as a sheltered space where they could be open, vulnerable, receptive, and present. Approaching and leaving psychotherapy sessions, the participants established different behavioral patterns and routines dealing with their anxieties and resistances. In this in-between area, the participants could handle interconnections and differences between therapy and everyday life. Participants stressed the clinical impact of transitions: transitions affect both therapy and everyday life; disturbed transitions have an adverse impact; transitions are insufficiently addressed in therapy.</p><p><strong>Conclusion: </strong>Transitions between therapy and life appear to be an essential but seldom recognized part of the therapy process beyond the borders of therapy sessions. Implications of these findings for psychotherapy training and practice are discussed, and a tentative transtheoretical framework for further research is proposed.</p>","PeriodicalId":48159,"journal":{"name":"Psychotherapy Research","volume":" ","pages":"899-912"},"PeriodicalIF":2.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61565530","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}