Psychotherapy Research最新文献

{"title":"Client characteristics and early working alliance development: A person-centered research approach.","authors":"Wilson T Trusty, Louis G Castonguay, Caitlin L Chun-Kennedy, Sultan A N Magruder, Rebecca A Janis, Katherine A Davis, Dominic C Augustin, Brett E Scofield","doi":"10.1080/10503307.2024.2418868","DOIUrl":"10.1080/10503307.2024.2418868","url":null,"abstract":"<p><strong>Objective: </strong>Certain client characteristics are associated with early working alliance difficulties in psychotherapy. However, there is limited quantitative evidence on whether combinations of these characteristics (e.g., intersectional identities, prior treatment experiences) are related to alliance development. The present study leveraged a person-centered research approach to examine profiles of early alliance development and differences in the latent class structure of client characteristics among alliance development profiles.</p><p><strong>Method: </strong>Individual psychotherapy clients (<i>N </i>= 2,579) rated the working alliance for their first four sessions and self-reported demographics, treatment history, and psychological distress. Therapists provided their assessment of clients' primary presenting concerns at baseline.</p><p><strong>Results: </strong>Latent profile analysis revealed three profiles of working alliance development: <i>high and stable</i>, <i>moderate and increasing</i>, and <i>low and stable</i>. Follow-up person-centered analyses (multigroup confirmatory latent class analysis) indicated that clients in the alliance profiles differed in their combinations of clinical and demographic characteristics. For example, women of color with high baseline distress and a history of prior psychotherapy were over-represented in the <i>low and stable</i> alliance profile.</p><p><strong>Conclusion: </strong>These results are consistent with recommendations to holistically consider how clients' characteristics and experiences shape psychotherapy processes. Results also highlight the utility of person-centered quantitative methods in psychotherapy research.</p>","PeriodicalId":48159,"journal":{"name":"Psychotherapy Research","volume":" ","pages":"1229-1243"},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548341","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":"Using machine learning methods to identify trajectories of change and predict responders and non-responders to short-term dynamic therapy.","authors":"Refael Yonatan-Leus, Gershom Gwertzman, Orya Tishby","doi":"10.1080/10503307.2024.2420725","DOIUrl":"10.1080/10503307.2024.2420725","url":null,"abstract":"<p><p><b>Abstract</b><b>Objectives:</b> Predicting therapy responders can significantly improve clinical outcomes. This study aims to identify predictors of response to short-term dynamic therapy. <b>Methods:</b> Data from 95 patients who underwent 16-session therapy were analyzed using machine learning. Weekly progress was monitored with the Outcome Questionnaire (OQ45) and Target Complaints (TC). A machine learning model identified change trajectories for responders and non-responders, with a random forest algorithm and elastic net modeling predicting trajectory group membership using pre-treatment data. <b>Results:</b> A weak positive relationship was found between the trajectories of the two outcome variables. The results of the different analysis methods were compared and discussed. Important predictors of OQ45 trajectories, based on random forest modeling, included initial symptom severity, difficulties in emotion regulation, coldness, avoidant attachment, conscientiousness, interpersonal problems, non-acceptance of negative emotion, neuroticism, emotional clarity, impulsivity, and emotion awareness (72.8% accuracy). Initial problem severity, self-scarifying extraversion, and non-assertiveness were the most dominant predictors for TC trajectories (62.8% accuracy). <b>Conclusions:</b> These findings offer data-driven insights for selecting short-term dynamic therapy. Predicting response for the OQ45, a nomothetic measure, does not extend to the TC, an idiographic measure, and vice versa, highlighting the importance of multidimensional outcome evaluations for personalized treatment.</p>","PeriodicalId":48159,"journal":{"name":"Psychotherapy Research","volume":" ","pages":"1070-1086"},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510551","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":"Client resources and the prediction of therapeutic change using an interview: An exploratory study.","authors":"Carina Magalhães, João Tiago Oliveira, Andreia Milhazes, Pablo Fernández-Navarro, Rui Braga, Patrícia Pinheiro, Robert A Neimeyer, Miguel M Gonçalves","doi":"10.1080/10503307.2024.2394191","DOIUrl":"10.1080/10503307.2024.2394191","url":null,"abstract":"<p><p><b>Objectives:</b> Although psychotherapy research suggests that clients' resources are related to positive outcomes, there is a lack of clinical tools available to consider their integration into psychotherapy. In this exploratory research, we studied the feasibility of a semi-structured interview to identify resources reported by clients at the onset of therapy and the relationship between resources and therapy outcomes. <b>Methods:</b> Data consisted of interviews with 30 clients from a clinical trial, in which elicitation of resources and their relationship with the outcomes were the main study objectives. <b>Results:</b> This interview was content analyzed and both adaptative resources and maladaptive resources (dysfunctional coping strategies) were identified. The association between the adaptive resources and the evolution of outcomes throughout treatment was analyzed. Time (i.e. sessions) and resources were negatively correlated with psychological distress. Moreover, resources positively influenced the impact of time on distress. <b>Conclusions:</b> Clinicians should not take at face value resources that are self-reported, as they may reflect the maladaptive functioning of the client. The finding that clients with higher resources at onset have better outcomes points to the need to study how resources may be elicited effectively during therapy, and if this improves psychotherapy outcomes.</p>","PeriodicalId":48159,"journal":{"name":"Psychotherapy Research","volume":" ","pages":"1136-1148"},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142086328","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":"Is symptom outcome the whole story?-A multilevel meta-analysis of systemic therapy for adults including family system functioning.","authors":"Niels Braus, Christoph Flückiger, Johanna Wichmann, Christian Frankman, Antonia Lang, Christina Hunger-Schoppe","doi":"10.1080/10503307.2024.2394192","DOIUrl":"10.1080/10503307.2024.2394192","url":null,"abstract":"<p><strong>Objective: </strong>Systemic Therapy conceives mental health symptoms in the context of social systems. Previous meta-analyses on Systemic Therapy focused on symptoms. This meta-analysis aims to focus on family system functioning while including all types of outcomes.</p><p><strong>Method: </strong>We conducted a systematic literature research in multiple databases (PsycInfo, PubMed, Embase, Cochrane Central). We included RCT-studies on adults with psychiatric diagnoses, which compared Systemic Therapy with active psychosocial control. The literature research resulted in 171 coded effect sizes of 32 RCTs. We conducted a random-effects three-level meta-analysis. We categorized outcomes into symptoms of patients, family system functioning, further secondary outcomes of patients, and psychopathology of family members.</p><p><strong>Results: </strong>The results show a small significant overall effect size of <i>g </i>= .30 (<i>CI:</i> .15-.45<i>, p </i>< .001, <i>k</i> = 171, <i>s</i> = 32) for all outcomes. Systemic Therapy revealed small effect sizes with regard to family system functioning (<i>g </i>= .34, <i>z</i> = 3.51, <i>p </i>= .0004, <i>k</i> = 26, <i>s</i> = 12), symptoms (<i>g </i>= .30, <i>z</i> = 3.74, <i>p </i>= .0002, <i>k</i> = 73, <i>s</i> = 29), and further secondary outcomes (<i>g </i>= .32, <i>z </i>= 3.83, <i>p </i>= .0001, <i>k</i> = 63, <i>s</i> = 19). The effect sizes for psychopathology of family system members were reported rarely (<i>k </i>= 9, <i>s </i>= 6).</p><p><strong>Conclusion: </strong>This meta-analysis shows the potential relevance of investigating family system functioning as a primary outcome for Systemic Therapy.</p>","PeriodicalId":48159,"journal":{"name":"Psychotherapy Research","volume":" ","pages":"1056-1069"},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142156394","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":"Effectiveness of solution-focused brief therapy: An umbrella review of systematic reviews and meta-analyses.","authors":"Andreea M Żak, Krzysztof Pękala","doi":"10.1080/10503307.2024.2406540","DOIUrl":"10.1080/10503307.2024.2406540","url":null,"abstract":"<p><strong>Objective: </strong>This umbrella review of systematic reviews and meta-analyses evaluates the effectiveness of Solution-Focused Brief Therapy (SFBT) across various populations and settings.</p><p><strong>Method: </strong>A total of 25 systematic reviews, including 15 meta-analyses, were analyzed. Reviews were included if they used systematic search methods and quality assessments and focused on the effectiveness of SFBT as a therapeutic approach.</p><p><strong>Results: </strong>SFBT demonstrated significant positive outcomes across different issues, settings, and cultural contexts, with no evidence of harm. High confidence in evidence of effectiveness was established for depression, overall mental health, and progress towards individual goals for the adult population. In addition, findings indicated mainly moderate confidence in evidence of SFBT effectiveness for a wide variety of outcomes for all age groups. No difference was found in the confidence in the evidence by world region, though Western and Eastern studies researched some different aspects.</p><p><strong>Conclusion: </strong>SFBT is an effective therapeutic approach for various psychological, social, school, medical, couple, or self-related issues. Further research with rigorous methodologies and comprehensive reporting is needed to strengthen the confidence in these findings and provide evidence for the brevity of the intervention.</p>","PeriodicalId":48159,"journal":{"name":"Psychotherapy Research","volume":" ","pages":"1043-1055"},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142337134","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":"Assessing the implementation of suicide-focused treatments delivered in hybrid telemental health format in a real-world setting.","authors":"Francesca Kassing, John R Seeley, Shireen L Rizvi, Scott N Compton, James Sinclair, Linda A Oshin, Kyla Blalock, David A Jobes, Jennifer Crumlish, Susan Stadelman, Filiz Gözenman-Sapin, Ted Snyderman, Allison K Ruork, Cassidy M Fry, Robert J Gallop, James Goodrich, Jacqueline Pistorello","doi":"10.1080/10503307.2024.2415104","DOIUrl":"10.1080/10503307.2024.2415104","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this study was to assess the implementation of suicide-focused treatments delivered via a hybrid telemental health (TMH) and in-person format.</p><p><strong>Method: </strong>This study was conducted at four university counseling centers (UCCs) across the United States. Treatment-seeking clients were recruited from their local UCCs and participated in adaptive treatment strategies (ATSs) involving Treatment as Usual (TAU), Collaborative Assessment and Management of Suicidality (CAMS), and Dialectical Behavior Therapy (DBT). Implementation outcomes, including appropriateness, acceptability, feasibility, fidelity, safety, and client satisfaction, were assessed. UCC clinicians participated in qualitative interviews focused on implementation of TMH for clients presenting with suicidal ideation (SI).</p><p><strong>Results: </strong>Overall, treatments delivered via hybrid format were reported to be appropriate, acceptable, feasible, and satisfactory by clinicians and clients. Implementation of TMH was reported to be equivalent to in-person treatment across multiple measurement methods.</p><p><strong>Conclusion: </strong>Results from this study demonstrate that TMH is an implementable treatment modality for addressing suicidality, particularly for college students presenting to UCCs with SI. This study has implications for real-world clinical settings planning to offer hybrid treatment modalities to address SI.<b>Trial registration:</b> ClinicalTrials.gov identifier: NCT04728815.</p>","PeriodicalId":48159,"journal":{"name":"Psychotherapy Research","volume":" ","pages":"1198-1212"},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12012162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510550","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":"Change in emotion-based narrative as a potential mechanism of change in a brief treatment for borderline personality disorder.","authors":"Ueli Kramer, Alessio Simonini, Ere Rrustemi, Romane Fellrath, Kim Stucchi, Eleonora Noseda, Chantal Martin Soelch, Stéphane Kolly, José Blanco-Machinea, Tali Boritz, Lynne Angus","doi":"10.1080/10503307.2024.2406543","DOIUrl":"10.1080/10503307.2024.2406543","url":null,"abstract":"<p><p><b>Background:</b> The move from inconsistent and problematic autobiographical narrative to a more coherent and reality-based narrative construction of the Self has been discussed as potential mechanism of change in psychotherapies for personality disorders. So far, little empirical evidence exists that demonstrates in a time-dependent design the role of narrative construction in the treatment of borderline personality disorder, in particular when it comes to understanding the integration of body-related information from the affective system with the autobiographical narrative. The present study aims at demonstrating change in emotion-based narrative markers over brief psychiatric treatment and to assess the impact of these changes on subsequent symptom change. <b>Methods:</b> A total of <i>N</i> = 57 clients with borderline personality disorder were assessed at three timepoint over the course of four months of brief psychiatric treatment, within the context of a secondary process-outcome analysis of a randomized controlled trial. Symptom change was assessed using the OQ-45.2 and emotion-narrative change was assessed using the Narrative-Emotion Process Coding System to code client's in-session speech in terms of problem, transition and change markers. <b>Results:</b> All three emotion-based marker categories evidenced significant changes in the assumed direction. The reduction in problem emotion-based narrative markers (e.g., empty story telling) between session 1 and 5 into the treatment predicted the symptom reduction assessed between session 5 and 10. <b>Conclusions:</b> Emotion-based narrative construction may be a suitable method to study the pathway of change toward a more coherent and reality-based narrative construction of the Self-in-interaction-with-the-Other. Reduction of emotion-based problem-marker may be a promising candidate for a mechanism of change in treatments for personality disorders which should be tested in a time-dependent controlled design.</p>","PeriodicalId":48159,"journal":{"name":"Psychotherapy Research","volume":" ","pages":"1162-1174"},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394316","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":"Exploring alliance ruptures through the lenses of therapeutic distance.","authors":"Sharon Egozi, Hadas Wiseman, Orya Tishby","doi":"10.1080/10503307.2024.2426550","DOIUrl":"10.1080/10503307.2024.2426550","url":null,"abstract":"<p><p><b>Objective:</b> To observe ruptures through clients' and therapists' experiences of closeness and distance in therapy. <b>Method:</b> Sixty-six clients and their 29 therapists underwent RAP interviews that were rated with the Therapeutic-Distance-Scale- observer version (TDS-O) and completed the Post-Session-Questionnaire (PSQ) three times along therapy (early, mid and late therapy). Using a dyadic model, we associated client and therapist self-report of ruptures with TDS-O observer ratings. <b>Results:</b> Clients' report of ruptures positively associated with clients' observed scores that the therapist was too distant, while therapists' report of ruptures related to their observed scores that the client was too close. Clients report that the rupture addressed related to their higher observed autonomy, but therapists report that the rupture addressed related to less client's autonomy. Resolution related to lower observed distance and higher observed engagement of both partners. In dyads in which the therapist was rated as experiencing distance, there was a higher level of resolution than in dyads in which the client observed as experiencing distance and the therapist did not. Clinical examples demonstrate how ruptures were manifested and understood through the therapeutic-distance prism. <b>Conclusions:</b> Observing the therapeutic-distance potentially improves therapists' ability to identify, negotiate, and resolve ruptures.</p>","PeriodicalId":48159,"journal":{"name":"Psychotherapy Research","volume":" ","pages":"1244-1260"},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717363","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":"Mechanisms of cognitive-behavioral and psychodynamic interventions for anxiety sensitivity- A randomized, controlled single-session study.","authors":"Maayan Gerecht Hacohen, Amit Sharoni, Baraa Kabha, Orya Tishby, Jonathan D Huppert","doi":"10.1080/10503307.2025.2548498","DOIUrl":"https://doi.org/10.1080/10503307.2025.2548498","url":null,"abstract":"<p><strong>Objective: </strong>This study utilized a single-session, randomized controlled analog design to investigate the mechanisms underlying cognitive-behavioral therapy (CBT) and psychodynamic therapy in treating anxiety sensitivity (AS). We hypothesized that changes in catastrophic interpretations of bodily sensations would predict reductions in AS in CBT, whereas improvements in panic-specific reflective functioning (pRF) would predict changes in the psychodynamic intervention (PDTp).</p><p><strong>Methods: </strong>Participants with elevated AS (<i>N</i> = 110; Mage = 43, 91 women) were randomized to CBT, PDTp, or a control group. Pre-to-post changes in mechanisms were examined as predictors of changes in AS at post-treatment and one-month follow-up.</p><p><strong>Results: </strong>Results partially supported the hypotheses. Catastrophic interpretations changed significantly in the CBT condition. However, pRF did not change in any group. The relationship between changes in mechanisms and AS was more complex than predicted. In CBT, reductions in AS were closely tied to changes in interpretations. Within-session, distress declined in CBT but did not consistently predict AS change. pRF change was related to AS reductions only in CBT.</p><p><strong>Conclusion: </strong>These findings highlight the clinical relevance of targeting catastrophic thinking in brief CBT for AS, and suggest that pRF may play a secondary role. Future work should test these mechanisms in clinical settings and longer treatments.</p>","PeriodicalId":48159,"journal":{"name":"Psychotherapy Research","volume":" ","pages":"1-14"},"PeriodicalIF":3.0,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144974561","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":"Targeting mechanisms of change as a path to precision psychotherapy for community settings.","authors":"Nili Solomonov","doi":"10.1080/10503307.2025.2545284","DOIUrl":"https://doi.org/10.1080/10503307.2025.2545284","url":null,"abstract":"<p><p>There have been exciting advancements in mechanisms of change research, but most innovations are rarely applied in community settings. Growing depression rates and clinician shortage call for a significant change in the field. I suggest that mechanisms of change research is a promising path to develop precision psychotherapies for the community. I focus on five key problems and possible solutions to advance psychotherapy through mechanisms research: (1) Depression is heterogeneous and patients' profiles vary. Identifying each patient's unique mechanism can inform precision psychotherapies that target this mechanism; (2) research often relies on self-reports, limiting precision. A multimodal approach with objective measures (e.g., brain, behaviors, voice, language) can improve precise measurement of mechanisms and guide personalization; (3) there is a need for simplified first-line treatments that community therapists can deliver. Simplified psychotherapies and digital interventions can target key mechanisms, enhancing efficacy and cost-effectiveness; (4) methods and technologies are evolving rapidly, no single lab can encompass all necessary expertise. Interdisciplinary collaborations can accelerate mechanisms research; (5) insights from mechanisms research are rarely applied due to academia-clinical practice disconnect. Research-practice networks can develop and tailor targeted psychotherapies for underserved communities. Taken together, discovering key mechanisms of change can improve psychotherapy precision, efficacy and effectiveness in real-world settings.</p>","PeriodicalId":48159,"journal":{"name":"Psychotherapy Research","volume":" ","pages":"1-11"},"PeriodicalIF":3.0,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144974590","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}