Psychotherapy Research最新文献

{"title":"Hope predicts long-term well-being following cognitive behavioral therapy for anxiety and related disorders.","authors":"Laura J Long, Nicole D Cardona, Audrey Hey, Julián Moreno, David H Barlow, Todd J Farchione","doi":"10.1080/10503307.2025.2523479","DOIUrl":"https://doi.org/10.1080/10503307.2025.2523479","url":null,"abstract":"<p><strong>Objective: </strong>Prior research indicates that cognitive behavioral therapy (CBT) results in moderate-to-large increases in hope and well-being, though long-term treatment outcomes are less clear. This study examined whether gains in these outcomes were maintained up to 36 months after CBT and whether hope - an established change mechanism during treatment - was associated with sustained well-being during long-term follow-up when controlling for post-treatment anxiety and depression.</p><p><strong>Method: </strong>A subset of 69 participants [M_age = 30.29 (<i>SD</i> = 9.94) yrs, 62.32% female, 89.86% White, 89.85% Non-Hispanic/Latinx] with anxiety disorders from a randomized equivalence trial of transdiagnostic and single-diagnosis CBT protocols were re-consented into a long-term follow-up study and completed assessments every 6 months across 3 years.</p><p><strong>Results: </strong>Standardized mean gain scores and multilevel modeling (MLM) revealed no significant differences in well-being or hope between post-treatment and follow-up timepoints in either condition. MLM indicated that higher hope at the within-person (standardized γ₁₀ = 0.26, <i>p</i> < .001) and between-person levels (standardized γ₀₁ = 0.42, <i>p</i> < .001) were associated with greater well-being across long-term follow-up, whereas post-treatment anxiety and depression were not significant predictors.</p><p><strong>Conclusion: </strong>Findings suggest sustained increases in hope may help preserve gains in well-being up to 3 years after CBT.</p>","PeriodicalId":48159,"journal":{"name":"Psychotherapy Research","volume":" ","pages":"1-14"},"PeriodicalIF":3.0,"publicationDate":"2025-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144974459","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":"Physiological, acoustic, and self-reported responses to benign and challenging therapy situations: A pilot study with psychotherapy trainees.","authors":"Kim De Jong, Noha M Yassen, Tom M Seinen, Cosima Nimphy, Noemi M Platania, Natasha L Hughes, Kane Steggles","doi":"10.1080/10503307.2025.2539403","DOIUrl":"https://doi.org/10.1080/10503307.2025.2539403","url":null,"abstract":"<p><strong>Objective: </strong>Challenging therapy situations are interpersonally charged moments in therapy and can serve as a critical marker for assessing therapists' interpersonal skills. This study aimed to investigate trainee therapists' stress response during such situations.</p><p><strong>Method: </strong>Trainees (<i>n</i> = 46) completed both the Facilitative Interpersonal Skills performance task to measure challenging therapy situations and an additional benign condition depicting interpersonally neutral moments in therapy. We assessed heart rate, heart rate variability, skin conductance level, fundamental frequency, speech rate, and self-reported distress to measure stress throughout the task.</p><p><strong>Results: </strong>Analyses show differences on most outcome measures between the benign and challenging condition in the predicted direction (more arousal), although there was no alignment with self-reported distress.</p><p><strong>Conclusion: </strong>These findings highlight the promising nature of considering trainees' stress responses in different therapy situations in future research.</p>","PeriodicalId":48159,"journal":{"name":"Psychotherapy Research","volume":" ","pages":"1-10"},"PeriodicalIF":3.0,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144974571","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":"Supervised therapist and supervisor impact on client therapy outcomes.","authors":"Heidi A Vogeler, Katie Allphin, Brett M Merrill, Lane Fischer","doi":"10.1080/10503307.2025.2548906","DOIUrl":"https://doi.org/10.1080/10503307.2025.2548906","url":null,"abstract":"<p><p><b>Objective:</b> We examined the impact of supervisor and supervised therapist factors on client psychotherapy outcomes as measured by the Outcome Questionnaire 45.2 (OQ-45). We hypothesized that random effects would account for only a small portion of the variance in client change scores and in the trajectory of client change over time.<b>Methods:</b> A total of 4,691 clients, 146 supervised therapists, and 43 supervisors from a large college counseling center in the Western United States were included in the study. Hierarchical linear modeling (HLM) was used to analyze the data.<b>Results:</b> While random supervised therapist effects accounted for a small but significant proportion of variance in change scores, random supervisor effects were not significant. Fixed effects of initial severity and clinic type were significant predictors. This corroborated findings from the previous studies. Results of the growth model revealed time as the only significant random effect, and supervisee experience along with its interaction with time as the only significant fixed effects.<b>Conclusion:</b> These findings suggest that supervisees have small and unique influences on client therapy outcomes, while supervisor direct impact on client outcomes appears statistically insignificant.</p>","PeriodicalId":48159,"journal":{"name":"Psychotherapy Research","volume":" ","pages":"1-10"},"PeriodicalIF":3.0,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144974552","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":"Leveraging large language models to identify microcounseling skills in psychotherapy transcripts.","authors":"Karin Hammerfald, Fabian Schmidt, Vladimir Vlassov, Henrik Haaland Jahren, Ole André Solbakken","doi":"10.1080/10503307.2025.2539405","DOIUrl":"https://doi.org/10.1080/10503307.2025.2539405","url":null,"abstract":"<p><p><b>Objective:</b> Microcounseling skills are fundamental to effective psychotherapy, yet manual coding is time- and resource-intensive. This study explores the potential of large language models (LLMs) to automate the identification of these skills in therapy sessions. <b>Method:</b> We fine-tuned GPT-4.1 on a set of psychotherapy transcripts annotated by human coders. The model was trained to classify therapist utterances, generate explanations for its decisions, and propose alternative responses. The pipeline included transcript preprocessing, dialogue segmentation, and supervised fine-tuning. <b>Results:</b> The model achieved solid performance (Accuracy: 0.78; Precision: 0.79; Recall: 0.78; F1: 0.78; Specificity: 0.77; Cohen's <i>κ</i>: 0.69). It reliably detected common and structurally distinct skills but struggled with more nuanced skills that rely on understanding implicit relational dynamics. <b>Conclusion:</b> Despite limitations, fine-tuned LLMs have potential for enhancing psychotherapy research and clinical practice by providing scalable, automated coding of therapist skills.</p>","PeriodicalId":48159,"journal":{"name":"Psychotherapy Research","volume":" ","pages":"1-19"},"PeriodicalIF":3.0,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144859785","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":"Conflict of interest in trials of internet-based interventions for depression: Systematic review and meta-regression.","authors":"Thomas Munder, Berit Barthelmes, Lenny Weber, Christoph Flückiger, André Kerber, Tobias Krieger, Birgit Watzke, Markus Wolf","doi":"10.1080/10503307.2025.2538549","DOIUrl":"https://doi.org/10.1080/10503307.2025.2538549","url":null,"abstract":"<p><strong>Objective: </strong>To investigate (a) the prevalence of industry sponsorship (InS), researchers' financial conflicts of interest (RFCOI) and researcher allegiance (RA) in clinical trials of internet-based interventions (IBI) for depression and (b) their possible relation with treatment effects.</p><p><strong>Method: </strong>We conducted a systematic review and meta-analysis of 94 comparisons of therapist-guided or self-guided IBI with a passive control group.</p><p><strong>Results: </strong>InS was present in 13 (38.24%) out of 34 comparisons of commercial IBI; RFCOI was present in 29 (30.85%), RA in 75 (79.79%) out of all 94 comparisons. In primary meta-regressions, presence of InS and RFCOI was significantly associated with larger treatment effects, while presence of RA was not. Overall, sensitivity analyses showed consistent results, but suggested differential results for trials of therapist-guided and self-guided IBI: While InS and RFCOI showed larger effects in trials of self-guided IBI, no effect was found for trials of therapist-guided IBI.</p><p><strong>Conclusion: </strong>InS, RFCOI, and RA are prevalent and should receive more attention in IBI research. The role of RA on outcome warrants further investigation because this meta-analysis did not include comparative trials. Small effect sizes in trials without InS or RFCOI suggest that current meta-analytic efficacy estimates of self-guided IBI for depression are overestimated.</p>","PeriodicalId":48159,"journal":{"name":"Psychotherapy Research","volume":" ","pages":"1-11"},"PeriodicalIF":3.0,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144838272","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":"Experience of self-discovery and change in a psychodynamic internet delivered programme for university students experiencing low mood.","authors":"Rose Mortimer, Dominika Iluczyk, Jakob Mechler, Karin Lindqvist, Nick Midgley, Gerhard Andersson, Henry Clements","doi":"10.1080/10503307.2025.2538552","DOIUrl":"https://doi.org/10.1080/10503307.2025.2538552","url":null,"abstract":"<p><strong>Objective: </strong>Psychodynamic \"talking\" therapies have been adapted to be delivered over the internet, with remote guidance from a therapist. The aim of this study is to explore participants' experiences of change during an internet-delivered psychodynamic psychotherapy (iPDT), with findings discussed in the light of psychodynamic theory.</p><p><strong>Method: </strong>Interviews were conducted with fifteen university students who had taken part in a 10-week therapist-supported iPDT programme for low mood. Data was analysed using Reflexive Thematic Analysis.</p><p><strong>Results: </strong>Participants described several experiences which fit closely with the hypothesized change mechanisms for iPDT, including: increased capacity for self-observation, learning to directly feel and accept difficult emotions, coming to recognize and change maladaptive defences, making sense of how early experiences had contributed to the development of these defences, and experimenting with new ways of relating to others and self.</p><p><strong>Conclusion: </strong>Overall, participants' experiences of change and self-discovery align with psychodynamic theory. This journey was described by many as an empowering yet challenging process.<b>Trial registration:</b> ClinicalTrials.gov identifier: NCT06133582.</p>","PeriodicalId":48159,"journal":{"name":"Psychotherapy Research","volume":" ","pages":"1-16"},"PeriodicalIF":3.0,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144822942","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":"Acceptability and preliminary effectiveness of the Unified Protocol in blended format in the Spanish public mental health system: Results from a Pilot Randomized Controlled Trial.","authors":"Laura Martínez-García, Carmen Schaeuffele, Óscar Peris-Baquero, María Ángeles Torres Alfosea, Jorge Osma","doi":"10.1080/10503307.2025.2541707","DOIUrl":"https://doi.org/10.1080/10503307.2025.2541707","url":null,"abstract":"<p><strong>Objective: </strong>This study evaluated the acceptability and preliminary effectiveness of the UP in blended format, combining face-to-face UP sessions with the use of the UP-App, versus Treatment as Usual (TAU) for treating Emotional disorders (ED) in Spanish specialized mental health units.</p><p><strong>Methods: </strong>A total of 76 adults presenting a diagnosis of ED were randomly assigned to UP + APP (<i>n</i> = 40) or TAU (<i>n</i> = 36) and completed self-report questionnaires at baseline, 3 and 6 months after treatment onset.</p><p><strong>Results: </strong>Improvements in both conditions for ODSIS (<i>b</i> = -2.84; <i>T</i> = -2.36), depressed mood (<i>b</i> = -6.85; <i>T</i> = 0.01), and the describing facet of mindfulness were found (<i>b</i> = 4.01; <i>T</i> = 2.31). No significant differences were found between both conditions in terms of treatment outcomes or in the Time∗Condition interaction. However, engagement with the UP-App understood as number of completed UP-App modules was related to improvements in emotion regulation and the acting with awareness facet of mindfulness, especially at 6 months, suggesting a possible time-dependent effect and UP-App modules completed. The UP-App showed good usability at 3 months (76.47) and excellent at 6 months (83.96), but low adherence (7.5% completers). Satisfaction with the treatment was similar in both conditions.</p><p><strong>Conclusions: </strong>This study suggests that the UP + APP may be as effective as TAU for ED in the SNHS. However, high dropout rates and low adherence to the UP-App constrain these results. Future research should explore a modified implementation format of the UP + APP ensuring a greater presence of the therapist, as well as an updated version of the UP-App incorporating feedback from the current study and new functionalities, in an RCT with a larger sample, as well as comparing standard UP vs UP + APP to determine the unique contribution of the UP-App on effectiveness, adherence, and user experience with UP.<b>Trial registration:</b>ClinicalTrials.gov identifier: NCT04304911.</p>","PeriodicalId":48159,"journal":{"name":"Psychotherapy Research","volume":" ","pages":"1-18"},"PeriodicalIF":3.0,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144822941","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":"Attitudes towards virtual reality usage in exposure treatment: Data from German practitioners and how a demonstration changes them.","authors":"Daniel Badeja, Florian Schier, Matthew McGinity, Jürgen Hoyer","doi":"10.1080/10503307.2025.2534978","DOIUrl":"https://doi.org/10.1080/10503307.2025.2534978","url":null,"abstract":"<p><strong>Background: </strong>Virtual reality exposure therapy (VRET) is well applicable within the framework of cognitive-behavioural anxiety treatment, yet its acceptance and implementation in psychotherapeutic practice remain unclear. This study assessed VRET-related attitudes among German psychotherapists and the impact of a brief demonstration on their intention to use VRET.</p><p><strong>Methods: </strong>The study involved an online survey (<i>N</i> = 140) and an optional on-site scenario demonstration (<i>n</i> = 45). Self-reported attitudes, experience rates, and Usage Intention were assessed. Predictors of Usage Intention were identified via hierarchical multiple regression. A linear mixed model estimated the demonstration's effect on Usage Intention.</p><p><strong>Results: </strong>Only 7.9% of participants reported at least occasional VR use in practice. A majority (78.7%) indicated a generally positive attitude towards VRET. While 77.9% participants could <i>imagine</i> integrating VRET into their work, only 20.0% reported intending to do so in the next year. Usage Intention was predicted by Performance Expectancy and Facilitating Conditions, increasing significantly (<i>d</i> = 1.50) from screening to post-demonstration.</p><p><strong>Conclusion: </strong>Despite their interest in VR, VRET implementation among German psychotherapists' remains low. The substantial impact of hands-on demonstrations indicates the potential of experiential education programmes in promoting early-stage dissemination.</p>","PeriodicalId":48159,"journal":{"name":"Psychotherapy Research","volume":" ","pages":"1-18"},"PeriodicalIF":3.0,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754898","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":"Psychotherapist's Nonverbal Coordination Scale: Introducing a New Measurement Tool for Child Psychotherapy.","authors":"Zeynep Catay, Sibel Halfon, Miriam Steele, George Downing","doi":"10.1080/10503307.2025.2535571","DOIUrl":"https://doi.org/10.1080/10503307.2025.2535571","url":null,"abstract":"<p><strong>Objective: </strong>Current study aims to develop an observer-based rating system, Psychotherapists' Nonverbal Coordination Scale (PNC), to evaluate psychotherapists' ability to coordinate their nonverbal expression and body movement with those of the patient in child psychotherapy.</p><p><strong>Methods: </strong>PNC was implemented in a clinical trial of Mentalization Based Treatment for Children (MBT-C) involving 101 children and their 16 therapists. 269 videotaped sessions from three different time points in treatment were coded with PNC by trained coders. Sessions were also coded for affect regulation and adaptive play qualities. Child-reported therapeutic alliance and parent-reported child problem measures were collected after the sessions. Multilevel Modeling was utilized to evaluate PNC's convergent and criterion validity based on its association with these process and outcome variables.</p><p><strong>Results: </strong>Excellent inter-rater reliability was achieved among coders. PNC's convergent validity was supported through its positive correlation with the Attention Control Interventions of the MBT-C Adherence Scale. PNC total score was also found to predict better affect regulation and increased adaptive play within sessions as well as stronger therapeutic alliance and a steeper decline in symptoms.</p><p><strong>Conclusion: </strong>This study provides initial support for the use of PNC as a reliable and valid tool to evaluate therapist's skill level in nonverbal coordination<i>.</i></p>","PeriodicalId":48159,"journal":{"name":"Psychotherapy Research","volume":" ","pages":"1-14"},"PeriodicalIF":3.0,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144734022","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 role of positive emotions in accelerated experiential dynamic psychotherapy.","authors":"Niv Gross, Eran Bar-Kalifa, Ben Shahar","doi":"10.1080/10503307.2025.2534972","DOIUrl":"10.1080/10503307.2025.2534972","url":null,"abstract":"<p><p><b>Objective:</b> Contemporary theories suggest that positive emotions play an important role in psychotherapy. The present study examined the role of positive emotions in Accelerated Experiential Dynamic Psychotherapy (AEDP), a psychotherapy approach designed to process positive emotions. <b>Method:</b> Forty-six patients, with a wide variety of psychological difficulties, participated in a 16-session course of AEDP in a naturalistic study. Following each session, participants reported the extent to which they experienced positive and negative emotions during the session, their perceived quality of the session, and their levels of functioning during the previous week. They also completed outcome measures before, at the end, and at 6-month follow-up. <b>Results:</b> Using multi-level and cross-lagged panel models, the results showed that positive emotions were associated with better session outcomes and better functioning during the following week, independent of negative emotions. Positive emotions during the entire treatment predicted improvements in depressive symptoms and interpersonal functioning but not general distress as measured directly post-treatment. However, these latter associations were nonsignificant at the 6-month follow-up. <b>Conclusion:</b> These findings provide initial evidence supporting the notion that positive emotions may be an important ingredient in psychotherapy and highlight the importance of developing interventions designed to facilitate the processing of positive emotions.</p>","PeriodicalId":48159,"journal":{"name":"Psychotherapy Research","volume":" ","pages":"1-12"},"PeriodicalIF":3.0,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144734023","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}