British Journal of Clinical Psychology最新文献

{"title":"The therapeutic alliance during remotely delivered therapy: A Delphi study with health professionals.","authors":"Sam Tyrell, Sandra Bucci, Katherine Berry","doi":"10.1111/bjc.12544","DOIUrl":"https://doi.org/10.1111/bjc.12544","url":null,"abstract":"<p><strong>Objectives: </strong>Delivering psychological therapy via videoconferencing and telephone is now commonplace across mental health services, but many therapists remain concerned about the impact on the therapeutic alliance. This study aimed to establish consensus amongst psychological therapists regarding the factors involved in establishing and maintaining the therapeutic alliance during remote therapy interventions.</p><p><strong>Methods: </strong>Psychological therapists from a range of professional backgrounds were invited to complete a three-Round Delphi survey online. Round 1 generated qualitative data which was used to develop a list of statements relating to key factors in establishing and maintaining alliance in therapy delivered over the telephone or videoconferencing. Participants were invited to rate their level of agreement with these statements in Rounds 2 and 3.</p><p><strong>Results: </strong>Of the 149 participants who completed Round 1, 93 completed Round 2, and 71 participants completed all three Rounds. Following Round 3, a high level of agreement (above 80%) was obtained in relation to 31/63 statements reflecting communication style, contracting, quality and value, environment, emotional differences, effort, and technological aspects of engaging clients in this way. Participants reported similar views for therapies delivered via telephone and videoconferencing.</p><p><strong>Discussion: </strong>Clinicians who have had to navigate the rapid rise in online delivery of therapy have valuable insights which warrant sharing amongst communities of practicing therapists and those in training. Identifying factors which therapists agree are important in developing alliances with patients remotely also guides researchers in identifying factors that warrant further investigation through empirical studies.</p>","PeriodicalId":48211,"journal":{"name":"British Journal of Clinical Psychology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The timing of symptom change and early treatment response in a self-guided digital treatment for obsessive-compulsive disorder.","authors":"Madelyne A Bisby, Bethany Wootton, Blake F Dear","doi":"10.1111/bjc.12543","DOIUrl":"https://doi.org/10.1111/bjc.12543","url":null,"abstract":"<p><strong>Objective: </strong>Self-guided digital treatment is effective for many people with OCD-however, little is known about when during treatment people experience significant symptom reductions. In addition, there is substantial variability in the literature regarding what factors predict treatment responding in self-guided digital treatment for OCD. There is preliminary evidence to suggest that adults with OCD may show early treatment responding (i.e., significant symptom reductions within the first month of treatment) and that this early response could be associated with better post-treatment outcomes.</p><p><strong>Methods: </strong>In a secondary analysis (n = 123), the current study examined the timing and magnitude of symptom change during self-guided digital CBT, the incidence of early response (at 4-weeks), and whether early treatment response predicted post-treatment response (at 8-weeks). These analyses were conducted for OCD symptoms (primary) and depression symptoms (secondary).</p><p><strong>Results: </strong>Results indicated a gradual reduction in OCD and depression symptoms across treatment. Although fewer participants experienced an early response in OCD symptoms (22%) compared to depression symptoms (45%), early response was significantly associated with an increased likelihood of post-treatment response in both symptom domains.</p><p><strong>Conclusions: </strong>These findings highlight that individuals with OCD symptoms may experience reductions in different symptom types at different points during treatment and that early response may be a prognostic factor for overall treatment response in this population across outcomes.</p>","PeriodicalId":48211,"journal":{"name":"British Journal of Clinical Psychology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding excessive sleep in people with psychotic disorders.","authors":"Kate Robbins, Joanne Hodgekins, Sarah Reeve","doi":"10.1111/bjc.12538","DOIUrl":"https://doi.org/10.1111/bjc.12538","url":null,"abstract":"<p><strong>Background: </strong>There has been increasing attention to sleep disturbances such as insomnia in psychosis, due to its impact on symptoms, well-being, and recovery. However, excessive sleep and extended sleep duration are common in psychosis (partly linked to sedating antipsychotic medication) and have been relatively neglected, despite plausible interactions with symptoms, functioning, and broader well-being.</p><p><strong>Aim: </strong>This study aimed to explore the experience of extended sleep duration and excessive sleepiness, or their combination (hypersomnia) in people with psychotic disorders through a qualitative interview around the experience, impacts, contributors, and role of treatment.</p><p><strong>Method: </strong>Ten patients experiencing excessive sleep (defined as excessive daytime sleepiness >3 days a week; extended sleep duration of > 11 h in 24 h or >9 h at night; or a combination of these) alongside a diagnosed psychotic disorder were recruited. They met with the researcher online to participate in a semi-structured interview, which was analysed using thematic analysis.</p><p><strong>Results: </strong>Five major themes were developed: (1) The Exhausting Everyday, (2) Medication is the story? (3) Indescribable Tiredness, (4) Overruled by Sleep and (5) An Unfair Fight. Excessive sleep impacts multiple domains of individual well-being and recovery - for example, limiting patients in everyday tasks and socializing. Cycles of emotional avoidance and inactivity were identified as potential maintainers or exacerbators of excessive sleep, in addition to medication side effects. Patients reported difficulty conveying the impact of their sleepiness symptoms to clinicians or others.</p><p><strong>Conclusion: </strong>The results support that excessive sleep requires further attention as a problematic and impactful sleep presentation in this group. Further research is needed to improve recognition and assessment of problematic excessive sleep, and how existing practices or novel treatments may be applied to reduce its impact on recovery.</p>","PeriodicalId":48211,"journal":{"name":"British Journal of Clinical Psychology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-compassion promotes social safeness in patients with eating disorders: A 12-week longitudinal study.","authors":"Aleece Katan, Jacqueline C Carter, Allison C Kelly","doi":"10.1111/bjc.12542","DOIUrl":"https://doi.org/10.1111/bjc.12542","url":null,"abstract":"<p><strong>Objectives: </strong>Social safeness, the affective experience of being comforted and soothed by others, promotes positive mental health and when compromised, contributes to mental illness. Although there is some knowledge about the factors that give rise to social safeness, research has focused on developmental predictors such as parental warmth, leaving it unclear how adults who lacked these early experiences can feel socially safe. Self-compassion is a skill that can be cultivated; it involves directing warmth inward and may thereby facilitate emotional states akin to social safeness. We tested this theory in a population known for low social safeness, adults with eating disorders, by examining whether increases in self-compassion facilitated subsequent increases in social safeness during a cognitive-behavioural group-based treatment.</p><p><strong>Design: </strong>A longitudinal design was used.</p><p><strong>Methods: </strong>Eighty-six patients with eating disorders completed the Eating Disorder Examination Questionnaire, Self-Compassion Scale, and Social Safeness and Pleasure Scale approximately every three weeks over a 12-week intensive eating disorder treatment program.</p><p><strong>Results: </strong>Multilevel modelling revealed that following periods of increased self-compassion, individuals reported higher levels of social safeness (B_t1 = .16, p < .01; B_t2 = .18, p < .05). Additionally, individuals with higher average levels of self-compassion over the course of treatment experienced higher social safeness (B = .53, p < .01).</p><p><strong>Conclusion: </strong>Findings suggest that the cultivation of self-compassion may facilitate the feelings of social safeness that individuals with eating disorders generally lack. Results therefore highlight the role that the development of self-compassion can play in fostering social safeness in people with psychological disorders.</p>","PeriodicalId":48211,"journal":{"name":"British Journal of Clinical Psychology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sleep dysfunction in social anxiety disorder.","authors":"Roni Oren-Yagoda, Adi Tene, Idan M Aderka","doi":"10.1111/bjc.12541","DOIUrl":"https://doi.org/10.1111/bjc.12541","url":null,"abstract":"<p><strong>Background: </strong>Anxiety disorders frequently co-occur with sleep disturbances, and social anxiety disorder (SAD) is no exception (Journal of affective disorders, 2020, 260, 200).</p><p><strong>Aims: </strong>The present study examined differences in sleep dysfunction between individuals with and without SAD as well as the temporal relationship between reported sleep quality and anxiety in individuals' daily lives.</p><p><strong>Materials & methods: </strong>Eighty-seven participants took part in the study: 44 met diagnostic criteria for SAD and 43 did not. Both groups completed a daily diary measurement to assess the levels of experienced anxiety and sleep quality every day for 21 consecutive days.</p><p><strong>Results: </strong>Individuals with SAD reported significantly poorer sleep across all measured variables compared with those without SAD. Hierarchical linear modelling (HLM) analyses showed reciprocal effects between sleep duration and anxiety, with both variables predicting each other on subsequent days. In addition, sleep quality and time to fall asleep predicted subsequent anxiety but not vice versa.</p><p><strong>Discussion: </strong>The findings suggest that sleep could play an important role in the maintenance of social anxiety.</p><p><strong>Conclusion: </strong>Sleep interventions targeting duration, quality, and time to fall asleep may be beneficial for improving SAD symptoms.</p>","PeriodicalId":48211,"journal":{"name":"British Journal of Clinical Psychology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143721971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Training emotion recognition in depression-An experimental study.","authors":"Mira A Preis, Katja Schlegel, Sophie Rehbein, Katja Lorenz, Timo Brockmeyer","doi":"10.1111/bjc.12540","DOIUrl":"https://doi.org/10.1111/bjc.12540","url":null,"abstract":"<p><strong>Background: </strong>Patients with depression often show a reduced emotion recognition ability (ERA), which is considered to contribute to interpersonal difficulties and thereby to the development and maintenance of the disorder. In light of the lack of experimental studies testing this hypothesis, the present study investigated whether a single session of computerized training can enhance ERA in patients with depression and whether this affects interpersonal problems and symptoms of depression.</p><p><strong>Methods: </strong>Forty outpatients with major depressive disorder or persistent depressive disorder were randomly assigned to a single session of either computerized training of ERA (TERA) or a sham training. One day prior to and 14 days after training, ERA, interpersonal problems and symptoms of depression were recorded.</p><p><strong>Results: </strong>Both groups showed significant improvements in ERA and in symptoms of depression. Participants who received TERA showed greater improvements in ERA than participants who received sham training. However, the groups did not differ regarding changes in symptoms of depression, and none of the groups showed significant changes in interpersonal problems.</p><p><strong>Conclusions: </strong>A single session of computerized training can effectively improve ERA in patients with depression. In the short term, however, TERA neither affected interpersonal problems nor symptoms of depression.</p>","PeriodicalId":48211,"journal":{"name":"British Journal of Clinical Psychology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143650344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving access to help with poor sleep across youth mental health services: Interim implementation and clinical outcomes.","authors":"Rebecca Rollinson, Ben Ewing, Sarah Reeve, Adam Graham, Jonathan Lyons, Brioney Gee, Jonathon Wilson, Ioana Tofan, Kelly Semper, Tim Clarke","doi":"10.1111/bjc.12531","DOIUrl":"https://doi.org/10.1111/bjc.12531","url":null,"abstract":"<p><strong>Objectives: </strong>There is a high, unmet sleep need in young people with mental health difficulties. We took a whole-system approach to improving access to sleep support across a youth mental health system (14-25 years).</p><p><strong>Methods: </strong>We used the Exploration, Preparation, Implementation and Sustainment (EPIS) framework to develop an implementation programme (The Better Sleep Programme) incorporating two levels of training: (i) therapeutic practitioners received training and supervision in CBT for insomnia (CBTi) adapted for young people with mental health difficulties, (ii) non-therapeutic practitioners received knowledge and skills workshops. Implementation and clinical outcome measures were collected.</p><p><strong>Design: </strong>Implementation outcomes of acceptability, adoption, appropriateness, accessibility and fidelity were considered for the programme and CBTi intervention within it. Clinical outcomes for the CBTi intervention covered sleep, wellbeing and personal goals and were evaluated using a pre-post comparison within-subject design.</p><p><strong>Results: </strong>High levels of attendance and uptake were seen for CBTi training (210 therapeutic practitioners from 18 services) and workshops (270 attendees from 29 services). Five of the six core service areas trained were routinely offering the CBTi intervention. Significant improvements were seen across all clinical outcome measures (n = 83, p ≤ 0.001 to p ≤ 0.05) with moderate to large effect sizes observed across measures of sleep (d = 0.61-1.35), mental health (d = 0.57-1.26) and personal goals (d = 1.77).</p><p><strong>Conclusions: </strong>This centrally-funded, system-wide implementation programme shows significant promise as a means of improving sleep in young people with mental health difficulties. High uptake with encouraging clinical outcomes was seen across services. Further evaluation is required to establish sustainability and generalizability.</p>","PeriodicalId":48211,"journal":{"name":"British Journal of Clinical Psychology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intolerance of uncertainty causally affects indecisiveness.","authors":"Helmut Appel, Alexander L Gerlach","doi":"10.1111/bjc.12534","DOIUrl":"https://doi.org/10.1111/bjc.12534","url":null,"abstract":"<p><strong>Objectives: </strong>Intolerance of uncertainty (IU) is characterized by a pervasive negative reaction to uncertainty. It is a transdiagnostic risk factor for various mental disorders. Since decisions often need to be made in the face of uncertainty, IU is associated with indecisiveness, a dispositional difficulty in making decisions. Indecisiveness is also linked to a range of mental disorders. While IU is seen as a causal factor in indecisiveness, experimental studies on this assumption are lacking.</p><p><strong>Methods: </strong>In this pre-registered, adequately powered study (N = 301), IU was experimentally increased or decreased compared to a control group, and the effect on indecisiveness was observed. Indecisiveness was assessed in a situational context, focusing on two decisions that were personally relevant to participants.</p><p><strong>Results: </strong>The manipulation successfully affected IU. As predicted, increased IU led to more indecisiveness across both decisions compared to decreased IU. Exploratory analyses found that situational IU mediated the effect of the experimental manipulation on indecisiveness.</p><p><strong>Conclusions: </strong>The results are the first to demonstrate a causal effect of IU on indecisiveness, thus contributing to the explanation of indecisiveness and the role that uncertainty management plays in it. Moreover, they have implications for treating various mental disorders by highlighting the role of IU in the transdiagnostic phenomenon of indecisiveness.</p>","PeriodicalId":48211,"journal":{"name":"British Journal of Clinical Psychology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fighting against self-stigma in adults with self-reported diagnosis of OCD: A single-arm pilot study using a mobile app-based intervention.","authors":"S Arnáez, M Roncero, J López-Santiago, G Del Valle, E Cabedo, G Bottesi, G García-Soriano","doi":"10.1111/bjc.12537","DOIUrl":"https://doi.org/10.1111/bjc.12537","url":null,"abstract":"<p><strong>Background: </strong>Obsessive-compulsive disorder (OCD) is a disabling disorder, and self-stigma negatively impacts quality of life, symptom severity and self-esteem. esTOCma is a smartphone-based serious game developed to increase knowledge about OCD and reduce stigma. It features 10 missions using psychoeducation, indirect contact and cognitive restructuring. Players help 10 characters escape the OCD stigma monster.</p><p><strong>Aims: </strong>To explore, in individuals with a self-reported diagnosis of OCD, the feasibility, acceptability and preliminary effectiveness of esTOCma to change self-stigma and knowledge about OCD, OC severity, guilt, quality of life and self-esteem.</p><p><strong>Materials and methods: </strong>A single-arm pilot study with 130 participants who completed esTOCma and pre-, post- and 3-month follow-up assessments.</p><p><strong>Results: </strong>Half of participants spent 9-10-days playing with the app and most of them found it useful/very useful and easy to use. Self-stigma was associated with higher OC symptoms, guilt and lower quality of life, self-esteem and knowledge about OCD. After using the app, participants showed lower levels of self-stigma, OC symptoms and guilt, and higher levels of quality of life, self-esteem and knowledge about OCD. Changes were maintained or increased at a 3-month follow-up.</p><p><strong>Discussion: </strong>esTOCma is a feasible and acceptable app that could help people with OCD to increase their knowledge and understanding of the disorder, dismiss self-stigma and OC symptoms, and at the same time increase self-esteem and quality of life. A replication of the study with a control sample is needed to validate our findings.</p><p><strong>Conclusion: </strong>Tools like the esTOCma app, accessible 24/7, offer a means to tackle self-stigma detrimental effects.</p>","PeriodicalId":48211,"journal":{"name":"British Journal of Clinical Psychology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emotion-related impulsivity factors and intolerance of uncertainty are uniquely associated with interpersonal-psychological risk factors for suicide.","authors":"Amelia S Dev, Theresa Davison, Hannah C Broos, Sheri L Johnson, Kiara R Timpano","doi":"10.1111/bjc.12535","DOIUrl":"https://doi.org/10.1111/bjc.12535","url":null,"abstract":"<p><strong>Objectives: </strong>The interpersonal-psychological theory of suicide identifies three risk factors for suicidal behaviours: perceived burdensomeness, thwarted belongingness, and acquired capability. We sought to clarify relationships between the interpersonal-psychological risk factors and two individual difference factors, emotion-related impulsivity (ERI) and intolerance of uncertainty (IU).</p><p><strong>Methods: </strong>In the current study, we analysed self-report scales from a large community sample (N = 169) that was oversampled for individuals with elevated suicidality. We considered two separate factors of ERI: Pervasive Influence of Feelings, which measures how much a person's emotions shape their worldview, and Feelings Trigger Action, which measures impulsive behavioural reactivity to emotions. We tested unique effects of ERI and IU and the interactions of ERI × IU on the three interpersonal-psychological risk factors using linear regression models.</p><p><strong>Results: </strong>Pervasive Influence of Feelings correlated with higher perceived burdensomeness and thwarted belongingness, whereas Feelings Trigger Action correlated with higher perceived burdensomeness and acquired capability. Within the regression models, IU correlated significantly with lower acquired capability but not perceived burdensomeness or thwarted belongingness. Interactions of ERI × IU were not significant.</p><p><strong>Conclusions: </strong>These results demonstrate the importance of considering both factors of ERI in understanding the risk for suicide. Our results also provide novel evidence that while IU may not impact risk factors such as perceived burdensomeness and thwarted belongingness, higher levels of IU may serve as some protection against individuals' acquired capability for suicidal action. Limitations and implications of findings are discussed.</p>","PeriodicalId":48211,"journal":{"name":"British Journal of Clinical Psychology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}