Behavior Therapy最新文献

{"title":"Targeting Higher-Order Dimensions of Personality in Treatment as a Parsimonious Means to Address Co-Occurring Psychopathology","authors":"Shannon Sauer-Zavala,&nbsp;Madeline Kushner,&nbsp;Martina Fruhbauerova,&nbsp;Hannah Croom,&nbsp;Matthew W. Southward","doi":"10.1016/j.beth.2024.10.007","DOIUrl":"10.1016/j.beth.2024.10.007","url":null,"abstract":"<div><div>People with borderline personality disorder (BPD) commonly have co-occurring mental health conditions that may be accounted for by higher-order factors in dimensional models of psychopathology. BPD Compass is a cognitive-behavioral treatment developed to target broad personality domains (i.e., negative affectivity, antagonism, disinhibition) associated with BPD and related conditions. The purpose of the present study was to explore the extent to which BPD Compass can serve as a transdiagnostic intervention for these comorbid conditions. Participants (<em>N =</em> 100; <em>M</em>_age <em>=</em> 28.13, 73.7% female, 79.6% White, 66% sexual minority) were assigned to either immediately begin treatment (randomized and naturalistic) or receive treatment after an 18-week waiting period. At baseline, participants met criteria for an average of 3.28 (<em>SD =</em> 2.02, range: 0–8) comorbid diagnoses ranging in clinical severity from 3.30 (for substance use disorder) to 4.91 (for persistent depressive disorder). Posttreatment clinical severity ratings (CSRs) for those randomized to receive BPD Compass were below clinical thresholds for all assessed conditions except premenstrual dysphoric disorder, whereas post-waitlist CSRs remained above clinical thresholds for all disorders except bipolar II, agoraphobia, and major depressive disorder. Collapsed across all patients who received BPD Compass, pre- to posttreatment improvements were significant and large in magnitude for most disorders assessed. These results suggest that BPD Compass may be an efficacious transdiagnostic intervention, though our small sample and high rate of dropout warrant further study.</div></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"56 4","pages":"Pages 738-752"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144312873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Internet-Delivered Rumination-Focused CBT Intervention for Adults With Depression and Anxiety: A Randomized Controlled Trial","authors":"Bogdan Tudor Tulbure,&nbsp;Diana Paula Dudău,&nbsp;Ștefan Marian,&nbsp;Edward Watkins","doi":"10.1016/j.beth.2024.12.004","DOIUrl":"10.1016/j.beth.2024.12.004","url":null,"abstract":"<div><div>Targeting transdiagnostic psychopathological mechanisms like repetitive negative thinking (RNT; worry, rumination) could improve interventions for depression and anxiety. The goal of the current study was to test whether therapist-supported internet-based RNT-targeting cognitive behavioral therapy reduces RNT, anxiety, and depression in adults with elevated RNT and anxiety and/or depression. To this end, a single-blind, two-arm parallel-group superiority randomized controlled trial (RCT) was conducted with 118 adults across Romania with elevated levels of worry and/or rumination and at least a subclinical/clinical diagnosis of major depressive disorder (MDD), dysthymia, generalized anxiety disorder (GAD), social anxiety disorder (SAD), or panic disorder. Eligible participants were randomized to internet rumination-focused CBT (i-RF-CBT; <em>n</em> = 59) or a waitlist control group (i-RF-CBT delayed 7 weeks; <em>n</em> = 59). Primary outcome was changes in perseverative thinking, anxiety, and depression 7 weeks after randomization. Secondary outcomes included changes on all measures after 6 months in the i-RF-CBT condition only. Participants in the i-RF-CBT arm showed significantly lower levels of perseverative thought [PTQ] (<em>d</em> = 0.44, 95% CI [0.23, 0.64], <em>p</em>&lt;.001), brooding (<em>d</em> = 0.56, 95% CI [0.35, 0.77], <em>p</em> &lt; .001), worry [PSWQ] (<em>d</em> = 0.62; 95% CI [0.40, 0.84], <em>p</em> &lt; .001), anxiety [GAD7] (<em>d</em> = 0.41; 95% CI [0.21, 0.62], <em>p</em> &lt; .001), and depression [PHQ9] (<em>d</em> = 0.38; 95% CI [0.18, 0.58], <em>p</em> &lt; .001) after 7 weeks, relative to waitlist control. Improvements were maintained at the 6-month follow-up. The results showed that i-RF-CBT significantly reduced RNT, worry, rumination, anxiety, and depression in adults with anxiety and/or major depressive disorders, providing proof of principle that this approach can target RNT and that targeting RNT has transdiagnostic benefits on anxiety and depression symptoms.</div></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"56 4","pages":"Pages 785-798"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144312756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Idionomic Network Analysis of Trichotillomania Treatment Processes: Gathering Group-Level and Individual-Level Insights to Inform a Personalized Therapeutic Framework","authors":"Mercedes G. Woolley,&nbsp;Baljinder K. Sahdra,&nbsp;Emily M. Bowers,&nbsp;Leila K. Capel,&nbsp;Michael P. Twohig,&nbsp;Michael E. Levin","doi":"10.1016/j.beth.2025.01.006","DOIUrl":"10.1016/j.beth.2025.01.006","url":null,"abstract":"<div><div>Trichotillomania, characterized by repetitive hair-pulling, leads to significant distress and impairment. Heterogeneity in symptom profiles challenges the effectiveness of treatment protocols for trichotillomania. Recent research endorses personalized treatment, emphasizing the assessment of biopsychosocial processes to tailor interventions more closely to the individual. This shift to a process-based, person-centered framework necessitates analytic methods capable of probing beyond nomothetic patterns to unveil nuanced individual-level processes. This study utilized Group Iterative Multiple Model Estimation (GIMME) to examine group-level and individual-level network dynamics as an initial step towards a process-based treatment framework for trichotillomania. Ecological momentary assessment data from 54 affected individuals were analyzed to identify shared patterns applicable at the group level and individual level for individualized treatment. Analysis revealed a nomothetic process dynamically related to cognitive fixation on the urge to pull. At the individual level, notable variability in network structures emerged. While centrality measures consistently identified the urge to pull as a pivotal process within GIMME individual-level networks, the influence of other processes differed considerably between individuals. Results indicate that despite some shared components, the heterogeneity within individual networks calls for customized treatment approaches, and the assessment of psychological process dynamics at the individual level. These insights support incorporating idionomic methods into the developmental stages of personalized interventions.</div></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"56 4","pages":"Pages 851-865"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144312826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preferences for Justice-Based Exposure and Response Prevention Among Individuals With Identity-Related Obsessive-Compulsive Disorder","authors":"Caitlin M. Pinciotti,&nbsp;Blake M. Upshaw,&nbsp;Samuel D. Spencer,&nbsp;Jennifer M. Park,&nbsp;Martin E. Franklin,&nbsp;Lauren P. Wadsworth,&nbsp;Bradley C. Riemann,&nbsp;Wayne K. Goodman,&nbsp;Eric A. Storch","doi":"10.1016/j.beth.2024.12.001","DOIUrl":"10.1016/j.beth.2024.12.001","url":null,"abstract":"<div><div>Justice-based exposure and response prevention (ERP) has been touted as an alternative approach to (mis)uses and “Fear Factor” overcorrection applications of ERP for obsessive-compulsive disorder (OCD) with identity-related themes (i.e., sexual orientation, gender identity, racism, age, disability/diagnostic status, and economic-themed). Justice-based exposure maintains fidelity to the theoretical and evidence-based mechanisms of ERP while avoiding inadvertent stigmatization of marginalized communities. Justice-based ERP also avoids contributing to societal stigma while potentially increasing buy-in among patients. Despite its widespread support across the OCD field, empirical evidence regarding preferences for justice-based ERP is currently lacking. The present study sought to compare perspectives on justice-based and overcorrection ERP approaches to identity-related OCD themes among 450 individuals with current or past identity-related obsessions (85.6% female, <em>M</em> age = 32.0). Participants reviewed idiographic, symptom-specific justice-based and overcorrection ERP hierarchies for each endorsed symptom theme and were asked a series of questions regarding their perspectives on each hierarchy. Participants reported a considerable preference for justice-based exposures over overcorrection exposures for these themes. Specifically, while overcorrection exposures were associated with higher anxiety expectancy, participants were much more likely to report a willingness to engage in justice-based exposures, perceived them to be more relevant and effective, and found them to be less derogatory and offensive than overcorrection exposures. Findings support the notion that (mis)uses and overcorrection exposures for identity-related OCD themes represent a “Fear Factor” approach that prioritizes anxiety increase at the expense of functionality, and that a justice-based approach may be better aligned with participants’ values and treatment expectancies.</div></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"56 4","pages":"Pages 753-767"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144312874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is the Unified Protocol for Children Effective for the Transdiagnostic Treatment of Children’s Emotional Disorders? A Randomized Controlled Trial","authors":"Brígida Caiado,&nbsp;Raquel Guiomar,&nbsp;Bárbara Gomes-Pereira,&nbsp;Ana Carolina Góis,&nbsp;Bruno de Sousa,&nbsp;Maria Cristina Canavarro,&nbsp;Jill Ehrenreich-May,&nbsp;Helena Moreira","doi":"10.1016/j.beth.2024.09.002","DOIUrl":"10.1016/j.beth.2024.09.002","url":null,"abstract":"<div><div>The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Children (UP-C) aims to reduce internalizing symptoms in children by addressing fundamental mechanisms that underlie emotional disorders through a combination of cognitive, emotional, and behavioral strategies. This study, the largest randomized controlled trial (RCT) to date of UP-C efficacy and the first one conducted outside the U.S., assesses the efficacy of UP-C compared to an active control group. A total of 153 children (6–13 years old; 58.8% girls) with at least one emotional disorder as a primary diagnosis and their parents (88.2% mothers) were randomly assigned to either the UP-C condition (<em>n</em> = 77) or an active control condition (<em>n</em> = 76; receiving a psychoeducational intervention, the <em>ABC of Emotions</em>). Participants completed self-report questionnaires at pretreatment, midtreatment, posttreatment, and at the 3-month follow-up, assessing children’s internalizing symptoms and their interference with the child and family functioning. Clinicians assessed the severity of the child’s symptoms and monitored clinical improvement throughout the study. Descriptive statistics, comparative tests and Linear Mixed Models were used. Results showed greater satisfaction, lower dropout rates, and better adherence in the UP-C condition, with a reduced need for additional interventions posttreatment compared to the control group. The UP-C demonstrated significantly greater efficacy in reducing internalizing symptoms, with a large effect size, including anxiety and depression, as well as in reducing the interference and severity of child symptoms and in improving clinical gains compared to the control group. These findings provide strong support for UP-C as a feasible, acceptable, and effective treatment for childhood emotional disorders, reinforcing its status as an evidence-based treatment.</div></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"56 4","pages":"Pages 689-707"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144313027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility of Using ChatGPT to Generate Exposure Hierarchies for Treating Obsessive-Compulsive Disorder","authors":"Emily E. Bernstein,&nbsp;Adam C. Jaroszewski,&nbsp;Ryan J. Jacoby,&nbsp;Natasha H. Bailen,&nbsp;Jennifer Ragan,&nbsp;Aisha Usmani,&nbsp;Sabine Wilhelm","doi":"10.1016/j.beth.2025.02.005","DOIUrl":"10.1016/j.beth.2025.02.005","url":null,"abstract":"<div><div>Obsessive-compulsive disorder (OCD) is a chronic, severe condition. Although exposure and response prevention (ERP), the first-line treatment for OCD, is highly effective, too few clinicians are equipped to deliver it. One barrier is the time and expertise required to develop personalized exposure hierarchies. In this study, we examined the feasibility and promise of using large language models (LLMs) to generate appropriate exposure suggestions for OCD treatment. We used ChatGPT-4 (Generative Pretrained Transformer, Version 4) to generate 10-item exposure hierarchies for simulated patient cases that were systematically varied along the following dimensions: OCD subtype, symptom complexity or number, level of detail, patient age, and patient gender. Expert clinicians also generated hierarchies for a subset of prompts. ChatGPT-generated hierarchies were first rated for completeness and degree to which input information was incorporated. Three OCD experts blinded to the aims of the study then rated each ChatGPT- and expert-generated hierarchy’s appropriateness, specificity, variability, safety/ethics, and overall usefulness or quality. ChatGPT generated partial (<em>n</em> = 15) or complete (<em>n</em> = 55) responses to 70 of 72 prompts and incorporated most input information (<em>M</em> = 4.29 out of 5, <em>SD</em> = 0.85). The only significant predictor of degree of input information incorporated was number of OCD symptoms; prompts with the most symptoms were rated as incorporating less input information than prompts with both low and moderate number of symptoms, <em>p</em>s &lt; .05. Overall, ChatGPT-generated hierarchies were viewed as appropriate (<em>M</em> = 4.47, SD = 0.58), specific (<em>M</em> = 4.17, SD = 0.65), variable (<em>M</em> = 3.96, <em>SD</em> = 0.79), safe/ethical (<em>M</em> = 4.89, <em>SD</em> = 0.24), and useful (<em>M</em> = 3.99, <em>SD</em> = 0.82). However, expert human-generated hierarchies were still rated as significantly more appropriate, specific, variable, and useful, <em>p</em>s &lt; .05, but not more or less safe and ethical than ChatGPT-generated hierarchies, <em>p</em> = .24. Only the level of symptom detail included in prompts was associated with ratings of ChatGPT-generated hierarchies, <em>p</em>s &lt; .05, such that hierarchies were rated significantly better when prompts had been more detailed. Results suggest that LLMs such as ChatGPT hold great promise in helping generate effective OCD exposure hierarchies, while also highlighting key limitations that require resolution prior to clinical implementation. Given that few clinicians specialize in OCD treatment, it would be advantageous to establish how face-to-face or digital treatment can be augmented with this technology.</div></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"56 4","pages":"Pages 680-688"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144313024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining the Role of Homework Compliance in Acceptance-Enhanced Behavior Therapy for Trichotillomania","authors":"Kathryn E. Barber,&nbsp;Douglas W. Woods,&nbsp;Michael P. Twohig,&nbsp;Stephen M. Saunders,&nbsp;Scott N. Compton,&nbsp;Martin E. Franklin","doi":"10.1016/j.beth.2025.01.003","DOIUrl":"10.1016/j.beth.2025.01.003","url":null,"abstract":"<div><div>Between-session therapy homework is a key component of cognitive-behavioral therapies, yet its role in trichotillomania treatment remains understudied. The present study examined the associations between homework compliance and treatment outcomes in acceptance and commitment therapy (ACT) enhanced behavior therapy (AEBT) for trichotillomania. Participants included 35 adults with trichotillomania who participated in a 12-week randomized controlled trial of AEBT. Therapists documented patient homework assignment completion and rated homework adherence after each session. Trichotillomania symptom severity was assessed posttreatment and at 6-month follow-up. Higher overall homework completion rate and therapist-rated homework adherence predicted lower trichotillomania symptom severity at posttreatment and follow-up. These findings were consistent for homework compliance during early and late treatment phases and for both ACT and behavior therapy–based homework assignments. A stronger therapeutic relationship strengthened the positive effects of homework compliance on symptom reduction. Higher automatic pulling moderated the association between overall homework completion and better outcomes. Predictors of higher homework compliance included higher therapeutic relationship quality, younger age, and lower anxiety. These findings underscore the importance of between-session homework in trichotillomania treatment and support the inclusion of both ACT and behavior therapy assignments. Interventions to promote homework compliance could enhance the efficacy of AEBT and lead to greater symptom improvements.</div></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"56 4","pages":"Pages 823-837"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144312877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Concentrated Cognitive-Behavior Therapy for Unmedicated Children and Adolescents With Obsessive-Compulsive Disorder in Routine Clinical Care: A Randomized Controlled Trial With a 6-Month Naturalistic Follow-up","authors":"Laura Hermida-Barros,&nbsp;Blanca García-Delgar,&nbsp;Sara Lera-Miguel,&nbsp;Eduard Forcadell,&nbsp;Elena Moreno,&nbsp;Mireia Primé-Tous,&nbsp;Núria Jaurrieta,&nbsp;Xavier Segú,&nbsp;Enric Vilajosana,&nbsp;Carles Soriano-Mas,&nbsp;Lorena Fernández de la Cruz,&nbsp;Eduard Vieta,&nbsp;Joaquim Radua,&nbsp;Luisa Lázaro,&nbsp;Miquel A. Fullana","doi":"10.1016/j.beth.2025.01.001","DOIUrl":"10.1016/j.beth.2025.01.001","url":null,"abstract":"<div><div>Cognitive-behavior therapy (CBT) is effective for obsessive-compulsive disorder (OCD). Because CBT requires significant time and resources, there is an increased interest in developing shorter formats of CBT for OCD (i.e., fewer sessions or in less time). We conducted a randomized single-blind controlled trial to investigate the effectiveness of concentrated CBT (co-CBT; 20 hours of therapist time across one month) compared to a waiting list (WL) in 30 unmedicated children and adolescents with OCD aged 7–17 in routine clinical care. Co-CBT was superior to the WL in reducing OCD symptom severity at posttreatment (primary endpoint; Cohen’s <em>d</em> = 1.76) and these results were maintained through the end of a naturalistic 6-month follow-up. Participants initially randomized to the WL were offered co-CBT at the end of the trial and post-hoc analyses showed that they had similar improvements to those initially randomized to co-CBT. In post-hoc predictor analyses, participants aged 7–12, compared to those aged 13–17, and those with higher baseline OCD severity showed better posttreatment outcomes. Co-CBT is an effective intervention for unmedicated children and adolescents with OCD in routine clinical care. Studies including more robust control groups and larger samples are needed to replicate and expand these findings. Trial registration number: NCT04042038.</div></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"56 4","pages":"Pages 799-811"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144312875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving Parent–Adolescent Conversation to Promote Adolescent Sleep Health Behavior Change: An Open Trial of the Parent Behavior Change Intervention","authors":"Lu Dong,&nbsp;Nicole B. Gumport,&nbsp;Eve R. Fine,&nbsp;Susan Michie,&nbsp;Qing Zhou,&nbsp;Alice Mullin,&nbsp;Cynthia G. Alvarado-Martinez,&nbsp;Heather E. Hilmoe Yates,&nbsp;Melanie Tran,&nbsp;Vera Portnova,&nbsp;Allison G. Harvey","doi":"10.1016/j.beth.2024.10.004","DOIUrl":"10.1016/j.beth.2024.10.004","url":null,"abstract":"<div><div>The Parent Behavior Change Intervention (PBC-I) was developed to target parent–adolescent conversations that promote adolescent health behavior change. We report on an open trial of the PBC-I. Participants were 36 parent–adolescent dyads. Adolescents received the Transdiagnostic Sleep and Circadian Intervention (TranS-C) as parents received the PBC-I. Dyads were assessed at pre- and postintervention for parent use of behavior change techniques (BCT) and positive and negative conversational behaviors, parent–adolescent conflict, adolescent motivation for change, and adolescent sleep outcomes. From pre to post, parents used fewer total and types of BCTs, more positive communication behaviors, and less negative communication behaviors when discussing a sleep-related hot topic. From pre to post, parents reported decreased coercion and less anger intensity, while adolescents reported fewer parental conflict behaviors and less quantity and anger intensity during parent–adolescent disagreement. There was a pre-to-post increase in interest/enjoyment of sleep and a decrease in effort/importance to participate in TranS-C. More positive and less negative communication was associated with select adolescent sleep outcomes. Parents rated the PBC-I as highly acceptable and perceived it as useful. These results provide preliminary evidence that supports the PBC-I in improving the parent–adolescent interpersonal process, which is linked to improved adolescent sleep. The results may be relevant to conversations parents have with adolescents about a range of health behavior changes.</div></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"56 4","pages":"Pages 708-722"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144312871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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 the Therapeutic Alliance and Social Anxiety Symptoms Along the Course of Internet-Delivered Cognitive Behavioral Treatment","authors":"Jonathan G. Shalom,&nbsp;Adi Prihar,&nbsp;Asher Y. Strauss,&nbsp;Jonathan D. Huppert,&nbsp;Gerhard Andersson,&nbsp;Idan M. Aderka","doi":"10.1016/j.beth.2025.01.002","DOIUrl":"10.1016/j.beth.2025.01.002","url":null,"abstract":"<div><div>The therapeutic alliance is a consistent predictor of treatment outcome. In the present study, we examined whether the therapeutic alliance is associated with symptoms of social anxiety along the course of internet-delivered cognitive behavior therapy (ICBT) for social anxiety disorder (SAD). We examined data from a large treatment trial (<em>n</em> = 182) in which individuals with SAD reported on their social anxiety and alliance with the therapist each week during the treatment (for 11 weeks). We examined the total variance in alliance as well as within- and between-individual variances separately. Consistent with our hypotheses, we found that the total variance in alliance predicted the total variance in social anxiety in the following week. In addition, we found that within-individual variance in alliance was negatively associated with within-individual variance in social anxiety (in the following week). Thus, weekly increases in alliances were associated with weekly reductions in social anxiety in the following week. Finally, we found that between-individual variance in alliance was positively associated with between-individual variance in social anxiety such that individuals who were more socially anxious created stronger alliances with their therapists over the course of treatment. Our findings suggest that the therapeutic alliance is important in ICBT for SAD, that separating variance into within and between components may help identify different psychological processes, and that improving within-individual alliance may lead to reductions in symptoms of social anxiety.</div></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"56 4","pages":"Pages 812-822"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144312876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}