Journal of Counseling Psychology最新文献

{"title":"Therapist effects, case-mix factors, and treatment characteristics in university counseling centers.","authors":"J Ryan Kilcullen, Louis G Castonguay, Wilson T Trusty","doi":"10.1037/cou0000862","DOIUrl":"10.1037/cou0000862","url":null,"abstract":"<p><p>Therapists differ in the amount of client progress they facilitate in psychotherapy, a phenomenon referred to as <i>therapist effects</i> (TEs). However, the size of TEs differs based on the characteristics of their caseloads (i.e., case-mix), treatment setting, and whether center effects are modeled with TEs. The present study estimated TEs in a specific treatment setting (university counseling centers; UCCs) and while controlling for an enhanced set of case-mix variables. A total of 43,284 clients treated by 1,486 therapists at 100 UCCs completed routine, individual psychotherapy. Therapist differences in overall effectiveness (amount of symptom change) and efficiency (speed of symptom change) were estimated with multilevel modeling while accounting for case-mix variables and center effects. Several case-mix variables accounted for portions of therapist variability in outcomes, including severity of suicidal ideation, nonrisk-related symptom severity, and prior treatment history. After controlling for case-mix and center effects, TEs of 1.85% for effectiveness and 1.67% for efficiency were found. Model-derived performance classes indicated that most therapists (near 90%) were average in effectiveness and efficiency. Despite this, the most efficient and effective therapists produced significantly better outcomes (up to 24% more symptom improvement) than their least efficient and effective counterparts. In routine practice at UCCs, therapists account for a relatively small proportion of client outcomes. However, differences between significantly above- and below-average therapists can be substantial. Examining the practices of highly effective UCC therapists may provide insight into effective psychotherapy processes and tailored recommendations for this setting. (PsycInfo Database Record (c) 2026 APA, all rights reserved).</p>","PeriodicalId":48424,"journal":{"name":"Journal of Counseling Psychology","volume":" ","pages":"473-487"},"PeriodicalIF":3.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147515815","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":"Temporal interplay between momentary identity-salient experiences, self-compassion, and affective-somatic well-being among sexual and gender diverse people.","authors":"Eddie S K Chong, Han Chen, Shuk Kwan Po","doi":"10.1037/cou0000880","DOIUrl":"10.1037/cou0000880","url":null,"abstract":"<p><p>Despite growing research on resilience among sexual and gender diverse (SGD) individuals, significant gaps remain in understanding the temporal dynamic between affirming identity-salient experiences (ISEs) and affective-somatic well-being as they unfold over time amid SGD-stress experiences. Prior intensive longitudinal research among SGD populations has primarily focused on concurrent intraindividual associations between stressful ISEs and health outcomes. Moreover, self-compassion, an adaptive mechanism showing promise in SGD health research, has been mainly studied as a trait-like construct rather than as a mindstate. To address these gaps, this intensive longitudinal study examined temporal relationships between momentary ISEs, self-compassion, and affective-somatic well-being among 141 SGD adults in Hong Kong (<i>M</i>_age = 28.32, <i>SD</i> = 7.09). Using experience sampling with three assessments daily over 2 weeks and dynamic structural equation modeling, the study tested two interrelated frameworks: social safeness (identity-affirming experiences promote self-compassion and, subsequently, well-being) and broaden-and-build (self-compassion improves well-being and, subsequently, invites identity-affirming experiences). Results from the two distinct models largely supported both perspectives. In the first model, affirming (but not stressful) ISE predicted higher compassionate self-responding, which subsequently contributed to improved positive affect, reduced negative affect, and unchanged somatic distress. In the second model, compassionate self-responding predicted improved positive affect and reduced negative affect, which contributed to a higher likelihood of subsequent affirming (but not stressful) ISE, while accounting for uncompassionate self-responding. These findings illuminate the dynamic processes underlying resilience and help guide the development of treatment approaches and community programs that foster health and well-being among SGD populations. (PsycInfo Database Record (c) 2026 APA, all rights reserved).</p>","PeriodicalId":48424,"journal":{"name":"Journal of Counseling Psychology","volume":" ","pages":"447-459"},"PeriodicalIF":3.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147965160","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":"Racially and ethnically diverse college students' preferences, beliefs, and self-efficacy in mental health treatment: A mixed methods analysis of therapist-client racial/ethnic concordance.","authors":"Yesenia Aguilar Silvan,Ji Yoon Gloria Kim,Joanna B Huang,Sarah Hamza,Angelica Fregoso,Lauren C Ng","doi":"10.1037/cou0000887","DOIUrl":"https://doi.org/10.1037/cou0000887","url":null,"abstract":"Racially and ethnically diverse college students experience disproportionately high rates of mental health concerns yet remain among the least likely to access care. Therapist-client racial/ethnic concordance may enhance treatment engagement, but little is known about how college students perceive its importance for care. This mixed methods study examined students' preferences for racially/ethnically concordant therapists, beliefs about whether concordance is necessary for effective treatment, and confidence in finding culturally concordant therapists. Eighty-six undergraduates (Mage = 21, SD = 3.96; 87% female; 44% Asian American, 36% other racial/ethnic minorities, 20% White) completed surveys and follow-up interviews. Linear regressions tested whether race/ethnicity predicted preferences, beliefs, and self-efficacy, controlling for age, gender, and prior treatment, and qualitative data were analyzed deductively to contextualize findings. Approximately half of participants preferred a therapist who matched their race/ethnicity, with students from other racially/ethnically minoritized groups more likely than Asian American students to endorse this preference. Race/ethnicity was not associated with beliefs that effective care requires concordance or with confidence in finding culturally concordant therapists. Qualitative findings revealed five themes: intersecting identities shaping mental health needs, contextual importance of concordance for identity-based stress, benefits of working with racially/ethnically dissimilar therapists, core therapist competencies, and access to identity-affirming therapists. Preferences for concordance were often shaped by prior therapy experiences and identity-based stressors, while therapist competence and cultural humility were widely prioritized. Findings suggest concordance preferences among college students are nuanced and context-dependent, underscoring the need for culturally concordant, identity-attuned care and improved access to diverse therapists. (PsycInfo Database Record (c) 2026 APA, all rights reserved).","PeriodicalId":48424,"journal":{"name":"Journal of Counseling Psychology","volume":"31 1","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148342402","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":"Navigating autism and mental health: A qualitative study of therapists' experiences of psychotherapy for comorbidities in autistic adults.","authors":"Sandra Graf-Kurtulus,Omar C G Gelo","doi":"10.1037/cou0000878","DOIUrl":"https://doi.org/10.1037/cou0000878","url":null,"abstract":"In this study, we explored the psychotherapeutic process for autistic adult clients without intellectual impairment with comorbid psychological disorders, drawing on the perspectives of highly specialized psychotherapists with extensive clinical experience in autism-focused practice. Within the context of the ongoing shift from deficit-based interventions toward neurodiversity-affirming approaches, we investigated how therapists conceptualize comorbidities in autism and how this conceptualization informs their therapeutic work. We employed a qualitative research design and collected data through semistructured interviews with 10 psychotherapists specialized in autism. We analyzed the data using a sequential combination of deductive and inductive thematic analysis. We identified five main themes (comprising a total of 22 subthemes): (a) development of comorbidity as an interactional vulnerability process; (b) change as a reorganization of self-understanding, regulation, and relational engagement; (c) helpful aspects of psychotherapy as needs-adapted, autism-informed relational practice; (d) therapeutic misfit as misattunement, overload, and contextual constraint; and (e) managing therapeutic misfit through adaptation, reattunement, and containment. Therapists viewed comorbid symptoms as arising from an interaction between autistic traits and environmental mismatches, rather than autism itself. Psychotherapy was conceived as prioritizing reducing comorbid symptoms, fostering self-acceptance, and mitigating social camouflaging. Therapists emphasized a flexible, integrative approach tailored to individual needs, supported by a strong therapeutic alliance. The accounts of specialized psychotherapists suggest a shift away from interventions targeting core autistic traits, with greater emphasis on promoting well-being and psychological health. The therapists aligned with neurodiversity principles, advocating for autism-specific expertise, individualized strategies, and systemic efforts to enhance social acceptance. (PsycInfo Database Record (c) 2026 APA, all rights reserved).","PeriodicalId":48424,"journal":{"name":"Journal of Counseling Psychology","volume":"74 1","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148342475","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":"Previous experiences of discrimination impact college students' mental health and treatment outcomes at university counseling centers.","authors":"Hongjun Tan,Jes L Matsick,Louis G Castonguay,Rebecca A Janis,Tyler D White,Sultan A N Magruder,Caitlin L Chun-Kennedy,Brett E Scofield","doi":"10.1037/cou0000883","DOIUrl":"https://doi.org/10.1037/cou0000883","url":null,"abstract":"Despite efforts to improve diversity, equity, inclusion, and belonging on college campuses in recent years, students with minority statuses (i.e., stigmatized identities based on race, gender, sexual orientation, nationality, disability, religion, etc.) continue to encounter identity-based discrimination. A robust body of literature has established that discriminatory experiences are related to poor mental health and academic outcomes in minoritized college students. However, among students who decide to seek treatment, it remains unclear how discrimination experiences might contribute to presenting distress and treatment outcomes. The present study used multivariate analyses to examine the differences in multiple domains of psychological symptoms at intake and at the end of treatment between students who reported discriminatory experiences in the past 6 months compared to those who did not. Data were collected through the Center for Collegiate Mental Health between July 2021 and June 2023 (N = 45,778). At intake, students who experienced discrimination reported more severe psychological symptoms, including suicidal ideation, compared to students who did not experience discrimination. These students also experienced less reduction in academic distress and internalized symptoms (i.e., depression and anxiety) at the end of treatment. Importantly, when clients experienced discrimination against multiple versus a singular facet of their identity (e.g., race and gender), the negative impact on their baseline symptoms was amplified, but this effect was not found in treatment outcome. We discuss the clinical implications of these findings and future directions for research and clinical practice in light of intersectionality theory. (PsycInfo Database Record (c) 2026 APA, all rights reserved).","PeriodicalId":48424,"journal":{"name":"Journal of Counseling Psychology","volume":"106 1","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148313849","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":"Supplemental Material for Previous Experiences of Discrimination Impact College Students’ Mental Health and Treatment Outcomes at University Counseling Centers","authors":"","doi":"10.1037/cou0000883.supp","DOIUrl":"https://doi.org/10.1037/cou0000883.supp","url":null,"abstract":"","PeriodicalId":48424,"journal":{"name":"Journal of Counseling Psychology","volume":"79 1","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148385868","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":"Mental health outcomes among LGBTQ+ emerging adults: Latent profiles of intrapersonal and interpersonal strengths.","authors":"Roberto L Abreu, Rodrigo Costa, Aldo Barrita, Teresa Vazquez","doi":"10.1037/cou0000882","DOIUrl":"10.1037/cou0000882","url":null,"abstract":"<p><p>Lesbian, gay, bisexual, transgender, and queer emerging adults' exposure to various forms of discrimination and systemic oppression increases their risk for negative mental health outcomes. Yet, access to factors that promote resilience contribute to positive mental health outcomes. Most research that incorporates individual-level and interpersonal-level resilience factors uses variable-centered approaches, which assume homogeneity and average effects that may obscure different patterns of resilience. To address this gap, in a sample of lesbian, gay, bisexual, transgender, and queer emerging adults (<i>N</i> = 460), this study used a person-centered approach (i.e., latent profile analysis) and multiple regressions to examine differences in three mental health outcomes (i.e., psychological well-being, depression symptoms, anxiety symptoms) on one individual-level (i.e., personal resilience) and two family/community-level (i.e., caregiver acceptance, social support) psychosocial resources. A five-profile solution emerged: (1) high intrapersonal and interpersonal strengths; (2) low intrapersonal and interpersonal strengths; (3) accepted by caregivers, moderately resilient, and socially supported; (4) accepted by caregivers and moderately resilient, but not socially supported; and (5) not accepted by caregivers but moderately resilient and socially supported. Findings show that the probability of belonging to the profile with high resources was associated with lower depression and anxiety symptoms, as well as higher psychological well-being. Furthermore, social support was associated with well-being above and beyond personal resilience and caregiver acceptance. Last, caregiver acceptance was linked with lower depression and anxiety symptoms, above and beyond personal resilience and social support. Results highlight the complex interplay between resilience factors and mental health outcomes among lesbian, gay, bisexual, transgender, and queer emerging adults. We discuss implications for theory, practice, and advocacy. (PsycInfo Database Record (c) 2026 APA, all rights reserved).</p>","PeriodicalId":48424,"journal":{"name":"Journal of Counseling Psychology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148253972","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":"Bias in follow-up assessment of psychotherapy: Are certain patients more likely to participate?","authors":"Flavio Iovoli, Juan Segundo Peña Loray, Tobias Lütgendorf, Martin Cordes, Jessica Fritz, Franziska Günther, Henning Schöttke, Julian A Rubel","doi":"10.1037/cou0000886","DOIUrl":"10.1037/cou0000886","url":null,"abstract":"<p><p>Follow-up (FU) assessments are a key component in evaluating the long-term effectiveness of psychotherapy, but participation is often incomplete. Therefore, with this study, we aimed to examine what patient characteristics predict follow-up participation and to estimate the potential bias this may introduce into treatment effectiveness estimates. We analyzed data from 586 patients who received cognitive-behavioral therapy. A random forest feature selection algorithm (Boruta) was applied in order to identify particularly important predictors of follow-up participation, 1-year posttreatment. To approximate the bias introduced by nonrandom follow-up participation, we conducted a post hoc propensity score matching analysis using the identified important predictors. Follow-up participation (38.2%) was associated with higher treatment satisfaction, a stronger therapeutic alliance at the end of treatment, and greater reductions of interpersonal sensitivity over the course of treatment. Older age was also linked to greater follow-up participation, while education, comorbidity, and baseline symptom severity were not. Patients with less improvement in somatization and interpersonal difficulties were more likely to respond. Propensity score matching revealed that treatment effectiveness (as measured by symptom reduction) may be overestimated by approximately 21% when relying solely on follow-up completers, relative to patients resembling nonparticipants. Our findings highlight a potential bias in psychotherapy outcome evaluations due to nonrandom follow-up participation. Strategies that may help improve follow-up response rates in routine care are discussed. (PsycInfo Database Record (c) 2026 APA, all rights reserved).</p>","PeriodicalId":48424,"journal":{"name":"Journal of Counseling Psychology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148220138","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":"Supplemental Material for Bias in Follow-Up Assessment of Psychotherapy: Are Certain Patients More Likely to Participate?","authors":"","doi":"10.1037/cou0000886.supp","DOIUrl":"https://doi.org/10.1037/cou0000886.supp","url":null,"abstract":"","PeriodicalId":48424,"journal":{"name":"Journal of Counseling Psychology","volume":"108 1","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148289787","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":"Supplemental Material for Mental Health Outcomes Among LGBTQ+ Emerging Adults: Latent Profiles of Intrapersonal and Interpersonal Strengths","authors":"","doi":"10.1037/cou0000882.supp","DOIUrl":"https://doi.org/10.1037/cou0000882.supp","url":null,"abstract":"","PeriodicalId":48424,"journal":{"name":"Journal of Counseling Psychology","volume":"33 1","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148287562","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}