Behaviour Research and Therapy最新文献

{"title":"When emotions persist: Emotional inertia predicts adolescent depression amid COVID-19 stress","authors":"Sihan Liu ,&nbsp;Jianjie Xu ,&nbsp;Wisteria Deng ,&nbsp;Anan Feng ,&nbsp;Jutta Joormann ,&nbsp;Reuma Gadassi-Polack","doi":"10.1016/j.brat.2025.104885","DOIUrl":"10.1016/j.brat.2025.104885","url":null,"abstract":"<div><div>Emotional inertia—the extent to which emotional states persist over time—has been identified as a risk factor for depression. However, longitudinal evidence from real-world chronic stress remains limited. Leveraging the COVID-19 pandemic as a naturalistic stressor, this study examined: (a) how emotional inertia changed across distinct phases of the pandemic, and (b) how changes in positive versus negative emotional inertia related to depression risk. A total of 140 adolescents (<em>M</em>_age = 11.91, 47.9 % girls) completed ecological momentary assessments across three stress phases: pre-pandemic (one year before pandemic onset), acute pandemic, and chronic pandemic (one year after pandemic onset), yielding 7465 observations. Hypotheses and data analyses were preregistered. Latent change score modeling showed that both positive and negative emotional inertia increased from pre-pandemic to acute pandemic, then decreased from acute to chronic pandemic. However, positive and negative emotional inertia showed distinct associations with depressive symptoms. Increases in positive emotional inertia associated with <em>fewer</em> depressive symptoms at Wave 3, whereas increases in negative emotional inertia associated with <em>more</em> depressive symptoms at Wave 3. These associations remained significant even after controlling for baseline (Wave 1) depressive symptoms. These findings suggest that persistent negative emotions may amplify vulnerability, while stable positive emotions confer resilience in the face of stress. Emotional inertia may thus serve as a key marker of stress reactivity and an early intervention target for youth mental health.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"194 ","pages":"Article 104885"},"PeriodicalIF":4.5,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145268744","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":"Results from a randomized controlled trial testing theory-driven enhancements – Growth mindsets and message framing -- to a brief CBT text-message invention for co-occurring PTSD symptoms and alcohol misuse","authors":"Kristen P. Lindgren ,&nbsp;Emily R. Dworkin ,&nbsp;Ty T. Tristao ,&nbsp;Brian H. Calhoun ,&nbsp;Mai L. Pham ,&nbsp;Debra L. Kaysen ,&nbsp;Isaac C. Rhew ,&nbsp;Michele A. Bedard-Gilligan","doi":"10.1016/j.brat.2025.104883","DOIUrl":"10.1016/j.brat.2025.104883","url":null,"abstract":"<div><div>This paper describes the primary outcomes from a registered randomized clinical trial (RCT; NCT05372042) evaluating a brief, self-directed cognitive behavioral therapy-based (CBT) text message intervention for individuals with PTSD symptoms and co-occurring alcohol misuse (PTSD + AM). The trial aimed to refine the intervention by testing whether evidence-based techniques from cognitive psychology (message framing) and social psychology (growth mindsets) increased intervention efficacy. A combination of messages that highlighted using skills to avoid future losses (vs. for future gains vs. no framing) and that sought to facilitate a mindset that challenges setbacks and encourages growth opportunities (vs. a simple reminder to use skills) was predicted to increase efficacy. The trial had a three (framing: loss vs. gain vs. no framing) x two (mindset: growth vs. simple reminder) factorial design. A series of <em>a priori</em> decision rules was created to identify the most efficacious and simplest condition. A sample of 505 adults from Washington State was recruited (71 % female, 20 % male, 9 % identified as another gender). Trauma exposure, PTSD symptoms, AM, and other mental health concerns were assessed. The 4-week intervention had follow-ups at post-intervention, 1-month, and 3-months, with excellent retention (89+%). Participants’ PTSD symptoms and AM improved across all conditions with large effect sizes. Decision rule implementation indicated the selection of the loss framing and growth mindset condition. This condition will be tested in a subsequent RCT with longer-term follow-up. It is expected to yield an additional, effective brief treatment option for individuals with PTSD + AM—a high risk population facing multiple treatment barriers.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"194 ","pages":"Article 104883"},"PeriodicalIF":4.5,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145269232","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 physiological signature of imagery rescripting: Associations between heart rate and session-level outcomes","authors":"Jessica Uhl ,&nbsp;Wolfgang Lutz ,&nbsp;Eshkol Rafaeli","doi":"10.1016/j.brat.2025.104879","DOIUrl":"10.1016/j.brat.2025.104879","url":null,"abstract":"<div><h3>Objective</h3><div>Imagery rescripting (IR) as an emotion-focused technique involves an evoking as well as a rescripting phase, which incorporates cognitive restructuring. The different components of IR might be characterized by different physiological patterns. The main aim of this study is to test whether clients' physiological arousal during the evoking phase and clients’ physiological arousal during the rescripting phase follows specific patterns and predicts improvement on next-session outcomes.</div></div><div><h3>Methods</h3><div>The results are based on 108 therapy sessions from an imagery-based treatment with 64 clients with test anxiety. The treatment protocol involves two consecutive IR sessions of past events related to test anxiety. Clients’ heart rate (HR) was continuously monitored, next-session outcome was assessed with the State Test Anxiety Measure and Outcome Rating Scale.</div></div><div><h3>Results</h3><div>Clients showed on average an increase in HR during the evoking phase and a decrease during the rescripting phase in the first IR session. These effects reduced in the second IR session. In addition, no latent subgroups were identified. Furthermore, an increase in HR during the evoking phase was significantly associated with lower next-session test anxiety and marginally associated with higher next-session well-being.</div></div><div><h3>Conclusion</h3><div>The results provide initial evidence that clients’ physiological arousal during the evoking phase of IR might play a role in the effectiveness of IR.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"194 ","pages":"Article 104879"},"PeriodicalIF":4.5,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259450","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":"Effectiveness of body exposure for the treatment of body image disturbance: A meta-analysis","authors":"Hannah Weins ,&nbsp;Noemi Berliner ,&nbsp;Alina Riefler ,&nbsp;Jana Kessel ,&nbsp;Fridtjof W. Nussbeck ,&nbsp;Andrea S. Hartmann","doi":"10.1016/j.brat.2025.104876","DOIUrl":"10.1016/j.brat.2025.104876","url":null,"abstract":"<div><div>Body image disturbance (BID) is a defining feature of several psychiatric disorders, notably eating disorders and body dysmorphic disorder. Although body exposure (BE) has been proposed as an effective intervention, the strength of its effects and the factors influencing its efficacy remain uncertain. We conducted random-effects meta-analyses of randomized controlled trials in which BE was delivered as a stand-alone intervention. Outcomes included negative affect, BID-related measures, arousal, and disorder-specific symptoms. Potential moderators (e.g., attention focus, facilitator presence) were examined. BE produced moderate effects on BID-related measures (0.60, 95 % CI [0.40, 0.80]) and disorder-specific symptoms (0.76, 95 % CI [0.15, 1.36]), but did not significantly reduce negative affect (0.30, 95 % CI [−0.07, 0.67]). Arousal could not be assessed due to insufficient data, and no significant moderators emerged, likely reflecting the small, heterogeneous evidence base. These results support BE as an effective approach for reducing BID and disorder-specific symptoms and highlight the need for experimental research comparing BE variations and targeting broader outcome domains to guide individualized, evidence-based clinical practice.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"194 ","pages":"Article 104876"},"PeriodicalIF":4.5,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145268742","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":"Joy beyond fear: Positive emotions after exposure in patients with anxiety disorders and their link to threat expectancy and treatment outcome","authors":"Thomas Borchert ,&nbsp;Ingmar Heinig ,&nbsp;Volker Arolt ,&nbsp;Christina Bartnick ,&nbsp;Udo Dannlowski ,&nbsp;Jürgen Deckert ,&nbsp;Katharina Domschke ,&nbsp;Thomas Fydrich ,&nbsp;Stephan Goerigk ,&nbsp;Alfons O. Hamm ,&nbsp;Maike Hollandt ,&nbsp;Jürgen Hoyer ,&nbsp;Tilo Kircher ,&nbsp;Katja Koelkebeck ,&nbsp;Ulrike Lueken ,&nbsp;Jürgen Margraf ,&nbsp;Peter Neudeck ,&nbsp;Paul Pauli ,&nbsp;Jan Richter ,&nbsp;Winfried Rief ,&nbsp;Andre Pittig","doi":"10.1016/j.brat.2025.104880","DOIUrl":"10.1016/j.brat.2025.104880","url":null,"abstract":"<div><div>Exposure-based CBT is effective in treating anxiety disorders, but individual responses vary substantially, underlining the need to identify and boost mechanisms underlying exposure. In this study, the role of positive emotions occurring after exposure was examined. In an analysis of 8416 exposure records of 648 anxiety patients undergoing exposure therapy, the degree of positive emotions hope and joy occurring after exposure exercises, their predictors, and their role regarding treatment success were investigated. Positive emotions after exposure were medium to high and increased slightly across repeated exposure exercises. They were associated with exposure-related learning indicators (i.e., expectancy violation and change as well as the prediction-error learning rate) and were mainly predicted by adjusted threat expectancy assessed after completing exposure, controlling for baseline depressive symptoms and affect. Higher positive emotions independently predicted better treatment outcome beyond learning indicators, and partially mediated the association between learning indicators and treatment outcome. These findings indicate that positive emotions are partly associated with successful learning during exposure but seem to have a unique contribution to overall treatment success, underlining the need to strengthen positive emotions via different possible means.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"195 ","pages":"Article 104880"},"PeriodicalIF":4.5,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145271442","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":"Awareness as a key component of mindfulness reduces psychological stress in adolescents: Evidence from multi-method studies","authors":"Yaoyao Zhang ,&nbsp;Xin Liu ,&nbsp;Huimin Wu ,&nbsp;Mingxin Shi ,&nbsp;Cheng Guo","doi":"10.1016/j.brat.2025.104877","DOIUrl":"10.1016/j.brat.2025.104877","url":null,"abstract":"<div><h3>Objective</h3><div>The components of mindfulness include awareness and acceptance. However, the effects of awareness and acceptance on psychological stress in adolescents remain controversial, and the underlying cognitive processes less attention. Therefore, this study aimed to examine their independent effects, and the relevant cognitive processes.</div></div><div><h3>Methods</h3><div>A cross-sectional survey study (Study 1, N = 3304, M_age = 15.53 years) employed regression models to examine the relationships between awareness, acceptance, and psychological stress. A randomized controlled trial (Study 2, N = 304, M_age = 15.07 years) was conducted by randomly assigning participants to four groups: an awareness group (MA), an awareness and acceptance group (MA + A), an active control group (AC), and a blank control group (BL). Study 2 aimed to examine the effects of awareness and acceptance on adolescents’ psychological stress. A cross-sectional observational study (Study 3, N = 111, M_age = 16.77 years) was conducted to examine the non-temporal mediating role of attention control.</div></div><div><h3>Results</h3><div>Study 1 indicated that both awareness and acceptance were negatively associated with psychological stress, with awareness showing a stronger negative relationship. Study 2 showed that adolescents’ psychological stress improved in both the MA and MA + A groups, with the MA group showing a more significant reduction than both the MA + A (<em>d</em> = −0.23) and BL groups (<em>d</em> = −0.56). Study 3 showed that conflict monitoring of attention control played a non-temporal mediating role in the relationship between awareness and psychological stress in adolescents. <strong><em>Conclusions</em></strong>: This study emphasizes the importance of awareness and conflict monitoring in developing mindfulness-based stress reduction programs for adolescents.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"194 ","pages":"Article 104877"},"PeriodicalIF":4.5,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253283","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":"Using the death/suicide implicit association task to prospectively predict near-term suicidal behavior in high-risk veterans","authors":"Megan S. Chesin ,&nbsp;Alejandro Interian ,&nbsp;Vibha Reddy ,&nbsp;Arlene King ,&nbsp;Kayla Maloney ,&nbsp;Rachael Miller ,&nbsp;Rokas Perskaudas ,&nbsp;Kailyn Rodriguez ,&nbsp;Lauren St Hill ,&nbsp;John Keilp ,&nbsp;Catherine E. Myers","doi":"10.1016/j.brat.2025.104874","DOIUrl":"10.1016/j.brat.2025.104874","url":null,"abstract":"<div><div>The 90-day period after a suicide attempt or hospitalization for suicidal behavior is a period of increased risk for psychiatric patients. However, predicting who among patients at suicide risk will engage in suicidal behavior in this window remains an elusive task. Neurocognitive task performance, such as performance on the Death/Suicide Implicit Association Task (D/S IAT), shows some promise for aiding in the prediction of suicidal behavior beyond risk factors routinely assessed in clinical practice, such as self-reported suicidal ideation. This study considered whether performance on the D/S IAT could prospectively predict suicidal behavior within a 90-day window. Sixty Veterans at high risk for suicide completed the D/S IAT at multiple timepoints over a one-year period. Each testing session was then coded according to whether the participant displayed suicidal behavior within 90 days following that testing session. As a secondary aim, drift diffusion modeling (DDM) was used to estimate latent cognitive processes mediating D/S IAT performance, including decisional efficiency. Two applications of the Generalized Estimating Equations (GEE) method were used to evaluate the incremental utility of (1) D/S IAT performance and (2) DDM-derived latent variables on predicting 90-day suicidal behavior over standard suicide risk factors including suicide attempt history, major depressive or bipolar disorder, and suicidal ideation at the time of testing. Age was also included in the models given the impact of age on reaction times and thus D/S IAT performance. The odds of 90-day suicidal behavior were significantly increased as implicit bias linking the self-concept to the concept of life as opposed to death weakened. The latent cognitive process of reduced decisional efficiency towards categorizing the concept of life relative to death as “like me” predicted 90-day suicidal behavior. D/S IAT performance may add to near-term suicidal behavior prediction. Reduced decisional efficiency is emerging as a general cognitive factor implicated in suicidal behavior.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"194 ","pages":"Article 104874"},"PeriodicalIF":4.5,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208045","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 combination of physical exercise and slow-paced breathing on psychophysiological indices of emotion reactivity, psychosocial stress reactivity and recovery: A multimodal investigation","authors":"Emmanuelle Schoonjans ,&nbsp;Zefeng Li ,&nbsp;Jens Allaert ,&nbsp;Evi Wezenbeek ,&nbsp;Pieter Van den Berghe ,&nbsp;Simon Helleputte ,&nbsp;Stefanie De Smet ,&nbsp;Rudi De Raedt ,&nbsp;Marie-Anne Vanderhasselt","doi":"10.1016/j.brat.2025.104852","DOIUrl":"10.1016/j.brat.2025.104852","url":null,"abstract":"<div><div>Stress is a major public health problem calling for scalable interventions. Physical activity (PA) and slow-paced breathing (SPB) can reduce stress, both by modulating cardiac parasympathetic activity. Given their shared target but different mechanisms, combining SPB and PA could enhance their stress-reducing effects. This study therefore explores whether SPB (vs control breathing at a faster rate) after PA increases the impact of PA on psychophysiological indices of emotional reactivity and psychosocial stress reactivity and recovery. In a crossover randomized design, 77 healthy volunteers completed twice a baseline, a bout of PA (at a personalized intensity), 3 × 5 min of breathing (SPB at 5,5 or control breathing at 15 breaths per minute), an emotional reactivity task with negative versus neutral images, a psychosocial stress task and a recovery phase. We measured psychophysiological indices of stress (i.e., heart rate, vmHRV, skin conductance, blood pressure, pupil dilation as well as self-reported stress and mood indices, rumination and coping strategy). Compared to control breathing, SPB decreased worry and made the difference between cardiac reactivities to negative and neutral images lower (as measured through interbeat intervals [IBI]). No effects on other psychophysiological indices of stress were found. Our results are the first to emphasize the potential of combining PA and SPB to reduce worrying and attenuated cardiovascular reactivity to emotional valence. However, the lack of effects on other stress indices indicates the need for future research to explore its broader applicability as a stress management technique.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"194 ","pages":"Article 104852"},"PeriodicalIF":4.5,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214212","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":"Same same but different: Threat expectancy change and fear reduction as readouts of exposure rationales are only weakly associated and contribute differentially to treatment outcome in anxiety disorders","authors":"Sophie Thaon de Saint André ,&nbsp;Ingmar Heinig ,&nbsp;Volker Arolt ,&nbsp;Christina Bartnick ,&nbsp;Udo Dannlowski ,&nbsp;Jürgen Deckert ,&nbsp;Katharina Domschke ,&nbsp;Thomas Fydrich ,&nbsp;Stephan Goerigk ,&nbsp;Alfons O. Hamm ,&nbsp;Maike Hollandt ,&nbsp;Jürgen Hoyer ,&nbsp;Tilo Kircher ,&nbsp;Katja Koelkebeck ,&nbsp;Ulrike Lueken ,&nbsp;Jürgen Margraf ,&nbsp;Peter Neudeck ,&nbsp;Paul Pauli ,&nbsp;Jan Richter ,&nbsp;Winfried Rief ,&nbsp;Andre Pittig","doi":"10.1016/j.brat.2025.104856","DOIUrl":"10.1016/j.brat.2025.104856","url":null,"abstract":"<div><div>Responses to exposure therapy vary across individuals, emphasizing the need for a deeper understanding of its underlying mechanisms. This study examined two key processes during exposure that serve as readouts of different clinical rationales: (1) within-session fear reduction (measured as the decline from peak to end fear within an exposure exercise) and (2) threat expectancy processes (assessed via expectancy violation, expectancy change, and learning rate). Data from 516 patients with anxiety disorders who completed at least 10 exposure exercises in a clinical trial were analyzed. Results showed that expectancy measures and fear reduction were only weakly correlated within exposure exercises. While no significant differences were found in their time courses, both readouts independently predicted treatment success. Specifically, a higher learning rate and greater relative fear reduction were associated with better outcomes. These findings highlight the clinical relevance of monitoring fear reduction and expectancy-related readouts as indicators of two distinct exposure rationales — the fear reduction rationale and the threat expectancy rationale. Although it remains unclear whether they reflect separate mechanisms of change or different aspects of a shared mechanism, addressing both rationales may help optimize and personalize exposure therapy.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"194 ","pages":"Article 104856"},"PeriodicalIF":4.5,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259633","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":"Understanding factors related to treatment retention in an online mental health support service: Analysis of a service database","authors":"Breanne Hobden ,&nbsp;Lauren Pollock ,&nbsp;Vincent Lau ,&nbsp;Sarah Leask ,&nbsp;Kristy Fakes","doi":"10.1016/j.brat.2025.104875","DOIUrl":"10.1016/j.brat.2025.104875","url":null,"abstract":"<div><h3>Background</h3><div>Engagement with and retention in mental health treatment remains a significant barrier to accessing effective mental health care. Early discontinuation of mental health treatments negatively impacts recovery, as well as other aspects of life such as education, employment and overall mental wellbeing. This study examined, among adults aged ≥18 years, the factors associated with mental health treatment retention via an online service in Australia.</div></div><div><h3>Methods</h3><div>A secondary analysis of 2021–2025 data from <em>Talked</em>, an Australian online therapy platform. Attendance of 1–2 therapy sessions was classed as lower retention; attendance of 3+ sessions was classed as higher retention. The association between treatment retention and sociodemographic, health and treatment-related variables were explored via multivariable logistic regression.</div></div><div><h3>Results</h3><div>Data for 7424 individuals were analysed. Among the sample, 52.7 % (n = 3911) engaged in 1–2 treatment sessions, and 47.3 % (n = 3513) engaged in 3+ treatment sessions. Those who had previously undertaken therapy, those reporting consuming alcohol more frequently and those who had selected three or more mental health-related issues at time of therapy booking, had greater odds of engaging with treatment. Those with dependents had lower odds of engaging with treatment.</div></div><div><h3>Conclusions</h3><div>The factors found to be associated with treatment retention can be used to identify targeted strategies to enhance treatment retention. These findings support the role of early identification and prioritisation of at-risk clients at the time of booking, such as those with dependants, and those who had not undertaken previous therapy, as they may require increased flexibility and accessibility considerations for psychological support.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"194 ","pages":"Article 104875"},"PeriodicalIF":4.5,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145160226","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}