Psychology and Psychotherapy-Theory Research and Practice最新文献

{"title":"A network analysis of gender differences in unresolved attachment, post-traumatic stress following COVID-19, psychiatric comorbidity, and contamination fear in adolescents: Implications for psychotherapy.","authors":"Man Cheung Chung, Fangsong Liu, Na Wang, Mengge Zhang, Yabing Wang","doi":"10.1111/papt.70013","DOIUrl":"https://doi.org/10.1111/papt.70013","url":null,"abstract":"<p><strong>Objectives: </strong>This study used a network approach to examine gender differences in adolescents regarding unresolved attachment styles, COVID-19 PTSD symptoms, comorbid psychiatric symptoms, and contamination fear. The rationale for the study stems from the suggestion that parents' relationships with adolescents (i.e., attachment) can influence how adolescents cope with distress during COVID-19. Since attachment is linked to gender differences, these differences should also be considered. Furthermore, while much has been documented on secure or insecure attachment, little is known about whether the impact of unresolved attachment can influence psychological distress in adolescents.</p><p><strong>Methods: </strong>Adolescents (n = 1715; 803 females, 912 males) from five Hong Kong secondary schools completed measures assessing unresolved attachment, contamination-related fears, PTSD symptoms, and general psychological disorders.</p><p><strong>Results: </strong>No significant gender differences were observed in network density or global strength. However, network structure analysis revealed weaker connections among males compared to females. For males, all unresolved attachment aspects were linked to COVID-19 PTSD and comorbid psychiatric symptoms, while for females, only perceived failed protection correlated with depression. Both genders showed associations between PTSD, comorbid symptoms, and contamination fear.</p><p><strong>Conclusions: </strong>While trauma and psychological reactions were shared, gender differences emerged in how unresolved attachment influenced distress. Males exhibited broader attachment-related distress links, whereas females showed more specific associations. These findings enhance understanding of adolescent psychotherapy needs during crises.</p>","PeriodicalId":54539,"journal":{"name":"Psychology and Psychotherapy-Theory Research and Practice","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145001962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CBT, parent training, and combined approaches for children with ADHD: A randomized study.","authors":"Burcu Hafiz Ahmet, Alperen Bıkmazer, Vahdet Gormez","doi":"10.1111/papt.70011","DOIUrl":"https://doi.org/10.1111/papt.70011","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the effectiveness of cognitive behavioural therapy (CBT), parent training programm (PTPs), and their combination as adjunctive interventions to medication in reducing core ADHD symptoms and functional difficulties in children aged 7-11 who had been receiving pharmacological treatment. The goal was to examine whether these psychosocial approaches could enhance treatment outcomes beyond medication alone.</p><p><strong>Method: </strong>Forty-two mother-child dyads were randomly assigned to one of four groups: (1) medication (M) plus cognitive behavioural therapy (CBT), (2) M plus parent training programme (PTP), (3) M plus both CBT and PTP (combined), and (4) M only (control). Families completed the sociodemographic data form, the Turgay DSM-IV ADHD Assessment Scale, and the Strengths and Difficulties Questionnaire (SDQ) before and after the intervention period. Data were analysed using Kruskal-Wallis H, Mann-Whitney U, Bonferroni correction, Wilcoxon signed-rank, and Chi-square tests, with a significance level set at p < .05.</p><p><strong>Results: </strong>Significant reductions in attention deficit, hyperactivity, and impulsivity were observed in the M + CBT, M + PTP, and combined groups, as measured by the Turgay DSM-IV ADHD Assessment Scale. According to the SDQ, all three groups also showed significant decreases in SDQ impact scores, suggesting improved functional outcomes. In contrast, the control group showed improvement only in attention deficit, despite a notable increase in SDQ impact scores, indicating worsened overall functioning.</p><p><strong>Conclusion: </strong>Adjunctive CBT, parent training, and their combination were more effective than medication alone in reducing core ADHD symptoms and improving children's functioning. These findings support the integration of psychosocial interventions into routine ADHD treatment, especially in school and family settings where behavioural support is essential. However, the small sample size limits generalizability, and further research with larger samples, extended follow-up, and placebo-controlled designs is needed to confirm these results and guide evidence-based policy and practice.</p>","PeriodicalId":54539,"journal":{"name":"Psychology and Psychotherapy-Theory Research and Practice","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145001988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does remote match reality? Comparing the effectiveness of a self-help app for panic disorder and agoraphobia to face-to-face CBT.","authors":"Justine Spies, Thomas Lang, Alexander L Gerlach, Tilo Kircher, Alfons Hamm, Georg W Alpers, Thomas Fydrich, Volker Arolt, Jürgen Deckert, Andreas Ströhle, Hans-Ulrich Wittchen, Sylvia Helbig-Lang","doi":"10.1111/papt.70012","DOIUrl":"https://doi.org/10.1111/papt.70012","url":null,"abstract":"<p><strong>Background: </strong>Exposure-based CBT is highly effective in treating patients with panic disorder and agoraphobia; however, access to such treatments is often limited. Smartphone-based self-management apps offer a promising low-threshold treatment alternative to face-to-face therapy. Although such health apps have shown to be effective in reducing anxiety symptoms, comparisons to active treatments are still scarce. Therefore, this study compared the effectiveness of a self-help app to an established face-to-face CBT intervention for panic and agoraphobia.</p><p><strong>Method: </strong>The present study conducts a post hoc comparison of two independent RCTs examining participants with panic disorder and/or agoraphobia. Interventions in both studies were based on the same CBT manual. Study 1 (n = 138) included face-to-face CBT; Study 2 addressed the effects of a digital self-help intervention (n = 57). Main outcomes comprised symptoms of both panic disorder and agoraphobia, depressive symptoms and agoraphobic avoidance. Data were analysed using linear mixed models in intent-to-treat and completer data sets.</p><p><strong>Results: </strong>Linear mixed models showed that face-to-face treatment was superior to app treatment in reducing panic and agoraphobic symptoms (R² = 0.32), depressive symptoms (R² = 0.24) and agoraphobic avoidance (R² = 0.12 and 0.15). Dropout rates did not differ significantly, and both interventions demonstrated high levels of adherence.</p><p><strong>Discussion: </strong>Although a smartphone-based CBT intervention was effective in reducing symptoms of panic and agoraphobia, its efficacy was significantly below the effects of the same intervention delivered in face-to-face format. Thus, digital interventions might be most suitable within a stepped-care approach or to bridge waiting times for psychotherapy.</p>","PeriodicalId":54539,"journal":{"name":"Psychology and Psychotherapy-Theory Research and Practice","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transition to online psychological support - Barriers, stereotypes and challenges from the perspective of service providers.","authors":"Miroslav Charvát, Leona Jochmannová, Petra Zia Sluková, Lucie Viktorová","doi":"10.1111/papt.70010","DOIUrl":"https://doi.org/10.1111/papt.70010","url":null,"abstract":"<p><strong>Objectives: </strong>This qualitative study, which provides practical insights for the field, described the transition process of psychological service providers towards online care provision. We aimed to describe the process of professionals' adaptation to new methods of distant psychological care, including its main facilitating and complicating elements.</p><p><strong>Methods: </strong>We used a qualitative approach, specifically evaluation design, employing reflexive thematic analyses conducted by the software ATLAS.ti. Semi-structured interviews were conducted with 51 professionals, and 14 focus groups with 44 experts. We worked with 95 experienced professionals specializing in clinical psychology, psychological counseling, and counseling those affected by domestic violence. All of them have had practical exposure to delivering care online.</p><p><strong>Results: </strong>The results show that after first-hand involvement, most of the providers have moved from being cautious experimenters to being regular practitioners of online remote psychological care in cases where it is appropriate. Technical difficulties and negative stereotypes receded, with many respondents striving to provide online services for their clients' benefit. However, some negative aspects persist, including the lack of timely support from key institutions.</p><p><strong>Conclusions: </strong>Logistical barriers stem from poor management and insufficient political, legislative and financial support. Ethical and legal challenges require serious attention from key system players. The question of embodiment, involving new therapeutic cues and compensating for absent ones, warrants thorough follow-up research. Bias and stereotype-related barriers, often shaped by providers' attitudes, can be addressed through targeted training and shared professional experiences.</p>","PeriodicalId":54539,"journal":{"name":"Psychology and Psychotherapy-Theory Research and Practice","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognitive analytic therapy-guided self-help for depression: A mixed methods evaluation.","authors":"Rebecca Kelly, Stephen Kellett, Mel Simmonds-Buckley, Niall Power","doi":"10.1111/papt.70008","DOIUrl":"10.1111/papt.70008","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate cognitive analytic therapy-guided self-help (CAT-GSH) for depression in terms of outcomes and acceptability.</p><p><strong>Design: </strong>A parallel mixed methods case series with session-by-session outcome measurement supplemented by patient and staff interviewing.</p><p><strong>Methods: </strong>Four psychological well-being practitioners (PWPs) delivered CAT-GSH to N = 11 patients in an NHS talking therapies service, and these patients were followed up at 1 month. Acceptability of CAT-GSH was assessed via treatment refusal and dropout rates, sessional attendance and qualitative interviewing of PWPs and patients. Outcomes were assessed by comparing group means at screening, termination and follow-up on sessional measures, calculating the case-by-case recovery rate and benchmarking against relevant research.</p><p><strong>Results: </strong>All 11 patients offered CAT-GSH accepted; one patient dropped out, all completers attended the full 6 sessions, and 7/10 were in reliable recovery at follow-up. Treatment gains were maintained over the follow-up period, and outcomes appeared equivalent when benchmarked against the evidence base. Patients found CAT-GSH to be a mostly acceptable intervention, and this was due to mood improvements, better recognition skills and implementation of 'exits'. CAT-GSH improved the diversity of the treatment offer for PWPs and provided professional development opportunities.</p><p><strong>Conclusions: </strong>CAT-GSH holds promise as a low-intensity treatment for depression, but clearly more controlled research is needed.</p>","PeriodicalId":54539,"journal":{"name":"Psychology and Psychotherapy-Theory Research and Practice","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144876880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Activation of the inner critic increases speech illusions and negative emotional valence of perceived speech.","authors":"June Engeland, Andrew Allen, Rachel Brand","doi":"10.1111/papt.70007","DOIUrl":"https://doi.org/10.1111/papt.70007","url":null,"abstract":"<p><strong>Objectives: </strong>Research consistently reports an association between auditory hallucinations and traumatic experiences, yet the psychological mechanisms underpinning this relationship remain poorly understood. Empirical evidence suggests that enduring dispositions, including early maladaptive schemas, interact with immediate stressors to elicit auditory hallucinations. The inner critic represents the activation of such enduring dispositions and concurs with common themes in auditory hallucinations. This study aimed to investigate the effect of the inner critic on speech illusions and the emotional valence of perceived words.</p><p><strong>Design: </strong>A quasi-experimental design was utilised.</p><p><strong>Methods: </strong>Forty-two non-clinical participants (67.40% female, M_age = 29.63) completed self-report questionnaires measuring predisposition to hallucination-like experiences, self-criticism and demanding and punitive parent schema modes. Participants then completed an auditory perception task, the Babble Task, inducing speech illusions before and after an inner critic imagery manipulation.</p><p><strong>Results: </strong>A mixed factorial analysis of variance revealed a significant main effect of the inner critic manipulation on speech illusions, with participants reporting more speech illusions after the manipulation. Participants scoring high on the demanding parent mode reported more speech illusions overall. Linguistic analysis of speech illusions demonstrated an increase in negative tone across groups following the inner critic manipulation.</p><p><strong>Conclusions: </strong>While acknowledging concerns regarding the convergent validity of the Babble Task, these findings add nuance to existing theories by suggesting that an activated inner critic impairs source monitoring and shapes the content of ensuing auditory intrusions. Additionally, the findings indicate the inner critic as a potential target for treatment in distressing auditory hallucinations.</p>","PeriodicalId":54539,"journal":{"name":"Psychology and Psychotherapy-Theory Research and Practice","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144876879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What works? A grounded theory investigation of training non-psychology staff in using Solution-Focused Brief Therapy.","authors":"Haakon Juul, Dominic Bray, Ian C Smith","doi":"10.1111/papt.70009","DOIUrl":"https://doi.org/10.1111/papt.70009","url":null,"abstract":"<p><strong>Objective: </strong>As part of a task-sharing strategy, clinical psychologists are becoming increasingly expected to offer therapy training for staff in health care services to develop psychological mindedness to increase access and provision of psychological support for clients. The current study explored how 10 staff working in health care settings experienced Solution-Focused Brief Therapy (SFBT) training and how they subsequently used it.</p><p><strong>Methods: </strong>One-to-one semi-structured interviews were conducted with 10 participants; a constructivist grounded theory (GT) approach was used to generate a model based on the participants' reflections after the training.</p><p><strong>Results: </strong>Staff shared how they felt they needed evidence of SFBT effectiveness in order to believe that learning a new model would be worth the required investment. They also found realistic role modelling that was relevant to their context to be particularly convincing as well as regular support from their peers and multidisciplinary meetings. Participants also shared some barriers to using SFBT in practice, including time-restricted clinics, service pressures and challenging clients.</p><p><strong>Conclusion: </strong>The model describes a complex dynamic between personal, interpersonal and systemic factors that influenced the staff members' individual decision to abandon the more familiar medical model that represented a sense of comfort and safety. The study includes recommendations for how clinical psychologists can address the identified facilitators and barriers to facilitate more effective training programmes and training transfer.</p>","PeriodicalId":54539,"journal":{"name":"Psychology and Psychotherapy-Theory Research and Practice","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144876881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers and accessibility-improving strategies in mental health services for persons with hearing or vision impairments: Perspectives from professionals and clients-A qualitative interview study.","authors":"Bastian Hardt, Thomas Heidenreich, Christina Hunger-Schoppe, Nele Adam, Julia Heinen, Joana Hopf, Axel Röhlig, Johannes Michalak","doi":"10.1111/papt.70006","DOIUrl":"https://doi.org/10.1111/papt.70006","url":null,"abstract":"<p><strong>Objectives: </strong>Despite studies showing that persons with hearing impairments (HI) or vision impairments (VI) have an increased risk of developing mental health disorders, mental health services frequently are not accessible and suited to the specific needs of both populations. However, there is limited research addressing how mental health services can be improved to meet these needs.</p><p><strong>Design: </strong>This qualitative interview study explores barriers and strategies to improve accessibility in mental health services for persons with HI or VI in Germany, as viewed with a multi-perspective approach.</p><p><strong>Methods: </strong>Using problem-centred interviews, which combine a flexible interview guide with a focus on specific issues, we applied a participatory research approach to gather insights from 58 participants, including mental health professionals specialised in treating persons with HI or VI and persons with HI or VI with lived experience as clients in mental health services.</p><p><strong>Results: </strong>The qualitative content analysis yielded 44 inductive subcategories within a category system of seven deductive main categories. Key barriers included communication, limited visual accessibility and environmental challenges, while improvement strategies focused on tailored therapeutic adaptations as well as proactive and collaborative practices between therapists and clients.</p><p><strong>Conclusions: </strong>Our findings highlight the need for structural changes and expanded mental health services that cater to the specific needs of persons with sensory impairments. These insights should contribute to improving mental health services, training programs for professionals and emphasise the importance of including persons with HI or VI, both professionals and clients, in the participatory development of accessible care.</p>","PeriodicalId":54539,"journal":{"name":"Psychology and Psychotherapy-Theory Research and Practice","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144838552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gendered dynamics in outpatient psychotherapy: An interpretative phenomenological analysis of female patients' and male therapists' experiences.","authors":"Erwin Schweitzer, Yvonne Schaffler, Thomas Probst, Elke Humer, Christoph Pieh, Brigitte Schigl","doi":"10.1111/papt.70005","DOIUrl":"https://doi.org/10.1111/papt.70005","url":null,"abstract":"<p><strong>Objectives: </strong>Gender dynamics within the patient-therapist relationship can influence the therapeutic process in meaningful ways. However, the female patient-male therapist dyad has received limited attention in recent psychotherapy research. This article explores how female patients and their male therapists experience the role of gender in outpatient psychotherapy.</p><p><strong>Design: </strong>This study is a qualitative subproject within a larger research initiative involving psychotherapists in private practice and their patients in Austria. Interviews with patients and therapists were conducted using a comprehensive, semi-structured interview guide.</p><p><strong>Method: </strong>Interviews were conducted with ten participants from female patient-male therapist dyads. The data were analyzed using dyadic interpretative phenomenological analysis and interpreted through the theoretical lens of relational phenomenology.</p><p><strong>Results: </strong>The analysis identified four themes that illustrate participants' recognition of gender as an important factor influencing psychotherapy: (1) gender shapes the topics and interventions in psychotherapy, (2) the male therapist's gender as valuable for the female patient, (3) the female patient's gender as valuable for the male therapist and (4) attraction between male therapist and female patient. A contrasting fifth theme reflects perspectives suggesting that (5) gender plays a lesser role in psychotherapy.</p><p><strong>Conclusion: </strong>Participants offered varied and sometimes conflicting views on gender's role in outpatient psychotherapy. While they acknowledged its influence, some felt other factors held greater significance. These differing perspectives reflect diverse experiences of gender, which, if not adequately addressed in therapy, may hinder the therapeutic process.</p>","PeriodicalId":54539,"journal":{"name":"Psychology and Psychotherapy-Theory Research and Practice","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144838594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sensitivity to betrayal and new intimate relationship building in survivors of intimate partner violence.","authors":"Alice Melin, Paul M Salkovskis","doi":"10.1111/papt.70004","DOIUrl":"https://doi.org/10.1111/papt.70004","url":null,"abstract":"<p><strong>Objectives: </strong>There is evidence that prior experience of intimate partner violence (IPV) can lead to high levels of sensitivity to betrayal, shame and self-criticism and interfere with initiation, development and maintenance of future intimate relationships. We measured these variables in women survivors of IPV, evaluating whether they are associated with the quality of current relationships.</p><p><strong>Design: </strong>A cross-sectional, between-groups design was used, comparing women survivors of IPV divided into those satisfied with current intimate relationships, those dissatisfied and IPV survivors not in such a relationship. Women without a history of IPV were included as a benchmark group.</p><p><strong>Method: </strong>Four groups: IPV single (N = 34), IPV dissatisfied (N = 25), IPV satisfied (N = 32) and those who had not experienced IPV (N = 42) were compared for betrayal sensitivity, followed by a secondary comparison of shame and self-criticism. Online questionnaires were completed by participants recruited through social media and screened for IPV and relationship status.</p><p><strong>Results: </strong>All IPV groups had significantly higher scores for betrayal sensitivity than the non-clinical group, with IPV satisfied having significantly lower scores than other IPV groups in two subscales: betrayal causing life change and lack of trust due to betrayal.</p><p><strong>Conclusions: </strong>Betrayal sensitivity is prominent in survivors of IPV, with evidence of a specific link between survivors' relationship satisfaction/status and their lack of trust and ideas of being permanently changed. Those appraisals may make it more challenging to build and maintain satisfactory relationships, or positive relationships may help survivors change their appraisals about betrayal, leading to a lack of trust and life-altering changes.</p>","PeriodicalId":54539,"journal":{"name":"Psychology and Psychotherapy-Theory Research and Practice","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144800962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}