Clinical psychology & psychotherapy最新文献

Suicide remains one of the most challenging client problems treated by mental health providers (MHPs). Treating client suicide can have negative health and professional impacts on MHPs. Moreover, MHPs frequently report low confidence and inadequate training in suicide prevention skills. The Core Competency Model (CCM) is one foundational approach to providing suicide prevention skills for MHPs. In the present article, we summarize the development and evidence for the CCM, with a focus on two types of suicide prevention skills for MHPs: clinician self-management (e.g., engaging in debriefing and self-care) and clinical care (e.g., developing a therapeutic and tailored risk formulation). With current CCM evidence as a foundation, we then summarize clinical and ethical reasons and considerations in tailoring CCM training to meet the unique cultural needs of lesbian, gay, bisexual, transgender, queer and diverse (LGBTQ+) individuals. Drawing on extant LGBTQ+ suicide and healthcare literatures, we outline what foundations and gaps inform a tailored CCM for LGBTQ+ individuals. The article concludes with recommendations on how to address three critically important areas for advancing MHP suicide prevention training in general and specific to serving LGBTQ+ clients. These focus areas include (1) building on existing suicide prevention training for MHPs, (2) accounting for the international cultural landscape when adapting the CCM and (3) enacting a rigorous research agenda to advance CCM training and LGBTQ+ suicide prevention.

Although previous research has examined the individual roles of unwanted intrusive thoughts (UITs), inferential confusion and feared selves in obsessive-compulsive disorder (OCD), no study to date has evaluated their combined effects on OCD severity. This is particularly relevant given that the inference-based approach (IBA) posits a close link between inferential confusion and feared selves in the context of obsessional doubt. The present study with a cross-sectional design investigated the role of inferential confusion and feared selves in mediating the relationship between OCD-relevant UITs and OCD severity. A clinical sample of 306 individuals with a primary diagnosis of OCD (mean age = 32.95, SD = 9.99, female = 58.8%) who also had some comorbid psychiatric disorders, with the exception of a current or previous history of personality disorders, psychotic disorders and substance use disorders, completed a battery of self-reported measures—including the Questionnaire of Unpleasant Intrusive Thoughts, Fear of Self Questionnaire-Multidimensional Version, Patient Health Questionnaire and Expanded Version of the Inference Confusion Questionnaire)—as well as the clinician-administered version of the Yale-Brown Obsessive-Compulsive Scale. Bootstrapped mediation analyses (5000 resamples, 95% confidence interval) revealed that UITs were indirectly associated with OCD severity via inferential confusion and one specific dimension of feared selves: the feared corrupted self. Mediation was not supported for the feared culpable or malformed selves in this model. However, a serial mediation pathway emerged wherein inferential confusion and both feared corrupted and culpable selves sequentially mediated the link between UITs and clinician-rated OCD severity. The findings suggest that inferential confusion, along with specific feared self domains, plays a critical role in differentiating intrusive thoughts that are common in the general population from obsessional doubt, as conceptualised in the IBA. Within the inference-based framework, these processes do not merely escalate UITs; rather, they actively produce obsessional doubts that disconnect the individual from reality and render the imagined threat personally meaningful, persistent and in need of resolution.

Few studies have examined the effectiveness of CBT among war-traumatised Arab children, including Palestinian children. This study aimed to assess the effect of a cognitive behavioural therapy (CBT) program on enhancing resilience and alleviating complex post-traumatic stress disorder (CPTSD) symptoms among Palestinian children affected by political detention. A quasi-experimental design utilising a one-group pretest–posttest approach was employed. The study included 50 affected children recruited from non-governmental organizations and community organizations in conflict-affected regions of the West Bank. The CBT program comprised seven sessions totaling 9 h. Each session lasted between 60 and 90 min. Data were collected before and after the program, which was implemented from March to May 2025. The findings from the pretest and posttest revealed a statistically significant reduction in CPTSD symptoms and improvement in resilience following the program. Resilience scores increased from a mean of 19.6 ± 4.6 to 30.0 ± 2.6, indicating enhanced resilience capacity (t = 16.457, p < 0.001). Post-traumatic stress disorder symptoms showed a substantial decline from severe 14.1 ± 2.5 to minimal 1.4 ± 1.8 (p ≤ 0.001). Similarly, disturbances in self-organization significantly decreased. The results proved the effectiveness of a CBT program in improving resilience and minimising CPTSD symptoms among participants. Thus, policymakers and healthcare professionals must ensure that psychological support programs, such as CBT, are implemented among war-traumatised children. Additionally, healthcare professionals, including nurses, should be equipped to respond effectively and provide high-quality care for traumatised children.

The current study reviewed the psychosocial effects of romantic breakups in emerging adulthood, particularly focused on evidence related to psychological health and psychosocial development, including aspects of identity and intimacy. A systematic literature search was conducted in accordance with the PRISMA guidelines across EBSCOhost, PubMed and Web of Science (ISI) databases. Studies with available evidence on psychosocial dimensions and emerging adult populations who had experienced a romantic breakup were included and subjected to review evaluation. Forty-seven studies were eligible for inclusion. Results showed several negative and positive psychosocial outcomes and supported the effect of breakups on changes in self-concept and interpersonal intimacy. Diverse factors influenced positive and negative adjustment. Specifically, individuals experiencing more challenges were especially those with insecure attachment, a history of childhood abuse and maladaptive coping strategies. Conversely, individuals employing adaptive coping mechanisms and personal resources such as emotional regulation and mentalization tended to exhibit better postbreakup outcomes. The long-term effects remain inconclusive, highlighting the need for further research. These findings underscore the complexity of breakup experiences and highlight the crucial role of supportive factors in shaping psychosocial adjustment. This first systematic review of the psychosocial effects of breakups suggested that interventions targeted at emerging adults should enhance psychosocial transformations and individuals' specific needs to prevent maladjustment to breakups and psychological problems.