Carmen Schaeuffele,Augustin Mutak,Solveig Behr,Friederike Fenski,Leona Hammelrath,Marie Puetz,Steffi Pohl,Christine Knaevelsrud,Johanna Boettcher
OBJECTIVEBlended care (BC), the integration of Internet-based interventions into psychotherapy (PT), is thought of as a promising approach to enhance PT's effectiveness and efficiency. This randomized controlled trial aimed to investigate the effectiveness as well as the implementation and usage of BC with transdiagnostic online modules compared to PT in routine care in Germany. Routine outpatient PT is delivered by licensed psychotherapists across different therapeutic orientations (cognitive behavioral therapy, psychodynamic, systemic), with variable treatment lengths and procedures.METHODPsychotherapists in routine outpatient care recruited 1,159 patients who were randomized to BC or PT. The primary outcome was self-reported mental distress (the composite of anxiety and depression); secondary outcomes included self-reported satisfaction with life, level of functioning, eating pathology, and drug and alcohol use, as well as therapist-rated severity and changes. Outcomes were measured at baseline, 6 weeks, 12 weeks, 6 months, and 12 months. We examined whether BC and PT groups changed differently over time using linear mixed models. We also investigated differences in sessions and terminations and report usage metrics of the BC platform.RESULTSContrary to our hypotheses, we did not find differences between BC and PT in outcomes, including anxiety, depression, satisfaction with life, level of functioning, eating pathology, alcohol and drug use, therapist-rated severity, and satisfaction with treatment at 6 months postrandomization (all p > .05). BC and PT did not differ in the number of sessions or terminations. Regarding usage of the BC platform, 534 patients (91.6%) received at least one online chapter, with M = 7.26 (SD = 7.01) of a total of 39 online chapters assigned on average, and patients logged in M = 19.73 (SD = 24.66) times and spent M = 367.14 (SD = 338.27) minutes on the platform.CONCLUSIONSIn this real-world application of BC, therapists had considerable flexibility in implementing BC and integrating Internet-based interventions with sessions. Our findings suggest that the benefits observed in more structured BC setups may not fully translate to a flexible and transdiagnostic BC setup in routine care, potentially due to variations in implementation and adherence. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
{"title":"Increasing the effectiveness of psychotherapy in routine care through transdiagnostic online modules? Randomized controlled trial investigating blended care.","authors":"Carmen Schaeuffele,Augustin Mutak,Solveig Behr,Friederike Fenski,Leona Hammelrath,Marie Puetz,Steffi Pohl,Christine Knaevelsrud,Johanna Boettcher","doi":"10.1037/ccp0000983","DOIUrl":"https://doi.org/10.1037/ccp0000983","url":null,"abstract":"OBJECTIVEBlended care (BC), the integration of Internet-based interventions into psychotherapy (PT), is thought of as a promising approach to enhance PT's effectiveness and efficiency. This randomized controlled trial aimed to investigate the effectiveness as well as the implementation and usage of BC with transdiagnostic online modules compared to PT in routine care in Germany. Routine outpatient PT is delivered by licensed psychotherapists across different therapeutic orientations (cognitive behavioral therapy, psychodynamic, systemic), with variable treatment lengths and procedures.METHODPsychotherapists in routine outpatient care recruited 1,159 patients who were randomized to BC or PT. The primary outcome was self-reported mental distress (the composite of anxiety and depression); secondary outcomes included self-reported satisfaction with life, level of functioning, eating pathology, and drug and alcohol use, as well as therapist-rated severity and changes. Outcomes were measured at baseline, 6 weeks, 12 weeks, 6 months, and 12 months. We examined whether BC and PT groups changed differently over time using linear mixed models. We also investigated differences in sessions and terminations and report usage metrics of the BC platform.RESULTSContrary to our hypotheses, we did not find differences between BC and PT in outcomes, including anxiety, depression, satisfaction with life, level of functioning, eating pathology, alcohol and drug use, therapist-rated severity, and satisfaction with treatment at 6 months postrandomization (all p > .05). BC and PT did not differ in the number of sessions or terminations. Regarding usage of the BC platform, 534 patients (91.6%) received at least one online chapter, with M = 7.26 (SD = 7.01) of a total of 39 online chapters assigned on average, and patients logged in M = 19.73 (SD = 24.66) times and spent M = 367.14 (SD = 338.27) minutes on the platform.CONCLUSIONSIn this real-world application of BC, therapists had considerable flexibility in implementing BC and integrating Internet-based interventions with sessions. Our findings suggest that the benefits observed in more structured BC setups may not fully translate to a flexible and transdiagnostic BC setup in routine care, potentially due to variations in implementation and adherence. (PsycInfo Database Record (c) 2026 APA, all rights reserved).","PeriodicalId":15447,"journal":{"name":"Journal of consulting and clinical psychology","volume":"39 1","pages":"11-25"},"PeriodicalIF":5.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145971855","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}
OBJECTIVELarge-scale efforts have disseminated couple and relationship programs to strengthen couple relationships among low-income families, with the hope that doing so would yield benefits for partners and their children. The present study provided a rigorous test of this hypothesis by examining indirect effects of a couple-focused preventive intervention on child outcomes in a large sample of low-income families.METHODData were drawn from the Supporting Healthy Marriage evaluation, in which 6,298 low-income married couples with children were randomized to a relationship education intervention with supplemental activities and family support services or to a control condition. Couple relationship functioning was assessed 12 months postrandomization, and five child outcomes (self-regulation, internalizing behavior problems, externalizing behavior problems, cognitive and academic performance, and social competence) were assessed 30 months postrandomization.RESULTSStructural equation models revealed that the intervention had significant indirect effects on children's self-regulation, internalizing behavior problems (children younger than 14 years), externalizing behavior problems (children younger than 14 years), cognitive and academic performance (children older than 5 years), and social competence, through enhanced couple functioning.CONCLUSIONSParticipation in a couple-focused intervention had significant indirect effects on low-income couples' children 30 months later through intervention-derived improvements in the couple relationship. These results suggest that strengthening couple relationships may be a viable option to indirectly promote child well-being in low-income families. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
{"title":"Strengthening couple functioning to enhance child outcomes in low-income families: A randomized controlled trial.","authors":"Justin A Lavner,Po-Heng Chen,Hannah C Williamson","doi":"10.1037/ccp0000988","DOIUrl":"https://doi.org/10.1037/ccp0000988","url":null,"abstract":"OBJECTIVELarge-scale efforts have disseminated couple and relationship programs to strengthen couple relationships among low-income families, with the hope that doing so would yield benefits for partners and their children. The present study provided a rigorous test of this hypothesis by examining indirect effects of a couple-focused preventive intervention on child outcomes in a large sample of low-income families.METHODData were drawn from the Supporting Healthy Marriage evaluation, in which 6,298 low-income married couples with children were randomized to a relationship education intervention with supplemental activities and family support services or to a control condition. Couple relationship functioning was assessed 12 months postrandomization, and five child outcomes (self-regulation, internalizing behavior problems, externalizing behavior problems, cognitive and academic performance, and social competence) were assessed 30 months postrandomization.RESULTSStructural equation models revealed that the intervention had significant indirect effects on children's self-regulation, internalizing behavior problems (children younger than 14 years), externalizing behavior problems (children younger than 14 years), cognitive and academic performance (children older than 5 years), and social competence, through enhanced couple functioning.CONCLUSIONSParticipation in a couple-focused intervention had significant indirect effects on low-income couples' children 30 months later through intervention-derived improvements in the couple relationship. These results suggest that strengthening couple relationships may be a viable option to indirectly promote child well-being in low-income families. (PsycInfo Database Record (c) 2026 APA, all rights reserved).","PeriodicalId":15447,"journal":{"name":"Journal of consulting and clinical psychology","volume":"5 1","pages":"39-48"},"PeriodicalIF":5.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145971856","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}
OBJECTIVECouple relationship education (CRE) seeks to enhance relationship functioning and prevent deterioration of relationship quality over time. However, impacts of CRE are mixed and often appear to be influenced by the characteristics of the couples receiving the intervention. To provide effective interventions, a better understanding of the couples who are most likely to benefit from CRE is needed. Unfortunately, the existing literature has failed to account for the complex and interdependent nature of pretreatment risk factors, leading to inconsistent and inconclusive results.METHODThe present study addresses this issue by applying causal forest, a machine learning technique, to two randomized controlled trials of CRE to determine the pretreatment characteristics that are most predictive of treatment outcomes. In Study 1, data from 6,298 couples were used to train causal forest algorithms, and in Study 2, data from 1,595 couples were used to test the accuracy and generalizability of the trained models.RESULTSCausal forest models indicated that pretreatment characteristics predicted 12-month treatment effects, such that participants with higher psychological distress and lower baseline relationship happiness experienced greater improvements in relationship happiness, while those with higher psychological distress and perceived stress had greater reductions in negative emotions and behaviors within the relationship. These results were robust when tested in a novel data set.CONCLUSIONSThis research highlights the underlying heterogeneity in CRE treatment effects and demonstrates the ability of machine learning methods to identify who may benefit most from CRE and can inform efforts to improve targeting of these interventions. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
{"title":"Who benefits most from couple relationship education: A machine learning approach.","authors":"Po-Heng Chen,Hannah C Williamson","doi":"10.1037/ccp0000991","DOIUrl":"https://doi.org/10.1037/ccp0000991","url":null,"abstract":"OBJECTIVECouple relationship education (CRE) seeks to enhance relationship functioning and prevent deterioration of relationship quality over time. However, impacts of CRE are mixed and often appear to be influenced by the characteristics of the couples receiving the intervention. To provide effective interventions, a better understanding of the couples who are most likely to benefit from CRE is needed. Unfortunately, the existing literature has failed to account for the complex and interdependent nature of pretreatment risk factors, leading to inconsistent and inconclusive results.METHODThe present study addresses this issue by applying causal forest, a machine learning technique, to two randomized controlled trials of CRE to determine the pretreatment characteristics that are most predictive of treatment outcomes. In Study 1, data from 6,298 couples were used to train causal forest algorithms, and in Study 2, data from 1,595 couples were used to test the accuracy and generalizability of the trained models.RESULTSCausal forest models indicated that pretreatment characteristics predicted 12-month treatment effects, such that participants with higher psychological distress and lower baseline relationship happiness experienced greater improvements in relationship happiness, while those with higher psychological distress and perceived stress had greater reductions in negative emotions and behaviors within the relationship. These results were robust when tested in a novel data set.CONCLUSIONSThis research highlights the underlying heterogeneity in CRE treatment effects and demonstrates the ability of machine learning methods to identify who may benefit most from CRE and can inform efforts to improve targeting of these interventions. (PsycInfo Database Record (c) 2026 APA, all rights reserved).","PeriodicalId":15447,"journal":{"name":"Journal of consulting and clinical psychology","volume":"34 1","pages":"49-62"},"PeriodicalIF":5.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145971916","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}
Hannah van Alebeek,Louisa D'Errico,Jaime Delgadillo,Ulrike Dinger,Johannes C Ehrenthal,Franziska Pfannerstill,Johannes Mander,Thomas Probst
OBJECTIVEThe mechanisms underlying psychotherapy's effects remain debated, with some emphasizing theory-specific therapeutic techniques and others highlighting common factors like therapeutic alliance. Evidence is inconclusive partially because it is rarely assessed which interventions are actually employed in naturalistic outpatient settings. The study thus examined (a) how patient- and therapist-reported interventions during cognitive-behavioral therapy predict outcome, (b) whether naturally occurring integration of intervention from different therapeutic orientations predicts a more or less favorable outcome, and (c) whether the intervention-outcome association depends on specific diagnoses.METHODUsing the Multitheoretical List of Therapeutic Interventions, 1,050 patients diagnosed with the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (Mage = 34.65, 58% female), and their 161 cognitive-behavioral therapy therapists reported which interventions were employed during psychotherapy. The patient-reported outcome, the Brief Symptom Checklist, was assessed at the beginning and end of therapy.RESULTSBayesian multilevel regression models revealed that patient-reported interventions were more consistently associated with the outcome than therapist-reported interventions. The person-centered subscale-especially reports on the exploration of personal meaning-emerged as the strongest predictor of the outcome. Integration of most interventions (i.e., reports on two subscales of the Multitheoretical List of Therapeutic Interventions) did not predict a more positive or negative outcome, though few combinations were beneficial. Findings regarding stronger intervention-outcome associations for specific diagnoses were not robust.CONCLUSIONBy leveraging natural variability in routine clinical practice, this study provides insights into psychotherapy mechanisms beyond controlled trial constraints. It highlights the relevance of patients' perspective and the integration of interventions targeting meaning in predicting the outcome in outpatient cognitive-behavioral therapy. In addition, there seem to be no advantages nor adverse consequences of integrating therapeutic techniques. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
{"title":"What works for whom in outpatient cognitive-behavioral therapy? Integration of techniques from different therapeutic orientations and their interactions as predictors of treatment outcome in different diagnostic groups.","authors":"Hannah van Alebeek,Louisa D'Errico,Jaime Delgadillo,Ulrike Dinger,Johannes C Ehrenthal,Franziska Pfannerstill,Johannes Mander,Thomas Probst","doi":"10.1037/ccp0000987","DOIUrl":"https://doi.org/10.1037/ccp0000987","url":null,"abstract":"OBJECTIVEThe mechanisms underlying psychotherapy's effects remain debated, with some emphasizing theory-specific therapeutic techniques and others highlighting common factors like therapeutic alliance. Evidence is inconclusive partially because it is rarely assessed which interventions are actually employed in naturalistic outpatient settings. The study thus examined (a) how patient- and therapist-reported interventions during cognitive-behavioral therapy predict outcome, (b) whether naturally occurring integration of intervention from different therapeutic orientations predicts a more or less favorable outcome, and (c) whether the intervention-outcome association depends on specific diagnoses.METHODUsing the Multitheoretical List of Therapeutic Interventions, 1,050 patients diagnosed with the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (Mage = 34.65, 58% female), and their 161 cognitive-behavioral therapy therapists reported which interventions were employed during psychotherapy. The patient-reported outcome, the Brief Symptom Checklist, was assessed at the beginning and end of therapy.RESULTSBayesian multilevel regression models revealed that patient-reported interventions were more consistently associated with the outcome than therapist-reported interventions. The person-centered subscale-especially reports on the exploration of personal meaning-emerged as the strongest predictor of the outcome. Integration of most interventions (i.e., reports on two subscales of the Multitheoretical List of Therapeutic Interventions) did not predict a more positive or negative outcome, though few combinations were beneficial. Findings regarding stronger intervention-outcome associations for specific diagnoses were not robust.CONCLUSIONBy leveraging natural variability in routine clinical practice, this study provides insights into psychotherapy mechanisms beyond controlled trial constraints. It highlights the relevance of patients' perspective and the integration of interventions targeting meaning in predicting the outcome in outpatient cognitive-behavioral therapy. In addition, there seem to be no advantages nor adverse consequences of integrating therapeutic techniques. (PsycInfo Database Record (c) 2026 APA, all rights reserved).","PeriodicalId":15447,"journal":{"name":"Journal of consulting and clinical psychology","volume":"30 1","pages":"26-38"},"PeriodicalIF":5.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145971918","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}
OBJECTIVESUsing feedback helps to improve psychological treatment outcomes, particularly for patients whose symptom trajectory is not-on-track. However, little is known about why some cases are not-on-track and what strategies can help to improve their treatment response. This study aimed to examine common obstacles and solutions identified by feedback-using therapists.METHODA cohort of therapists (N = 10) used a feedback algorithm that classified cases as on-track or not-on-track using session-by-session measures of depression (Patient Health Questionnaire-9) and anxiety (Generalized Anxiety Disorder-7). They followed a structured protocol to identify obstacles and potential solutions in not-on-track cases, and to document these using qualitative case notes. Case notes from 192 therapy sessions (across N = 44 cases) were analyzed using topic modeling, a machine learning approach to process qualitative data.RESULTSCommon obstacles were: (a) impact of traumatic experiences, (b) indicators of resistance, (c) social/interpersonal problems, (d) stressful life events, and (e) therapy process problems. Common solutions included: (a) strengthening agreement on goals and tasks, (b) enhancing focality, (c) individualized case formulation, and (d) enhancing expectations and motivation for change.CONCLUSIONSConsistent with prior quantitative research, the topics identified in this qualitative study generally reflected problems related to motivation/resistance or interpersonal/relational problems. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
{"title":"Why are some cases not on track? An investigation of common obstacles and solutions during feedback-informed psychological therapy.","authors":"Eleanor Williams,Heidi Christensen,Elisa Aguirre,Jon Wheatley,Adam Corfe,Janet Thomson,Jaime Delgadillo","doi":"10.1037/ccp0000977","DOIUrl":"https://doi.org/10.1037/ccp0000977","url":null,"abstract":"OBJECTIVESUsing feedback helps to improve psychological treatment outcomes, particularly for patients whose symptom trajectory is not-on-track. However, little is known about why some cases are not-on-track and what strategies can help to improve their treatment response. This study aimed to examine common obstacles and solutions identified by feedback-using therapists.METHODA cohort of therapists (N = 10) used a feedback algorithm that classified cases as on-track or not-on-track using session-by-session measures of depression (Patient Health Questionnaire-9) and anxiety (Generalized Anxiety Disorder-7). They followed a structured protocol to identify obstacles and potential solutions in not-on-track cases, and to document these using qualitative case notes. Case notes from 192 therapy sessions (across N = 44 cases) were analyzed using topic modeling, a machine learning approach to process qualitative data.RESULTSCommon obstacles were: (a) impact of traumatic experiences, (b) indicators of resistance, (c) social/interpersonal problems, (d) stressful life events, and (e) therapy process problems. Common solutions included: (a) strengthening agreement on goals and tasks, (b) enhancing focality, (c) individualized case formulation, and (d) enhancing expectations and motivation for change.CONCLUSIONSConsistent with prior quantitative research, the topics identified in this qualitative study generally reflected problems related to motivation/resistance or interpersonal/relational problems. (PsycInfo Database Record (c) 2026 APA, all rights reserved).","PeriodicalId":15447,"journal":{"name":"Journal of consulting and clinical psychology","volume":"39 1","pages":"1-10"},"PeriodicalIF":5.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145971917","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 The Long-Term Effectiveness of Psychodynamic and Analytical Psychotherapy in Routine Care: Results From a Naturalistic Study Over 6 Years","authors":"","doi":"10.1037/ccp0000985.supp","DOIUrl":"https://doi.org/10.1037/ccp0000985.supp","url":null,"abstract":"","PeriodicalId":15447,"journal":{"name":"Journal of consulting and clinical psychology","volume":"93 1","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145689061","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":"Acknowledgment of Ad Hoc Reviewers","authors":"","doi":"10.1037/ccp0000993","DOIUrl":"https://doi.org/10.1037/ccp0000993","url":null,"abstract":"","PeriodicalId":15447,"journal":{"name":"Journal of consulting and clinical psychology","volume":"71 1","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145689048","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}
OBJECTIVEThis naturalistic study examines the long-term effectiveness of two psychoanalytically oriented therapies-psychodynamic psychotherapy (PP) and analytical psychotherapy (AP)-in routine care settings in Germany.METHODA total of 428 patients diagnosed with various mental disorders according to the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, underwent treatment with either PP or AP. Diagnoses were reassessed at the end of treatment, and patients provided annual self-reports of their mental health over a 6-year period. We employed propensity score methods and piecewise linear latent growth curve models to estimate treatment effects on primary outcomes (i.e., number of diagnoses, symptom distress) and secondary outcomes (i.e., personality dysfunction, interpersonal problems, general life satisfaction).RESULTSPatients exhibited substantial and sustained improvements across all outcomes in both treatments. Notably, those receiving AP experienced greater (long-term) improvement in primary and most secondary outcomes compared to those in PP. Improvements in PP primarily occurred during the 1st year, while AP patients continued to show progress throughout the entire observation period. For some outcomes (symptom distress, personality dysfunction, and interpersonal problems), AP was particularly effective for patients with more severe problems at baseline.CONCLUSIONSPsychoanalytically oriented treatments in routine care are associated with substantial and lasting improvements, even posttreatment. Our findings highlight an incremental benefit of AP over PP, particularly for complex cases. Future research should explore treatment mechanisms, cost-effectiveness, and implications for health policy. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
目的：本自然主义研究考察了德国常规护理环境中两种以精神分析为导向的治疗方法——精神动力心理治疗（PP）和分析性心理治疗（AP）的长期有效性。方法：共有428名根据《精神疾病诊断与统计手册》（第四版）诊断为各种精神障碍的患者接受了PP或AP治疗。在治疗结束时对诊断进行重新评估，患者每年提供6年期间的精神健康自我报告。我们采用倾向评分方法和分段线性潜在增长曲线模型来估计治疗对主要结局（即诊断次数、症状困扰）和次要结局（即人格功能障碍、人际关系问题、总体生活满意度）的影响。结果在两种治疗中，患者在所有结果中均表现出显著和持续的改善。值得注意的是，与接受PP治疗的患者相比，接受AP治疗的患者在主要和大多数次要预后方面有更大的（长期）改善。PP的改善主要发生在第一年，而AP患者在整个观察期内持续表现出进展。对于某些结果（症状困扰、人格功能障碍和人际关系问题），AP对基线时问题更严重的患者特别有效。结论在常规护理中，以心理分析为导向的治疗与实质性和持久的改善相关，甚至在治疗后也是如此。我们的研究结果强调了AP优于PP的益处，特别是对于复杂的病例。未来的研究应探讨治疗机制、成本效益和对卫生政策的影响。（PsycInfo Database Record (c) 2025 APA，版权所有）。
{"title":"The long-term effectiveness of psychodynamic and analytical psychotherapy in routine care: Results from a naturalistic study over 6 years.","authors":"Miriam Henkel,Johannes Zimmermann,Matthias Volz,Dorothea Huber,Hermann Staats,Cord Benecke","doi":"10.1037/ccp0000985","DOIUrl":"https://doi.org/10.1037/ccp0000985","url":null,"abstract":"OBJECTIVEThis naturalistic study examines the long-term effectiveness of two psychoanalytically oriented therapies-psychodynamic psychotherapy (PP) and analytical psychotherapy (AP)-in routine care settings in Germany.METHODA total of 428 patients diagnosed with various mental disorders according to the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, underwent treatment with either PP or AP. Diagnoses were reassessed at the end of treatment, and patients provided annual self-reports of their mental health over a 6-year period. We employed propensity score methods and piecewise linear latent growth curve models to estimate treatment effects on primary outcomes (i.e., number of diagnoses, symptom distress) and secondary outcomes (i.e., personality dysfunction, interpersonal problems, general life satisfaction).RESULTSPatients exhibited substantial and sustained improvements across all outcomes in both treatments. Notably, those receiving AP experienced greater (long-term) improvement in primary and most secondary outcomes compared to those in PP. Improvements in PP primarily occurred during the 1st year, while AP patients continued to show progress throughout the entire observation period. For some outcomes (symptom distress, personality dysfunction, and interpersonal problems), AP was particularly effective for patients with more severe problems at baseline.CONCLUSIONSPsychoanalytically oriented treatments in routine care are associated with substantial and lasting improvements, even posttreatment. Our findings highlight an incremental benefit of AP over PP, particularly for complex cases. Future research should explore treatment mechanisms, cost-effectiveness, and implications for health policy. (PsycInfo Database Record (c) 2025 APA, all rights reserved).","PeriodicalId":15447,"journal":{"name":"Journal of consulting and clinical psychology","volume":"33 1","pages":"814-828"},"PeriodicalIF":5.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145673537","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":"Questioning the distinction between active elements and mechanisms: Evidence from a reanalysis in cognitive behavioral therapy of depression.","authors":"Iony D. Ezawa, Daniel R. Strunk","doi":"10.1037/ccp0000984","DOIUrl":"https://doi.org/10.1037/ccp0000984","url":null,"abstract":"","PeriodicalId":15447,"journal":{"name":"Journal of consulting and clinical psychology","volume":"24 1","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145447385","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}
Julian A. Rubel, Juan S. Peña Loray, Miriam I. Hehlmann, Anne-Katharina Deisenhofer, Brian Schwartz, Wolfgang Lutz
{"title":"The impact of routine outcome monitoring and feedback integration on treatment outcome: A therapist-specific indicator of belief updating processes?","authors":"Julian A. Rubel, Juan S. Peña Loray, Miriam I. Hehlmann, Anne-Katharina Deisenhofer, Brian Schwartz, Wolfgang Lutz","doi":"10.1037/ccp0000974","DOIUrl":"https://doi.org/10.1037/ccp0000974","url":null,"abstract":"","PeriodicalId":15447,"journal":{"name":"Journal of consulting and clinical psychology","volume":"34 1","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145447384","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}
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