Psychotherapy最新文献

Despite the availability of evidence-based psychosocial and pharmacologic interventions for mental health concerns, access to care remains suboptimal. We present a time-efficient mental health treatment program designed to improve overall community access to evidence-based care. Quality of care within the time-efficient model was prioritized by focusing on a multifaceted program of evidence-based interventions and facilitating connections to long-term care when needed. We present the results of a proof-of-concept open trial that indicates that access to care can be improved while maintaining quality mental health services. The Time-Efficient, Evidence-Based, Accessible, Multidisciplinary approach includes time-limited care provided by a team of psychotherapists, psychiatrists, nurse practitioners, and case managers working in pods, supported by measurement-based care, to develop individualized treatment plans. We used data from the electronic health record to evaluate (a) access to care, (b) engagement, and (c) treatment outcomes for an initial sample of 1,726 patients. Patients waited on average 17 days to see a therapist and 20 days to see a psychopharmacologist. Patients received on average 10 sessions of psychotherapy and four medication management sessions. Fifty-seven percent remained in treatment for at least 3 months. Patients demonstrated large improvements in depression (d = 1.18) and anxiety (d = 1.20) with small to moderate effects for improvements in functioning (d = 0.40). By capitalizing on a package of evidence-based interventions delivered with equitable time limits, the Time-Efficient, Evidence-Based, Accessible, Multidisciplinary clinic demonstrates initial access while yielding good engagement in services and moderate to large treatment effects. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Deficits in emotional processing are considered to underlie a range of psychopathologies, and thus constitute a crucial target to improve mental health. Given the broad consensus on the importance of emotional processing during psychotherapy to reduce symptomology, it is surprising that there is no self-report scale designed to measure this construct. The purpose of this study was to develop the Emotional Processing Self-Report (EP-SR), a practical easy-to-use tool for assessing client emotional processing during therapeutic sessions. In Study 1, 53 items were developed according to theory and evaluated by experts. Exploratory factor analyses of the newly created EP-SR items were administered in a cross-sectional design to 124 individuals in treatment. In Study 2, multilevel exploratory factor analyses were performed on a sample of 114 patients who completed the EP-SR after each therapy session (1956 measurements). The results indicated that the EP-SR could be used to assess three independent lower order emotional processes: emotional expression, regulation, and understanding emotional meaning. In Study 3, multilevel confirmatory factor analysis was conducted on additional sample of 77 patients who completed the EP-SR after each therapy session (1,423 measurements). Results confirmed the factor structure of the EP-SR. The internal consistency, convergent, incremental, and predictive validity of the EP-SR were confirmed by showing its association with clients' process and outcome measures. The results of these three studies support the reliability and validity of the EP-SR and its clinical importance. Given its user-friendliness and strong psychometric properties, the EP-SR emerges as a good instrument to assess individuals' emotional processing. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Childhood sexual abuse (CSA) affects approximately 30% of American children assigned female at birth. CSA often has a negative impact on survivors, leading to poorer mental health and an increased risk of subsequent sexual victimization. The current proof-of-concept study sought to examine the acceptability, feasibility, and fidelity of a peer-facilitated, online, one-time group intervention model to simultaneously promote recovery and prevent further victimization. We developed a brief intervention model drawing from components of previously tested protocols (i.e., expressive writing, interpersonal skills). Undergraduate students were trained as facilitators. We conducted online group sessions via Zoom with -three to seven participants per group (n = 40 in k = 10 groups). Participants were women (95.7%) or assigned female at birth nonbinary (4.3%) aged 17-30 who had experienced CSA. They were surveyed pre- and postintervention regarding acceptability. Qualitatively, feedback on the group intervention was very positive. Quantitatively, participants reported feeling more comfortable asking someone to stop sexual advances (M = 4.32/5.0), reported a desire to continue using skills learned (M = 4.56/5.0), and felt comfortable working with the peer providers (M = 4.63/5.0). From the participant-feasibility perspective, 100% of participants reported some level of postintervention skill practice during the one-week follow-up. The average, dichotomous, fidelity rating was 84.9%. Our findings indicate that an online group intervention facilitated by peers to improve health after CSA is acceptable, feasible, and meets minimal fidelity standards. Further development and refinement of this intervention model are warranted. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

To test the hypotheses that supervision improves therapeutic skills and therapeutic alliance (Hypothesis 1) and that this effect is stronger for immediate rather than for delayed supervisory feedback (Hypothesis 2). Eighty psychology students (M = 24.29 years; 72.5% identified as female; 75.0% were studying for a bachelor's degree) conducted three consecutive sessions with a standardized patient in a simulated therapy. These students were randomly assigned to live supervision (LS) or delayed video-based supervision (DS). While the LS group received support from a supervisor during the second session, the DS group received such support after the second session. Several outcomes (students' skills, self-efficacy, fear of negative evaluation, therapeutic and supervisory alliances, and supervision quality) were assessed from different perspectives (i.e., independent raters, students, patients). From all perspectives, supervision significantly increased students' skills and self-efficacy, and the therapeutic alliance (d = 0.29-0.49, Hypothesis 1). Moreover, LS was not significantly superior to DS in any of the outcomes (Hypothesis 2). In addition, students subjectively perceived DS as more effective (d = 0.83, 95% confidence interval [0.37, 1.29]), but they identified the supervisory relationship as equally pleasant and the feedback as equally helpful in both conditions. Supervision positively influenced students' skills and self-efficacy, and the therapeutic alliance, and both LS and DS were viewed as high quality. Thus, live and delayed supervision formats have comparable effects. However, future research should further investigate the specific mechanisms through which they exert their positive influences. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Deliberate practice has been introduced to psychotherapy training to improve therapist performance. The emerging empirical evidence supporting the positive impacts of deliberate practice is complicated by confusion regarding how deliberate practice should be operationalized and applied in the psychotherapy context and wider debate about its role in developing expertise. This systematic literature review aimed to appraise and synthesize the preliminary evidence available regarding the role of deliberate practice in improving psychotherapy outcomes. We searched MEDLINE, EMBASE, APA PsycInfo, CINAHL, Web of Science, reference lists of articles, and other sources (last checked June 2023). Quantitative English language studies that examined deliberate practice interventions in psychotherapy contexts were included. Two authors independently extracted study data and assessed quality using the relevant Joanna Briggs Institute critical appraisal checklist. Randomized controlled trials were further appraised using the Cochrane risk of bias tool. Discrepancies were resolved through discussion with a third author (Stephen Arthey). Twenty studies were included. There was wide variability in how deliberate practice had been operationalized, and only three studies met the contemporary definition that experts in the field have clarified. Significant methodological limitations impacted the reliability of studies, and the evidence was too preliminary to support or refute its use. Further research is required to establish whether deliberate practice is an effective means of improving psychotherapy outcomes. This should include increased fidelity to contemporary operationalizations, more robust methodology, and more reliable measures of long-term client outcomes. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Over the past 2 decades, a growing body of research has revealed that therapists differ in how effective they are at facilitating change depending on their clients' social identities (see Imel et al., 2011, for example). Most studies examining the phenomenon of variability within therapists' caseloads are based on the study of client race/ethnicity. However, two were recently published that found that therapists varied in the association between their clients' sexual orientation and their therapy outcomes (Cabrera et al., 2023; Drinane et al., 2022). The present study sought to replicate and expand upon these findings in a national data set composed of 78,681 clients from university counseling centers who are part of the Center for Collegiate Mental Health. We employed multilevel modeling techniques to detect within-therapist disparities based on client sexual orientation on the following three outcomes: depression scores, an index of distress, and treatment dropout. The association between sexual orientation and all three outcome variables varied significantly across therapists. The presence of sexual orientation disparities within therapist caseloads in such a large and widespread sample is concerning and highlights a need for the analysis of other demographic variables and training that might mitigate this problem. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Subgroups in group therapy have long been considered an important concern. In this study, we examined how identity-based faultlines (i.e., the likelihood of splitting into subgroups based on member demographic information; Meyer & Glenz, 2013) would moderate the link between therapeutic factors and the reduction of psychological distress. Using data from 26 Chinese counseling groups comprising 141 group members (52.34% women, M_age = 22.41), we investigated the relations between identity-based faultlines (group level), early therapeutic factors (member level, measured at Session 2), and group members' psychological distress (member level). Results from the two-level linear regression model indicated that being in a group with higher identity-based faultlines did not directly predict members' symptom reduction. Furthermore, high faultline seemed to facilitate rather than impede group process, such that a member's perceived helpfulness of the group process (therapeutic factors) in early group more strongly predicted symptom reduction in high-faultline groups and that members with higher levels of pregroup psychological distress reported more symptom reduction in high-faultline groups. Our findings provided new evidence that identity-based faultlines could also have positive effects on group therapy. We discussed the implications of identity-based faultlines in the Chinese context. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

The two articles by Kopelovich, Brian, et al. (2025) and Kopelovich, Slevin, et al. (2025) mark a new era in psychotherapy research and practice. The articles detail the development and validation of one of the first conversational artificial intelligence- (AI-) enhanced psychotherapy training tools, with profound implications for the future of clinical training. Following the new trail blazed by Kopelovich, Brian, et al. (2025) and Kopelovich, Slevin, et al. (2025), this commentary traces some of the most promising future directions for clinical training and research. In clinical training, trainees will be able to practice therapeutic skills and techniques with virtual clients before working with real ones. After mastering common therapeutic skills and treatment-specific techniques, they will begin treating real clients and receive detailed, immediate, and constructive AI-based feedback on their work to augment supervision sessions. Posttraining, clinicians can maintain and enhance their clinical expertise, acquire new skills, and incorporate the latest evidence-based knowledge into their practice through AI-based solutions. In research, it will be possible to explore the most effective techniques to be used by trainees and therapists at certain moments in a therapeutic session with individual patients, enabling the development of more precise and personalized therapeutic interventions. It will also be possible to explore the most effective trainee-specific supervision approaches to enhance a transformative experience and serve as a catalyst for the trainee's professional identity development within the supervisor-supervisee relationship, augmented by a systematic mapping of the trainee's strengths and areas for improvement. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

This article introduces a special section that addresses the need for culturally and structurally responsive training in psychotherapy. Nine articles explore how to prepare psychotherapists to address cultural and structural factors, in addition to individual and interpersonal factors, in their practice. Key themes include fostering a more critical form of cultural humility, building critical consciousness, and addressing oppressive systems within psychotherapy, supervision, the training environment, and accreditation. The articles also highlight the importance of advocacy for social or structural change, challenging psychotherapists to expand their scope to include systemic influences on client well-being. Together, these contributions provide actionable frameworks to prepare psychotherapists for antioppressive, equity-driven care. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

To be responsive to the growing mental health inequities in our communities, we must move beyond incremental changes to our graduate training to bolder, more transformative changes. Such efforts must move beyond targeting our academic, internship, and postdoctoral programs and instead focus on critiquing our accreditation process. Without transformation of accreditation and other macrostructural dynamics in psychology, our training programs will continue to perpetuate the status quo and limit the ability of graduate trainees to adequately address mental health disparities. The purpose of this article is to call upon regulatory entities, such as the American Psychological Association Commission on Accreditation, to consider shifting training within applied doctoral programs from individual and cultural diversity competencies to a structural competency framework. Redefining this competency using structural perspectives will acknowledge the power, privilege, and oppression inherent within institutions, policies, and structures and better prepare psychology training programs to address the root causes of health inequities. Recommendations for change will be guided by the work of Metzl and Hansen (2014) on structural competencies and focus on the profession-wide and discipline-specific competencies required by the Commission on Accreditation. Barriers to change will also be examined, along with suggestions for resistance and reimagining of the accreditation process and our graduate training. (PsycInfo Database Record (c) 2025 APA, all rights reserved).