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Let's get real: Identity concealment, burnout, and therapeutic relationship quality among psychology trainees with concealable stigmatized identities. 实话实说:身份隐藏、职业倦怠和具有可隐藏污名身份的心理学学员的治疗关系质量。
IF 2.5 2区 心理学 Q2 Psychology Pub Date : 2024-06-01 Epub Date: 2024-03-21 DOI: 10.1037/pst0000522
Benjamin F Shepherd, Paula M Brochu

Identity concealment thwarts psychological needs of authenticity and belonging, both of which are important for mental health and relationship building. Through the lens of minority stress theory and relational-cultural theory, the present study examined whether identity concealment in the workplace by psychology trainees is indirectly associated with greater burnout and poorer therapeutic relationship quality. To test this hypothesis, a parallel mediation analysis was conducted on data from 335 clinical and counseling psychology doctoral trainees with concealable stigmatized identities using Hayes's (2018) PROCESS macro. As expected, identity concealment at a practicum or internship site was negatively associated with authenticity and belonging, both of which were negatively associated with burnout and positively associated with therapeutic relationship quality. Furthermore, identity concealment was associated with lower therapeutic relationship quality and greater burnout indirectly through lower authenticity and lower belonging. Findings suggest trainees who engage in more identity concealment at their clinical training sites may be at increased risk for burnout and poorer relationships with clients due to limited opportunities for authenticity and belonging. Future research is encouraged to longitudinally examine the impact of identity concealment on professional burnout and relationships, as well as potential protective factors. Such knowledge can support the development of interventions and policies that foster safer, more welcoming work environments for trainees with concealable stigmatized identities. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

身份隐藏阻碍了对真实性和归属感的心理需求,而这两种需求对于心理健康和人际关系的建立都很重要。本研究通过少数群体压力理论和关系文化理论的视角,考察了心理学受训者在工作场所的身份隐藏是否与更大的职业倦怠和更差的治疗关系质量间接相关。为了验证这一假设,我们使用 Hayes(2018)的 PROCESS 宏对 335 名临床和咨询心理学博士受训者的数据进行了平行中介分析,这些受训者都具有可隐瞒的污名化身份。不出所料,实习或实习地点的身份隐藏与真实性和归属感呈负相关,而真实性和归属感与职业倦怠呈负相关,与治疗关系质量呈正相关。此外,身份隐藏通过降低真实性和归属感间接地与较低的治疗关系质量和较高的职业倦怠相关联。研究结果表明,在临床培训地点进行更多身份隐藏的受训者可能会增加职业倦怠的风险,并且由于真实性和归属感的机会有限,他们与客户的关系也会变差。我们鼓励未来的研究纵向考察身份隐藏对职业倦怠和人际关系的影响,以及潜在的保护因素。这些知识有助于制定干预措施和政策,为具有可隐藏的污名化身份的受训者营造更安全、更受欢迎的工作环境。(PsycInfo Database Record (c) 2024 APA,保留所有权利)。
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引用次数: 0
A tripartite model of the psychotherapy relationship: Interrelations among its components and their unfolding across sessions. 心理治疗关系的三方模式:各组成部分之间的相互关系及其在不同疗程中的展开。
IF 2.5 2区 心理学 Q2 Psychology Pub Date : 2024-06-01 Epub Date: 2024-03-18 DOI: 10.1037/pst0000521
Erin M Hill, Mira An, Dennis M Kivlighan, Charles J Gelso

The tripartite model of the therapy relationship, which includes the working alliance, real relationship, and transference-countertransference configuration, has been a useful way to conceptualize the complexity of the connection between a therapist and a client. However, little research has focused on the interrelationships between these three components over time. This study sought to replicate the findings of Bhatia and Gelso (2018) by examining the between-person relationships among each of the three elements averaged across all sessions. Additionally, we extended earlier work by examining the within-person relationship between the working alliance, the real relationship, and transference-countertransference with themselves as well as with each of the other elements across sessions. Using 5,931 sessions across 142 clients and 36 therapists, we examined time-ordered associations among the cocreated working alliance, cocreated real relationship, and the therapist-rated transference-countertransference configuration using latent variable dynamic structural equation modeling. Results replicated the findings of Bhatia and Gelso (2018), demonstrating that in one session, the working alliance and the real relationship were positively related, and both the working alliance and the real relationship were negatively related to the transference-countertransference configuration. Regarding the interrelations over time, the findings revealed that the working alliance in the previous session had a significant and positive relationship with real relationship in the current session, and the real relationship in the previous session was related to reduced transference-countertransference in the current session. These findings provide support for complex interrelations among the components over time. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

治疗关系的三方模式,包括工作联盟、真实关系和移情-反移情配置,一直是概念化治疗师与客户之间复杂联系的有用方法。然而,很少有研究关注这三个组成部分之间随着时间推移的相互关系。本研究试图复制巴蒂亚和盖尔索(2018)的研究结果,研究了所有疗程中平均三个要素中每个要素之间的人际关系。此外,我们还扩展了之前的工作,研究了工作联盟、真实关系、移情-反移情之间的人际关系,以及与其他各要素在不同疗程中的关系。通过对 142 名求助者和 36 名治疗师的 5931 次治疗,我们使用潜变量动态结构方程模型研究了共同创建的工作联盟、共同创建的真实关系以及治疗师评定的移情-反移情配置之间的时序关联。结果重复了Bhatia和Gelso(2018)的研究结果,表明在一个疗程中,工作联盟和真实关系呈正相关,而工作联盟和真实关系与移情-反移情配置呈负相关。关于随时间变化的相互关系,研究结果表明,上一疗程的工作联盟与当前疗程的真实关系有显著的正相关,而上一疗程的真实关系与当前疗程的移情-反移情减少有关。这些研究结果证明,随着时间的推移,各组成部分之间存在复杂的相互关系。(PsycInfo Database Record (c) 2024 APA, 版权所有)。
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引用次数: 0
Beyond the dyad: Broadening the APA supervision guidelines to include group supervision. 超越二人世界:拓宽美国心理学会(APA)督导指南,将小组督导纳入其中。
IF 2.5 2区 心理学 Q2 Psychology Pub Date : 2024-06-01 Epub Date: 2024-03-28 DOI: 10.1037/pst0000525
Maria T Riva, Randyl D Smith

Group supervision is an extensively used format across many training agencies, yet it has been largely disregarded in theory and research within the supervision literature. In fact, the Guidelines for Clinical Supervision in Health Service Psychology (American Psychological Association, 2015a) mentions group supervision only one time, despite the fact that supervision within a group context includes competencies and considerations that are both unique and essential to the effective and ethical practice of group supervision. Because supervision conducted with multiple supervisees is multilayered and-as a result-more complex, group supervisors need to develop special skills that go beyond the supervision dyad. This article looks to the literature on supervision-both individual and group modalities-and on group psychotherapy to highlight the practices and processes that set group supervision apart. Building upon the seven supervision competencies outlined by the American Psychological Association (Supervisor Competence; Diversity; Supervisory Relationship; Professionalism; Assessment/Evaluation/Feedback; Professional Competence Problems; and Ethical, Legal and Regulatory Considerations), which currently concentrate exclusively on individual supervision, we extend each area to include distinct features of group supervision. We include recommendations for supervisor training and for the application of effective group supervision practices, as well as ideas on how best to approach the formal adoption of group supervision guidelines for psychotherapists. Our hope is that, either in a revision of the Guidelines for Clinical Supervision in Health Service Psychology or in a freestanding supplement to the Guidelines, guidance for group supervision will be more explicitly included. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

小组督导是许多培训机构广泛采用的一种形式,但在督导文献的理论和研究中,小组督导在很大程度上被忽视了。事实上,《健康服务心理学临床督导指南》(美国心理学会,2015a)只提到过一次小组督导,尽管小组督导包含的能力和考虑因素对于小组督导的有效和道德实践来说既独特又重要。由于与多名被督导者一起进行的督导是多层次的,因此也更加复杂,所以团体督导需要发展超越督导二人组的特殊技能。本文从个人督导和团体督导模式以及团体心理治疗的文献中,强调了团体督导与众不同的实践和过程。美国心理学会概述了七种督导能力(督导能力;多样性;督导关系;专业性;评估/评价/反馈;专业能力问题;以及伦理、法律和监管考虑),目前这些能力只集中在个人督导方面,我们在此基础上扩展了每个领域,使之包括团体督导的独特特征。我们对督导培训和有效团体督导实践的应用提出了建议,并就如何以最佳方式正式采用心理治疗师团体督导指南提出了想法。我们希望,无论是在《健康服务心理学临床督导指南》的修订版中,还是在《指南》的独立增补版中,都能更明确地纳入对小组督导的指导。(PsycInfo Database Record (c) 2024 APA,保留所有权利)。
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引用次数: 0
Supplemental Material for The Relationship Between Interpersonal Problems and Therapeutic Alliance in Psychotherapy: A Three-Level Mixed-Effects Meta-Analysis 心理治疗中人际关系问题与治疗联盟之间的关系》补充材料:三层混合效应 Meta 分析
IF 2.5 2区 心理学 Q2 Psychology Pub Date : 2024-05-16 DOI: 10.1037/pst0000534.supp
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引用次数: 0
Supplemental Material for Native American College Students in Counseling: Results From a Large-Scale, Multisite Effectiveness Study 美国本土大学生咨询补充材料:大规模、多地点有效性研究的结果
IF 2.5 2区 心理学 Q2 Psychology Pub Date : 2024-05-13 DOI: 10.1037/pst0000526.supp
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引用次数: 0
Supplemental Material for Pathological Narcissism’s Impact on Psychodynamic Group Therapy for Perfectionism 病态自恋对完美主义心理动力学团体疗法的影响》补充材料
IF 2.5 2区 心理学 Q2 Psychology Pub Date : 2024-05-09 DOI: 10.1037/pst0000528.supp
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引用次数: 0
Supplemental Material for Psychotherapist Factors That Patients Perceive Are Associated With Treatment Failure 患者认为与治疗失败有关的心理治疗师因素》补充材料
IF 2.5 2区 心理学 Q2 Psychology Pub Date : 2024-05-06 DOI: 10.1037/pst0000527.supp
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引用次数: 0
The evolution of feedback: Toward a multicultural orientation. 反馈的演变:多元文化导向
IF 2.5 2区 心理学 Q2 Psychology Pub Date : 2024-04-18 DOI: 10.1037/pst0000524
Barry L Duncan, Robert J Reese
There have been great strides in psychology regarding diversity, equity, inclusion, and multicultural competence, but a need remains to translate these values into actionable practices in psychotherapy. While the case has been made that measurement-based care is an evidence-based intervention that improves outcomes and reduces dropouts (de Jong et al., 2021) and recently that it provides a transparent collaborative process to engage clients in treatment (Boswell et al., 2023), it has not been widely considered as a methodology for multicultural competence. We trace the evolution of what was once called "patient-focused research" (Lambert, 2001) and identify a significant change in recent writings to include important clinical and collaborative processes, a transition from a strictly normative or nomothetic understanding of the value of feedback to an appreciation of its communicative or idiographic processes. We propose that systematic client feedback promotes a "multicultural orientation" (Owen, 2013) at the individual therapist-client level and that client responses to outcome and process measures can foster cultural humility and create cultural opportunities (Hook et al., 2017) to address marginalization and other sociocultural factors relevant to treatment. Using one system to illustrate what is possible for all feedback approaches, we present client examples that demonstrate an integration of a multicultural orientation. We suggest that systematic client feedback can provide a structure to address diversity, marginalization, and privilege in psychotherapy. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
心理学在多样性、公平、包容和多元文化能力方面取得了长足进步,但仍需要将这些价值观转化为心理治疗中的可操作实践。虽然人们已经证明,基于测量的护理是一种基于证据的干预措施,可以提高疗效并减少辍学率(de Jong 等人,2021 年),最近还证明它提供了一种透明的合作过程,可以让客户参与治疗(Boswell 等人,2023 年),但它还没有被广泛视为一种提高多元文化能力的方法。我们追溯了曾被称为 "以患者为中心的研究"(Lambert,2001 年)的演变过程,发现近期的著作发生了重大变化,将重要的临床和合作过程纳入其中,从对反馈价值的严格规范或唯名论理解过渡到对其交流或成因过程的理解。我们提出,系统性的客户反馈可以在治疗师与客户个体层面促进 "多元文化取向"(Owen,2013),客户对结果和过程测量的反应可以促进文化谦逊并创造文化机会(Hook 等人,2017),以解决边缘化问题以及与治疗相关的其他社会文化因素。我们用一个系统来说明所有反馈方法的可能性,并介绍了一些客户案例,展示了多元文化取向的融合。我们认为,系统化的客户反馈可以为解决心理治疗中的多样性、边缘化和特权问题提供一个结构。(PsycInfo 数据库记录 (c) 2024 APA,保留所有权利)。
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引用次数: 0
Development and validation of the Gender Identity and Expression Microaggressions in Therapy Scale (GIEMTS). 治疗中的性别认同与表达微冒犯量表(GIEMTS)的开发与验证。
IF 2.5 2区 心理学 Q2 Psychology Pub Date : 2024-04-18 DOI: 10.1037/pst0000523
Brandon L Velez, Jillian R Scheer, Christian N Adames, Elizabeth Cavic, A. Breslow
Developing affirming interventions for transgender and nonbinary (TNB) therapy clients requires understanding their experiences with microaggressions in psychotherapy, yet no self-report measure of anti-TNB microaggressions in this context exists. Moreover, few studies have tested the associations between anti-TNB microaggressions and therapy processes. To better address the burden of unmet mental health care needs among TNB people, this three-study investigation designed and tested the psychometric properties of the Gender Identity and Expression Microaggressions in Therapy Scale (GIEMTS), a measure of TNB individuals' encounters with microaggressions in psychotherapy. Study 1 (N = 225) identified a four-factor model, comprising the themes of Educational Burdening, Lack of Affirmation, Inflation, and Invalidation. These subscales exhibited strong internal consistency reliabilities and demonstrated convergent and discriminant validity. The results of Study 2 (N = 435) replicated the four-factor structure through confirmatory factor analysis. However, bifactor analysis revealed that the Educational Burdening, Inflation, and Invalidation subscale scores were mostly accounted by a General Anti-TNB Microaggressions scale score-though Lack of Affirmation showed evidence of its independence. Also in Study 2, both scales were uniquely negatively associated with the working alliance. Study 3 (N = 151) found evidence for the test-retest reliability of GIEMTS scores over a 2-3-week period. Overall, the GIEMTS emerged as a robust and psychometrically sound instrument that captures the experiences of TNB individuals in therapy settings. The study concludes with valuable recommendations for training and clinical practice to bolster TNB mental health. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
要为变性和非二元(TNB)治疗客户制定肯定性干预措施,就必须了解他们在心理治疗中受到微侵害的经历,但目前还没有针对反变性和非二元微侵害的自我报告测量方法。此外,很少有研究测试过反 TNB 微诽谤与治疗过程之间的关联。为了更好地解决 TNB 患者未得到满足的心理健康护理需求问题,本研究设计并测试了 "治疗中的性别认同与表达微观诽谤量表"(GIEMTS)的心理测量特性,该量表用于测量 TNB 患者在心理治疗中遭遇微观诽谤的情况。研究 1(N = 225)确定了一个四因素模型,包括教育负担、缺乏肯定、膨胀和无效等主题。这些子量表显示出很强的内部一致性可靠性,并具有收敛性和区分性。研究 2(N = 435)的结果通过确认性因子分析复制了四因子结构。然而,双因素分析表明,教育负担、膨胀和无效子量表得分主要由一般反黑人微冒犯量表得分来解释--尽管缺乏肯定显示了其独立性的证据。同样在研究 2 中,这两个量表都与工作联盟有独特的负相关。研究 3(N = 151)发现了 GIEMTS 分数在 2-3 周时间内的重测可靠性证据。总体而言,GIEMTS是一种稳健且心理计量学上可靠的工具,能够捕捉TNB个体在治疗环境中的体验。研究最后为培训和临床实践提出了宝贵建议,以促进 TNB 心理健康。(PsycInfo Database Record (c) 2024 APA,保留所有权利)。
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引用次数: 0
Supplemental Material for Development and Validation of the Gender Identity and Expression Microaggressions in Therapy Scale (GIEMTS) 性别认同与表达微冒犯治疗量表(GIEMTS)的开发与验证补充材料
IF 2.5 2区 心理学 Q2 Psychology Pub Date : 2024-04-08 DOI: 10.1037/pst0000523.supp
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引用次数: 0
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Psychotherapy
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