Psychotherapy最新文献

Group therapy has evolved as a powerful therapeutic approach, facilitating mutual support, interpersonal learning, and personal growth among members. However, the complexity of studying communication dynamics, emotional expressions, and group interactions between multiple members and often coleaders is a frequent barrier to advancing group therapy research and practice. Fortunately, advances in machine learning technologies, for example, natural language processing (NLP), make it possible to study these complex verbal and behavioral interactions within a small group. Additionally, these technologies may serve to provide leaders and members with important and actionable feedback about group therapy sessions, possibly enhancing the utility of feedback-informed care in group therapy. As such, this study sought to provide a proof of concept for applying NLP technologies to automatically assess alliance ratings from participant utterances in two community-based online support groups for weight stigma. We compared traditional machine learning approaches with advanced transformer-based language models, including variants pretrained on mental health and psychotherapy data. Results indicated that several models detected relationships between participant utterances and alliance, with the best performing model achieving an area under the receiver operating characteristic curve of 0.654. Logistic regression analysis identified specific utterances associated with high and low alliance ratings, providing interpretable insights into group dynamics. While acknowledging limitations such as small sample size and the specific context of weight stigma groups, this study provides insights into the potential of NLP in augmenting feedback-informed group therapy. Implications for real-time process monitoring and future directions for enhancing model performance in diverse group therapy settings are discussed. (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).

Meta-analyses indicate that patient outcome expectation (OE) and therapeutic alliance quality each correlate positively with improvement across diverse psychotherapies. Moreover, research demonstrates that these constructs relate to one another, including higher OE correlating with better subsequent alliance. However, notable gaps in this area remain. First, most studies that have examined the OE-alliance association have done so from the patient perspective only, despite both constructs having dyadic properties. Second, few studies have examined the connection between these two constructs longitudinally to capture their dynamic interrelations. Third, few studies have parsed OE-alliance links into their within- and between-dyad components, masking interpretability. Finally, most studies derive from controlled trials for specific diagnoses, limiting generalizability. Addressing these gaps, we tested the dyadic, dynamic, and statistically parsed associations among patient and therapist OE and alliance in naturalistic psychotherapy. Patients and therapists rated OE and alliance quality across up to 16 weeks of treatment. For dyads with the requisite data (N = 111 patients nested within 37 therapists), we used a multilevel actor-partner interdependence model that simultaneously tested all within- and between-dyad actor and partner effects of OE on alliance quality. At the within-dyad level, there were no significant actor or partner effects. At the between-dyad level, there were no significant partner effects, but there was a positive OE-alliance actor effect for both patients and therapists. Results suggest that community-based therapists may consider attending most to each participant's average level of OE across therapy (vs. fluctuations) when forecasting its influence on their own overall relationship experience. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

The field of psychotherapy research has come a long way since its inception. In addition to foundational data on psychotherapy's general efficacy and effectiveness, there has been steadily mounting evidence to answer questions, such as how, for which patients, when delivered by which therapists, and under what conditions does psychosocial treatment work? Moreover, there have been key methodological and data analytic developments over time, which have supported or catalyzed, respectively, more nuanced or new psychotherapy knowledge. Nonetheless, given the field's relatively young age, as well as the need for greater replication of results, better science-practice integration, and higher consensus on psychotherapy's core and consensual scientific principles, the field arguably remains somewhat immature and in need of more empirical advancements to meet the ever-rising need for effective mental health care. Such progressions will often come in incremental steps; however, "big needle movements" are also needed to embody or set the stage for more revolutionary changes in how we study, understand, and practice psychotherapy. To this end, the articles in the present special section exemplify such innovations through their big-impact results and/or promising proof-of-concept methods. In this introduction to the section, we summarize the sizeable potential of the nine included articles to influence and inspire the field of psychotherapy. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Research shows how therapists struggle to stay present with their clients' existential concerns. Our goal was to explore what hinders and enables therapists to stay present and engaged when existential concerns surface in the session. We invited 22 therapists (12 novice and 10 experienced) to engage in a role-play with a client expressing her existential concerns using a standardized script. Subsequently, the therapists were interviewed using a videotape-assisted recall procedure. Data were analyzed according to the descriptive-interpretive qualitative research approach. When confronted with existential themes in the session, novice therapists experienced overwhelming feelings of powerlessness and uncertainty, blocking their ability to remain open to the client's existential experiences. Lack of knowledge and encountering their own existential vulnerability were mentioned as triggers. For experienced therapists, the main challenge was to stay present while feeling impacted by the existential topic, which they managed by grounding and reanchoring themselves. Our findings support the idea that embracing one's own existential issues and being at ease with existential themes may be essential conditions for staying present and fostering an authentic therapeutic encounter. Furthermore, our findings suggest that gaining knowledge about the existential process and learning to ground and reanchor oneself are essential for therapists. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

This article applies the multicultural orientation framework (D. E. Davis et al., 2018) to enhance religious/spiritual competencies. The skills gap in multicultural training is especially pronounced in the area of spiritual, existential, religious, and theological competencies; many clinicians report minimal and insufficient training (Vieten & Lukoff, 2022). We frame orienting to clients' values and visions as a cultural opportunity. To integrate multicultural orientation skills into routine clinical training throughout the career, we propose three approaches: (a) course curriculum, (b) peer consultation, and (c) continuing education. First, we provide instruction on incorporating video case studies into any course to engage students in discussions that promote perspective-taking, dialectical thinking, and wisdom. Second, we outline an eight-step model of peer consultation that focuses on cultural humility to promote trust and cultural comfort and increase sensitivity in clinical judgment. Third, given the American Psychological Association's forthcoming revisions to their ethics code emphasizing social justice (Campbell et al., 2024), we propose integrating the previous two approaches with routine ethics training for continuing education. With an eye toward future innovations in training, we also discuss how these structures align with projects that employ artificial intelligence to identify markers in therapy. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

In this study, we sought to develop and test a trainee-driven educational intervention to increase competency in working with religion and spirituality (R/S) in psychotherapy. Trainees currently in mental health graduate training programs (N = 363) were randomly assigned to one of three conditions: (a) peer group plus self-study (PG), (b) immediate self-study (ISS), and (c) delayed self-study (DSS). All participants completed six weekly online training modules that included both didactic materials and deliberate practice. Using complete case analysis, we determined that compared to those in DSS, participants in PG reported a significantly greater increase from pre- to postintervention in religious/spiritual (R/S) cultural humility, R/S skills, comfort with R/S, positive R/S attitudes, and R/S self-efficacy. Compared to those in ISS, participants in PG reported significantly greater change in R/S self-efficacy in psychotherapy. We also compared these results with results using imputed data and only the comparison between DSS and PG remained significant for R/S skills and R/S self-efficacy. In addition, although participants in the peer-group plus self-study condition were less likely to complete both pre- and postintervention questionnaires, they completed almost twice as many training modules. The findings of this study support the possible benefit of trainee-driven educational interventions to help mental health graduate students increase their cultural humility, skills, comfort, positive attitudes, and self-efficacy for working with R/S in psychotherapy. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

One of the critical gaps in promoting religious and spiritual (R/S) competencies among clinicians in training revolves around student clinician hesitancy to engage in R/S conversations in session. This reluctance, in part, may be due to attitudinal biases based on one's own R/S experiences, which do not readily improve with knowledge and skills training. There is a need to understand how clinicians in training experience the actual process of addressing R/S content in clinical practice and academic training environments. This study describes findings based on the administration of a training tool-the Religious, Spiritual, and Secular Life Story Interview (adapted version of the Life Story Interview; McAdams, 2007)-designed to help trainees explore the nature and dynamics of clinician resistance to engage with R/S in psychotherapy. Participants included a religiously and spiritually diverse sample of 23 student clinicians from master's and doctoral-level programs across counseling, psychology, and social work disciplines, all of whom reported moderate to high levels of hesitancy about broaching R/S in the training process (i.e., in the classroom and/or psychotherapy sessions). Three themes emerged from the evaluative findings-person-centered skills, contextual factors, and growth through reflective storytelling-that offer clues about factors supporting the process of opening and engaging with religiousness, spirituality, and secularity. The discussion will address the potential of the Religious, Spiritual, and Secular Life Story Interview as a training tool to facilitate the acquisition of attitude-based R/S competencies that may lay the foundation for cultivating skills-based competencies. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Psychedelic-assisted therapies (PAT) can provoke personally meaningful spiritual or existential experiences in patients; these experiences have been associated with improved outcomes across several treatment targets and populations. The need for spiritual and religious competence, though present across the spectrum of psychotherapeutic practice, is especially strong in psychedelic-assisted psychotherapies. The relational spirituality model (RSM), a systematically developed and empirically tested framework for spiritual and religious competency in psychotherapy, offers a theoretical and practical framework for spiritual competency training in psychedelic therapies (Sandage et al., 2020). The model's inclusive spiritual, existential, religious, and theological (SERT) framework provides a broad and pluralistic approach that can meaningfully engage a wide range of SERT experiences and traditions in psychedelic-assisted psychotherapy. Further, the RSM can readily be integrated with other models of clinical care (e.g., palliative care), with a range of psychotherapeutic modalities, and within existing psychedelic training frameworks. To illustrate the application of the RSM to the development of religious and spiritual competence in PAT training, this article first describes the RSM. It then introduces methods for pragmatic training based on the RSM, which can be integrated with standard licensure-focused mental health training programs that might someday include applications for psychedelics or with specialized psychedelic-assisted therapy facilitation training programs. These include deliberate practice and experiential training components, "SERT groups," content and clinical theory, and training in assessment and case conceptualization. Finally, we discuss how the RSM can inform future directions in PAT training and support interdisciplinary approaches to PAT including collaborations across disciplines and healing communities. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

This article is a practical contribution to the literature focused on developing competencies in addressing religion and spirituality in clinical practice, particularly with students in education and training programs. Details of a course in an American Psychological Association accredited doctoral program in clinical psychology are provided, illustrating the ways and means through which students are engaged in exploring, identifying, and articulating a conceptual and theoretical framework as well as developing methods and competencies that will be ethical and efficacious in the conduct of their clinical work. The course described is the third in a four-course required sequence that is focused on acquiring knowledge, skills, and attitudes that are consistent with competencies identified in the American Psychological Association Accreditation Standards as well as in the program's defined areas of special emphasis, one of which is addressing religion and spirituality in clinical practice. Key aspects of pedagogy related to readings, assignments, and classroom engagement are presented. Methods used to assess competencies are included as well as quantitative and qualitative data from student ratings of course effectiveness. Suggestions for future teaching, training, and research are offered. (PsycInfo Database Record (c) 2025 APA, all rights reserved).