Psychotherapy最新文献

Studies of psychotherapy efficacy have highlighted the importance of feedback-informed treatment (FIT), which involves the routine collection of client process and outcome data to inform intervention formulation and clinical decision making. Despite the relative ease with which FIT measures can be integrated into therapeutic practices, many providers do not use these information-gathering tools. The present study analyzed survey responses from therapists whose use of FIT was systemically incentivized and structurally supported. Within this sample, two groups of providers emerged: one (n = 30) that remained engaged in the use of FIT and another (n = 19) that discontinued its use despite its implementation being facilitated. There were some significant differences between the groups. Clinicians who persisted with FIT perceived it as more valid and reported more openness to information from an outside source, whereas clinicians who disengaged from FIT endorsed more antagonistic views about measurement. In addition, clinicians who discontinued FIT reported having a greater belief in the predictive validity of their own judgments without the use of FIT data than did current FIT users. There were statistically significant differences between the two groups in terms of their reliance on intuition, but not on their feedback propensities. These findings contribute to the growing literature regarding the effect of attitudes on the use of measurement in therapy when structural barriers to implementation are reduced. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Psilocybin-assisted therapy (PAT) is an experimental treatment with transformative promise. Developing standards for PAT psychotherapy protocols is a priority, but psychotherapeutic protocol components of PAT have been subjected to little rigorous research. This study was designed to assess protocol components in a trial of PAT. The Enhanced Critical Incident Technique (E-CIT) was used to identify critical incidents in the treatment, wish list items comprising components or modifications that would have improved the treatment experience, and contributing factors that influenced the treatment. Participants included patients (n = 10), facilitators (n = 7 licensed mental health clinicians and certified spiritual health clinicians), and caregivers (n = 7) in an open-label trial investigating PAT for cancer-related demoralization and chronic pain. Patients and caregivers were interviewed after their last treatment session in the trial; facilitators were interviewed at the end of the entire trial. Rapid qualitative analysis identified specific domains for improvement in the treatment protocol based on the E-CIT. Critical incidents, wish list items, and contributing factors pertained to aspects of the therapy (e.g., importance of intention-setting) and the overall protocol (e.g., navigating transitions in the treatment). Findings indicate the importance of tailoring PAT to accommodate the medical history and needs of this population, support common factors, and ensure collaborative care. Recommendations across nine topic areas were derived from the data and presented in the Discussion. The E-CIT shows promise for advancing early stage research on PAT components. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

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).

Emotionally focused individual therapy (EFIT; Johnson, 2019) is a newly developed therapeutic modality. In this study, we used a randomized controlled trial (Clinical Trial Registration NCT04719780) intent-to-treat design to examine the effects of 15 sessions of EFIT in comparison with a 15-week wait-list control on general symptom distress and symptoms of depression and anxiety. Eighty-eight participants who met the diagnostic criteria for major depressive disorder and comorbid anxiety, as determined by the Anxiety and Related Disorders Interview Schedule for the Diagnostic and Statistical Manual of Mental Disorders, fifth edition, were randomized to an EFIT treatment group (n = 44) or to a wait-list control group (n = 44). Average age was 35.73 years (SD = 12.28). Sixty-three percent identified as women, and 37% identified as male. In terms of ethnicity, 73% identified as White, 1.3% as Black, 7.7% as Southeast Asian, 7.7% as East Asian, 3.8% as Latinx, and 2.6% as First Nation. Participants completed the Outcome Questionnaire-30.2, the Patient-Reported Outcomes Measurement Information System (PROMIS)-Depression scale, and the PROMIS-Anxiety scale. Multilevel modeling results confirmed a significant difference in growth curves between the treatment group and controls on all measures. Follow-up analyses demonstrated significant reductions in symptom distress (Outcome Questionnaire-30.2) and symptoms of depression and anxiety (PROMIS-Depression and PROMIS-Anxiety) across 15 weeks. Overall, the results of this study suggest that EFIT leads to significant symptom reduction among people with depression and anxiety. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Recent scholarship has highlighted the value of therapists adopting a multicultural orientation (MCO) within psychotherapy. A newly developed performance-based measure of MCO capacities exists (MCO-performance task [MCO-PT]) in which therapists respond to video-based vignettes of clients sharing culturally relevant information in therapy. The MCO-PT provides scores related to the three aspects of MCO: cultural humility (i.e., adoption of a nonsuperior and other-oriented stance toward clients), cultural opportunities (i.e., seizing or making moments in session to ask about clients' cultural identities), and cultural comfort (i.e., therapists' comfort in cultural conversations). Although a promising measure, the MCO-PT relies on labor-intensive human coding. The present study evaluated the ability to automate the scoring of the MCO-PT transcripts using modern machine learning and natural language processing methods. We included a sample of 100 participants (n = 613 MCO-PT responses). Results indicated that machine learning models were able to achieve near-human reliability on the average across all domains (Spearman's ρ = .75, p < .0001) and opportunity (ρ = .81, p < .0001). Performance was less robust for cultural humility (ρ = .46, p < .001) and was poorest for cultural comfort (ρ = .41, p < .001). This suggests that we may be on the cusp of being able to develop machine learning-based training paradigms that could allow therapists opportunities for feedback and deliberate practice of some key therapist behaviors, including aspects of MCO. (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).