Psychotherapy最新文献

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).

Given that spiritual and religious (S/R) topics can elicit discomfort and countertransference among psychotherapists, training frameworks that promote introspection and opportunities for repeated practice, or exposure, may be ideal starting points to develop S/R competencies. The current deliberate practice informed training program targeted cultural comfort and associated multicultural orientation constructs, aligning with prescribed attitude/awareness and broaching S/R competencies. This quasi-experimental, mixed method investigation analyzed whether a new S/R training program informed by deliberate practice principles was associated with changes in participants' (graduate students in graduate clinical/counseling psychology programs in the United States; N = 126) cultural comfort, self-perceived clinical performance, and self-perceived difficulty when engaging S/R video vignettes using specification curve analyses and a content analysis of follow-up interviews. Analyses indicated that all specifications had positive effects for the treatment (training condition, n = 65) for comfort (B_median = .46, range: .36-.58; 24 of 36 specifications were significant) and self-perceived performance (B_median = .48, range: .45-.55; all specifications significant). Analyses indicated that all specifications for treatment had an inverse association with self-rated difficulty, but all specifications were nonsignificant, suggesting no difference between training and control (n = 61) participants. Training condition participants indicated in a survey that the training was high quality, useful, and had no technology issues; the follow-up interviews with a smaller number of training condition participants provided insights into the training's strengths and weaknesses. The data in full create a roadmap for further study and training program modifications. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Family Competency addressing religion and spirituality in relationships is based on principles of systems theory applied to diversity training in religion and spirituality. Relational spirituality and family systems theory are the theoretical bases for training clinicians to address religion and spirituality (R/S) competently. Relational issues of R/S include religious differences and conflicts in close relationships, spiritual impairment due to relationship distress, and the use of spiritual resources for coping in a family or community. Principles of cultural humility and comfort, clinical assessment of R/S, nonanxious presence, multidirected partiality, and differentiation were used to train clinicians. Participants (N = 174) were graduate students and professionals in mental health care who engaged in a 5-hr online training with switching replication measurement at three points before and after the training at 2-week intervals. Measurement included a newly validated six-item global measure of couple and family spiritual and religious competency (J. S. Ripley et al., 2024) and the Religious/Spiritually Integrated Practice Assessment Scale (Oxhandler, 2019). Mixed-effects models with two-way cross-level interactions of Treatment Condition (Immediate Treatment, Delayed Treatment) × Time (T1, T2, T3) supported change based on the intervention, especially for measures of self-efficacy, attitude, increased frequency of R/S integrated practice, and global relational R/S competency. Qualitative analysis of interviews with some participants (n = 10) identified several experiential themes. The models showed significant change after the training and maintenance of gains for the immediate treatment group. In conclusion, this demonstrated the efficacy of the relationally based training model in improving R/S competency in training graduate students and professionals. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

This study evaluated the effectiveness of a live videoconferencing training program in spiritually integrated psychotherapy offered by ACPE: The Standard for Spiritual Care and Education (ACPE). We used a quasi-experimental one-group pretest-posttest group design to investigate whether participants' religious/spiritual competencies (self-efficacy, attitudes, and skills) improved and whether their use of spiritual interventions increased after completing the training program. We also assessed whether their perceptions of the barriers to practicing spiritually integrated treatment in their practice setting changed after training. The research participants were 84 adult men and women from diverse spiritual backgrounds, mental health specialties, and geographic locations who completed the measures before and after the training program. A repeated measures multivariate analysis of variance and follow-up t-tests revealed that the participants' spiritual competency and usage of spiritual interventions during treatment sessions significantly increased after the training program. Most Cohen's d effect sizes were large or moderately large, indicating that the improvements were educationally and clinically meaningful. The study provides preliminary evidence that ACPE's live, videoconferencing spiritually integrated psychotherapy training program enhanced the spiritual competencies of the participating mental health and pastoral professionals. (PsycInfo Database Record (c) 2025 APA, all rights reserved).