Psychotherapy最新文献

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).

In this preregistered Prospero (CRD42022334071) review, the authors updated a meta-analysis review that examined the relation between therapist facilitation of patient emotional experience/expression and outcome in psychodynamic psychotherapy. Computer, manual, and backwards searches were conducted for relevant publications, and 14 independent samples of short-term dynamic psychotherapy were included in the meta-analysis. Data analysis included calculation of an overall effect size of the relationship between therapist affect focus and outcome, statistical significance, and test for homogeneity. In addition, moderator analyses were conducted to examine the potential impact of the methodological quality of individual studies. The overall weighted average r was .265, which was statistically significant, p < .001 (k = 14; 95% confidence interval [.130, .392]), indicating that therapist affect focus was associated with greater degree of patient change over the course of psychodynamic therapy. The results were not demonstrably heterogeneous, Q(13) = 14.787, p = .321, I² = 12.085, and publication bias analyses did not indicate cause for concerns regarding the results (all ps > .05). Trim-and-fill results indicated an adjusted weighted average r of .250 (decrease of 5.660%). None of the moderator analyses examining study methodology quality were statistically significant (all ps > .10). These data indicate that therapist facilitation of patient affective experience/expression is associated with patient improvement over the course of psychodynamic psychotherapy. The size of this relation was not significantly related to methodological quality. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Exposure and response prevention (ERP) is an effective treatment for obsessive-compulsive disorder. However, ERP's distressful nature may be too demanding for some patients, resulting in low engagement with treatment or even dropout. The current review aimed to summarize and categorize the components of ERP plus add-on protocols. Studies were deemed eligible when an ERP treatment was combined with a psychological add-on in the treatment of adult obsessive-compulsive disorder patients. Nineteen studies fulfilled the inclusion criteria. Add-ons were divided into eight categories: acceptance and commitment therapy, cognitive therapy-based interventions, family accommodation, inhibitory learning theory strategies, inhibitory training, mindfulness-based techniques, and motivational interviewing. Studies were divided into two methods of combining ERP with an add-on: the additive and the integrative format. These types of protocols may offer a feasible way for clinicians to personalize, according to the patient's needs, an otherwise structured treatment, increasing its responsiveness. Future studies, besides studying the efficacy of these adaptations, should also assess whether clinicians who are reluctant to use exposure therapy are more willing to employ the technique in an ERP plus add-on protocol. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

The objective of this study was to examine the experiences and expertise of Black mental health professionals (BMHPs) who work with Black racial trauma across the lifespan. Authors conducted a qualitative study with a critical-ideological paradigm as the methodology of this study. Twenty-five BMHPs (psychologists and counselors) were interviewed about their experiences working with Black clients suffering from racial trauma. Four superordinate themes were identified in the analysis of the data describing (a) how BMHPs define racial trauma and the effects they see racial trauma having on Black persons, (b) how BMHPs work to alleviate the symptoms of racial trauma, (c) the toll that working with racial trauma takes on their own well-being as BMHPs, and (d) ways BMHPs engage in restorative practices in order to continue to engage in the work of healing within the Black community. BMHPs report a strong sense of calling to work with Black persons suffering from racial trauma. They also report joy in their work, yet the complexity of working with racial trauma can be emotionally exhausting. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

A number of studies have shown an association between therapist skills (particularly insight skills) and the working alliance, but few studies have examined the directionality of this relationship. In addition, studies have used either the client or therapist report of the working alliance rather than a dyadic perspective. Thus, we examined whether (a) dyadic insight skills are indirectly related to client outcome through the working alliance and (b) the dyadic working alliance is indirectly related to client outcome through insight skills. The dyadic working alliance was measured as a latent, dyadic average of both the client and therapists' reports of the working alliance. Therapist use of insight skills was operationalized via the use of skills such as interpretations, immediacies, challenges, and disclosures of insight. We used dynamic structural equation modeling to analyze longitudinal data in long-term, psychodynamic treatment. Results indicated that at the within-client level, the use of insight skills was associated with the working alliance in the next session, and the working alliance was associated with therapist use of insight skills in the next session; however, there were no mediation effects. However, at the between-client level, the pathway from working alliance at T-1 to therapist use of insight skills at T-2 to client outcome at T-3 was significant but only for clients in longer term treatments. Findings reveal the importance of the working alliance as a signal for therapists to use insight skills for client improvement in long-term, psychodynamic therapy. (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).

We designed and implemented a multimodal training program for clinicians in how to deliver spiritual psychotherapy for inpatient, residential, and inpatient treatment (SPIRIT), a group-based, spiritually integrated psychotherapy for acute psychiatric settings. The overall goals for this project were to facilitate competency in spiritually integrated psychotherapy among clinicians and meeting established needs for spiritual psychotherapy among patients presenting for acute psychiatric treatment. Our training program in SPIRIT includes the following elements: (a) a training manual, (b) 80-min training video, (c) brief competency exam, and (d) practice component involving the provision of SPIRIT to at least 12 groups of patients. This article provides an overview of the training program and describes its initial dissemination with a multidisciplinary cohort of 17 clinicians within the Massachusetts General Brigham health system, who collectively provided treatment to over 700 diagnostically, demographically, and religiously diverse patients. We also provide preliminary feedback from select clinicians about their experience in the training program, areas for future development, and implications for training clinicians in evidence-based spiritual psychotherapy. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

The current literature for the various mental health professions is replete with studies demonstrating the critical importance of addressing spiritual and religious concerns in mental health treatment, yet many clinicians remain untrained in spiritual and religious competence. In recent years, researchers have developed training programs to support clinicians' understanding of how spirituality influences mental health and provided resources for how clinicians can address it with clients. The present study investigates the effectiveness of two online training programs, Spiritual Competency Training in Mental Health (SCT-MH) and a contemplative pedagogy-based program called Multicultural Orientation and Contemplative Awareness (MOCA), in enhancing spiritual and religious competence among counselors. We conducted a three-parallel-arm randomized controlled trial with a sample of practicing counselors to compare the SCT-MH (n = 10), MOCA (n = 15), and a wait-list control group (n = 29). We recruited our sample from state licensure boards for mental health practitioners, alumni listservs for counseling programs, and social media marketing. Additionally, the study examined the explanatory role of cultural humility on spiritual competence over time. Linear mixed modeling revealed a significant interaction between group and time, demonstrating that the SCT-MH group had a large effect and MOCA had a moderate effect in improving clinicians' total spiritual competence score compared with the control group. The findings suggest that both SCT-MH and MOCA can effectively enhance spiritual competence in counselors and cultural humility plays a significant role in this development. Implications and recommendations for implementation are discussed. (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).

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).