Psychotherapy最新文献

To be responsive to the growing mental health inequities in our communities, we must move beyond incremental changes to our graduate training to bolder, more transformative changes. Such efforts must move beyond targeting our academic, internship, and postdoctoral programs and instead focus on critiquing our accreditation process. Without transformation of accreditation and other macrostructural dynamics in psychology, our training programs will continue to perpetuate the status quo and limit the ability of graduate trainees to adequately address mental health disparities. The purpose of this article is to call upon regulatory entities, such as the American Psychological Association Commission on Accreditation, to consider shifting training within applied doctoral programs from individual and cultural diversity competencies to a structural competency framework. Redefining this competency using structural perspectives will acknowledge the power, privilege, and oppression inherent within institutions, policies, and structures and better prepare psychology training programs to address the root causes of health inequities. Recommendations for change will be guided by the work of Metzl and Hansen (2014) on structural competencies and focus on the profession-wide and discipline-specific competencies required by the Commission on Accreditation. Barriers to change will also be examined, along with suggestions for resistance and reimagining of the accreditation process and our graduate training. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

The present article aims to provide a pathway for trainers to expand and transform queer-affirmative psychotherapy practice to be more inclusive of queer groups that are underdiscussed in research and misunderstood in therapy settings, namely, people who are asexual, aromantic, and polyamorist. The article begins by outlining findings from a small but growing body of literature focusing on people who identify as asexual, aromantic, and polyamorist, which suggests that these populations face unique challenges and forms of discrimination when navigating their relationships, identity, and community. At the same time, these groups also report negative experiences of psychotherapy, including ignorance, minimization, and lack of understanding empathy on part of therapists. Such gaps may be bridged through cultural and structural changes in the way in which queer-affirmative psychotherapy models are disseminated in training contexts. Building upon models of queer-affirmative psychotherapy, critical theory, and queer theory, the article proposes steps that trainers may take to encourage students to expand their queer-affirmative practice so that it is more inclusive of and responsive to the experiences of asexual, aromantic, and polyamorist populations. The steps involve (a) cultivating criticality among trainees, (b) holding space for "not knowing," (c) providing diverse case examples, and (d) underlining advocacy as central and necessary to queer-affirmative practice. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Between the racial reckoning of 2020 and wider spread policy development that is explicitly homophobic and transphobic, there have been consistent and resurgent calls for clinicians to address aspects of power and privilege in psychotherapy. This is especially important in a field that continues to be largely White, cisgender, and heterosexual (not to mention abled, socioeconomically privileged, and privileged in many other aspects of human diversity). However, too few models for how to accomplish this in actual practice are offered in the literature. Further, while there is little guidance for clinicians on how to address power, privilege, and intersectionality in the therapy room, there is even less direction for how to train those learning to be clinicians to do this from the start. The purpose of this article is to translate existing knowledge into a framework for supervisors to guide trainees' application in psychotherapy. The article provides an overview of social location, including an analytic framework, as well as a set of practical steps for supervisors and trainees. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

There is a growing consensus that effective psychotherapists and counselors require antioppressive, social-justice-oriented, culturally and structurally responsive training (e.g., Neville et al., 2021; Singh, 2020; Vera & Speight, 2003). The field has a long way to go to answer this call (Wilcox et al., 2024), including with social class topics (Liu, 2012) and peer-to-peer initiatives (Stigmar, 2016). Thus, the current qualitative study examined five student facilitators' perspectives on a counseling psychology graduate program's antioppressive peer-to-peer social class workshop (SCW). The SCW was originally grounded in the Social Class Worldview Model-Revised (Liu, 2012) and the multicultural orientation (MCO) framework (Davis et al., 2018) and later incorporated ideas from liberation psychology (Comas-Díaz & Torres Rivera, 2020) and decolonial pedagogies (Goodman et al., 2015). To illuminate the factors that affect student facilitators' SCW experiences, and how this work can inform culturally and structurally responsive psychotherapy training more broadly, we collected student facilitators' collaborative autoethnographic reflections. Using reflexive thematic analysis, we constructed two core themes: (a) nurturing growth: ingredients and orientations and (b) navigating barriers: oppressive structures manifest at multiple levels. Even as student facilitators acknowledged ways that they and the SCW fell short, they remained optimistic about growth both achieved and hoped for. We discuss limitations and implications for the promotion of peer-to-peer and/or social class initiatives in psychotherapy training. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Trainees often express anxieties when working with clients from different sociocultural backgrounds. Group supervision can provide a space to address such concerns, including managing culturally related countertransference and understanding sociocultural factors in issues faced by clients. This process requires critical consciousness and discussion of trainees' and clients' cultural identities. This study built on research highlighting the positive role of cultural humility in individual supervision and group therapy to examine cultural humility in group supervision and its contribution to trainees' self-efficacy in adapting therapy and managing relationship conflicts with a range of clients (i.e., cultural responsiveness self-efficacy), via sociocultural awareness and minimal cultural concealment about themselves and their clients. Ninety-one master's level counseling trainees in Hong Kong from 18 supervision groups in two training programs completed measures of cultural humility, cultural concealment, sociocultural awareness, and cultural responsiveness self-efficacy. Multilevel modeling indicated that, at the within-trainee level, higher group cultural humility was associated with higher sociocultural awareness and lower cultural concealment about themselves and their clients. Greater sociocultural awareness, but not cultural concealment, was, in turn, linked to higher cultural responsiveness self-efficacy. At the between-trainee level, higher group cultural humility correlated with lower trainee cultural concealment, but not sociocultural awareness, which was associated with cultural responsiveness self-efficacy, although no mediation was observed. This study underscores the value of cultural humility in the context of group supervision. Implications for multicultural group supervision are discussed. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

There is a rich history of psychological movements that call upon the field to collaborate with clients to both acknowledge and resist oppression, as well as an increasing emphasis in professional guidelines on conceptualizing clients with attention to the role of the social and physical environment, to contemporary experience with power, privilege, and oppression, and to institutional barriers and related disparities. These calls indicate the need for psychological case conceptualization to move beyond preconceived assessments of which aspects of clients' identities are salient to them, to engage with clients' sociocultural identities as situated within systems of power and oppression, and to engage in advocacy to improve clients' socioenvironmental contexts and to challenge structural oppression. In this article, we attend to the foundational contributions of Black psychology, intersectionality, liberation psychology, Indigenous healing, and radical healing for using case conceptualization to guide structurally responsive and impactful treatment and advocacy. We then present a case example drawn from a composite of clinical encounters that captures client distress interwoven with structural forces such as addiction stigma, intersecting classism and sexism, White privilege, and caregiver leave policies. To demonstrate how to integrate structural forces with theory, we present how this case would be conceptualized utilizing psychodynamic frameworks infused with attention to the ways in which structural forces shape and perpetuate the client's distress. To move from naming to integrating structural competency in case conceptualization, psychotherapy training must address how structural forces shape how client distress develops and is maintained and necessitates advocacy outside of the session. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Psychotherapy theories have long been criticized for their White western cultural assumptions (Katz, 1985; Sue et al., 2024). With the growing call to decolonize psychology (e.g., Singh, 2020), we re-envisioned a psychotherapy theories curriculum from a liberation psychology framework (Martín-Baró, 1994). This framework contextualizes and historicizes people's lived experiences and highlights the ways in which oppressed communities have survived and resisted. A liberatory pedagogy for teaching psychotherapy theories involves critical consciousness (concientización; Freire, 1970), which allows students and instructors to bring a critical lens as they learn and discuss theories of counseling and psychotherapy; reflexivity, to locate themselves within the colonial, White supremacist and capitalist structures in which the classroom is situated; and somatic and affective engagement to decenter colonial rationality. The bookend approach (Wright et al., 2022) can be used to interrogate psychotherapy theories (a) as an overarching strategy for the entire course and (b) as a teaching strategy within each week's lesson on a specific theory. It is our hope that students will be equipped to re-envision psychotherapy and healing as located in our collective liberation from oppressive structures. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

The accessibility of training and fidelity assessment is critical to implementing and sustaining empirically supported psychotherapies like cognitive behavioral therapy for psychosis (CBTp). We describe the development of an online CBTp training tool that incorporates behavioral rehearsal tasks to enable deliberate practice of cognitive and behavioral techniques for psychosis. The development process consisted of designing content, inclusive of didactics, client profiles, and learner prompts; constructing standardized performance tasks and metrics; collecting responses to learner prompts; establishing intraclass correlation (ICC) of responses among trained raters; and training a transformer-based machine learning (ML) model to meet or surpass human ICC. Authenticity ratings of each simulated client surpassed benchmarks. CBTp trainers (n = 12), clinicians (n = 78), and nonclinicians (n = 119) generated 3,958 unique verbal responses to 28 unique prompts (7 skills × 4 simulated clients), of which the coding team rated 1,961. Human ICC across all skills was high (mean ICC = 0.77). On average, there was a high correlation between ML and human ratings of fidelity (r_s = .74). Similarly, the average percentage of human agreement was high at 96% (range = 87%-102%), where values greater than 100 indicate that the ML model agreed with a human rater more than two human raters agreed with each other. Results suggest that it is possible to reliably measure discrete CBTp skills in response to simulated client vignettes while capturing expected variation in skill utilization across participants. These findings pave the way for a standardized, asynchronous training that incorporates automated feedback on learners' rehearsal of CBTp skills. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

This article reports program evaluation findings of the effectiveness of a pilot training program integrating key principles from the psychological framework for radical healing (French et al., 2020) and models aimed at decreasing internalized stigma (Israel et al., 2021). Our main goal of the training program was to increase psychotherapists' knowledge and skills related to competent and affirming practice with two-spirit, transgender, and nonbinary clients who are Black, Brown, and people of color adults. Pre- and posttraining qualitative and quantitative data were collected from 82 psychotherapist attendees to assess the acceptability of the training for learning goals and to provide preliminary evidence of training effectiveness for the training's learning objectives. Descriptive content analysis of qualitative data was used to assess the degree to which the training addressed psychotherapists' goals and increased knowledge and skills. Regression analyses of quantitative data found significant increases in psychotherapists' self-reported knowledge of key concepts and frameworks and confidence to apply new learning to psychotherapy practice. Program evaluation results largely support the acceptability and effectiveness of this training for increasing self-rated competency for psychotherapy practice with two-spirit transgender, and nonbinary Black, Brown, and people of color adult clients. Implications are discussed. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Reports an error in "Defining and assessing adverse events and harmful effects in psychotherapy study protocols: A systematic review" by Rahel Klatte, Bernhard Strauss, Christoph Flückiger, Francesca Färber and Jenny Rosendahl (Psychotherapy, 2023[Mar], Vol 60[1], 130-148). Psychotherapy Study Protocols: A Systematic Review" by Klatte et al. (2022) In the article "Defining and Assessing Adverse Events and Harmful Effects in Psychotherapy Study Protocols: A Systematic Review" by Rahel Klatte, Bernhard Strauss, Christoph Flückiger, Francesca Färber, and Jenny Rosendahl (Psychotherapy, 2022, Vol. 60, No. 1, pp. 130-148, https://doi.org/10 .1037/pst0000359), author contributions were corrected in the author note: Rahel Klatte served as support for methodology and project administration, and served as lead for data curation, formal analysis, and investigation, original draft, and writing, review, and editing. Bernhard Strauss served as lead for resources, contributed equally to conceptualization, funding acquisition and supervision, and served as support for methodology, validation, and writing, review, and editing. Christoph Flückiger contributed equally to supervision and served as support for methodology, validation, original draft, and writing, review, and editing. Francesca Färber served as support for data curation and writing, review, and editing. Jenny Rosendahl served as lead for methodology and project administration, contributed equally to conceptualization, funding acquisition, and supervision, and served as support for data curation, formal analysis, and investigation. (The following abstract of the original article appeared in record 2022-23289-001.) The assessment of safety data has become a standard across many clinical interventions. The aim of this systematic review is to investigate the extent to which harm is addressed within psychotherapy study protocols. The review includes study protocols of randomized controlled trials published between 2004 and 2017 investigating the effects of psychotherapy in adult patients with affective disorders, phobia, anxiety, obsessive-compulsive disorder, posttraumatic stress disorder, and/or personality disorders. We conducted a systematic search in the CENTRAL, Medline, PsycINFO, and Web of Science databases as well as in relevant journals. In total, 115 study protocols were included, examining 168 psychotherapy and 85 control conditions. These protocols differed considerably in the way they conceptualized harm: 77 explicitly addressed harm, 62 considered serious adverse events, and 39 considered adverse events. Although serious adverse events were defined somewhat consistently, adverse events were not. Our results imply that clinical researchers do not apply standardized approaches with regard to harm concepts, assessment, and management. To gather data on frequencies of harmful effects, we argue a higher degree of standardization would be useful. Feasible recommendations are provided