Psychotherapy最新文献

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).

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).

Cultural humility is an oft-studied construct in psychotherapy and supervision and, as such, has multiple definitions and frameworks and is frequently contextualized as the organizing pillar of the multicultural orientation framework (MCO; alongside cultural comfort and cultural opportunities; Davis et al., 2018; Owen, 2013). Many definitions of cultural humility emphasize a high level of self-awareness, openness to feedback, empathy, and curiosity toward others' cultural experiences (Davis et al., 2018; Foronda et al., 2016; Hook et al., 2013; Zhang et al., 2022). Despite empirical evidence linking cultural humility processes, and MCO more generally, to indicators of successful psychotherapy and supervision (e.g., Davis et al., 2018; Wilcox, Drinane, et al., 2022), little guidance exists for how supervisors may assess and foster their supervisees' cultural humility. Drawing from the literature, we delineate what we see as effective pedagogy and assessment of the key ingredients of cultural humility and provide recommendations for how supervisors can use the supervisory relationship to cultivate in their supervisees each of the necessary ingredients. Given cultural humility's key role in the MCO framework, we discuss how the ingredients required for cultural humility lay the groundwork for cultural comfort and cultural opportunities. Supervision vignettes and additional resources for supervisors are included. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

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).