Clinical Psychology in Europe最新文献

英文中文

Mental flexibility and epistemic trust through implicit social learning – A meta-model of change processes in psychotherapy with personality disorders 通过内隐社会学习实现心理灵活性和认识信任--人格障碍心理治疗变化过程的元模型

Q2 Psychology

Clinical Psychology in Europe

Pub Date : 2024-04-26 DOI: 10.32872/cpe.12433

Svenja Taubner, Carla Sharp

This position paper follows the call for transtheoretical meta-models of general clinical change by concentrating on severe mental illness such as Personality Disorders (PDs). We have identified a core process of change related to mental flexibility through implicit learning and propose recommendations for stance and technique that are informed by research on Mentalization-Based-Treatment (MBT) and the learning components as represented in the Mediational Intervention for Sensitizing Caregivers (MISC). While the idea of corrective emotional experience as a general change mechanism involves discriminating between an old and new relationship to update relationship knowledge, the capacity to understand and process corrective emotional experiences may be limited and even iatrogenic in patients with PDs. By integrating MBT and MISC, a meta-model of change is created that allows training in and observation of the granular-level, behaviorally anchored, actions taken by the therapist to open up social learning. Here, social learning is conceptualized as epistemic trust, increasing the client’s reflective functioning during sessions to ultimately enhance cognitive flexibility outside the therapy room. This opens the possibility to implement and observe micro changes in what should be termed now implicit cognitive and emotional corrective experiences. Thus, we propose to shift towards implicit learning within professional relationships; that is, internalizing a new way of thinking about any life-event that requires adaption thereby creating adaptive capacities via mental flexibility as the general change mechanism of Personality Disorder (PD) treatment.

本立场文件关注人格障碍（PDs）等严重精神疾病，响应了建立一般临床改变的跨理论元模型的号召。我们通过内隐学习确定了一个与心理灵活性相关的核心改变过程，并根据心理化治疗（MBT）的研究以及感化护理人员中介干预（MISC）中的学习内容，提出了立场和技巧方面的建议。作为一种普遍的改变机制，纠正情绪体验的理念涉及对新旧关系的辨别，以更新关系知识，但对于帕金森病患者来说，理解和处理纠正情绪体验的能力可能有限，甚至是先天性的。通过整合 MBT 和 MISC，创建了一种变革元模型，允许对治疗师采取的细粒度、行为锚定行动进行培训和观察，从而开启社会学习。在这里，社会学习被概念化为认识信任，在治疗过程中提高客户的反思功能，最终增强治疗室外的认知灵活性。这就为实施和观察微观变化提供了可能性，这些微观变化现在应被称为内隐认知和情绪矫正体验。因此，我们建议在专业关系中转向内隐式学习；即对任何需要适应的生活事件内化一种新的思维方式，从而通过心理灵活性创造适应能力，作为人格障碍（PD）治疗的一般改变机制。

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引用次数: 1

Four versions of transtheoretical stances, and the Bernese view 跨理论立场的四个版本和伯尔尼观点

Q2 Psychology

Clinical Psychology in Europe

Pub Date : 2024-04-26 DOI: 10.32872/cpe.12453

F. Caspar, Thomas Berger

A brief characterization of transtheoretical stances to which existing approaches can be allocated is followed by a description of the "Bernese view", that is, what Klaus Grawe and his colleagues, including the authors of this article have developed: the origins, a model of the multiple constraint satisfaction construction of therapist action, a discussion of psychotherapy integration, the crucial role of supervisors in an integrative multiple constraint satisfaction approach, and a discussion of when and how trainees should be introduced to a transtheoretical stance.

在简要介绍了现有方法可归属的跨理论立场之后，我们将介绍 "伯尔尼观点"，即克劳斯-格拉韦及其同事（包括本文作者）所提出的观点：起源、治疗师行动的多重约束满意度构建模型、心理治疗整合讨论、督导在多重约束满意度整合方法中的关键作用，以及关于何时和如何向受训者介绍跨理论立场的讨论。

引用次数: 1

Case conceptualization in clinical practice and training 临床实践和培训中的病例概念化

Q2 Psychology

Clinical Psychology in Europe

Pub Date : 2024-04-26 DOI: 10.32872/cpe.12103

Eva Gilboa-Schechtman

Case conceptualization is central to the success of the therapeutic process. However, integrative case conceptualization research has lagged behind research on integrating therapeutic intervention techniques. A successful case conceptualization provides (a) a dynamic, context-sensitive, yet parsimonious model of the client’s functioning; (b) relevant treatment targets and associated assessment procedures; and (c) a treatment plan including intervention phases and potential obstacles. Success in case conceptualization is a core clinical competency goal for trainees in clinical psychology and a career-long learning goal even for expert clinicians. Emerging technological trends and the formation of adversarial collaborative teams may assist research on the utility of well-constructed case conceptualizations.

病例概念化是治疗过程成功的核心。然而，综合病例概念化研究却落后于综合治疗干预技术的研究。成功的个案概念化可以提供：（a）一个动态的、对情境敏感的、但又简洁的客户功能模型；（b）相关的治疗目标和相关的评估程序；以及（c）包括干预阶段和潜在障碍在内的治疗计划。案例概念化的成功是临床心理学受训者的核心临床能力目标，甚至是临床专家的职业学习目标。新出现的技术趋势和对抗性合作团队的形成可能会有助于对精心构建的病例概念化的效用进行研究。

引用次数: 2

Psychological Clinical Science: Meeting the Challenge of Public Mental Health. 心理临床科学：迎接公共心理健康的挑战。

Q2 Psychology

Clinical Psychology in Europe

Pub Date : 2024-04-26 eCollection Date: 2024-04-01 DOI: 10.32872/cpe.12067

Richard J McNally

The purpose of this article is to provide a brief overview of how clinical psychology evolved in the United States as a prelude to discussing the emergence of psychological clinical science in the closing years of the 20th century. Despite the growth of clinical psychology, mental disorders remain highly prevalent, compelling us to envision new ways to deliver services in an effective but efficient manner. Topics include the dissemination gap, the affordable access gap, and the Psychological Clinical Science Accreditation System (PCSAS). Examples of novel methods for addressing the problem of public mental health in the 21st century are discussed. Finally, I close by considering the potential relevance of our experience in America for European clinical psychology.

本文旨在简要概述美国临床心理学的发展历程，为讨论 20 世纪末心理临床科学的兴起作铺垫。尽管临床心理学得到了发展，但精神障碍仍然非常普遍，这迫使我们设想新的方法，以有效且高效的方式提供服务。主题包括传播差距、负担得起的获取差距以及心理临床科学认证系统（PCSAS）。此外，我还讨论了在 21 世纪解决公共心理健康问题的新方法实例。最后，我考虑了我们在美国的经验对欧洲临床心理学的潜在意义。

引用次数: 0

Thinking transtheoretically about alliance and rupture: Implications for practice and training 从跨理论角度思考联盟与破裂：对实践和培训的影响

Q2 Psychology

Clinical Psychology in Europe

Pub Date : 2024-04-26 DOI: 10.32872/cpe.12439

S. Zilcha-Mano, J. Muran

Repairing alliance ruptures has the potential to serve as a powerful mechanism of change in psychotherapy. In this article, a transtheoretical individual-specific framework for repairing alliance ruptures is proposed. According to the proposed framework, at the intake session, the therapist evaluates the trait-like tendencies of individual patients to face ruptures in interpersonal relationships. We propose a typology based on which patients are assigned to one of the following therapeutic strategies: (a) a treatment where alliance rupture and repair is the main mechanism of change (Type A), (b) an added module that augments another treatment, focusing on rupture and repair (Type B), or (c) treatment where no rupture resolution work is carried out (Type C). The proposed framework is based on cumulative clinical knowledge, and its validity and utility need to be assessed in future research.

修复联盟破裂有可能成为心理治疗中一种强大的改变机制。本文提出了一个修复联盟破裂的跨理论个体特异性框架。根据所提出的框架，治疗师会在接诊时评估个体患者面对人际关系破裂时的特质倾向。我们提出了一种类型学，根据这种类型学，患者会被分配到以下治疗策略之一：(a) 以联盟破裂和修复为主要改变机制的治疗（A 型），(b) 增强另一种治疗的附加模块，侧重于破裂和修复（B 型），或 (c) 不进行破裂解决工作的治疗（C 型）。建议的框架是基于积累的临床知识，其有效性和实用性需要在今后的研究中进行评估。

引用次数: 1

Needs, modes, and stances: Three cardinal questions for psychotherapy practice and training 需求、模式和立场：心理治疗实践和培训的三个基本问题

Q2 Psychology

Clinical Psychology in Europe

Pub Date : 2024-04-26 DOI: 10.32872/cpe.12753

Eshkol Rafaeli, Alexandra K. Rafaeli

Background Advances in motivational science (Dweck, 2017), personality dynamics (Lazarus & Rafaeli, 2023), and process-based psychotherapy (Hofmann & Hayes, 2019) converge into a pragmatic, integrative, and transtheoretical model of practice and training. Method The model comprises three elements: a formulation centered on clients’ psychological needs which provides guidance regarding the goals and processes most profitable to pursue; a recognition that such pursuit frequently requires contending with a multiplicity of clients’ internal self-states (i.e., modes); and an enumeration of pragmatic therapeutic stances likely to help address clients’ need-related goals in light of their modes. Results We distill these elements into three cardinal questions: What needs does this client have that are not currently met, and what are the most profitable ways of remedying that frustration? What mode or modes does this client manifest – both generally and at this very moment? and What stance should I adopt in response to the client’s current mode? We suggest that clinicians should be trained to continually pose these questions and seek to answer them collaboratively with their clients. Conclusion This model – illustrated here using schema therapy terms – offers a process-based approach which serves as a theoretically integrative starting point but is general enough to provide an assimilative integration roadmap for therapists anchored in most primary orientations. Integrative or assimilative therapists trained to attend to needs, modes, and stances are likely to be (and be perceived as) particularly responsive, and thus, to enact “common factor” practices known to be conducive to therapeutic alliance and gains.

背景激励科学（Dweck，2017 年）、人格动力学（Lazarus & Rafaeli，2023 年）和基于过程的心理疗法（Hofmann & Hayes，2019 年）的进展汇聚成一个务实、综合和跨理论的实践和培训模型。方法该模式包括三个要素：以客户的心理需求为中心的表述，为追求最有利的目标和过程提供指导；认识到这种追求经常需要与客户的多种内部自我状态（即模式）进行抗争；根据客户的模式，列举可能有助于实现客户需求相关目标的务实治疗立场。结果我们将这些要素提炼为三个主要问题：该客户有哪些需求目前没有得到满足？该客户在一般情况下和此时此刻表现出了哪种或哪几种模式？针对客户当前的模式，我应该采取什么立场？我们建议，临床医生应接受培训，不断提出这些问题，并寻求与客户合作回答这些问题。结论这一模式--在此使用模式疗法术语进行说明--提供了一种基于过程的方法，作为理论整合的起点，但其通用性足以为大多数主要取向的治疗师提供同化整合路线图。接受过关注需求、模式和立场培训的整合治疗师或同化治疗师可能会（并被视为）特别敏感，因此，他们会采取 "共同因素 "的做法，而这些做法是众所周知的，有利于治疗联盟和治疗成果。

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引用次数: 1

Between-session homework in clinical training and practice: A transtheoretical perspective 临床培训和实践中的课间作业：跨理论视角

Q2 Psychology

Clinical Psychology in Europe

Pub Date : 2024-04-26 DOI: 10.32872/cpe.12607

T. Ryum, Nikolaos Kazantzis

Background This paper defines and illustrates the ways in which Between-Session Homework (BSH) may be integrated into clinical work with clients across various treatment approaches. In line with the focus of this special issue, we explore how clinical training and supervision can enhance therapist skills and competence in the use of BSH. Method After providing a brief historical overview and an integrative perspective on BSH, along with a review of empirical research supporting its efficacy, we delve into the discussion of BSH as a transtheoretical clinical method with heuristic value across different treatment approaches, such as cognitive-behavioral, psychodynamic, and humanistic-experiential therapies. Results There exists diversity in how BSH is incorporated into distinct treatment approaches. Furthermore, we emphasize the significance of therapist skills and competence in utilizing BSH to facilitate client engagement and achieve positive treatment outcomes. Finally, we address how clinical training and supervision contribute to the development of these essential skills and competence. Conclusions Our findings highlight three main points: (1) substantial empirical support for the integration of BSH within cognitive-behavioral therapies, (2) the potential of BSH as a promising transtheoretical clinical method, even though research beyond cognitive-behavioral therapies remains limited, and (3) the imperative need for further research into how clinical training and supervision can effectively enhance therapist skills and competence in implementing BSH.

背景本文定义并说明了如何将 "疗程间家庭作业"（BSH）融入各种治疗方法的临床工作中。根据本特刊的重点，我们将探讨临床培训和督导如何提高治疗师使用 BSH 的技能和能力。方法在简要介绍了 BSH 的历史概况和综合视角，并回顾了支持其有效性的实证研究之后，我们深入讨论了 BSH 作为一种跨理论临床方法，在认知行为疗法、心理动力学疗法和人本体验疗法等不同治疗方法中具有启发式价值。结果在如何将 BSH 纳入不同的治疗方法方面存在多样性。此外，我们还强调了治疗师在利用 BSH 促进客户参与并取得积极治疗效果方面的技能和能力的重要性。最后，我们探讨了临床培训和督导如何促进这些基本技能和能力的发展。结论我们的研究结果强调了三个要点：（1）大量经验支持将 BSH 纳入认知行为疗法；（2）尽管认知行为疗法以外的研究仍然有限，但 BSH 作为一种有前途的跨理论临床方法具有潜力；（3）迫切需要进一步研究临床培训和督导如何有效提高治疗师实施 BSH 的技能和能力。

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引用次数: 2

A 21st century principle-based training approach to psychotherapy: A contribution to the momentum of transtheoretical work 21 世纪基于原则的心理治疗培训方法：为推动跨理论工作做出贡献

Q2 Psychology

Clinical Psychology in Europe

Pub Date : 2024-04-26 DOI: 10.32872/cpe.11925

Anna Babl, Catherine F. Eubanks, M. Goldfried

Background Despite the finding that the majority of psychotherapists adopt a rather process-oriented and integrative stance, it is uncommon that psychotherapy trainings are transtheoretical and transdiagnostic. Considering principles of change that cut across different schools of therapy holds promise for developing truly research-informed psychotherapy trainings. Common principles of change may answer the question what should be trained. Another important question is how to train. In current psychotherapy training programs, transfer of theory into practice relies mainly on role-playing exercises and supervised practice, both of which have their limitations. Aims A fantasy for the future would be the development, implementation, and evaluation of a complementary 21st century online principle-based and marker-led psychotherapy training: incorporating the concepts of deliberate practice as well as expert training, the huge potential of technologies, and considering the importance of (context) responsiveness. Conclusion To illustrate this idea, we present a training that we are currently developing, an online Alliance-Focused Training.

背景尽管发现大多数心理治疗师都采取以过程为导向的综合立场，但跨理论和跨诊断的心理治疗培训却并不多见。考虑跨越不同治疗流派的变革原则，为开发真正以研究为基础的心理治疗培训带来了希望。共同的变革原则可以回答应该培训什么的问题。另一个重要问题是如何培训。在目前的心理治疗培训项目中，将理论转化为实践主要依靠角色扮演练习和督导实践，而这两种方法都有其局限性。目标未来的一个幻想是开发、实施和评估一种互补的、以原则为基础、以标记为主导的 21 世纪在线心理治疗培训：将刻意练习和专家培训的概念、技术的巨大潜力结合起来，并考虑到（情境）响应的重要性。结论为了说明这一想法，我们介绍了我们目前正在开发的一项培训，即以联盟为重点的在线培训。

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引用次数: 1

A process-based approach to transtheoretical clinical research and training 基于过程的跨理论临床研究和培训方法

Q2 Psychology

Clinical Psychology in Europe

Pub Date : 2024-04-26 DOI: 10.32872/cpe.11987

Stefan G. Hofmann, Steven C. Hayes

Background The science and practice of psychopathology and psychological intervention of today is more like an island archipelago than it is a single land mass, and connections between different traditions are both limited and fraught with misunderstanding. Method Our analysis and solution to the problem is process-based therapy (PBT). PBT defines psychopathology as failed adaptation processes to a given context. Therapy involves adaptation through context-dependent or context-altering applications of biopsychosocial strategies that allows a goal to be met. Results This coherent approach to more transtheoretical and integrative concepts of clinical training and practice provides a firm foundation by targeting biopsychosocial processes of change, analyzing these processes using an idiographic complex network analytic approach, and organizing findings on the intellectual agora of multi-dimensional and multi-level evolutionary science. Conclusion PBT is a new empirical form of functional analysis, resulting in interventions and trainings that are built on elements or kernels of direct relevance to client’s specific needs. In PBT, case formulation continues as long as treatment persists.

背景当今的心理病理学和心理干预的科学和实践更像是一个群岛，而不是单一的陆地，不同传统之间的联系既有限又充满误解。方法我们对这个问题的分析和解决方案是基于过程的疗法（PBT）。基于过程的疗法将心理病理学定义为对特定环境的适应过程失败。治疗包括通过应用生物-心理-社会策略的情境依赖或情境改变来进行适应，从而实现目标。结果这种连贯的方法为临床培训和实践提供了一个坚实的基础，它针对生物-心理-社会的变化过程，使用特异性复杂网络分析方法对这些过程进行分析，并在多维度和多层次进化科学的知识论坛上对研究结果进行组织。结论 PBT 是功能分析的一种新的实证形式，其干预和培训建立在与客户具体需求直接相关的要素或内核之上。在 PBT 中，只要治疗持续进行，病例制定就会继续。

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引用次数: 1

From Theory to Practice: A Transtheoretical Treatment and Training Model (4TM). 从理论到实践：跨理论治疗和培训模式 (4TM)。

Q2 Psychology

Clinical Psychology in Europe

Pub Date : 2024-04-26 eCollection Date: 2024-04-01 DOI: 10.32872/cpe.12421

Wolfgang Lutz, Brian Schwartz, Anne-Katharina Deisenhofer, Jana Schaffrath, Steffen T Eberhardt, Jana Bommer, Antonia Vehlen, Danilo Moggia, Kaitlyn Poster, Birgit Weinmann-Lutz, Julian A Rubel, Miriam I Hehlmann

Background: In this paper, we present the conceptual background and clinical implications of a research-based transtheoretical treatment and training model (4TM).

Method: The model implements findings from psychotherapy outcome, process, and feedback research into a clinical and training framework that is open to future research.

Results: The framework is based on interventions targeting patient processes on a behavioral, cognitive, emotional, motivational, interpersonal, and systemic/socio-cultural level. The 4TM also includes a data-based decision support and feedback system called the Trier Treatment Navigator (TTN).

Conclusion: We discuss important problems associated with clinical orientations solely based on one school of thought. We then contrast these concerns with a clinical and training framework that embraces ongoing research, serving as a guiding structure for process-based transtheoretical interventions. Such research-based psychological therapy can take both traditional and novel clinical developments as well as findings from psychotherapy research into account and be adaptively disseminated to a variety of patient populations.

背景：在本文中，我们介绍了基于研究的跨理论治疗和培训模型（4TM）的概念背景和临床意义：方法：该模型将心理治疗结果、过程和反馈研究的结果融入到一个临床和培训框架中，并对未来研究开放：结果：该框架基于针对患者行为、认知、情感、动机、人际关系和系统/社会文化层面的干预措施。4TM 还包括一个基于数据的决策支持和反馈系统，称为特里尔治疗导航仪（TTN）：我们讨论了仅基于一种学派的临床取向所存在的重要问题。然后，我们将这些问题与接受持续研究的临床和培训框架进行对比，作为基于过程的跨理论干预的指导结构。这种以研究为基础的心理疗法既能考虑到传统的和新颖的临床发展，也能考虑到心理疗法研究的成果，并能适应性地传播给不同的患者群体。

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引用次数: 0

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