Clinical Psychology in Europe最新文献

Background: Despite the growing evidence that trauma-focused treatments can be applied as first-line approaches for individuals with childhood trauma-related PTSD (Ch-PTSD), many therapists are still reluctant to provide trauma-focused treatments as a first-choice intervention for individuals with Ch-PTSD, especially by telehealth. The current manuscript will therefore give an overview of the evidence for the effectiveness of trauma-focused therapies for individuals with Ch-PTSD, the delivery of trauma-focused treatments via telehealth, and a case example on how a specific form of trauma focused therapy: Imagery Rescripting (ImRs) can be applied by telehealth.

Method: This article presents a clinical illustration of a blended telehealth trajectory of imagery rescripting (ImRs) Ch-PTSD delivered during the COVID-19 pandemic.

Results: The presented case shows that ImRs can be safely and effectively performed by telehealth for ch-PTSD, no stabilization phase was needed and only seven sessions were needed to drastically reduce Ch-PTSD and depressive symptoms, and to increase quality of life.

Conclusion: This case report shows the effectiveness of ImRs by telehealth for Ch-PTSD, which gives hope and additional possibilities to reach out to patients with ch-PTDS. Telehealth treatment might have some of advantages for specific patients, especially, but certainly not only, during the pandemic.

Background: Facing the COVID-19 pandemic, some psychotherapists had to propose remote consultations, i.e., teleconsultation. While some evidence suggests positive outcomes from teleconsultation, professionals still hold negative beliefs towards it. Additionally, no rigorous and integrative practice framework for teleconsultation has yet been developed. This article aims to explore the use and experience of teleconsultation by 1) investigating differences between psychotherapists proposing and not proposing it; 2) evaluating the impact of negative attitudes towards teleconsultation on various variables; 3) determining the perceived detrimental effect of teleconsultation, as opposed to in-person, on the therapeutic relationship and personal experience; and 4) providing insights for the development of a teleconsultation practice framework.

Method: An online survey was distributed via different professional organisations across several countries to 246 (195 women) French-speaking psychotherapists.

Results: Psychotherapists who did not propose teleconsultation believed it to be more technically challenging than psychotherapists who proposed it, but felt less constrained to propose it, and had less colleagues offering it. Attitudes towards teleconsultation showed no significant associations with therapeutic relationship, personal experience, and percentage of teleconsultation. As compared to in-person, empathy, congruence, and therapeutic alliance were perceived to significantly deteriorate online, whereas work organisation was perceived to be significantly better. While most psychotherapists proposed remote consultations, they did not provide adaptations to such setting (e.g., ascertaining a neutral video background); nor used videoconferencing platforms meeting privacy and confidentiality criteria.

Conclusion: Training and evidenced-based information should be urgently provided to practitioners to develop rigorous guidelines and an ethically and legally safe practice framework.

Background: Few studies have investigated implicit and explicit attitudes toward psychotherapy in youths (Study 1), although information about attitudes would improve interventions that aim to decrease barriers to accessing psychotherapy including parents (Study 2), who facilitate the help-seeking process of youths.

Method: The Study 1 sample comprised 96 youths (14-21 years) and the Study 2 sample 38 parent-youth dyads. Differences in implicit attitudes regarding psychotherapy and a medical treatment were measured with the Implicit Association Test, and psychotherapy knowledge and self-reported barriers to psychotherapy were assessed with questionnaires. The actor-partner interdependence model was used to test the dyadic effects of implicit attitudes on explicit attitudes in parents and youths.

Results: We did not find evidence for an implicit bias toward psychotherapy compared to a medical treatment, neither in youths, nor in parents. Self-reported barriers were a predictor for lower help-seeking intentions. Deficits in psychotherapy knowledge were more relevant in younger participants. Having a prior or current experience with psychotherapy and having a friend or family member with a prior or current experience with psychotherapy were predictors for better psychotherapy knowledge, but was not for lower barriers to accessing psychotherapy. Partner effects (degree to which the individual's implicit attitudes are associated with explicit attitudes of the other dyad's member) were not found.

Conclusion: Specific deficits in psychotherapy knowledge should be addressed in interventions to lower barriers accessing psychotherapy. Parents should be included in interventions as a valuable resource to support youths in seeking psychotherapy for mental disorders.

The paper presents professional activities and the major works of an ambassador of the European Association of Clinical Psychology and Psychological Treatment (EACLIPT), Prof. Danutė Gailienė. Prof. Gailienė is among the most influential European clinical psychologists who contributed to clinical psychology training, research, and practice in former post-communist East European countries. Her entire career was dedicated to the development of clinical psychology, and through her work, Prof. Gailienė demonstrated how even in an oppressive and politically difficult environment, it is possible to keep the integrity and work up to higher standards.

Background: Why clients discontinue their psychotherapies has attracted more attention recently as it is a major problem for many healthcare services. Studies suggest that dropout rates may be affected by the mode of therapy, low-quality therapeutic alliance, low SES, and by conditions such personality disorders or substance abuse. The aims of the study were to investigate what happens in therapies which end in a dropout, and to estimate how common dropout is as reported by practicing clinicians.

Method: An online questionnaire was developed and completed by 116 therapists working in clinical settings. They were recruited via social media (Facebook and different online psychotherapy groups) in Sweden and worked with Cognitive Behavioural Therapy (CBT), Psychodynamic Therapy (PDT), Interpersonal Psychotherapy (IPT) and Integrative Psychotherapy (IP).

Results: Psychotherapists rated the frequency of premature dropout in psychotherapy to be on average 8.89% (MD = 5, SD = 8.34, Range = 0-50%). The most common reasons for a dropout, as stated by the therapists, were that clients were not satisfied with the type of intervention offered, or that clients did not benefit from the treatment as they had expected. The most common feeling following a dropout was self-doubt.

Conclusion: In conclusion, premature dropout is common in clinical practice and has negative emotional consequences for therapists. Premature dropout may lead to feelings of self-doubt and powerlessness among therapists. The therapeutic alliance was mostly rated as good in dropout therapies. Further research is needed to validate the findings with data on the prevalence and subjective reasons behind a dropout from point of view of clients.

Background: Physical exercise is an evidence-based treatment to reduce symptoms and negative affect in several psychiatric disorders, including depressive, anxiety, and psychotic disorders. However, the effect of physical exercise on negative affect in patients with borderline personality disorder (BPD) has not yet been investigated. In this pilot study, we tested the safety, acceptability, and potential acute effects on negative affect of a single session of aerobic physical exercise in adults with BPD.

Method: After completing a negative mood induction procedure, 28 adults with BPD were randomly assigned to a 20-minute single session of stationary bicycle or a control condition (emotionally neutral video).

Results: No adverse effects attributed to the physical exercise were reported and it was considered acceptable to patients. Following the negative mood induction, both conditions decreased the level of negative affect with a medium effect size but there was no significant difference between them.

Conclusion: The results suggest that a single 20-minute session of physical exercise does not produce a reduction of negative affect in BPD. Future research should consider the duration and intensities of physical exercise with the greatest potential to reduce negative affect both acutely and in a more prolonged manner in this patient group.

Background: Developmental Coordination Disorder (DCD) is a common neurodevelopmental disorder primarily characterized by fine and gross motor coordination difficulties. Yet, many aspects remain unclear regarding the clinical presentation of secondary symptoms and their implications for Clinical Psychology. Therefore, the purpose of this review is to provide an update about the current understanding of DCD for clinical psychologists and psychotherapists across Europe, particularly based on new insights stemming from the last decade of research.

Method: We provide a narrative review of articles published in the last decade on the topic of DCD, and relevant aspects to clinical psychologist, including lesser known aspects of DCD (e.g., executive functions, psychological consequences, and adult DCD).

Results: DCD is a highly prevalent, disruptive, and complex disorder, which should be investigated further in many areas (e.g., co-occurrence to ADHD). Existing evidence points toward a key role of executive functioning difficulties at all ages. Most patients report secondary psychological problems, but little headway has been made in examining the effectiveness of psychotherapy for DCD.

Conclusions: Insights and remaining research gaps are discussed. It is critical for psychologists and clinical researchers to raise awareness for DCD, take note of the growing literature, and foster continued interdisciplinary approaches to research and treatment of DCD.

Background: Social media use has vastly increased during the past few years, especially among young adults. Studies examining the relationship of social media use with mental health have yielded mixed findings. Additionally, such studies are extremely limited in Greece. The present study aimed to investigate the association between social media use, depressive symptoms and self-esteem among Greek young adults.

Method: A total of 654 individuals (50.5% male) aged 18-30 years (Μ = 23.62, SD = 2.71) completed self-reported questionnaires regarding social media use, depressive symptoms and self-esteem.

Results: Increased daily use of YouTube (more than five hours) showed a significant association with higher depressive symptomatology, b = 2.99, 95% CI [.78, 5.20], p = .008, while daily use of Facebook between two and five hours was related to significantly higher self-esteem, b = 1.61, 95% CI [.78, 2.44], p < .001, after adjusting for participants' gender, age, educational level and employment status. The association of increased daily use of YouTube with depressive symptoms was more pronounced in males than in females. Moreover, self-reported active use of Facebook and Instagram were linked with significantly lower depressive symptoms and higher self-esteem compared to passive involvement.

Conclusion: The results suggest that social media use is closely related to self-esteem and depressive symptomatology in young adults. These findings may contribute to a deeper clinical understanding of the association between electronic social networking and mental health.

Background: We wanted to analyze trends in psychotherapy research during the last decade. We used published randomized clinical trials (RCTs) that are cited in Web of Science (WoS) as an index for these activities.

Method: We searched for RCTs published between the years 2010 and 2019. Search criteria included cognitive-behavioral treatments (CBT), e-mental health, Acceptance and Commitment Therapy (ACT), psychodynamic treatments, interpersonal therapy (IPT), schema therapy, systemic therapy, mindfulness treatments, and emotion-focused therapy (EFT). The numbers of publications for each treatment approach were accumulated for 5-year blocks (2010 to 2014; 2015 to 2019).

Results: The search revealed 4,523 hits for the selected treatment options, of which 1,605 were finally included in the analysis. There was a continuous increase in published RCTs, with 68% more trials during the second five-year block. CBT (68%) and eHealth interventions (18%) show an increase in the number of studies, but there were no significant changes in its percentage in relation to all published RCTs. The next frequent treatments were ACT (4%), psychodynamic treatments (2%), IPT (2%), and mindfulness interventions (2%). We found a significant increase of the percentage of mindfulness (p = .008) and a significant decrease of the percentage of psychodynamic treatments (p = .02). Systemic (1.1%), emotion-focused (0.7%) and schema therapy (0.6%) represented smaller parts of published RCTs.

Conclusion: A continuous increase of published RCTs underlines an active field of research on psychological interventions. Third wave treatments such as mindfulness increased their representation in research, while the part of psychodynamic treatments decreased.