Counselling & Psychotherapy Research最新文献_第2页

Outcome of Individual Outpatient Psychotherapy in Adults Under Clinically Representative Conditions in Austria 奥地利临床代表性条件下成人个体门诊心理治疗的结果

IF 1.3 Q3 PSYCHOLOGY, CLINICAL

Counselling & Psychotherapy Research

Pub Date : 2026-01-05 DOI: 10.1002/capr.70074

Elke Humer, Yvonne Schaffler, Katja Haider, Christoph Pieh, Barbara Haid, Wolfgang Schimböck, Peter Stippl, Brigitte Schigl, Thomas Probst

Background

While randomised controlled trials have established the efficacy of psychotherapy, their applicability to routine care is limited. Naturalistic studies offer ecological validity, but representative data for the effectiveness of psychotherapy in Austrian outpatient private settings are lacking.

Aim

This study examined psychotherapy outcomes under real-world conditions in Austria.

Method

Austrian psychotherapists in outpatient private practice were invited to participate by enrolling patients in the study (recruitment: September 2020 to December 2023). Outcomes were assessed at the start of therapy (baseline assessment) and at the end of therapy or study (post assessment). Outcome questionnaires included the Positive Mental Health Scale (PMH), the WHO Disability Assessment Schedule (WHODAS), the Patient Health Questionnaire-9 (PHQ-9), the Generalised Anxiety Disorder Scale-7 (GAD-7), and the Standardised Assessment of Severity of Personality Disorder (SAS-PD).

Results

Eighty-seven psychotherapists from the four psychotherapeutic clusters (psychoanalytic-psychodynamic, humanistic, systemic, behavioural) participated in the study. Of 163 patients completing the baseline-assessment, 58 (35.6%) provided post-assessment data (treated by 39 psychotherapists). Missing post-assessment values were estimated using the Baseline Observation Carried Forward method, yielding small to moderate effect sizes (d = 0.21 to 0.48), and the Expectation Maximisation method, resulting in small to large effects (d = 0.32 to 1.08). Analyses based on the patients with complete baseline- and post-assessment revealed small to large effects (d = 0.36 to 1.03).

Conclusions

Results indicate that psychotherapy in Austrian private practice yields significant improvements in mental health. Future studies should investigate strategies to enhance recruitment to ensure a more comprehensive database for psychotherapy research in Austria.

背景：虽然随机对照试验已经证实了心理治疗的有效性，但其在日常护理中的适用性是有限的。自然主义研究提供了生态有效性，但缺乏奥地利门诊私人设置心理治疗有效性的代表性数据。目的本研究考察了奥地利现实世界条件下的心理治疗结果。方法通过招募患者，邀请奥地利门诊私人诊所的心理治疗师参与研究（招募时间：2020年9月至2023年12月）。在治疗开始（基线评估）和治疗或研究结束（后评估）时评估结果。结果问卷包括积极心理健康量表（PMH）、世卫组织残疾评估表（WHODAS）、患者健康问卷-9 （PHQ-9）、广泛性焦虑障碍量表-7 （GAD-7）和人格障碍严重程度标准化评估（SAS-PD）。结果来自精神分析-精神动力、人本、系统和行为四个心理治疗集群的87名心理治疗师参与了研究。在163名完成基线评估的患者中，58名（35.6%）提供了评估后的数据（由39名心理治疗师治疗）。使用基线观察结转法估计缺失的后评估值，产生小到中等的效应量（d = 0.21至0.48），使用期望最大化法产生小到大的效应量（d = 0.32至1.08）。基于完成基线和后评估的患者的分析显示，效果从小到大（d = 0.36至1.03）。结论：结果表明，奥地利私人诊所的心理治疗显著改善了心理健康。未来的研究应该调查加强招募的策略，以确保奥地利心理治疗研究有一个更全面的数据库。

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引用次数: 0

The Working Alliance in the Focus-Based Integrated Model: An Interpretative Phenomenological Analysis 焦点整合模式中的工作联盟：解释性现象学分析

IF 1.3 Q3 PSYCHOLOGY, CLINICAL

Counselling & Psychotherapy Research

Pub Date : 2026-01-05 DOI: 10.1002/capr.70077

E. Volpato, S. Bergamaschi, M. Cis, D. Sattin, M. Ruffino, G. Tognasso, M. C. Gislon, F. Pagnini

Background

The Working Alliance (WA) can be considered a core variable influencing the efficacy of the Focus-Based Integrated Model (FBIM), able to emphasise diagnosis, focus, integrated intervention and self-therapy. Recognising and resolving WA ruptures is critical, particularly in a model that demands adaptability and precision. However, limited research has explored the role of WA in FBIM, especially from the psychotherapist's perspective.

Objectives

The main aim of this study was to explore psychotherapists' experiences of the WA with clients who have received psychotherapy based on the FBIM.

Methods

Using Interpretative Phenomenological Analysis (IPA), semi-structured interviews were conducted with 16 psychotherapists treating 25 clients, audio-recorded, and transcribed verbatim.

Results

The findings are organised into three key areas: the construction of the therapeutic alliance, the setting and the dyadic relationship. These areas are further delineated into superordinate themes, each of which is characterised by specific themes and sub-themes. The superordinate themes include: (1) the definition of the WA; (2) the perceived WA; (3) moments of rupture; (4) strategies employed to address ruptures; (5) the therapeutic setting; (6) the therapeutic focus; (7) the reins; (8) therapist characteristics; and (9) client characteristics.

Discussion

This study highlights the role of WA within FBIM-based psychotherapy, emphasising the need for therapists to remain attuned to ruptures and relational dynamics. Findings underscore the importance of therapist adaptability, relational sensitivity, and responsivity in navigating the complexities of WA. These insights offer valuable implications for training and supervision within FBIM frameworks, supporting psychotherapists in optimising outcomes through enhanced alliance management.

工作联盟（Working Alliance， WA）可以被认为是影响焦点综合模型（focus - based Integrated Model， FBIM）疗效的核心变量，它能够强调诊断、焦点、综合干预和自我治疗。识别和解决WA断裂是至关重要的，特别是在需要适应性和精度的模型中。然而，有限的研究探索了WA在FBIM中的作用，特别是从心理治疗师的角度。本研究的主要目的是探讨心理治疗师对接受基于FBIM的心理治疗的来访者的WA体验。方法采用解释现象学分析（IPA）对16名心理治疗师进行半结构化访谈，对25名来访者进行录音和逐字转录。结果研究结果分为治疗联盟的构建、治疗联盟的设置和治疗联盟的二元关系三个方面。这些领域进一步划分为上级主题，每个主题都有具体主题和副主题的特征。上级主题包括：(1)WA的定义；(2)感知WA；(3)破裂力矩；(4)应对破裂的策略；(5)治疗环境；(6)治疗焦点；（七）缰绳；(8)治疗师特征；(9)客户特征。本研究强调了WA在基于fbim的心理治疗中的作用，强调治疗师需要保持对破裂和关系动态的协调。研究结果强调了治疗师的适应性、关系敏感性和反应性在引导WA复杂性方面的重要性。这些见解为FBIM框架内的培训和监督提供了有价值的启示，支持心理治疗师通过加强联盟管理来优化结果。

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引用次数: 0

Anti-Oppressive Andragogy in Counselling and Psychotherapy Education: A Critical Analytic Synthesis 心理咨询和心理治疗教育中的反压迫性学：批判性分析综合

IF 1.3 Q3 PSYCHOLOGY, CLINICAL

Counselling & Psychotherapy Research

Pub Date : 2025-12-31 DOI: 10.1002/capr.70072

Harvey Charles Peters, Thomas Killian, Barbara Dos Santos, Wanqi Yang

Background

Anti-oppressive andragogy has recently gained prominence within international counselling and psychotherapy education, yet remains fragmented, largely conceptual and inconsistently applied. Scholars continue to call for frameworks that move beyond multicultural paradigms to dismantle systemic oppression across training environments.

Method

Using Critical Analytic Synthesis, we systematically reviewed and synthesised interdisciplinary literature across counselling and psychotherapy professions. We analysed approximately 150 peer-reviewed articles, engaging in an iterative process of construction, deconstruction and reconstruction to develop guiding principles for anti-oppressive andragogy.

Results

Thematic findings yielded eleven dynamic principles that address the process and praxis of anti-oppressive andragogy in counselling and psychotherapy education. These principles highlight the importance of reflexivity, power sharing, relational accountability and socioecological transformation.

Conclusion

Our findings suggest that anti-oppressive andragogy requires educators to interrogate dominant paradigms, centre those within margins, and engage in continuous critical reflection and community accountability. Educators can use these principles to challenge Eurocentric and assimilationist approaches, integrate decolonising practices and foster liberatory spaces that support empowerment and collective action. Policy and practice implications include revising curricula, gatekeeping, programme development, and professional standards to advance equity and justice for historically marginalised communities. Future research should build on this framework to explore practical applications, assess outcomes, and continue evolving anti-oppressive andragogical literature within counselling and psychotherapy education.

反压迫性学最近在国际咨询和心理治疗教育中获得了突出地位，但仍然是碎片化的，主要是概念性的和不一致的应用。学者们继续呼吁建立超越多元文化范式的框架，以消除跨培训环境的系统性压迫。方法采用批判性分析综合，我们系统地回顾和综合了咨询和心理治疗专业的跨学科文献。我们分析了大约150篇同行评议的文章，参与构建、解构和重建的迭代过程，以制定反压迫性学的指导原则。结果专题研究结果产生了11个动态原则，解决了在咨询和心理治疗教育中反压迫性学的过程和实践。这些原则强调了反身性、权力分享、关系问责制和社会生态转型的重要性。我们的研究结果表明，反压迫性取向要求教育者质疑主流范式，将其置于边缘，并参与持续的批判性反思和社区问责。教育工作者可以利用这些原则挑战欧洲中心主义和同化主义方法，整合非殖民化实践，培育支持赋权和集体行动的解放空间。政策和实践方面的影响包括修订课程、把关、项目开发和专业标准，以促进历史上边缘化社区的公平和正义。未来的研究应该建立在这个框架上，探索实际应用，评估结果，并在咨询和心理治疗教育中继续发展反压迫和神学文献。

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引用次数: 0

Patients' Experiences of Non-Mutual Psychotherapy Termination: A Qualitative Content Analysis 非相互心理治疗终止的患者经历：定性内容分析

IF 1.3 Q3 PSYCHOLOGY, CLINICAL

Counselling & Psychotherapy Research

Pub Date : 2025-12-29 DOI: 10.1002/capr.70066

Lorenzo Antichi, Simona Notarnicola, Alessio Gori, Marco Giannini

Aim

This study aimed to explore patients' reasons and experiences regarding the non-mutual termination of their psychotherapy (i.e., either the patient or the therapist did not agree to terminate the therapy).

Methods

Participants who had experienced psychotherapy were recruited via social media (e.g., Facebook, LinkedIn) by posting a participation invitation on the personal profiles of the researchers. If interested, participants responded to an online self-report survey, writing about their experiences, including the reasons for termination, related emotions or thoughts, whether they would make the same choice again, and what they would say to their therapists in an imagined conversation. Then, a conventional content analysis was conducted to create categories for each theme/question.

Results

The study included 63 females (79.70%) and 16 males (20.30%). The average age was 29.62 years (SD = 9.00), with a range of 21–63 years. Considering the results, the motivations for the termination were attributed to relationship dynamics, therapists' behaviours, the mismatch between therapy and patients' needs, feeling ready, and economic-structural aspects. Emotionally, patients experienced negative feelings, while a few patients felt satisfied after termination. Many participants wanted to share their progress and express their gratitude to their therapists, continue psychotherapy, and criticise their therapists. Lastly, regarding the decision to terminate therapy, most patients would repeat their choice, while others would not.

Conclusion

To conclude, these results can inform therapists about the causes of treatment termination, and help them monitor these factors during therapy to reduce the likelihood of non-mutual termination.

目的本研究旨在探讨患者对非相互终止心理治疗（即患者或治疗师均不同意终止治疗）的原因和经历。方法通过社交媒体（如Facebook、LinkedIn）在研究人员的个人资料上发布参与邀请，招募经历过心理治疗的参与者。如果有兴趣的话，参与者可以回答一份在线自我报告调查，写下他们的经历，包括终止治疗的原因、相关的情绪或想法、他们是否会再次做出同样的选择，以及他们会在想象的对话中对治疗师说些什么。然后，进行常规的内容分析，为每个主题/问题创建类别。结果女性63例（79.70%），男性16例（20.30%）。平均年龄29.62岁（SD = 9.00），年龄范围21 ~ 63岁。考虑到结果，终止治疗的动机可归因于关系动态，治疗师的行为，治疗与患者需求之间的不匹配，感觉准备好了，以及经济结构方面。在情感上，患者有负面情绪，少数患者在终止后感到满意。许多参与者想要分享他们的进步，并对他们的治疗师表示感谢，继续心理治疗，并批评他们的治疗师。最后，关于终止治疗的决定，大多数患者会重复他们的选择，而其他人则不会。综上所述，这些结果可以帮助治疗师了解治疗终止的原因，并帮助他们在治疗过程中监测这些因素，以减少非相互终止的可能性。

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引用次数: 0

Validation of the Arabic California Brief Multicultural Competence Scale Among Counsellors and Its Association With Professional Identity and Demographics 阿拉伯语加州多元文化能力量表在辅导员中的验证及其与职业认同和人口统计学的关联

IF 1.3 Q3 PSYCHOLOGY, CLINICAL

Counselling & Psychotherapy Research

Pub Date : 2025-12-28 DOI: 10.1002/capr.70070

Ayman O. Baniamer, Othman A. Alfuqaha, Kyle Msall

Background and Aims

University students, in their future professional practice, are anticipated to demonstrate robust professional identity (PI) and multicultural competence (MC). The purpose of this study was to examine the validity and reliability of the California Brief Multicultural Competence Scale (CBMCS) in the Arabic language. Moreover, it explored the effect of PI and several demographic factors on MC among counselling candidates.

Methods

The researchers selected two public universities in Amman, Jordan, to recruit participants using an online Google Form between the period of 26 August and 5 September 2025. Accordingly, 223 counselling candidates were recruited. The researchers translated and back-translated CBMCS and then conducted both exploratory and confirmatory factor analyses for the validation process.

Results

The results highlighted that the translated CBMCS into Arabic is valid and reliable. Results showed that MC and PI are at higher levels among counselling candidates.

Conclusions

PI has a direct effect on MC among counselling candidates. The researchers recommend psychological training programmes for all university students to promote PI and MC.

大学学生，在他们未来的专业实践中，预计将表现出强大的专业认同（PI）和多元文化能力（MC）。本研究的目的是检验加州多元文化能力量表（CBMCS）在阿拉伯语中的效度和信度。此外，本研究还探讨了个人情感指数和几个人口统计学因素对心理咨询候选人心理管理的影响。方法研究人员选择了约旦安曼的两所公立大学，在2025年8月26日至9月5日期间使用在线谷歌表格招募参与者。因此，征聘了223名咨询候选人。研究人员对CBMCS进行了翻译和反翻译，然后对验证过程进行了探索性和验证性因素分析。结果结果表明，CBMCS阿拉伯文译文有效、可靠。结果显示，在辅导考生中，MC和PI水平较高。结论心理素质对心理咨询考生的心理素质有直接影响。研究人员建议对所有大学生进行心理训练，以促进个人情感和情感管理。

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引用次数: 0

Let's Talk About Us: Insights Into the Impact of Routine Outcome Monitoring on Therapeutic Dyads 让我们谈谈我们：观察常规结果监测对治疗性双性恋的影响

IF 1.3 Q3 PSYCHOLOGY, CLINICAL

Counselling & Psychotherapy Research

Pub Date : 2025-12-28 DOI: 10.1002/capr.70068

Selin Demir, Pauline Wrase, Eva-Lotta Brakemeier, Tim Kaiser

Objective

Routine Outcome Monitoring and Feedback (ROM) systems have been widely implemented to improve outcomes of psychotherapy. While their additive effects are robust, effect sizes remain modest, and research indicates differential effectiveness. This study investigates how therapeutic dyads perceive the influence of ROM systems on both intrapersonal and interactive therapeutic processes to identify potential barriers and opportunities for a personalisation of feedback in therapy.

Method

Qualitative interviews were conducted with 18 participants (9 outpatients and their therapists) who had used the Greifswald Psychotherapy Navigation System (GPNS) during their treatment. Data were analysed using Kukartz's method of qualitative content analysis.

Results

Eight main categories emerged: (1) structure and use of feedback discussions, (2) reflection and competence development in patients and therapists, (3) reflection and competence change in patients and therapists, (4) patient empowerment, (5) applicability, satisfaction and perceived usefulness, (6) treatment adjustment and changes, (7) reflection on the psychotherapeutic process and (8) therapeutic alliance.

Conclusion

Overall, the therapeutic dyads agreed on positive influences of the GPNS on intrapersonal competencies and their therapeutic alliance. However, results indicate a differential effectiveness, and clinicians underestimated the benefits their patients reported. To confirm causal mechanisms and optimise feedback applications, further experimental studies are warranted.

目的：常规疗效监测和反馈（ROM）系统已被广泛应用于改善心理治疗的疗效。虽然它们的加性效应很强，但效应大小仍然不大，研究表明存在差异效应。本研究调查了治疗双极性如何感知ROM系统对个人和互动治疗过程的影响，以确定治疗中反馈个性化的潜在障碍和机会。方法对在治疗过程中使用格雷夫斯瓦尔德心理治疗导航系统（GPNS）的18名门诊患者（9名门诊治疗师）进行定性访谈。数据分析采用Kukartz的定性内容分析方法。主要有八个类别：(1)反馈讨论的结构和使用，(2)患者和治疗师的反思和能力发展，(3)患者和治疗师的反思和能力变化，(4)患者授权，(5)适用性，满意度和感知有用性，(6)治疗调整和变化，(7)心理治疗过程反思，(8)治疗联盟。结论总体而言，治疗组一致认同GPNS对个人能力的积极影响及其治疗联盟。然而，结果显示了不同的有效性，临床医生低估了患者报告的益处。为了确认因果机制和优化反馈应用，需要进一步的实验研究。

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引用次数: 0

“Taking Off the Mask”: Experiences of Gender Roles and Mental Health Stigma for Men in Uganda “摘下面具”：乌干达男性的性别角色和心理健康耻辱的经历

IF 1.3 Q3 PSYCHOLOGY, CLINICAL

Counselling & Psychotherapy Research

Pub Date : 2025-12-24 DOI: 10.1002/capr.70069

Maureen Kobusingye, Lay-nah Blue Morris-Howe, Amanda C. DeDiego

Objective

The purpose of the current research was to understand the intersection of gender roles, societal expectations, and the experience of seeking mental health services for men in Uganda.

Methods

The study employed hermeneutic phenomenology to explore the experiences of men related to gender roles and their seeking of professional counselling services. Semi-structured interviews were conducted with eight men in Uganda who had received professional mental health services. Thematic analysis of interviews was conducted using the whole-parts-whole data analysis approach and hermeneutic circle in the tradition of hermeneutic phenomenology.

Results

Results include an overview of qualitative themes identified from thematic analysis. Themes described the impressions and experiences of men who received professional mental health experiences. Analysis of participant experiences yielded themes of “Be A Man,” “Burden of Strength”, and “Breaking the Cycle.”

Conclusion

The internal conflict of being a man who is self-sufficient and needing mental health help was contradictory and induced feelings of shame rooted in the societal expectations of manhood. For men in Uganda, seeking help for emotional needs is a sign of weakness. Considering the lingering shame of associating mental health support with the HIV crisis, nonjudgmental attitudes are critical for mental health professionals serving men in Uganda and African nations.

当前研究的目的是了解性别角色、社会期望和乌干达男性寻求心理健康服务的经验之间的交集。方法运用解释学现象学的方法，探讨男性在性别角色方面的经历及其对专业咨询服务的寻求。对乌干达接受过专业心理健康服务的8名男子进行了半结构化访谈。访谈的主题分析采用解释学现象学传统的整体-部分-整体数据分析方法和解释学循环。结果包括从主题分析中确定的定性主题的概述。主题描述了接受专业心理健康治疗的男性的印象和经历。对参与者经历的分析产生了“做一个男人”、“力量的负担”和“打破循环”的主题。结论作为一个自给自足的男人和需要心理健康帮助的内在冲突是矛盾的，并诱发了根植于社会对男子气概期望的羞耻感。对于乌干达的男性来说，寻求情感上的帮助是软弱的表现。考虑到将心理健康支持与艾滋病毒危机联系在一起的耻辱挥之不去，对于乌干达和非洲国家为男性服务的心理健康专业人员来说，不加评判的态度至关重要。

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引用次数: 0

Evaluating the Effectiveness of a Psychological Counselling Service for Italian University Students: A Focus on Emotion Regulation and Loneliness 评价意大利大学生心理咨询服务的有效性：以情绪调节和孤独感为重点

IF 1.3 Q3 PSYCHOLOGY, CLINICAL

Counselling & Psychotherapy Research

Pub Date : 2025-12-14 DOI: 10.1002/capr.70062

Gaia Caldarelli, Gaetana Affuso, Marina Cosenza, Lavinia Barone, Barbara Pizzini, Alda Troncone

<div> <section> <h3> Background and Aims</h3> <p>University counselling services and their effectiveness is a growing field of interest, given their key role in students' well-being and mental health improvement. The poor homogeneity in defining outcome variables and predictors of treatment efficacy has resulted in considerable variability across studies, with some important aspects having received limited attention or being underexplored. The present study aimed to contribute to this field by analysing the effectiveness of a psychological counselling service in reducing students' psychological difficulties. The main aim of the study was to identify the main predictors of reliable change (RC) in psychological distress and dropout intentions, with a particular focus on the role played by emotion regulation and loneliness.</p> </section> <section> <h3> Methods</h3> <p>A one-group pre-post-test design was adopted. A total of 263 students (183 female, <i>M</i><sub>age</sub> 23.85 ± 3.98) from a university in Southern Italy were asked to complete CORE-OM, Dropout Intentions Questionnaire, DERS and UCLA-LS3. Data were collected between March 2021 and October 2023, at the beginning (T0) and at the end (T1) of the intervention.</p> </section> <section> <h3> Results</h3> <p>Of the 263 participants, 154 (111 female, <i>M</i><sub>age</sub> 24.86 ± 4.15) completed the pre-post assessment. Repeated-measures ANOVA showed a significant decrease at T1 in all dimensions of psychological distress, emotion regulation difficulties, loneliness and dropout intention (all <i>p</i> < 0.0001). A total of 107 (69.5%) students showed RC in distress levels. A multiple group structural equation model (SEM) indicated that RC for emotion regulation difficulties significantly and positively affected the RC for the psychological distress and dropout intention scores.</p> </section> <section> <h3> Conclusions</h3> <p>These findings emphasise the effectiveness of psychological counselling intervention in reducing psychological difficulties among university students. Furthermore, they underscore the role of emotion regulation as a potential predictor of psychological distress and dropout intention, contributing to a more precise definition of the key variables that may play a role in making psychological counselling interventions effective in supporting psychological well-being and mental health.</p> </section> <section> <h3> Trial Registration</h3> <p>The study has been registere

背景和目的大学咨询服务及其有效性是一个越来越受关注的领域，因为它们在学生的福祉和心理健康改善方面发挥着关键作用。结果变量和治疗效果预测因素的定义同质性差，导致研究之间存在相当大的差异，一些重要方面受到的关注有限或未得到充分探索。本研究旨在通过分析心理咨询服务在减少学生心理困难方面的有效性，为这一领域做出贡献。该研究的主要目的是确定心理困扰和辍学意图的可靠变化（RC）的主要预测因素，特别关注情绪调节和孤独感所起的作用。方法采用单组前-后试验设计。对意大利南部一所大学263名学生（女183人，年龄23.85±3.98）进行了CORE-OM、退学意向问卷、DERS和UCLA-LS3问卷调查。数据收集于2021年3月至2023年10月，干预开始时（T0）和结束时（T1）。结果263例受试者中，154例（女性111例，男性24.86±4.15例）完成了前后评估。重复测量方差分析显示，心理困扰、情绪调节困难、孤独感和退学意向的所有维度在T1时均显著降低（p均为0.0001）。共有107名学生（69.5%）表现出焦虑水平。多组结构方程模型（SEM）显示，情绪调节困难RC显著正向影响心理困扰和辍学意向得分RC。结论心理咨询干预在减少大学生心理困难中的作用。此外，他们强调了情绪调节作为心理困扰和辍学意图的潜在预测因素的作用，有助于更精确地定义可能在使心理咨询干预有效地支持心理健康和心理健康方面发挥作用的关键变量。该研究已在ClinicalTrials.gov注册为NCT06333444

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引用次数: 0

Artificial Clients, Genuine Interactions? Assessing ChatGPT4's Process-Level Performance in Clinical Simulations Using Qualitative Content Analysis 人工客户端，真正的互动？使用定性内容分析评估ChatGPT4在临床模拟中的过程级性能

IF 1.3 Q3 PSYCHOLOGY, CLINICAL

Counselling & Psychotherapy Research

Pub Date : 2025-12-14 DOI: 10.1002/capr.70063

Xihe Tian, Yanhong Liu, Sarah Litt, Kahyen Shin, Tanqiu Jiang

Objective

With rapid advances in technology, growing attention has been directed towards evaluating Artificial Intelligence (AI) performance in human tasks; however, limited research has examined AI's performance as clinical clients in counselling simulations, particularly at the process level. This study explores how ChatGPT-4.0 (GPT-4), an advanced AI Large Language Model (LLM) with voice functioning, performs as a simulated client and how its responses reflect counselling processes within counselling interactions.

Method

Twelve fictional client scenarios were developed to assess GPT-4's performance across diverse counselling situations. Using qualitative content analysis (QCA), we examined GPT-4-simulated client responses on the content level.

Results

GPT-4 demonstrated multiple elements of counselling process, including the ability to form therapeutic alliance, attune to counsellors' theoretical orientations and adapt to different stages of the counselling process. Analysis also showed the GPT-4-simulated clients expressed strong motivation for positive changes, advanced mental health literacy and low but selective defence mechanisms. Additionally, a detectable yet limited amount of non-verbal information emerged through tone and pacing within the model's voice output.

Conclusion

Findings suggest that GPT-4 can produce process-level behaviours that align with key components of counselling interactions and has the potential to become a strong supplementary training tool for counselling role-play practices.

随着技术的快速进步，越来越多的人关注评估人工智能（AI）在人类任务中的表现；然而，有限的研究考察了人工智能作为临床客户在咨询模拟中的表现，特别是在过程层面。本研究探讨了ChatGPT-4.0 (GPT-4)，一种具有语音功能的高级人工智能大型语言模型（LLM），如何作为模拟客户执行，以及它的响应如何反映咨询互动中的咨询过程。方法设计了12个虚构的客户场景来评估GPT-4在不同咨询情况下的表现。使用定性内容分析（QCA），我们检查了gpt -4模拟客户在内容层面的反应。结果GPT-4显示了咨询过程的多个要素，包括形成治疗联盟的能力，与咨询师的理论取向相协调的能力，以及适应咨询过程不同阶段的能力。分析还显示，gpt -4模拟的客户表现出积极改变的强烈动机，先进的心理健康素养和低但选择性的防御机制。此外，在模型的语音输出中，通过语调和节奏出现了可检测但数量有限的非语言信息。研究结果表明，GPT-4可以产生与咨询互动的关键组成部分相一致的过程级行为，并有可能成为咨询角色扮演实践的强大补充培训工具。

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引用次数: 0

A Hermeneutic Phenomenological Exploration of the Male Therapists' Embodied Lived Experience—Being With Male Clients Who Have Disordered Eating Behaviours: When Two Bodies Meet in the Therapy Room 男性治疗师具身生活经验的诠释学现象学探索——与饮食行为失调的男性来访者在一起：当两个身体在治疗室相遇

IF 1.3 Q3 PSYCHOLOGY, CLINICAL

Counselling & Psychotherapy Research

Pub Date : 2025-12-09 DOI: 10.1002/capr.70064

Maria Guiñazu, Simon Wharne

Background

A first hermeneutic phenomenological exploration of cis-men therapists' embodied experiences when working with male clients who engage in disordered eating. Men are found to have different forms of disordered eating from women, with different health risks. Men are less likely to identify and disclose their disordered eating and less likely to receive services. It is problematic that assumptions about genders could replicate stereotypical roles and thereby propagate the social narratives that contribute to eating disorders.

Aims

This study aims to deepen our understanding of the role that cis-men practitioners play in their clients' recovery.

Materials and Methods

Data were obtained through a written description of a clinical experience, provided by each participant and through online interviews. A conversational approach was employed, and transcribed interviews with six participants were analysed using the methodology of van Manen's Hermeneutic Phenomenology of Practice (van Manen, M. 2014. Phenomenology of Practice: Meaning-Giving Methods in Phenomenological Research and Writing. Left Coast Press). Each transcript segment was labelled, organised and clustered to themes; then a cross-participant analysis was carried out, revealing themes across all interviews.

Results

Three interconnected themes emerged: a ‘mutual experience of starvation between the cis-male therapist and male client’, ‘what feels unbearable in the therapy room’ and ‘the connection established through their shared maleness’.

Discussion

While cis-men therapists continue to feel pressure to control their bodies and remain in silent isolation, a potential is revealed for them to be a role model and advocate.

Conclusion

Cis-men therapists can work with clients to share and accept their vulnerability and challenge unhelpful social narratives.

背景：对顺男性治疗师在治疗患有饮食失调的男性来访者时的具体体验进行首次解释学现象学探索。研究发现，男性与女性的饮食失调形式不同，健康风险也不同。男性不太可能发现和披露自己的饮食失调，也不太可能接受服务。关于性别的假设可能会复制刻板的角色，从而传播导致饮食失调的社会叙事，这是有问题的。目的本研究旨在加深我们对顺男医师在其来访者康复中所扮演角色的理解。资料和方法通过每位参与者提供的临床经历的书面描述和在线访谈获得数据。采用对话方法，并使用van Manen的《实践的解释学现象学》（van Manen， M. 2014）的方法对六名参与者的访谈记录进行了分析。实践现象学：现象学研究与写作中的意义赋予方法。左海岸出版社)。每个文本片段被标记，组织和聚集到主题；然后进行了跨参与者分析，揭示了所有访谈的主题。三个相互关联的主题出现了：“顺式男性治疗师和男性来访者之间的饥饿共同体验”，“治疗室中难以忍受的感觉”和“通过他们共同的男性特征建立的联系”。当顺式男性治疗师继续感受到控制自己身体的压力，并保持沉默孤立时，他们显示出成为榜样和倡导者的潜力。顺式男性治疗师可以与来访者一起分享和接受他们的脆弱性，挑战无益的社会叙事。

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引用次数: 0