Counselling & Psychotherapy Research最新文献

Objective

This study aimed to examine the impact of a brief body scan session on individuals' anxiety and pain levels considering individuals' levels of symptom severity (low vs. high).

Method

The sample was composed of 355 undergraduate or graduate students. Participants completed a series of questionnaires, performed a 14-min body scan exercise and completed some of the questionnaires a second time. Two questionnaires were aimed at identifying individuals reporting high and low levels of symptomatology (i.e. anxiety and somatic symptoms) in their everyday life, while other questionnaires were aimed at assessing the effectiveness of the body scan session in reducing current symptoms.

Results

As hypothesised, body scanning was more effective in decreasing anxiety and pain for students with high-symptom severity than for those with low-symptom severity.

Discussion

We demonstrated that individuals with high levels of symptoms, and especially anxiety symptoms, can benefit from a brief form of body scan.

Aim

Black queer men in the UK are increasingly at risk of mental health problems related to anxiety and depression, often triggered by traumatic experiences. This study explored the efficacy of integrative practice with Black queer men who experienced trauma from a decolonised, intersectional and queer-affirming perspective.

Method

One-to-one semi-structured interviews with nine integrative practitioners were completed. Data collected from these interviews were analysed using Braun and Clarke's six stages of reflexive thematic analysis (RTA).

Findings

RTA identified four subordinate themes: (1) understanding the experience of Black queer men, (2) developing the working alliance and use of self in practice, (3) effective integrative practice and (4) intersectional differences and considerations. Findings discussed the varying forms of trauma Black queer male clients experienced that impacted their mental health and how developing a strong working alliance with Black queer men was crucial when supporting them to recover from trauma. Additionally, the participants described a breadth of trauma-informed integrative counselling and coaching practice. A decolonised approach utilising the intersection of race, gender and sexuality of Black queer men was successfully integrated into the approach used by practitioners in this study.

Conclusion

Overall, this study evidenced that a decolonised perspective to integrative practice effectively supports Black queer men to recover from trauma. Future research should focus on an integrated approach with Black queer men and other gender and sexual ethnic minority clients who experienced trauma.

Objective

The present study examined client profiles in observed emotion to explore possible subgroups among clients given that there is substantial heterogeneity in clients' expression of emotion in therapy. Subgroups were identified using the sequential model of emotional processing, which posits that global distress, shame/fear and rejecting anger represent ‘early expressions of distress’, whereas assertive anger, self-compassion and grief/hurt are conceptualised to be ‘adaptive states’ that predict good outcomes. The present study also offers a unique strategy for studying differences in clients' emotional presentation with implications for within-session assessment by therapists.

Method

Sections of videotaped therapy sessions for 34 participants in emotion-focussed therapy were coded for each emotional state. Through cluster analysis, participants were grouped based on the relative magnitude of each emotion state in the model.

Results

In the first set of analyses, two naturalistic groups were formed: Cluster 2 had higher levels of adaptive emotion and rejecting anger than Cluster 1. There was a significantly greater proportion of good within-session outcomes in Cluster 2 than in Cluster 1. In the second set of analyses, a separate cluster analysis categorised participants based on their early expressions of distress. Four groups were described as follows: Distressed, Protesters, Fearful & Ashamed and Minimally Distressed. Only the Minimally Distressed group showed significantly higher rates of good within-session outcome.

Discussion

These findings provide support for the emotional processing model by using novel methods and analyses. Although the findings are preliminary, they have implications for clinicians' assessments of clients' emotional needs and characteristic presentations.

Introduction

Counsellors and psychotherapists working with trauma experience constant exposure to clients' adverse events, placing their well-being in jeopardy. The pivotal role of empathy in maintaining their well-being is underscored, given the imperative for these professionals to sustain empathetic engagement with clients. However, prior research has solely focussed on other helping professions.

Methodology

This study employed semi-structured interviews to explore the subjective experiences of 14 psychotherapists and counsellors in trauma-informed settings regarding the role of empathy and its implications for well-being. Reflexive thematic analysis was utilised to analyse these data.

Results

Three main themes were identified from the analysis: Empathy is crucial, empathy as a risk factor and empathy can be regulated and developed.

Conclusions

The study's findings reinforce previous research and provide new insights into empathy's development and management in the context of professional trauma work.

Introduction

Research supervisors are uniquely positioned to recognise student abilities and needs. This mixed methods study explores how research supervision can support counselling, psychotherapy and counselling psychology doctoral students in their development of new knowledge, with diversity-related opportunities and challenges in mind.

Methods

Guided by ‘dialectical pragmatism’, we used a semi-qualitative online survey, Reflective Online Practitioner Survey (ROPS; McBeath, 2020), with closed and open questions disseminated across learning institutes in the UK, Europe and North America.

Results

The survey received 105 responses, with 45 coming from research supervisors and 60 from research students. Only a minority considered their own research supervision team to be diverse, and two-thirds of respondents did not see matters relating to diversity and inclusion receiving sufficient emphasis in published research.

Conclusions

Both our quantitative and qualitative data addressed unequal representations in terms of gender and sexuality, ethnicity and heritage, (dis-)ability and social class—several referring to a ‘history of domination by white, cis, non-disabled male perspectives’. Many described ‘diversity being left out of research’ with consequences on the capacity to meet clients' need in clinical practice. As one said: ‘we need to decolonise the training material by critically analysing and situating knowledge and calling out missing voices’. Another stated: ‘If the research we conduct and draw on as practitioners cannot actively reckon with oppression within…we risk furthering the violence that marginalised clients, practitioners, and researchers face’. Support and training of supervisors to address diversity and power in research from the start of supervision were argued as essential, with both the supervisory relationship and innovative epistemological angles to knowledge and ‘reality’ in the field of mental health in mind.

Background

This study examined the topic of online psychological counselling, focusing on the perspectives of both clients and professionals. In light of the widespread adoption of computer-mediated psychological support during the COVID-19 pandemic, the research analysed how it has taken shape in the collective consciousness, the role of trust, and perceived effectiveness.

Method

The sample consisted of 133 professionals (M = 46) and 716 patients (M = 33), recruited through non-probabilistic snowball sampling. Data, collected through two ad hoc questionnaires, were analysed using the EVOC 2005 software (for social representations) and SPSS (for quantitative data).

Results

Overall, regarding the social representation of online psychological support, in the central core of the therapists' representation there seems to be a structured idea of the emotional distance that online therapy inevitably brings with it. In the core of the patients' representation, the idea of online support has been structured as a form of assistance that has shown its full usefulness during the pandemic.

Quantitative data reveal a perceived efficacy of online psychological support comparable to in-person therapy. Efficacy is enhanced by an already-established trust relationship. The adoption of the online mode seems to have favoured the deployment of new resources by therapists and patients, attesting to an adaptation to this new way of conducting therapy. The online mode, in particular, will continue to be chosen by both, along with face-to-face meetings, as a mode of psychological support post-pandemic.

Conclusion

Based on these findings, this study holds strong potential for practical application in the field of remote therapy.

Background

Current outcome measures in digital mental health lack granularity, especially for single-session interventions. This study aimed to address this by utilising natural language processing (NLP) methods to create a clear and relevant outcome measure. This paper describes the development of the Adult Session Wants and Needs Outcome Measure (Adult SWAN-OM), a novel outcome measure for the Qwell digital mental healthcare platform to understand service user (SU) needs engaging in single-session therapy (SST).

Methods

The research employs a multi-phased approach combining NLP methods with the typical stages of outcome measures development as follows: (1) assumption definition and validation with SUs and clinicians; (2) transcript theme extraction using the RoBERTa large language model (LLM) in conjunction with topic modelling to extract themes from 254 single-session transcripts from 192 SUs; (3) clinical item refinement focus group; (4) content validity with clinicians and SUs to improve the relevance and clarity of the items; and (5) outcome measure finalisation in a workshop held with clinicians to consolidate the final wording.

Results

Ninety-six potential wants and needs were generated and distilled into 12 measure items. The outcome measure was shown to be relevant and clear to both SUs and clinicians when used in the context of SST.

Conclusion

This study highlights the potential of combining NLP approaches with co-creation methods in single-session outcome measure development. We argue that the incorporation of clinical expertise and SU experience ensures the clarity and applicability of such measures and that this approach to capturing single-session wants and needs promises novel insights for supporting digital mental health interventions.

Introduction

Machine learning techniques have been leveraged to predict client psychological treatment outcomes. Few studies, however, have tested whether providing such model predictions as feedback to therapists improves client outcomes. This randomised controlled trial examined (1) the effects of implementing therapist feedback via a deep-learning model (DLM) tool that predicts client treatment response (i.e., reliable improvement on the Patient Health Questionnaire-9 [PHQ-9] or Generalized Anxiety Disorder-7 [GAD-7]) to internet-delivered cognitive behavioural therapy (iCBT) in routine clinical care and (2) therapist acceptability of this prediction tool.

Methods

Fifty-one therapists were randomly assigned to access the DLM tool (vs. treatment as usual [TAU]) and oversaw the care of 2394 clients who completed repeated PHQ-9 and GAD-7 assessments.

Results

Multilevel growth curve models revealed no overall differences between the DLM tool vs. TAU conditions in client clinical outcomes. However, clients of therapists with the DLM tool used more tools, completed more activities and visited more platform pages. In subgroup analyses, clients predicted to be ‘not-on-track’ were statistically significantly more likely to have reliable improvement on the PHQ-9 in the DLM vs. TAU group. Therapists with access to the DLM tool reported that it was acceptable for use, they had positive attitudes towards it, and reported it prompted greater examination and discussion of clients, particularly those predicted not to improve.

Conclusion

Altogether, the DLM tool was acceptable for therapists, and clients engaged more with the platform, with clinical benefits specific to reliable improvement on the PHQ-9 for not-on-track clients. Future applications and considerations for implementing machine learning predictions as feedback tools within iCBT are discussed.

Background

This study delves into the ethical considerations of artificial intelligence (AI) use in higher education, focusing on counselling and psychotherapy students' perspectives. Amidst growing interest in AI across educational sectors, this research aimed to highlight student views on the benefits, risks and ethical challenges posed by AI tools in their training.

Methods

Employing a qualitative approach, this scoping study gathered data from seven counselling and psychotherapy students through an online survey, which were analysed using reflexive thematic analysis.

Findings

Four main themes were constructed: (1) guidelines, (2) concerns about the use of AI with highly sensitive information, (3) acceptable and unacceptable uses, and (4) risk of AI compromising the quality of knowledge and practice.

Conclusion

This research underscores the necessity for collaborative guideline development that addresses ethical AI use, the protection of sensitive information, and the delineation of AI's appropriate roles in education and practice. It advocates for ongoing discussion amongst educational institutions, professional bodies and students to create dynamic, ethical standards that evolve with AI advancements, ensuring technology enhances learning outcomes, upholds integrity and respects privacy.