Psychotherapy Research最新文献

Objective: Remote forms of psychotherapy became more common during the COVID-19 pandemic, increasing the importance of understanding how technological factors might affect remote treatment. Past research on other modes of communication suggests that perceptions can be influenced when the audiovisual quality of online communication is distorted. The aim of the current research was to examine the potential influence of visual or audio distortions during online therapy.

Method: 263 participants judged the interpersonal characteristics and skill of a psychotherapist after viewing segments of treatment sessions in either a video or audio-only format and where the presentation was either clear or distorted.

Results: Contrary to expectations, participants who viewed a poorer quality version of a therapy segment perceived the therapist to have more positive interpersonal characteristics than those who saw a segment of higher quality. There was no reliable difference in perception of the therapist's skill as a function of segment quality.

Conclusion: The findings from the study suggest that perceptions of a therapist are not adversely affected if the video or audio quality of a remote therapy session is less than ideal. Therefore, these technical aspects of online treatment may not need to be a top concern.

Objective: To investigate the role of decentering as a mediator of the effect of mindfulness/mindfulness-based intervention (MBI) on emotional distress, we conducted cross-sectional and longitudinal designs.

Method: In Study 1, a total of 998 participants with high emotional distress were included. Mindfulness, decentering, anxiety, and depression were measured at baseline. In Study 2, 688 participants with high emotional distress were randomized to a Mindfulness Intervention for Emotional Distress (MIED) group (N = 344) and a waitlist control (WL) group (N = 344). The same variables were assessed at pre-intervention, week 3, week 5, and post-intervention.

Results: In the cross-sectional design, simple mediation analyses pointed to decentering as a significant mediator of the relationship between mindfulness and symptoms of anxiety and depression. In the longitudinal designs, repeated measures ANOVAs showed that decentering, anxiety, and depression significantly improved in the MIED group compared to WL group. Random-intercept cross-lagged panel models found that decentering and emotional distress reciprocally influenced each other. Longitudinal mediation analyses showed that decentering during the intervention significantly mediated the effect of the MIED program on alleviating emotional distress.

Conclusion: Decentering may potentially act as a pivotal mediator for alleviating emotional distress in MBIs.

Objective: Therapists' emotional responses play a significant role in the therapeutic relationship and in the therapy process. The current study examined the associations between therapists' emotional responses before and after therapy sessions, and patients' experience of them as attuned and responsive.

Method: Forty patient-therapist dyads participated in 16 weekly sessions of Supportive Expressive Psychotherapy. Therapists' emotions were assessed on the Feeling Word Checklist-58. We examined one positive feeling (Parental) and one negative feeling (Inadequate) Following each session, patients and therapists rated responsiveness on the Patient's Experience of Attunement and Responsiveness.

Results: Feeling Parental before sessions was associated with patients' post-session ratings of therapist empathy, but not with session helpfulness or sensed achievement. Therapists' feelings of inadequacy before sessions were negatively associated with patients' ratings of helpfulness and achievement, but not with empathy. Therapists' Parental feelings after the session were positively associated with patients' ratings and their own ratings on all 3 PEAR subscales. Feeling Inadequate after the session was negatively associated with patients' ratings of helpfulness, achievement and empathy. Therapists' ratings were only negatively associated only with helpfulness.

Conclusion: The study demonstrates that therapists' emotional reactions play a role in their patients' experience of their responsiveness.

Objective: This study explores the experience of an individual and family therapy youth suicide intervention from the perspectives of seven psychotherapy triads (young people aged 12-18, their parents/caregivers and therapists).

Method: Data were collected through semi-structured individual interviews and analyzed using consensual qualitative research methods.

Results: Four domains were identified: Focusing on the youth-parent relationship, individual therapy for young people and their parents, conjoint therapy, and public service structures and systemic practice that facilitated tailored treatment. All participant groups valued intervention that improved the youth-parent relationship; however, they held different views about its influence on suicidality and recovery. Separate youth and parent therapy was crucial for facilitating the tailoring of treatment and enhancing the reparative potential of conjoint therapy. Barriers to productive intervention included inaccessible, fragmented, and siloed treatment that excluded parents, stigmatizing clinician responses, and acute care that was not attuned to need or developmental context. Helpful intervention was systemically and attachment-informed, multi-disciplinary, individually tailored, and integrated freely available specialist therapy with crisis and inpatient care.

Conclusion: A relational, nuanced, and flexible approach is needed to tailor youth suicide treatment in the context of the complexity of youth-parent relationships.

Therapist responsiveness denotes that therapists provide therapeutic interventions within an emerging context of client manifestations and moment-by-moment internal and external changes. So far, psychotherapy research on explaining how therapy works falls short of operationalizing the sequence of events constituted by therapist responsiveness. The present special section of Psychotherapy Research addresses this conceptual and methodological gap and proposes six original contributions, using several validated assessment protocols, both from a quantitative and qualitative viewpoint, to study therapist responsiveness in psychotherapy. It aims at providing a rigorous conceptual and methodological basis for studying a core principle of change in psychotherapy for the future.

Objective: Negative effects of psychotherapy are a broad term that encompasses events such as non-response, deterioration, and novel symptoms. The aim of the present study was to explore experiences with negative effects among clinicians working within an intensive short-term dynamic psychotherapy (ISTDP) framework.

Method: Eight ISTDP clinicians consented to participate and were interviewed using semi-structured video interviews. Data were transcribed and analyzed using a reflexive thematic analysis framework.

Results: The thematic analysis resulted in five themes. Overall, the clinicians found it difficult to define negative effects, but that negative effects, regardless of cause, could be used therapeutically. Inaccurate assessment was seen as the main cause of negative effects. Other themes concerned the connection between dropout and negative effects, patient feedback, and the ISTDP community's relationship to negative effects.

Conclusions: The results are largely in line with qualitative studies of CBT clinicians' views of negative effects although clinicians in the present study emphasized more strongly the therapeutic potential of these events. The research field could be further improved by using mixed-method designs while including both patients and therapists.

Objective: Sudden gains (SGs) are rapid symptom improvements between two consecutive therapy sessions that predict treatment outcomes. This study investigated SGs in posttraumatic stress disorder (PTSD) symptoms, interpersonal relationship functioning, and social role functioning in Cognitive Processing Therapy (CPT).

Method: Participants were 121 patients and 81 therapists involved in a parent randomized controlled hybrid implementation-effectiveness trial of CPT. Descriptive analyses examined the frequency and timing of different forms of SGs. Multilevel modeling examined the impact of the three SGs on outcomes.

Results: PTSD SGs occurred more often and at different sessions than SGs in facets of social functioning. Most individuals experienced only one form of SG and there were no significant clinical or demographic differences in those who had PTSD only SGs, social functioning only SGs, or both SGs. PTSD SGs and interpersonal relationship functioning SGs both predicted changes in PTSD symptoms and interpersonal difficulties over time, but not changes in social role functioning. SGs in social role functioning predicted all three forms of outcomes.

Conclusions: The findings suggest that there are multiple forms of SGs in CPT beyond primary symptom changes that are predictive of patient outcomes. Clinicians should highlight various SGs that patients experience to further enhance outcomes.

AbstractResponsiveness is currently a hot topic in the psychotherapy literature with a large variation in what the term means to colleagues of various orientations. This adds to its popularity but limits the scope of whatever is written or said about responsiveness. The fact that the meaning of responsiveness has developed over time within the approaches adds also to the variation, while an understanding of development has the potential of deepening the understanding of each approach. As a fair description and comparison of even just the most important approaches is by far out of reach for a page-limited article, the development of one approach, which may be termed the "Bernese" approach is described here, along with lessons learnt and general comments. The approach includes Plan Analysis case formulations, the concept of complementary or Motive-Oriented Relationship, a description of a combined qualitative and quantitative assessment, and many methodological and conceptual considerations. Personal development is woven in. Overall, it seems fair to say that this approach, at its core developed long before responsiveness became popular, has turned out to still be useful, with a gain in depth as far as concepts and assessment are concerned.

Objective: Psychiatric disorders have been linked to poor social functioning, including deficits in relationship satisfaction. Treatments have shown strong effectiveness in reducing clinical symptoms for a range of disorders, though less is known of the effects disorder-focused treatments have on relationship satisfaction.

Methods: The present study describes a systematic review that was conducted to determine the efficacy of treatments for specific psychiatric disorders in improving relationship satisfaction. Surprisingly, only seventeen studies were identified and included in the review.

Results: We found that a majority of these studies reported modest improvement in relationship satisfaction among people who completed treatment. However, studies were severely hampered by methodological limitations, and all therapy-related improvements could be attributable to placebo effects or the passage of time.

Conclusion: Important gaps in the literature were found that future research should seek to address to maximize treatment outcomes and psychosocial functioning.