Psychotherapy Research最新文献

Objectives: The Therapist Work Involvement Scales (TWIS) is a self-report research instrument that enables a multilayered description of psychotherapists' experiences when treating clients. The TWIS was created in a comprehensive study of close to 5,000 psychotherapists, and has been used in multiple studies. The aim of the current paper is to clarify the organization and statistical characteristics of the TWIS, and to present an updated version for longitudinal and cross-sectional research.

Methods: Collection of a large sample of psychotherapy trainees made possible the use of confirmatory factor analysis (CFA) to evaluate the dimensions and structure of therapists' process experiences, assessing reliabilities, measurement invariance over gender, item statistics, and correlations with other measures to show concurrent and predictive validity.

Results: The CFAs largely confirmed the factor structure of four of the five facets, and of the global super-factors. The global factors of Healing Involvement and Stressful Involvement each showed substantial correlations with therapists' attachment style and professional growth, and were used to describe four practice patterns that typify the experiences of therapists.

Conclusion: The results have shown the TWIS to be a statistically sound, multidimensional research instrument enabling therapists to describe their experience in current therapeutic work.

Objective: Early improvement predicts good outcome in psychotherapy for eating disorders. Prior studies have examined change in body mass index (BMI) or Eating Disorder Examination Questionnaire scores (EDE-Q) as indicators of early response, but not both simultaneously. Little research has examined early change among Anorexia Nervosa (AN) samples treated with eating disorder-focussed cognitive behavioural therapy (CBT-ED). We studied the process of early change in a fine-grained way to better understand whether early response predicts later response and post-treatment outcomes in CBT-ED for AN, and how the changes in EDE-Q and BMI are related. Method: Adults (N = 193) diagnosed with AN were treated with outpatient CBT-ED. We used bivariate Latent Change Score models to examine change in BMI and EDE-Q and relations between them. Results: Early change in BMI was independent of early change in EDE-Q. Larger changes in EDE-Q over the first five weeks of therapy followed smaller ones over the next five weeks, meanwhile smaller changes followed larger ones. Early change was predictive of post-treatment scores. Conclusion: Early change in BMI and EDE-Q during CBT-ED appear to be unrelated and follow different trajectories. Therefore, individuals declared as early responders may differ depending on which variable is used for the decision.

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.

AbstractObjective: Psychotherapy does not work equally well for all clients. For research to support clinicians in helping more clients, we need to better understand the process of when therapy become particularly challenging. In this study, we investigated challenging change processes from the therapists' perspective when applying Emotion-Focused Therapy (EFT). Method: We interviewed 14 therapists trained in EFT about their experiences of difficulties with applying EFT to clients with varying severity of mental health difficulties. Interviews were analyzed using reflexive thematic analysis. Results: Five themes were constructed. Three describing what EFT therapist find challenging; (1) Challenges in the therapeutic relationship, (2) When feelings are too big, too small or difficult to experience, (3) Matching EFT with the client's challenges, and two describing therapist responses to the challenges: (4) Do I know EFT, and what would I have needed to know more? (5) What do I do when it becomes difficult? A total of 20 subthemes were identified. Conclusion: Reported experiences of applying EFT to a diverse population suggests a need for either model refinement or strengthening of the dissemination process to better enable EFT-therapists to help clients with more severe mental health difficulties.

Objective: There is a pervasive underrepresentation of researchers and clinicians from diverse backgrounds in psychology. This is the first study to focus on diversity gaps in Psychotherapy Research. We examine a gap in the representation of research from low-income countries and summarize barriers and solutions to increase diversity in the field.

Method: We examined trends in submission, acceptance, and rejection rates of all submissions (n = 7183) from 75 countries, representing eight geographical regions to Psychotherapy Research, between 28 April 2005 and 22 June 2023.

Results: Most submissions were from Europe and North America, with the fewest from Africa and Asia/Northeast Asia. High-income countries had significantly more submissions than low-income countries, with gaps increasing over time. North America and Europe had the highest acceptance rates and Africa and Asia/Southeast Asia had the lowest rates.

Conclusion: Psychotherapy Research is one of the most internationally representative journals in the field. Yet, we found underrepresentation of non-western countries. There is a need to increase the representation of research participants and researchers from non-western countries through direct initiatives and investments in research and researchers from underrepresented backgrounds.

Objective: The tendency to linguistically synchronize is an adaptive and prosocial process observed in verbal and written communication. Research in therapeutic contexts has primarily conceptualized reciprocal language style matching (rLSM; i.e., similarity of function words) as indicating the therapeutic relationship. However, in non-therapeutic contexts, rLSM has been conceptualized as facilitating relationship formation and maintenance. The aim of the present study was to examine if an indication model or facilitation model provided a better explanation for the association between rLSM and the therapeutic bond.

Methods: Online text-based crisis-counseling sessions (N = 350) with clients in suicidal crisis were coded for rLSM and therapeutic bond. To examine and compare the indication and facilitation models, we used random intercept cross-lagged panel models.

Results: The association between rLSM and therapeutic bond was better explained by the facilitation model (i.e., rLSM predicting bond) than the indication model (i.e., rLSM co-occurring with bond). However, a model that included (a) rLSM predicting therapeutic bond and (b) the cross-sectional association between therapeutic bond and rLSM was the best fit.

Conclusions: Our findings indicate that rLSM may play a role in establishing the therapeutic relationship and be reflective of the client-counselor relationship. Implications for counseling practice are discussed.

Objective: Develop a Psychotherapy Change Motivation Scale (PCMS) with robust psychometric properties.

Method: A literature review, semi-structured interviews, and expert evaluation were used to draft the scale. The scale was administered to participants receiving psychological counseling or therapy at specialized hospital psychological intervention centers, university mental health education centers, and social psychological counseling agencies using convenience sampling. The initial sample (n = 178) was subjected to item analysis and exploratory factor analysis, and the formal sample (n = 180) was then subjected to confirmatory factor analysis and reliability and validity testing. Criterion validity was tested using the Outcome Questionnaire-45(OQ-45) and the revised Chinese version of the University of Rhode Island Change Assessment (URICA).

Results: The final scale comprised 19 items across four dimensions: Activation, Expected benefits, Agency, and Maintenance and Orientation. The Cronbach's α coefficients ranged from 0.608 to 0.897 for the total scale and subscales; split-half reliability was 0.796; cumulative explained variance was 58.363%, with good structural validity (X²/df = 1.69, RMSEA = 0.062, GFI = 0.875, CFI = 0.915, IFI = 0.917, TLI = 0.901). PCMS scores and its four factors were negatively correlated with OQ-45 (r = -0.234 to -0.375, p<0.01) and positively correlated with the Chinese URICA (r = 0.386-0.694, p<0.01).

Conclusion: The developed PCMS demonstrates good reliability and validity, meeting psychometric standards.

Objective: To investigate the attitudes of mental health professionals towards Routine Outcome Monitoring (ROM) in Eastern and Western cultures.

Method: Two samples of American (N = 455) and Chinese (N = 505) mental health professionals completed the prevalent Monitoring and Feedback Attitudes Scale (MFA). We tested the measure's psychometric characteristics, measurement invariance, and latent mean difference across cultures.

Results: Confirmatory factor analysis (CFA) found a two-factor structure of the MFA within both cohorts. The MFA subscales showed excellent internal consistency in both the Chinese and American samples. The MFA demonstrated partial scalar invariance between the two cultural groups, supporting the comparison of latent means among Chinese and American professionals. Chinese professionals perceived greater harm from ROM than their American counterparts.

Conclusions: The findings show that the MFA is a valid tool to evaluate and compare the US and Chinese mental health professionals' attitudes toward ROM, suggesting that the measure may be useful in both Eastern and Western cultures.

Objective: Worldwide, the numbers of refugees and displaced people being exposed to traumatic and inhumane experiences are escalating, resulting in an enhanced need for appropriate psychological management of trauma in this at-risk group. This study explores therapists' perspectives on and preparedness for supporting adult refugees with trauma-related interventions. Method: Therapists (N = 17), with varying ranges of experiences supporting adult refugee clients, were recruited nationally, and participated in semi-structured interviews, exploring their experiences and preparedness for therapeutically supporting refugee clients with trauma-related interventions. Data were analyzed using reflexive thematic analysis. A Patient Public Involvement (PPI) approach was embedded within this study. Results: Five major themes were developed throughout the analysis: (i) Therapists' Fears and Apprehensions in Meeting Client Complexities, (ii) Preparation and Support for Competency Development, (iii) Adjusting Preconceptions of the Nature of Therapeutic Work, (iv) Humanity Within the Therapeutic Relationship, and (v) Balancing Therapeutic Meaningfulness and Hardships. Conclusion: Therapist training must reflect trauma-informed care and inter-cultural awareness to allow therapists to feel better prepared within mainstream and specialist services. Further, therapists' well-being needs to be prioritized to prevent vicarious trauma, burn-out and ultimately, improve interventions for clients.

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.