Psychotherapy Research最新文献

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.

Objective: Client non-attendance and drop-out are common challenges in psychotherapy, often framed as issues of client engagement. Less attention has been paid to how therapists respond to these events, particularly within cognitive behavioural therapy (CBT). This study explores CBT therapists' cognitive, emotional, and behavioural responses to client non-attendance and drop-out using qualitative methods.

Methods: CBT therapists working in NHS or private settings were interviewed using a semi-structured format. Transcripts were analysed using Braun and Clarke's thematic analysis.

Results: Six overarching themes were developed, detailing the personal, contextual, and systemic factors that influence how therapists respond to non-attendance and drop-out.

Conclusion: These preliminary findings are consistent with previous literature in terms of cognitive and affective responses. A novel finding is CBT therapists' use of alternative approaches to manage their own distress. Implications for training and clinical practice are discussed.

Objective: Emotion regulation (ER) is increasingly recognized as a key mechanism in couple therapy. However, little is known about how ER changes across treatment or how early adverse events and current attachment experiences shape this process. Methods: Using a sample of 308 married individuals in couple therapy, this study examined changes in ER difficulties across a total of 24 sessions. We also tested whether adverse childhood experiences (ACEs) and current attachment insecurity (anxiety, avoidance) predicted baseline levels and changes in ER. Results: Multilevel modelling showed a small but significant decline in ER difficulties across sessions. Both ACEs and insecure attachment were associated with higher baseline ER difficulties. However, only avoidant attachment predicted greater improvement over time. ACEs and attachment anxiety were unrelated to change. Variance analysis revealed that most variation in ER occurred between individuals (70%) and within individuals over time (23%), with minimal variance at the couple (5%) and therapist (2%) levels. Conclusion: Findings support ER as a dynamic treatment target and underscore the importance of assessing developmental history and current attachment insecurity to guide intervention.

Objective: Chairwork describes a set of experiential techniques where different parts of the self or representations of others are placed into chairs and given a voice. Using chairwork, individuals can practice self-reflexivity, address internal conflicts, and develop greater acceptance of their self-parts. There is a dearth of research regarding chairwork with young people and little is known about how therapists perceive and implement chairwork with this population. This study aims to explore therapists' experiences of chairwork with children and adolescents.

Method: Twelve qualified therapists from seven countries who were trained in and had facilitated chairwork with young people were recruited using convenience sampling. Semi-structured interviews were conducted online and analysed using reflexive thematic analysis.

Results: Six themes were generated: "Playfulness and Creativity", "Working with the Developmental Needs of the Young Person", "Contextualizing the Young Person in their Relational World", "Facilitating Insight and Integration of the Self", "Overcoming Fear of Failure- Therapists' Professional Development", and "Therapist Agency and Confidence".

Conclusion: Therapists should seek to facilitate chairwork more effectively with young people by incorporating playful and creative methods, tailor the work to the young person's developmental stage, consider those in their relational system, and address therapist hesitations through peer support and supervision.

Objective: Given their professional developmental stage, couple and family therapy (CFT) students are likely to have clinical concerns or fears about potential negative experiences that could occur in their clinical work as they progress through their training. A recently developed self-report measure was used to increase awareness of these clinical concerns and ultimately decrease the potential of their negative impact during clinical care.Method: 71 CFT students (mostly female, 87.3%, and White, 70.4%) completed this measure and other potentially relevant measures (e.g., clinical self-efficacy, attachment security) at bi-monthly intervals throughout their clinical training.Results: Results suggest that clinical concerns decreased over the course of their training and that increases in clinical self-efficacy led to a greater decrease in clinical concerns over time.Conclusion: This study has important practical implications for clinical training programs, particularly for ways through which supervisors can support clinicians in growing awareness of potential clinical concerns, and their impact on care delivery.