Psychology and Psychotherapy-Theory Research and Practice最新文献

Objectives

Gender dynamics within the patient–therapist relationship can influence the therapeutic process in meaningful ways. However, the female patient–male therapist dyad has received limited attention in recent psychotherapy research. This article explores how female patients and their male therapists experience the role of gender in outpatient psychotherapy.

Design

This study is a qualitative subproject within a larger research initiative involving psychotherapists in private practice and their patients in Austria. Interviews with patients and therapists were conducted using a comprehensive, semi-structured interview guide.

Method

Interviews were conducted with ten participants from female patient–male therapist dyads. The data were analyzed using dyadic interpretative phenomenological analysis and interpreted through the theoretical lens of relational phenomenology.

Results

The analysis identified four themes that illustrate participants' recognition of gender as an important factor influencing psychotherapy: (1) gender shapes the topics and interventions in psychotherapy, (2) the male therapist's gender as valuable for the female patient, (3) the female patient's gender as valuable for the male therapist and (4) attraction between male therapist and female patient. A contrasting fifth theme reflects perspectives suggesting that (5) gender plays a lesser role in psychotherapy.

Conclusion

Participants offered varied and sometimes conflicting views on gender's role in outpatient psychotherapy. While they acknowledged its influence, some felt other factors held greater significance. These differing perspectives reflect diverse experiences of gender, which, if not adequately addressed in therapy, may hinder the therapeutic process.

Objectives

There is evidence that prior experience of intimate partner violence (IPV) can lead to high levels of sensitivity to betrayal, shame and self-criticism and interfere with initiation, development and maintenance of future intimate relationships. We measured these variables in women survivors of IPV, evaluating whether they are associated with the quality of current relationships.

Design

A cross-sectional, between-groups design was used, comparing women survivors of IPV divided into those satisfied with current intimate relationships, those dissatisfied and IPV survivors not in such a relationship. Women without a history of IPV were included as a benchmark group.

Method

Four groups: IPV single (N = 34), IPV dissatisfied (N = 25), IPV satisfied (N = 32) and those who had not experienced IPV (N = 42) were compared for betrayal sensitivity, followed by a secondary comparison of shame and self-criticism. Online questionnaires were completed by participants recruited through social media and screened for IPV and relationship status.

Results

All IPV groups had significantly higher scores for betrayal sensitivity than the non-clinical group, with IPV satisfied having significantly lower scores than other IPV groups in two subscales: betrayal causing life change and lack of trust due to betrayal.

Conclusions

Betrayal sensitivity is prominent in survivors of IPV, with evidence of a specific link between survivors' relationship satisfaction/status and their lack of trust and ideas of being permanently changed. Those appraisals may make it more challenging to build and maintain satisfactory relationships, or positive relationships may help survivors change their appraisals about betrayal, leading to a lack of trust and life-altering changes.

Objectives

To evaluate the effectiveness of inpatient cognitive analytic therapy (CAT) for functional neurological disorder and associated suicidality.

Design

A single case experimental A-B-C plus follow-up design. Intervention phases (A-B-C) were conducted on a psychiatric ward, with the 1-month follow-up (FU) phase in the community.

Methods

The intervention was eight-session CAT. The ABC phases of the SCED were synchronized with the reformulation, recognition and revision phases of the CAT. Idiographic anxiety, depression, burden, emotion regulation, distrust and frequency counts of epileptic and functional seizures were measured daily for N = 61 days across all the phases of the study. Recognition and revision of target problems (TPs) and target problem procedures (TPPs) were rated at each session. The PHQ-9 and GAD-7 were completed at assessment, end of therapy and follow-up. A change interview was conducted at the point of discharge from the ward and at follow-up.

Results

The number of seizure-free days did not change markedly. Recognition and revision of TP and TPPs increased positively over time and according to the phase of CAT. Daily depression significantly improved, but there was less change in other idiographic measures. There was a reliable improvement in PHQ-9 and GAD-7 scores. Personal changes at end of therapy and at follow-up were described in the change interview as important, impactful and unlikely without therapy.

Conclusions

The outcome picture was complex, with evidence of significant change on some indices and little change on others. This suggests a partially effective intervention. Inpatient CAT and also CAT as an FND intervention both seem to hold promise, but clearly more controlled research is needed.

Objective

Although there is notable evidence supporting the importance of the therapeutic alliance and therapist presence in psychotherapy practice, the question of how these factors interact dynamically over time remains to be answered. This study investigated how therapists adjust their presence in response to client distress and how this responsive pattern is moderated by therapeutic alliance during the beginning phase of psychotherapy.

Method

Pre-session symptom measurements and post-session ratings of therapist presence and alliance were collected across the first five consecutive sessions from 46 clients and 22 novice therapists, allowing examination of temporal sequences in therapeutic processes.

Results

Therapists' presence increased in response to higher pre-session symptom levels, with this responsive pattern evolving over time. This relationship was moderated by therapeutic alliance, with stronger alliance providing a context that attenuated the presence-symptom association. Notably, therapist ratings showed stronger predictive relationships with outcomes than client ratings, possibly reflecting the unique observational capacity of therapists in their earliest professional encounters.

Conclusion

These findings demonstrated how therapist presence operates as a dynamic, responsive intervention rather than a static therapeutic factor, suggesting that alliance functions as a contextual moderator rather than merely a direct predictor of outcome.

Objectives

Eye movement desensitization and reprocessing (EMDR) is an effective evidence-based treatment for post-traumatic stress disorder. However, the therapeutic mechanisms underlying eye movements (EM) remain unclear. This study aimed to investigate the effect of horizontal EM on fear extinction learning in healthy individuals, using an Eye Blink Conditioning (EBC) task. This experimental paradigm has been widely used to explore associative fear learning and memory as a form of classical conditioning.

Methods

Healthy participants were included to the study protocol and divided randomly into two groups. The EM group (n = 20) were asked to follow horizontally the experimenter's moving finger at the beginning of the extinction phase and the control group (n = 19) did not engage in any specific task. Sociodemographic and clinical information was collected. Percentage of conditioned response (CR) occurrence, time of onset and intensity between and within groups over longitudinal time were analysed using generalized multilevel mixed effects for repeated measures.

Results

Results showed accelerated extinction learning in the EM group, with an 18.2% probability of CR occurrence in the first block of extinction, compared to the control group (40.9%) (p-value = .007).

Conclusions

The findings indicate that horizontal EM accelerates the extinction process in the EBC task. Therefore, this paradigm, used for studying associative learning and memory, could serve as an objective measure to investigate the mechanisms of action involved in desensitizing traumatic experiences during EMDR treatment.

Objective

Empathy is a critical skill for effective counselling, yet novice counsellors often struggle to develop it. Traditional training methods may not sufficiently address the complexities of empathic development. This study aims to develop and assess an empathy training programme using machine learning (ML) and natural language processing (NLP) to enhance empathy in novice counsellors.

Methods

We developed the ‘Empathy Feedback’ WeChat mini-programme to provide real-time feedback through counselling exercises. In a randomized controlled trial (RCT), 143 participants were randomly assigned to one of four groups: control, feedback, practice or feedback-practice. Over 5 days, participants completed daily empathy exercises through the mini-programme. Empathy levels, as measured by the Helpful Responses Questionnaire (HRQ), and self-efficacy were assessed immediately post-intervention and at a 2-week follow-up.

Results

Significant improvements in empathy and HRQ scores were observed in the experimental groups compared to the control group (p < .05), but no changes were found in self-efficacy scores.

Conclusions

The AI-driven empathy training programme effectively enhanced empathic skills among novice counsellors, demonstrating the potential of integrating machine learning and NLP into counsellor education. The lack of change in self-efficacy suggests that additional strategies may be needed to boost counsellors' confidence in applying these skills in practice.

Over recent decades, there has been more evidence of the connection between trauma and depression. More research is needed on the relationship between different types of trauma and their combination (cumulative trauma) with respect to the severity of depressive symptoms. The extent to which trauma and cognitive processes that manifest as polarised or ‘black and white’ thinking affect the severity of depression has yet to be explored.

Objective

The objective of this research was to examine the impact of cumulative trauma and polarised thinking on the severity of depressive symptoms.

Method

In total, 172 patients, mostly women, with a diagnosis of Major Depressive Disorder or Dysthymia (or both) were evaluated using the Cumulative Trauma Scale. The Repertory Grid Technique was used to measure polarised thinking, and the Beck Depression Inventory-II was used to assess the severity of depressive symptoms.

Results

The severity of depressive symptoms was strongly associated with a high level of polarised thinking and a high frequency of perceived negative trauma.

Conclusions

Our findings underscore the need to address polarised thinking and trauma (when present) as a target of interventions aimed at reducing depression symptoms.