Exposure to racism is repeatedly experienced by individuals from racially minoritised backgrounds, and has a range of negative emotional, physical and social consequences; however, its traumatising effects are under-recognised. Further, psychological therapists often lack sufficient knowledge, training and confidence to sensitively manage conversations about racism. As this has important implications for the standards of care this population receives, this study explored how racially minoritised clients experience disclosing, or attempting to disclose racial trauma in psychological therapy.
Design
The study utilised an online qualitative survey design.
Methods
Participants were 28 adults who identified as belonging to minoritised racial groups and had engaged in psychological therapy in the UK. Therapy spanned a range of modalities, and providers included the NHS, private therapists/organisations, charities and university services. Data were analysed using thematic analysis.
Results
Three superordinate themes were constructed: The Dangers of Disclosure;Holding the Burden; and Feeling Heard and Held. These demonstrated both the range of potential harms and burdens associated with disclosures of racial trauma in therapy, and examples of meaningful, validating therapist responses to disclosure.
Conclusions
Therapists, regardless of racial heritage, have the potential to both perpetuate harm and provide meaningful support in response to disclosures of racial trauma. Racial reflexivity and education on racism and racial trauma are essential to ethical and antiracist therapeutic practice, and crucial to safeguarding racially minoritised clients from racial harm in therapy. These must be embedded in training, practice and policy for meaningful improvements in racially minoritised clients' experiences of therapy to occur.
{"title":"Disclosing racial trauma in psychological therapy: Exploring the experiences of racially minoritised people in the UK","authors":"Nicole K. S. Samuel, Laura M. Simonds","doi":"10.1111/papt.12592","DOIUrl":"10.1111/papt.12592","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Exposure to racism is repeatedly experienced by individuals from racially minoritised backgrounds, and has a range of negative emotional, physical and social consequences; however, its traumatising effects are under-recognised. Further, psychological therapists often lack sufficient knowledge, training and confidence to sensitively manage conversations about racism. As this has important implications for the standards of care this population receives, this study explored how racially minoritised clients experience disclosing, or attempting to disclose racial trauma in psychological therapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>The study utilised an online qualitative survey design.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Participants were 28 adults who identified as belonging to minoritised racial groups and had engaged in psychological therapy in the UK. Therapy spanned a range of modalities, and providers included the NHS, private therapists/organisations, charities and university services. Data were analysed using thematic analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Three superordinate themes were constructed: <i>The Dangers of Disclosure</i><i>;</i> <i>Holding the Burden</i>; and <i>Feeling Heard and Held</i>. These demonstrated both the range of potential harms and burdens associated with disclosures of racial trauma in therapy, and examples of meaningful, validating therapist responses to disclosure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Therapists, regardless of racial heritage, have the potential to both perpetuate harm and provide meaningful support in response to disclosures of racial trauma. Racial reflexivity and education on racism and racial trauma are essential to ethical and antiracist therapeutic practice, and crucial to safeguarding racially minoritised clients from racial harm in therapy. These must be embedded in training, practice and policy for meaningful improvements in racially minoritised clients' experiences of therapy to occur.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54539,"journal":{"name":"Psychology and Psychotherapy-Theory Research and Practice","volume":"98 4","pages":"859-883"},"PeriodicalIF":2.7,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://bpspsychub.onlinelibrary.wiley.com/doi/epdf/10.1111/papt.12592","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bipolar disorder (BD) is a severe and enduring mental health condition that persists into older adulthood. The number of people living with BD into later life is set to increase as our population ages and awareness of the condition increases. BD in later life may present with additional challenges, such as increased physical health comorbidities and poorer cognitive function. Despite these additional challenges, there has been a paucity of research focused specifically on the treatment needs of older people with BD, highlighted by several review papers. In comparison, the last 30 years have witnessed a rapid development of psychological treatments for younger people with BD.
Methods
The authors completed a literature review of peer-reviewed journal articles reporting on psychological therapies developed specifically for older adults with BD. The authors also considered adaptations to psychological therapies that may benefit this population.
Results
This review highlighted that there is limited available research investigating the efficacy of psychological treatments for older adults with BD, despite their unique care needs. The available evidence demonstrated the importance of adapting psychological interventions to meet this client group's needs and outlined potentially beneficial adaptations, such as increasing the flexibility of treatment, taking into account health-related and symptom changes, and developing treatments in consultation with older adults with BD.
Conclusions
Improved attention and awareness of the challenges faced by older adults with BD is warranted. The development of tailored psychological treatments for this group may help reduce the significant inequalities they currenty face.
{"title":"Psychological therapies for bipolar disorder in later life: Current evidence, practice and future directions","authors":"Elizabeth Tyler, Aaron Warner","doi":"10.1111/papt.12593","DOIUrl":"10.1111/papt.12593","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Bipolar disorder (BD) is a severe and enduring mental health condition that persists into older adulthood. The number of people living with BD into later life is set to increase as our population ages and awareness of the condition increases. BD in later life may present with additional challenges, such as increased physical health comorbidities and poorer cognitive function. Despite these additional challenges, there has been a paucity of research focused specifically on the treatment needs of older people with BD, highlighted by several review papers. In comparison, the last 30 years have witnessed a rapid development of psychological treatments for younger people with BD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The authors completed a literature review of peer-reviewed journal articles reporting on psychological therapies developed specifically for older adults with BD. The authors also considered adaptations to psychological therapies that may benefit this population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>This review highlighted that there is limited available research investigating the efficacy of psychological treatments for older adults with BD, despite their unique care needs. The available evidence demonstrated the importance of adapting psychological interventions to meet this client group's needs and outlined potentially beneficial adaptations, such as increasing the flexibility of treatment, taking into account health-related and symptom changes, and developing treatments in consultation with older adults with BD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Improved attention and awareness of the challenges faced by older adults with BD is warranted. The development of tailored psychological treatments for this group may help reduce the significant inequalities they currenty face.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54539,"journal":{"name":"Psychology and Psychotherapy-Theory Research and Practice","volume":"98 3","pages":"821-831"},"PeriodicalIF":2.7,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://bpspsychub.onlinelibrary.wiley.com/doi/epdf/10.1111/papt.12593","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143782024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Charlotte Hill, Vasilis S. Vasiliou, Fuschia M. Sirois, Olivia Hughes, Andrew R. Thompson
Objective
Attachment might shape the extent to which a person is self-compassionate. Despite the plethora of research examining attachment and self-compassion, no previous systematic review has quantified the magnitude of the associations between self-compassion and different attachment dimensions.
Design
Random-effects meta-analyses examined the magnitude of the associations of self-compassion with anxious, avoidant, and secure attachment, using correlational effects (r-value). Moderator analyses tested whether the effects varied as a function of participant age, sex, population type (students vs. community sample) and attachment measure used within studies.
Methods
A systematic search of the literature using SCOPUS, Web of Science, and CINAHL databases retrieved 37 eligible studies.
Results
The meta-analyses revealed a medium effect size for the positive association between self-compassion with secure attachment, ravg = .395, 95% CI [0.248, 0.524], and medium and small effect sizes for the negative associations with anxious attachment, ravg = −.282, 95% CI [−0.329, −0.233], and avoidant attachment, ravg = −.280, 95% CI [−0.320, −0.240]. Moderator analyses indicate that the magnitude of associations with avoidant attachment varied as a function of participant age and population type (students vs. community samples).
Conclusions
The findings suggest differential associations between self-compassion and attachment dimensions. Self-compassion was positively associated with secure attachment, while the reverse was found for insecure attachment. Negative associations between self-compassion and avoidant attachment were larger for older individuals. Ageing populations may be vulnerable to lower self-compassion when already more prone to experiencing avoidant attachment. Compassion-focused therapy may be an effective therapeutic option when working with individuals reliant on anxious or avoidant attachment dimensions.
{"title":"A meta-analysis of self-compassion and attachment in adults","authors":"Charlotte Hill, Vasilis S. Vasiliou, Fuschia M. Sirois, Olivia Hughes, Andrew R. Thompson","doi":"10.1111/papt.12590","DOIUrl":"10.1111/papt.12590","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Attachment might shape the extent to which a person is self-compassionate. Despite the plethora of research examining attachment and self-compassion, no previous systematic review has quantified the magnitude of the associations between self-compassion and different attachment dimensions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Random-effects meta-analyses examined the magnitude of the associations of self-compassion with anxious, avoidant, and secure attachment, using correlational effects (<i>r</i>-value). Moderator analyses tested whether the effects varied as a function of participant age, sex, population type (students vs. community sample) and attachment measure used within studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic search of the literature using SCOPUS, Web of Science, and CINAHL databases retrieved 37 eligible studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The meta-analyses revealed a medium effect size for the positive association between self-compassion with secure attachment, <i>r</i><sub>avg</sub> = .395, 95% CI [0.248, 0.524], and medium and small effect sizes for the negative associations with anxious attachment, <i>r</i><sub>avg</sub> = −.282, 95% CI [−0.329, −0.233], and avoidant attachment, <i>r</i><sub>avg</sub> = −.280, 95% CI [−0.320, −0.240]. Moderator analyses indicate that the magnitude of associations with avoidant attachment varied as a function of participant age and population type (students vs. community samples).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The findings suggest differential associations between self-compassion and attachment dimensions. Self-compassion was positively associated with secure attachment, while the reverse was found for insecure attachment. Negative associations between self-compassion and avoidant attachment were larger for older individuals. Ageing populations may be vulnerable to lower self-compassion when already more prone to experiencing avoidant attachment. Compassion-focused therapy may be an effective therapeutic option when working with individuals reliant on anxious or avoidant attachment dimensions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54539,"journal":{"name":"Psychology and Psychotherapy-Theory Research and Practice","volume":"98 4","pages":"833-858"},"PeriodicalIF":2.7,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://bpspsychub.onlinelibrary.wiley.com/doi/epdf/10.1111/papt.12590","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143782007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Paul Gilbert, Jaskaran Basran, Ptarmigan Plowright, Kelly Morter, Malcolm B. Schofield, Jean Gilbert
<div> <section> <h3> Background</h3> <p>It is clinically recognised that some people find it difficult to engage with, or commit to, self-help for life difficulties. This may be due to various reasons such as experiences of helplessness, feeling overwhelmed and lacking skills, and low confidence in the process. Another reason can be beliefs of ‘needing others’ to bring change about; that they are not able to do it for themselves and are ‘hoping and waiting’ for others to ‘rescue’ them.</p> </section> <section> <h3> Objectives</h3> <p>This study developed a new self-report scale to explore people's experiences of hoping and waiting to be rescued from distressing mental states. Second, we sought to explore how this orientation links to mental health, social relating, early life experiences, and emotion dysregulation.</p> </section> <section> <h3> Methods</h3> <p>The scale comprised 18 items derived from clinical experiences and was completed online by two general population samples from the United Kingdom (total <i>n</i> = 445). Participants also completed measures of emotion dysregulation, reassurance-seeking, depression, anxiety, stress, self-other relating, social comparison, social safeness, early memories of warmth and parental bonding.</p> </section> <section> <h3> Results</h3> <p>Exploratory and confirmatory factor analyses revealed a good factor structure that separated into two key themes: 1. Hoping and waiting for rescue from others and 2. Self-reliance. Hoping and waiting for rescue was negatively correlated with self-reliance. It was also correlated with parental over-protection (but not care), lack of feeling socially safe, higher reassurance-seeking, depression, anxiety, stress, and emotion dysregulation. Network analysis revealed a stable network in which hoping and waiting for rescue is a central node with direct connections to variables of mental health, social relating, and early life experiences. The scales demonstrated good test–retest reliability and internal consistency.</p> </section> <section> <h3> Conclusions</h3> <p>This study suggests that individuals who feel they need others to rescue them from distressing mental states are less oriented to self-reliance and self-help. Moreover, this coping style is associated with a range of mental health difficulties. Therapists can be alert to these difficulties regarding why clients might not engage in self-help and help clients address them, including linking them to other issues suc
{"title":"Hoping and waiting for rescue: Concepts, scale development and process","authors":"Paul Gilbert, Jaskaran Basran, Ptarmigan Plowright, Kelly Morter, Malcolm B. Schofield, Jean Gilbert","doi":"10.1111/papt.12588","DOIUrl":"10.1111/papt.12588","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>It is clinically recognised that some people find it difficult to engage with, or commit to, self-help for life difficulties. This may be due to various reasons such as experiences of helplessness, feeling overwhelmed and lacking skills, and low confidence in the process. Another reason can be beliefs of ‘needing others’ to bring change about; that they are not able to do it for themselves and are ‘hoping and waiting’ for others to ‘rescue’ them.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study developed a new self-report scale to explore people's experiences of hoping and waiting to be rescued from distressing mental states. Second, we sought to explore how this orientation links to mental health, social relating, early life experiences, and emotion dysregulation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The scale comprised 18 items derived from clinical experiences and was completed online by two general population samples from the United Kingdom (total <i>n</i> = 445). Participants also completed measures of emotion dysregulation, reassurance-seeking, depression, anxiety, stress, self-other relating, social comparison, social safeness, early memories of warmth and parental bonding.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Exploratory and confirmatory factor analyses revealed a good factor structure that separated into two key themes: 1. Hoping and waiting for rescue from others and 2. Self-reliance. Hoping and waiting for rescue was negatively correlated with self-reliance. It was also correlated with parental over-protection (but not care), lack of feeling socially safe, higher reassurance-seeking, depression, anxiety, stress, and emotion dysregulation. Network analysis revealed a stable network in which hoping and waiting for rescue is a central node with direct connections to variables of mental health, social relating, and early life experiences. The scales demonstrated good test–retest reliability and internal consistency.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study suggests that individuals who feel they need others to rescue them from distressing mental states are less oriented to self-reliance and self-help. Moreover, this coping style is associated with a range of mental health difficulties. Therapists can be alert to these difficulties regarding why clients might not engage in self-help and help clients address them, including linking them to other issues suc","PeriodicalId":54539,"journal":{"name":"Psychology and Psychotherapy-Theory Research and Practice","volume":"98 3","pages":"799-820"},"PeriodicalIF":2.7,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://bpspsychub.onlinelibrary.wiley.com/doi/epdf/10.1111/papt.12588","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To evaluate how treatment credibility, the expectancy of improvement and the relationship with the therapist (the working alliance) change in relation to symptoms in cognitive behaviour therapy (CBT) for pathological health anxiety.
Design
Secondary study of a randomised controlled trial of Internet-delivered (n = 102) and face-to-face CBT (n = 102) for health anxiety.
Methods
The trial was conducted at a primary health care clinic in Stockholm, Sweden, between December 2014 and July 2018. Both treatments lasted 12 weeks. Health anxiety was measured using the 18-item Health Anxiety Inventory. Credibility/expectancy (Borkovec credibility/expectancy scale) and the strength of the working alliance (Working Alliance Inventory) were self-reported by the participant at weeks two and eight. Symptom slopes from a linear mixed model were related to these process scales.
Results
Correlations between the process variables (credibility/expectancy, working alliance) and the overall, 12-week pre- to post-treatment, reduction in health anxiety were small to moderate, and slightly higher based on data from week 8 (rs = 0.33–0.41) than week 2 (rs = 0.17–0.29). In the whole sample, week 2 credibility/expectancy and working alliance were significant predictors of subsequent symptom reduction. In secondary subgroup analyses, the process variables predicted improvement in Internet-delivered CBT, but not in face-to-face CBT. Direct between-format tests were not significant. Week 8 credibility/expectancy and working alliance were more closely related to previous than subsequent symptom reduction.
Conclusions
The patient's early ratings of credibility/expectancy and the strength of the working alliance appear to be predictive of subsequent symptom reduction. Later ratings appear to be of more limited predictive utility.
{"title":"Associations between treatment credibility, patient expectancies, working alliance and symptom trajectory in cognitive behaviour therapy for pathological health anxiety","authors":"Erland Axelsson, Erik Hedman-Lagerlöf","doi":"10.1111/papt.12591","DOIUrl":"10.1111/papt.12591","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To evaluate how treatment credibility, the expectancy of improvement and the relationship with the therapist (the working alliance) change in relation to symptoms in cognitive behaviour therapy (CBT) for pathological health anxiety.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Secondary study of a randomised controlled trial of Internet-delivered (<i>n</i> = 102) and face-to-face CBT (<i>n</i> = 102) for health anxiety.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The trial was conducted at a primary health care clinic in Stockholm, Sweden, between December 2014 and July 2018. Both treatments lasted 12 weeks. Health anxiety was measured using the 18-item Health Anxiety Inventory. Credibility/expectancy (Borkovec credibility/expectancy scale) and the strength of the working alliance (Working Alliance Inventory) were self-reported by the participant at weeks two and eight. Symptom slopes from a linear mixed model were related to these process scales.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Correlations between the process variables (credibility/expectancy, working alliance) and the overall, 12-week pre- to post-treatment, reduction in health anxiety were small to moderate, and slightly higher based on data from week 8 (<i>r</i>s = 0.33–0.41) than week 2 (<i>r</i>s = 0.17–0.29). In the whole sample, week 2 credibility/expectancy and working alliance were significant predictors of subsequent symptom reduction. In secondary subgroup analyses, the process variables predicted improvement in Internet-delivered CBT, but not in face-to-face CBT. Direct between-format tests were not significant. Week 8 credibility/expectancy and working alliance were more closely related to previous than subsequent symptom reduction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The patient's early ratings of credibility/expectancy and the strength of the working alliance appear to be predictive of subsequent symptom reduction. Later ratings appear to be of more limited predictive utility.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54539,"journal":{"name":"Psychology and Psychotherapy-Theory Research and Practice","volume":"98 3","pages":"779-798"},"PeriodicalIF":2.7,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://bpspsychub.onlinelibrary.wiley.com/doi/epdf/10.1111/papt.12591","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This study investigates the role of mentalization and attachment in the development of schizotypy into aberrant salience. Specifically, we examine how disruptions in these socio-cognitive capacities interact with multidimensional schizotypy to influence self-fragmentation, emotional instability and social detachment.
Method
Study variables were measured using self-report scales. A two-wave cohort study design was implemented with a 9-month assessment interval. The cross-sectional and longitudinal associations between mentalizing, attachment, negative affect, aberrant salience and schizotypy were estimated using network modelling.
Results
The study involved 312 participants aged 18–37 years, with 77% identifying as female and 57% receiving mental health treatment during the follow-up period. Results indicated that mentalizing capacity was central in linking concurrent negative affect, attachment and psychosis risk and served as a temporal bridge connecting multiple dimensions of psychosis risk.
Conclusion
Mentalizing difficulties can heighten psychosis risk by maintaining affective dysregulation and consolidating schizotypy. The results may be influenced by potential sampling errors, as indicated by the analyses of network stability and accuracy. Interventions promoting mentalizing capacity may attenuate psychosis risk.
{"title":"Modelling the longitudinal associations between schizotypy and aberrant salience: The role of mentalization and attachment","authors":"Ercan Ozdemir, Angus MacBeth, Helen Griffiths","doi":"10.1111/papt.12589","DOIUrl":"10.1111/papt.12589","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study investigates the role of mentalization and attachment in the development of schizotypy into aberrant salience. Specifically, we examine how disruptions in these socio-cognitive capacities interact with multidimensional schizotypy to influence self-fragmentation, emotional instability and social detachment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Study variables were measured using self-report scales. A two-wave cohort study design was implemented with a 9-month assessment interval. The cross-sectional and longitudinal associations between mentalizing, attachment, negative affect, aberrant salience and schizotypy were estimated using network modelling.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study involved 312 participants aged 18–37 years, with 77% identifying as female and 57% receiving mental health treatment during the follow-up period. Results indicated that mentalizing capacity was central in linking concurrent negative affect, attachment and psychosis risk and served as a temporal bridge connecting multiple dimensions of psychosis risk.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Mentalizing difficulties can heighten psychosis risk by maintaining affective dysregulation and consolidating schizotypy. The results may be influenced by potential sampling errors, as indicated by the analyses of network stability and accuracy. Interventions promoting mentalizing capacity may attenuate psychosis risk.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54539,"journal":{"name":"Psychology and Psychotherapy-Theory Research and Practice","volume":"98 3","pages":"763-778"},"PeriodicalIF":2.7,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://bpspsychub.onlinelibrary.wiley.com/doi/epdf/10.1111/papt.12589","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jelka Alice Berger, Lilli Katharina Kalmbach, Nadja Samia Bahr, Bernhard Strauß, Antje Gumz
Objectives
This study aimed to examine therapists' personal involvement in alliance ruptures, considering their level of experience by capturing their subjective perceptions through qualitative interviews.
Method
We conducted 23 interviews, which were subsequently analysed using Consensual Qualitative Research (CQR; American Psychological Association, 2012). Following that, group differences based on therapeutic experience were examined.
Results
The data analysis revealed a total of five overarching domains: characteristics of the initial therapeutic relationship, emotional reactions, attempts to repair the rupture, involvement in the rupture, and benefits and challenges of supervision, intervision, and personal therapy in managing ruptures. Although therapists generally considered the clients' disturbance as a contribution, 20 therapists also reported their own biographical issues that were triggered during the rupture. Experienced therapists reported biographical triggers more frequently and mentioned self-disclosure more often in dealing with the rupture than novice therapists.
Conclusion
The results of the qualitative study suggest that experienced therapists demonstrate a deeper personal involvement in reflecting on the causes of ruptures and in their efforts to repair them. It appears that experienced therapists have a stronger integration of personal and professional selves, whereas novice therapists tend to keep the two more separate. This should be considered in training and practice by dismantling the sharp divide between professional (supervision) and personal (personal therapy) development.
{"title":"Between personal and professional involvement: A qualitative interview study on insights of novice and experienced therapists in Alliance ruptures","authors":"Jelka Alice Berger, Lilli Katharina Kalmbach, Nadja Samia Bahr, Bernhard Strauß, Antje Gumz","doi":"10.1111/papt.12587","DOIUrl":"10.1111/papt.12587","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aimed to examine therapists' personal involvement in alliance ruptures, considering their level of experience by capturing their subjective perceptions through qualitative interviews.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>We conducted 23 interviews, which were subsequently analysed using Consensual Qualitative Research (CQR; American Psychological Association, 2012). Following that, group differences based on therapeutic experience were examined.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The data analysis revealed a total of five overarching domains: characteristics of the initial therapeutic relationship, emotional reactions, attempts to repair the rupture, involvement in the rupture, and benefits and challenges of supervision, intervision, and personal therapy in managing ruptures. Although therapists generally considered the clients' disturbance as a contribution, 20 therapists also reported their own biographical issues that were triggered during the rupture. Experienced therapists reported biographical triggers more frequently and mentioned self-disclosure more often in dealing with the rupture than novice therapists.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The results of the qualitative study suggest that experienced therapists demonstrate a deeper personal involvement in reflecting on the causes of ruptures and in their efforts to repair them. It appears that experienced therapists have a stronger integration of personal and professional selves, whereas novice therapists tend to keep the two more separate. This should be considered in training and practice by dismantling the sharp divide between professional (supervision) and personal (personal therapy) development.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54539,"journal":{"name":"Psychology and Psychotherapy-Theory Research and Practice","volume":"98 3","pages":"743-762"},"PeriodicalIF":2.7,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Compassion-focused therapy (CFT) has an emerging evidence base and is becoming an increasingly popular therapeutic modality. The journey through later life poses individuals with various challenges to navigate, including loss of roles and relationships, deteriorating physical health and cognition and death of friends and family members. In addition to any unprocessed challenges lived through in earlier life. Later life is also a unique period where reflection on one's life experiences and choices can occur, which can lead to feelings of regret, disappointment and shame for some, whilst simultaneously facing ageism and barriers to accessing therapy. CFT is well-placed to facilitate older people to face these challenges by exploring their relationship to themselves and others as they navigate ageing. This is increasingly important as we are living longer and more and more older people develop conditions where they will require care. Developing greater compassion for oneself and allowing ourselves to be cared for by others may facilitate a smoother journey and minimise distress.
Methodology
The paper summarises the published work trialling CFT across a range of older patient groups, which shows that older people are open to a CFT approach, they find it an acceptable intervention and it has had wide-reaching benefits. There remains a paucity of high-quality research delivering CFT to older people which limits our conclusions of its effectiveness.
Recommendations
Recommendations of ways in which CFT can be adapted for older people and those living with dementia, consistent with Gilbert's therapeutic themes (2022), are provided.
{"title":"Compassion focused therapy for older people: Why it is needed and adaptations for clinical practice","authors":"Rebecca Poz, Catriona Craig","doi":"10.1111/papt.12579","DOIUrl":"10.1111/papt.12579","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Compassion-focused therapy (CFT) has an emerging evidence base and is becoming an increasingly popular therapeutic modality. The journey through later life poses individuals with various challenges to navigate, including loss of roles and relationships, deteriorating physical health and cognition and death of friends and family members. In addition to any unprocessed challenges lived through in earlier life. Later life is also a unique period where reflection on one's life experiences and choices can occur, which can lead to feelings of regret, disappointment and shame for some, whilst simultaneously facing ageism and barriers to accessing therapy. CFT is well-placed to facilitate older people to face these challenges by exploring their relationship to themselves and others as they navigate ageing. This is increasingly important as we are living longer and more and more older people develop conditions where they will require care. Developing greater compassion for oneself and allowing ourselves to be cared for by others may facilitate a smoother journey and minimise distress.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methodology</h3>\u0000 \u0000 <p>The paper summarises the published work trialling CFT across a range of older patient groups, which shows that older people are open to a CFT approach, they find it an acceptable intervention and it has had wide-reaching benefits. There remains a paucity of high-quality research delivering CFT to older people which limits our conclusions of its effectiveness.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Recommendations</h3>\u0000 \u0000 <p>Recommendations of ways in which CFT can be adapted for older people and those living with dementia, consistent with Gilbert's therapeutic themes (2022), are provided.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54539,"journal":{"name":"Psychology and Psychotherapy-Theory Research and Practice","volume":"98 3","pages":"726-742"},"PeriodicalIF":2.7,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://bpspsychub.onlinelibrary.wiley.com/doi/epdf/10.1111/papt.12579","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The purpose of this study is to critically reflect on the value of the House-Tree-Fire-Water-Person (HTFWP) drawing as a tool to engage the parents of children aged 10–12 in sandplay therapy for Generalized Anxiety Disorder (GAD). To do so, we draw on empirical work that addressed gaps in the existing parent-psychologist alliance literature by exploring the usefulness of sharing the HTFWP drawing series with parents at feedback sessions.
Methods
We employed an instrumental, multiple case study design. The sample consisted of 7 cases, involving parents (n = 9) and child-clients referred for GAD (n = 7). Parent-generated data included the verbatim transcripts of initial semi-structured interviews, three HTFWP drawing elicitation conversations (i.e. HTFWP-facilitated feedback sessions) and a post-intervention semi-structured interview. Child-generated data included three HTFWP drawings and child-driven explanations of these drawings. Psychologist-generated data included journal-recorded reflections and process notes. Using reflexive thematic analysis, we identified patterns in these data.
Results
Findings suggest that an alliance created between parent and psychologist through sharing the HTFWP drawing series with parents was a win for everyone (parents, child and psychologist). This ‘win-win’ situation included enhanced care for the child, bolstered parental support and heightened efficacy for the psychologist.
Conclusion
The HTFWP drawing has high potential to support the therapeutic process, with emphasis on its facilitation of a parent –psychologist alliance and spillover benefits for parents, the treating psychologist and the child-client.
{"title":"The benefits of sharing house-tree-fire-water-person drawings with parents when their anxious child is in sandplay therapy","authors":"Judith Bredekamp, Linda Theron","doi":"10.1111/papt.12586","DOIUrl":"10.1111/papt.12586","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The purpose of this study is to critically reflect on the value of the House-Tree-Fire-Water-Person (HTFWP) drawing as a tool to engage the parents of children aged 10–12 in sandplay therapy for Generalized Anxiety Disorder (GAD). To do so, we draw on empirical work that addressed gaps in the existing parent-psychologist alliance literature by exploring the usefulness of sharing the HTFWP drawing series with parents at feedback sessions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We employed an instrumental, multiple case study design. The sample consisted of 7 cases, involving parents (<i>n</i> = 9) and child-clients referred for GAD (<i>n</i> = 7). Parent-generated data included the verbatim transcripts of initial semi-structured interviews, three HTFWP drawing elicitation conversations (i.e. HTFWP-facilitated feedback sessions) and a post-intervention semi-structured interview. Child-generated data included three HTFWP drawings and child-driven explanations of these drawings. Psychologist-generated data included journal-recorded reflections and process notes. Using reflexive thematic analysis, we identified patterns in these data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Findings suggest that an alliance created between parent and psychologist through sharing the HTFWP drawing series with parents was a win for everyone (parents, child and psychologist). This ‘win-win’ situation included enhanced care for the child, bolstered parental support and heightened efficacy for the psychologist.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The HTFWP drawing has high potential to support the therapeutic process, with emphasis on its facilitation of a parent –psychologist alliance and spillover benefits for parents, the treating psychologist and the child-client.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54539,"journal":{"name":"Psychology and Psychotherapy-Theory Research and Practice","volume":"98 3","pages":"701-725"},"PeriodicalIF":2.7,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://bpspsychub.onlinelibrary.wiley.com/doi/epdf/10.1111/papt.12586","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Reem Alharbi, Susanne Langer, Cheryl Hunter, Nusrat Husain, Filippo Varese, Peter James Taylor
Background
Previous research suggests that complex trauma and Complex Posttraumatic Stress Disorder (C-PTSD) experiences can contribute to the risk of developing and possibly maintaining Non-Suicidal Self-Injury (NSSI). Individuals' accounts of how complex trauma and subsequent development of C-PTSD experiences can contribute to the difficulties of NSSI remain underexplored. This qualitative study aimed to explore in-depth: (1) how individuals with C-PTSD experiences narrate life conditions and events that influenced their difficulties with NSSI over time and (2) what factors the individuals perceived to have helped the process of controlling their experience of NSSI.
Methodology
This novel qualitative narrative study used an adapted version of the Free Association Narrative Interviewing Method (FANIM) to facilitate the exploration of the lived experiences of eight individuals aged 20–56 years. The initial data analysis involved an interpretation of individuals' stories followed by a thematic narrative analysis of 14 interviews to explore the shared and unique experiences narrated by participants.
Results
Four primary themes were established: (1) Voiceless, invisible, and out of control within the dysfunctional system during childhood, (2) “shaky foundation” leading to future traumas, (3) the link between complex trauma, mental health difficulties, and NSSI, and (4) Regaining autonomy and a sense of control in managing NSSI. The findings highlight the importance of adopting a flexible and person-centred treatment that addresses the specific needs of these individuals. The treatment plan should empower individuals to improve their control and autonomy and support them to live a meaningful life.
{"title":"“My entire life has moulded the person that I am”: Narrations of non-suicidal self-injury and complex trauma in individuals with complex posttraumatic stress experiences","authors":"Reem Alharbi, Susanne Langer, Cheryl Hunter, Nusrat Husain, Filippo Varese, Peter James Taylor","doi":"10.1111/papt.12583","DOIUrl":"10.1111/papt.12583","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Previous research suggests that complex trauma and Complex Posttraumatic Stress Disorder (C-PTSD) experiences can contribute to the risk of developing and possibly maintaining Non-Suicidal Self-Injury (NSSI). Individuals' accounts of how complex trauma and subsequent development of C-PTSD experiences can contribute to the difficulties of NSSI remain underexplored. This qualitative study aimed to explore in-depth: (1) how individuals with C-PTSD experiences narrate life conditions and events that influenced their difficulties with NSSI over time and (2) what factors the individuals perceived to have helped the process of controlling their experience of NSSI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methodology</h3>\u0000 \u0000 <p>This novel qualitative narrative study used an adapted version of the Free Association Narrative Interviewing Method (FANIM) to facilitate the exploration of the lived experiences of eight individuals aged 20–56 years. The initial data analysis involved an interpretation of individuals' stories followed by a thematic narrative analysis of 14 interviews to explore the shared and unique experiences narrated by participants.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Four primary themes were established: (1) Voiceless, invisible, and out of control within the dysfunctional system during childhood, (2) “shaky foundation” leading to future traumas, (3) the link between complex trauma, mental health difficulties, and NSSI, and (4) Regaining autonomy and a sense of control in managing NSSI. The findings highlight the importance of adopting a flexible and person-centred treatment that addresses the specific needs of these individuals. The treatment plan should empower individuals to improve their control and autonomy and support them to live a meaningful life.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54539,"journal":{"name":"Psychology and Psychotherapy-Theory Research and Practice","volume":"98 3","pages":"683-700"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://bpspsychub.onlinelibrary.wiley.com/doi/epdf/10.1111/papt.12583","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143532164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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