Amy L. Zarandi, Josie F. A. Millar, Erin Waites, Judith L. Stevenson
Objective
Trichotillomania (TTM) is a condition in which individuals repeatedly pull out their hair despite adverse consequences. Several models have suggested underlying processes, with a central feature of hairpulling being an external means to regulate internal states. The frustrated action model suggests that certain affective states arise from perfectionistic beliefs and an overactive, overprepared style of planning, triggering episodes of hairpulling. To date, there is limited research investigating perfectionism in people with TTM. The current study investigated the experiences of hairpulling behaviour in people with TTM, with specific attention given to perfectionism.
Design
A qualitative methodology was employed.
Method
Twenty participants completed online screening questionnaires and were interviewed via an online communication platform. Data were analysed using reflexive thematic analysis.
Results
The findings identified the role and development of maladaptive perfectionism in hairpulling. Furthermore, a maintenance cycle is proposed, in which hairpulling is maintained via the positive function it plays in preventing confirmation of self-critical cognitions.
Conclusions
The results indicate that interventions targeting perfectionism specifically in individuals with TTM could be beneficial. Furthermore, clinicians should be sensitive to the positive functions that hairpulling can serve for people with TTM.
{"title":"A qualitative study exploring the role of perfectionism in trichotillomania","authors":"Amy L. Zarandi, Josie F. A. Millar, Erin Waites, Judith L. Stevenson","doi":"10.1111/papt.12597","DOIUrl":"10.1111/papt.12597","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Trichotillomania (TTM) is a condition in which individuals repeatedly pull out their hair despite adverse consequences. Several models have suggested underlying processes, with a central feature of hairpulling being an external means to regulate internal states. The frustrated action model suggests that certain affective states arise from perfectionistic beliefs and an overactive, overprepared style of planning, triggering episodes of hairpulling. To date, there is limited research investigating perfectionism in people with TTM. The current study investigated the experiences of hairpulling behaviour in people with TTM, with specific attention given to perfectionism.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A qualitative methodology was employed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Twenty participants completed online screening questionnaires and were interviewed via an online communication platform. Data were analysed using reflexive thematic analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The findings identified the role and development of maladaptive perfectionism in hairpulling. Furthermore, a maintenance cycle is proposed, in which hairpulling is maintained via the positive function it plays in preventing confirmation of self-critical cognitions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The results indicate that interventions targeting perfectionism specifically in individuals with TTM could be beneficial. Furthermore, clinicians should be sensitive to the positive functions that hairpulling can serve for people with TTM.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54539,"journal":{"name":"Psychology and Psychotherapy-Theory Research and Practice","volume":"98 4","pages":"901-917"},"PeriodicalIF":2.7,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://bpspsychub.onlinelibrary.wiley.com/doi/epdf/10.1111/papt.12597","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082034","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}
Psychologists can bring social justice into their professional presence on social media, with the public perceiving health care professionals as a reputable source of information online. This study aimed to explore practitioner psychologists' use of social media for social justice advocacy as a mental health influencer.
Methods
Twelve UK-based practitioner psychologists were interviewed who had an Instagram account that they used as a mental health influencer. The semi-structured interview transcripts were analysed using reflexive thematic analysis.
Results
Systemic issues have motivated many psychologists to begin work as a mental health influencer. There are challenges between the use of social media for social justice advocacy and for business purposes to promote private practice. Psychologists can use social media to share psychoeducation to increase mental health literacy and encourage access to therapy. The accessibility of this content is particularly valuable for people from marginalised communities and for people on long waiting lists to access mental health support. Psychologists can use social media to raise critical consciousness of social inequalities and reduce an individual's sense of self-blame.
Conclusion
Irrespective of working in the public sector or private practice, there are opportunities for psychologists to use social media as a resource for social justice advocacy.
{"title":"‘I think that we can effect change’: Psychologist use of social media for social justice advocacy","authors":"Ella White, Terry Hanley","doi":"10.1111/papt.12601","DOIUrl":"10.1111/papt.12601","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Psychologists can bring social justice into their professional presence on social media, with the public perceiving health care professionals as a reputable source of information online. This study aimed to explore practitioner psychologists' use of social media for social justice advocacy as a mental health influencer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Twelve UK-based practitioner psychologists were interviewed who had an Instagram account that they used as a mental health influencer. The semi-structured interview transcripts were analysed using reflexive thematic analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Systemic issues have motivated many psychologists to begin work as a mental health influencer. There are challenges between the use of social media for social justice advocacy and for business purposes to promote private practice. Psychologists can use social media to share psychoeducation to increase mental health literacy and encourage access to therapy. The accessibility of this content is particularly valuable for people from marginalised communities and for people on long waiting lists to access mental health support. Psychologists can use social media to raise critical consciousness of social inequalities and reduce an individual's sense of self-blame.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Irrespective of working in the public sector or private practice, there are opportunities for psychologists to use social media as a resource for social justice advocacy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54539,"journal":{"name":"Psychology and Psychotherapy-Theory Research and Practice","volume":"98 4","pages":"884-900"},"PeriodicalIF":2.7,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://bpspsychub.onlinelibrary.wiley.com/doi/epdf/10.1111/papt.12601","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045131","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}
Purpose: This paper aims to build on a recent theoretical and empirical review of CFT for psychosis by outlining a more detailed account of how voice-hearing perceptions may be generated and triggered, and the implications for clinical practice. It also aims to provide a detailed and practical illustration of how CFT for voice-hearing is applied in therapy.
Method: This paper summarises the evolution-informed rationale for CFT for voice-hearing and integrates into this framework some major developments in cognitive neuroscience-namely predictive processing models of perception-to develop a richer account of the mechanisms and targets of CFT for voice-hearing. The clinical application of this model is demonstrated using a description of compassion-focused chairwork for voice-hearing.
Results: The enriched perceptual modelling of CFT for voice-hearing is complementary to the (evolution-informed) accounts in the existing CFT literature, while adding precision and utility when it comes to describing compassion-focused chairwork for voice-hearing and discussing some of the key clinical considerations for therapists wishing to use this method.
Conclusions: CFT for voice-hearing is an integrated biopsychosocial approach that indicates therapy targets linked to both sides of the voice-to-voice hearer relationship, to corresponding embodied and motivational states, and to the past traumas and conflicts that may drive these patterns. CFT chairwork is particularly well suited to addressing some of the perceptual, embodied and motivational drivers of voice-hearing experiences. We recommend the development of detailed intervention protocols for therapist guidance on specific techniques such as CFT chairwork, which can be used in future evaluation research.
{"title":"Compassion-focused chairwork for voice-hearing relationships, body triggers and motivational states.","authors":"Charles Heriot-Maitland, Tobyn Bell","doi":"10.1111/papt.12600","DOIUrl":"https://doi.org/10.1111/papt.12600","url":null,"abstract":"<p><strong>Purpose: </strong>This paper aims to build on a recent theoretical and empirical review of CFT for psychosis by outlining a more detailed account of how voice-hearing perceptions may be generated and triggered, and the implications for clinical practice. It also aims to provide a detailed and practical illustration of how CFT for voice-hearing is applied in therapy.</p><p><strong>Method: </strong>This paper summarises the evolution-informed rationale for CFT for voice-hearing and integrates into this framework some major developments in cognitive neuroscience-namely predictive processing models of perception-to develop a richer account of the mechanisms and targets of CFT for voice-hearing. The clinical application of this model is demonstrated using a description of compassion-focused chairwork for voice-hearing.</p><p><strong>Results: </strong>The enriched perceptual modelling of CFT for voice-hearing is complementary to the (evolution-informed) accounts in the existing CFT literature, while adding precision and utility when it comes to describing compassion-focused chairwork for voice-hearing and discussing some of the key clinical considerations for therapists wishing to use this method.</p><p><strong>Conclusions: </strong>CFT for voice-hearing is an integrated biopsychosocial approach that indicates therapy targets linked to both sides of the voice-to-voice hearer relationship, to corresponding embodied and motivational states, and to the past traumas and conflicts that may drive these patterns. CFT chairwork is particularly well suited to addressing some of the perceptual, embodied and motivational drivers of voice-hearing experiences. We recommend the development of detailed intervention protocols for therapist guidance on specific techniques such as CFT chairwork, which can be used in future evaluation research.</p>","PeriodicalId":54539,"journal":{"name":"Psychology and Psychotherapy-Theory Research and Practice","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042698","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}
{"title":"Editorial acknowledgement","authors":"","doi":"10.1111/papt.12561","DOIUrl":"10.1111/papt.12561","url":null,"abstract":"","PeriodicalId":54539,"journal":{"name":"Psychology and Psychotherapy-Theory Research and Practice","volume":"98 2","pages":"549-552"},"PeriodicalIF":2.7,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143930284","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}
Purpose: To present a treatment protocol for Relating Therapy-a novel psychological intervention which supports adults to respond assertively to their distressing voice hearing experiences.
Method: This paper reports the background to the development of Relating Therapy. Thereafter, the four phases of the therapy are described: (1) exploring the hearer's relational landscape and identification of patterns of relating; (2) selection of a difficult relationship and a specific conversation, and re-scripting of the conversation; (3) introduction to and engagement with roleplays and (4) reflection, consolidation and preparing for the continuation of learning. Implementation issues are discussed, and the evidence base is reviewed.
Results: The findings from preliminary evaluations of Relating Therapy suggest that a definitive randomised controlled trial is feasible. Current evidence suggests that Relating Therapy is an acceptable and safe intervention that has the potential to generate benefits for hearers.
Conclusion: Learning to respond assertively may be beneficial to some adults who are distressed by hearing voices. A definitive randomised controlled trial is warranted to evaluate the clinical and cost-effectiveness of Relating Therapy and to explore the mechanisms through which any benefits might be generated.
{"title":"Relating Therapy for distressing voices: A treatment protocol.","authors":"Mark Hayward, Matthias Pilny, Tania Lincoln","doi":"10.1111/papt.12595","DOIUrl":"https://doi.org/10.1111/papt.12595","url":null,"abstract":"<p><strong>Purpose: </strong>To present a treatment protocol for Relating Therapy-a novel psychological intervention which supports adults to respond assertively to their distressing voice hearing experiences.</p><p><strong>Method: </strong>This paper reports the background to the development of Relating Therapy. Thereafter, the four phases of the therapy are described: (1) exploring the hearer's relational landscape and identification of patterns of relating; (2) selection of a difficult relationship and a specific conversation, and re-scripting of the conversation; (3) introduction to and engagement with roleplays and (4) reflection, consolidation and preparing for the continuation of learning. Implementation issues are discussed, and the evidence base is reviewed.</p><p><strong>Results: </strong>The findings from preliminary evaluations of Relating Therapy suggest that a definitive randomised controlled trial is feasible. Current evidence suggests that Relating Therapy is an acceptable and safe intervention that has the potential to generate benefits for hearers.</p><p><strong>Conclusion: </strong>Learning to respond assertively may be beneficial to some adults who are distressed by hearing voices. A definitive randomised controlled trial is warranted to evaluate the clinical and cost-effectiveness of Relating Therapy and to explore the mechanisms through which any benefits might be generated.</p>","PeriodicalId":54539,"journal":{"name":"Psychology and Psychotherapy-Theory Research and Practice","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143999930","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}
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}
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