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John C Norcross, Bruce E Wampold
The therapeutic relationship and responsiveness/treatment adaptations rightfully occupy a prominent, evidence-based place in any guidelines for the psychological treatment of trauma. In this light, we critique the misguided efforts of the American Psychological Association's (APA, 2017) Clinical Practice Guideline on Posttraumatic Stress Disorder in Adults to advance a biomedical model for psychotherapy and thus focus almost exclusively on treatment methods for particular disorders. Instead, the research evidence, clinical expertise, and patient preferences and culture (the necessary triumvirate of evidence-based practice) should converge on distinctive psychological guidelines that emphasize the therapy relationship, treatment adaptations, and individual therapist effects, all of which independently account for patient improvement more than the particular treatment method...
April 22, 2019: Psychotherapy
Andrés E Pérez-Rojas, Rebecca Brown, Alejandro Cervantes, Tania Valente, Steve R Pereira
There has been a growing recognition of the role that various aspects of culture play in the theory and practice of psychotherapy. One aspect of culture that has received little attention, however, is language. Specifically, we lack comprehensive understanding of the value bilingual clients find in expressing thoughts, feelings, and experiences in two languages. Research that enhances understanding of the role that bilingualism plays in psychotherapy may thus help improve the quality of services that bilingual clients receive...
April 18, 2019: Psychotherapy
Zac E Imel, Brian T Pace, Christina S Soma, Michael Tanana, Tad Hirsch, James Gibson, Panayiotis Georgiou, Shrikanth Narayanan, David C Atkins
Direct observation of psychotherapy and providing performance-based feedback is the gold-standard approach for training psychotherapists. At present, this requires experts and training human coding teams, which is slow, expensive, and labor intensive. Machine learning and speech signal processing technologies provide a way to scale up feedback in psychotherapy. We evaluated an initial proof of concept automated feedback system that generates motivational interviewing quality metrics and provides easy access to other session data (e...
April 8, 2019: Psychotherapy
April L Connery, Nancy L Murdock
Using family systems theory (Kerr & Bowen, 1988), interpersonal theory (Kiesler, 1996; Leary, 1957), and the interactional theory of countertransference (CT; Gelso & Hayes, 2007) as a framework, we investigated the influences of therapist personal factors (differentiation of self in relation to the family of origin; DoS) and client presentation as predictors of CT feelings and behaviors in response to a video analog client. Therapist-participants viewed either an interpersonally hostile-submissive or interpersonally hostile-dominant (HD) client...
March 28, 2019: Psychotherapy
Mindi N Thompson, Mun Yuk Chin, Molly Kring
There is negligible research exploring mental health clinicians' perceptions of clients based upon client social class and sexual orientation (McGarrity, 2014; Whitcomb & Walinsky, 2013). The purpose of this study was to examine how licensed mental health clinicians' perceptions of clients were influenced by a hypothetical client's social class and sexual orientation using a 2 (lower social class vs. higher social class) × 2 (lesbian vs. straight) quasi-experimental vignette-based design. Results from 257 practitioners demonstrated that the hypothetical client portrayed in the video was rated differently on levels of depression, anxiety, and flourishing, as well as job satisfaction and meaningful work...
March 25, 2019: Psychotherapy
Stephanie P B McLaughlin, Sarah Barkowski, Gary M Burlingame, Bernard Strauss, Jenny Rosendahl
Treatment guidelines for borderline personality disorder (BPD) recommend psychotherapy as an important, if not essential, component of patient care. The current study is a meta-analysis of randomized controlled trials comparing group psychotherapy for BPD with treatment as usual (TAU). We included moderator analysis to examine how outcomes differ based on group and patient characteristics, risk of bias variables, and treatment elements of the TAU comparison condition (e.g., whether psychotherapy was included)...
March 14, 2019: Psychotherapy
Désirée Schoenherr, Jane Paulick, Bernhard M Strauss, Anne-Katharina Deisenhofer, Brian Schwartz, Julian A Rubel, Wolfgang Lutz, Ulrich Stangier, Uwe Altmann
Premature termination is a problem in psychotherapy. In addition to the examination of demographic and clinical variables as predictors of dropout, research indicates the importance of dyadic variables. Nonverbal synchrony (e.g., movement synchrony) operationalizes the coordination of patient and therapist and is a promising candidate for predicting premature termination. This secondary data analysis included data on patients with social anxiety disorder ( N = 267) that were treated with > 20 sessions of cognitive-behavioral therapy or psychodynamic therapy...
March 14, 2019: Psychotherapy
Vicky Christina Hennissen, Reitske Meganck, Kimberly Van Nieuwenhove, Ufuoma Angelica Norman, Tom Loeys, Mattias Desmet
Drawing on Blatt's theory about personality styles, we examined therapists' affective experiences toward depressed patients with dependent (anaclitic) and self-critical (introjective) personality styles. In addition, we investigated the relationship between therapists' responses, symptom severity, and therapeutic change. Therapists (N = 8) completed the Therapist Response Questionnaire (TRQ) at 5 time points for 50 dependent (anaclitic) and 34 self-critical (introjective) patients (N = 84) over the course of 20-session therapies...
March 14, 2019: Psychotherapy
Akash Wasil, Katherine Venturo-Conerly, Rebecca Shingleton, John Weisz
Patients with eating disorders (EDs) often lack motivation to recover, and interventions designed to increase recovery motivation have not demonstrated to be effective. In fact, few studies have identified factors that increase recovery motivation in patients with EDs. We performed interviews with 13 women who recovered from EDs to identify factors that influenced their motivation to recover. Here, we present exploratory findings about a central theme from these interviews: the importance of hearing from others who had recovered from EDs (i...
March 14, 2019: Psychotherapy
John R Keefe, Zeeshan M Huque, Robert J DeRubeis, Jacques P Barber, Barbara L Milrod, Dianne L Chambless
In panic-focused psychodynamic psychotherapy (PFPP), exploration and interpretation of avoided and conflicted emotions and fantasies surrounding anxiety are thought to promote panic-specific reflective functioning (PSRF), which drives panic disorder improvements. Patient emotional expression within a session may be a marker of engaged processing and experiencing of affectively charged material. Degree of in-session expressed emotion, indicating both verbal and nonverbal emotions, was examined across three early therapy sessions for prediction of subsequent outcomes...
March 14, 2019: Psychotherapy
Edward J Alessi, Frank R Dillon, Rebecca Van Der Horn
In this study, we tested a conceptual model through which lesbian, gay, bisexual, and queer (LGBQ) clients' perceptions of their therapists' affirmative practices and the therapeutic relationship (i.e., working alliance and the real relationship) would correlate with psychological well-being. We hypothesized that the therapeutic relationship would mediate the relation between clients' perceptions of their therapists' affirmative practices and psychological well-being while controlling for precounseling distress, client age, client race/ethnicity, number of psychotherapy sessions, and therapist gender...
February 4, 2019: Psychotherapy
Alice E Coyne, Michael J Constantino, Heather J Muir
As the conceptualization of evidence-based practice expands beyond the phasic application of treatment manuals for specific mental health diagnoses, greater attention is being paid to treatment personalization, including at its very first steps. One approach to such early personalization involves therapist flexible responsivity to patients' presenting nondiagnostic characteristics, such as their treatment-related beliefs, that are known to correlate with treatment outcomes. Such tailoring represents one element of the context-responsive psychotherapy integration framework that privileges the therapist's use of evidence-informed strategies in response to specific patient characteristics and contextual process markers (Constantino, Boswell, Bernecker, & Castonguay, 2013)...
January 28, 2019: Psychotherapy
George Stricker, Marvin R Goldfried
The authors, friends, colleagues, and collaborators for almost 60 years engage in an informal discussion concerning the gap between science and practice. They identify some sources of the problem, some manifestations of it, and point the way to some possible solutions. The articles in this special section, because of their use of data collected in a naturalistic setting and the prominent role of clinicians, are viewed as one of many promising directions for the reconciliation of the activity of researchers and the needs of clinicians...
March 2019: Psychotherapy
Frank J Don, Ellen Driessen, Pieter J Molenaar, Jan Spijker, Jack J M Dekker
In cognitive behavioral therapy for depression, the first sessions play a crucial role in determining treatment outcome. In the first sessions, the therapist needs to form an alliance to facilitate application of the techniques; agree with the patient on problem definition, problem solution, and goals; explain the rationale; and create confidence in therapy by producing early symptom relief. This article illustrates the cognitive behavioral therapy treatment process of two depressed clients: one for whom the treatment manual was followed neatly and one for whom the therapist chose not to adhere to the manual strictly...
March 2019: Psychotherapy
Andrew J Curreri, Todd J Farchione, Mengxing Wang
This article describes the early sessions of a transdiagnostic cognitive-behavioral treatment for emotional disorders that is designed to target temperamental characteristics, particularly neuroticism and resulting emotion dysregulation, underlying all anxiety, depressive, and related disorders. These sessions facilitate clinical improvement by setting realistic expectations, fostering a collaborative therapeutic alliance, and improving motivation for change. Addressing these common factors in early sessions strengthens patient engagement, which is necessary for patients to benefit most greatly from subsequent treatment elements...
March 2019: Psychotherapy
Caleb J Siefert
Brief psychodynamic psychotherapy (BPP) begins with an assessment to gauge client appropriateness for treatment, generate treatment goals, and build a dynamic focus. During this assessment, other goals must also be achieved for treatment to have a successful start. Building a strong alliance, empathizing and bonding with the client, and clarifying the client's understanding of key therapeutic activities are all common factors known to improve treatment course and outcome. Although these goals are desirable across treatment approaches, clinicians typically pursue them in a manner aligned with their treatment orientation...
March 2019: Psychotherapy
Trevor N Coyle, Charlotte D Brill, Frances M Aunon, A Paige Peterson, Melissa L Gasser, Kevin S Kuehn, Melanie S Harned
The pretreatment phase in dialectical behavior therapy (DBT) sets the critical foundation for working with multiproblem, often highly suicidal clients. Despite the importance of this stage of treatment, very little has been written to aid DBT clinicians in navigating these early sessions most effectively. This article describes the functions and goals of pretreatment in DBT and research relevant to strategies employed in pretreatment. Additionally, a case example of a pretreatment session in DBT is provided, and challenges commonly encountered in pretreatment are discussed, along with recommendations for overcoming those challenges...
March 2019: Psychotherapy
Michael P Twohig, Clarissa W Ong, Jennifer Krafft, Jennifer L Barney, Michael E Levin
This article describes the initial phase of acceptance and commitment therapy (ACT). The article begins with a review of ACT's theoretical orientation. Basic empirical support for ACT and its model are covered. A case description follows that highlights the initial phases of ACT. The article concludes with practical recommendations for starting therapy using ACT. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
March 2019: Psychotherapy
Julie Spencer, Jonathan Goode, Elizabeth A Penix, Wilson Trusty, Joshua K Swift
Establishing a collaborative therapeutic relationship is an important research-supported goal for the initial sessions of psychotherapy. Fostering a collaborative relationship can occur through strategies such as recognizing the client's expertise in treatment, involving the client in the treatment decision-making process, and discussing the possibility of therapist mistakes. In this article, we present theoretical and research support for establishing a collaborative relationship. We then provide a case example that illustrates different collaboration-building strategies...
March 2019: Psychotherapy
Jamie D Bedics
The current article presents an introduction to the Special Section on "Beginning Psychotherapy." The importance of the earliest moments of psychotherapy is briefly discussed, and a review of the individual contributions to the special section is provided. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
March 2019: Psychotherapy
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