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Predictors of change in patient treatment outcome expectation during cognitive-behavioral psychotherapy for generalized anxiety disorder.
Positive patient-rated psychotherapy outcome expectation at pre- or early treatment is associated with posttreatment improvement. However, there is limited research on patients’ change in outcome expectation across therapy and participant factors that predict both pretreatment outcome expectation and expectation change. The present study aimed to examine (a) the overall trajectory of change in patients’ outcome expectation from pretreatment through treatment’s end; (b) baseline patient characteristics as predictors of their pretreatment outcome expectation; (c) early change in general self-efficacy (controlling for b...
Source: Psychotherapy: Theory, Research, Practice, Training - August 19, 2021 Category: Psychiatry & Psychology Source Type: research

Attachment style change and working alliance in panic disorder patients treated with cognitive behavioral therapy.
An insecure attachment style (AS), described as being highly anxious and/or avoidant, is often assumed to be stable over time, yet some studies show that AS can change. To the extent that AS may be malleable over shorter time periods, it potentially impacts key therapy processes and outcomes. In the present study, we first investigated the stability of AS in patients with panic disorder (N = 49) treated with short-term cognitive behavioral therapy (CBT) including follow-up. Second, we tested whether time-specific change of AS predicted subsequent symptom severity, interpersonal distress (ID), and alliance, or vice versa. T...
Source: Psychotherapy: Theory, Research, Practice, Training - August 19, 2021 Category: Psychiatry & Psychology Source Type: research

Can a pure motivational interviewing intervention be manualized and still efficacious? A test of feasibility and initial efficacy.
This study evaluated the feasibility and initial efficacy of a pure MI intervention manual – MI for risky social drinking (MI-RSD) – designed to target risky social drinking behaviors in college students with social anxiety. A pilot sample of 42 college students completed measures of alcohol use and mental health symptoms and the MI-RSD intervention. We developed a manual for the 2-session MI-RSD intervention, trained 4 clinical doctoral students, and used observer-, therapist- and participant-completed measures to evaluate fidelity. Therapists met beginner proficiency in MI fidelity and participant gave high ratings o...
Source: Psychotherapy: Theory, Research, Practice, Training - August 19, 2021 Category: Psychiatry & Psychology Source Type: research

Enhancing motivation and self-efficacy for safety plan use: Incorporating motivational interviewing strategies in a brief safety planning intervention for adolescents at risk for suicide.
Suicide is one of the leading causes of death among adolescents in the United States, and risk for recurring suicidal thoughts and behavior remains high after discharge from psychiatric hospitals. Safety planning, a brief intervention wherein the main focus is on identifying personal coping strategies and resources to mitigate suicidal crises, is a recommended best practice approach for intervening with individuals at risk for suicide. However, anecdotal as well as emerging empirical evidence indicate that adolescents at risk for suicide often do not use their safety plan during the high-risk postdischarge period. Thus, to...
Source: Psychotherapy: Theory, Research, Practice, Training - July 29, 2021 Category: Psychiatry & Psychology Source Type: research

Connecting in-session corrective emotional experiences with postsession therapeutic changes: A systematic case study.
This systematic case study investigated the nature of corrective emotional experiences (CEEs) that occurred over the course of psychotherapy in a single case and how those in-session CEEs were related to changes in the client’s life. Client’s e-mails on her experience of therapy sessions and postsession changes sent to the therapist, as well as outcome and postsession measures, were analyzed. The client was a Japanese woman who sought help for a variety of psychological symptoms including depression, anxiety, and emotional dysregulation. A long-term therapy of 67 sessions was conducted by a Japanese male psychotherapis...
Source: Psychotherapy: Theory, Research, Practice, Training - July 22, 2021 Category: Psychiatry & Psychology Source Type: research

Rupture resolution strategies and the impact of rupture on the working alliance after racial microaggressions in therapy.
This study used a mixed methodology to examine the occurrence of racial microaggressions in therapy and their potential impact on the participants’ relationship with their therapist. Participants included 128 self-identified people of color who have had at least 1 counseling session and were recruited from across the United States. Results suggested that experiencing racial microaggressions negatively impacted the client–therapist relationship and that clients of color had more positive therapeutic alliances when their therapists engaged in active cultural repair strategies. (PsycInfo Database Record (c) 2021 APA, all ...
Source: Psychotherapy: Theory, Research, Practice, Training - July 22, 2021 Category: Psychiatry & Psychology Source Type: research

Telehealth cognitive behavioral therapy for depression in Parkinson’s disease: A case study.
Parkinson’s disease (PD) is characterized as a motor disorder, but the majority of individuals with PD also suffer from nonmotor symptoms, including mental health difficulties, such as depression, anxiety, and apathy, as well as decreased cognitive function, daily function, sleep quality, and quality of life. Cognitive behavioral therapy (CBT) is an effective treatment for depression in PD, but motor disability, work schedule, transportation issues, and care partner burden may cause difficulty in attending weekly face-to-face therapy sessions. A promising avenue in the delivery of CBT is telehealth. CBT administered live...
Source: Psychotherapy: Theory, Research, Practice, Training - June 24, 2021 Category: Psychiatry & Psychology Source Type: research

An examination of parent sessions in regulation-focused psychotherapy for children.
Collateral work with parents is a widely adopted practice within child psychotherapy. Therapeutic process within these parent sessions has not been empirically studied or defined, despite a sizable process-outcome literature in both child and adult individual therapy. This link between research and practice is particularly important among manualized, child-focused treatments, where the proposed therapeutic action and clinical approach to parent work is defined according to distinct theoretical principles. To address this gap in the child treatment literature, the present study used the Psychotherapy Process Q Set to examin...
Source: Psychotherapy: Theory, Research, Practice, Training - April 15, 2021 Category: Psychiatry & Psychology Source Type: research

The alliance–outcome association in the treatment of adolescent depression.
A growing body of research has consistently demonstrated a relationship between alliance and treatment outcomes in youth psychotherapy. However, previous research often suffered methodological issues that prevented detailed investigation of temporal relationships between alliance and symptomatology. The current study explored the directions of effect between alliance and outcome by examining the associations between early alliance and subsequent outcome while controlling for patients’ baseline severity and prior symptom change. It also examined potential moderators of this association. Data were drawn from the IMPACT stu...
Source: Psychotherapy: Theory, Research, Practice, Training - April 15, 2021 Category: Psychiatry & Psychology Source Type: research

The gender-affirmative life span approach: A developmental model for clinical work with transgender and gender-diverse children, adolescents, and adults.
The gender-affirmative life span approach (GALA) is an innovative therapeutic framework for promoting the mental health of transgender and gender-diverse (TGD) clients of all ages. Based in interdisciplinary philosophical foundations, GALA proposes that TGD clients can be supported in psychotherapy through (a) developing gender literacy, (b) building resiliency, (c) moving beyond the binary, (d) exploring pleasure-oriented sexuality, and (e) making connections to medical interventions. Psychotherapy incorporating these 5 core components is developmentally tailored for children, adolescents, young adults, or older adults. D...
Source: Psychotherapy: Theory, Research, Practice, Training - April 15, 2021 Category: Psychiatry & Psychology Source Type: research

You can tell me anything: Disclosure of suicidal thoughts and behaviors in psychotherapy.
Only half of clients disclose suicidal thoughts or behaviors in psychotherapy. Qualitatively, we sought to understand the experience of disclosing suicidal thoughts and behaviors (STBs) to clinicians and applied the disclosure processes model (Chaudoir & Fisher, 2010) to frame our findings. Participants (N = 68) responded to an anonymous, open-ended survey about their experience of disclosing or withholding recent STBs in therapy. Half of our sample (n = 34) withheld their STBs from their psychotherapist, whereas the other half (n = 34) disclosed. We coded primary themes of the disclosure process and framed these processes...
Source: Psychotherapy: Theory, Research, Practice, Training - March 18, 2021 Category: Psychiatry & Psychology Source Type: research

Do birds of a feather flock together? Clients’ perceived personality similarity, real relationship, and treatment progress.
In the present study, we examined whether clients’ perceptions of similarity to their therapists in terms of the Big Five personality traits were associated with the real relationship and, indirectly through the real relationship, to treatment progress. Data collected through an online crowdsource platform from 212 adult clients in individual psychotherapy were analyzed using polynomial regression and response surface analysis. Results indicated that clients who perceived greater similarity to their therapists at higher (vs. lower) levels of Conscientiousness and Openness to Experience reported stronger real relationship...
Source: Psychotherapy: Theory, Research, Practice, Training - March 18, 2021 Category: Psychiatry & Psychology Source Type: research

Using topic models to identify clients’ functioning levels and alliance ruptures in psychotherapy.
Computerized natural language processing techniques can analyze psychotherapy sessions as texts, thus generating information about the therapy process and outcome and supporting the scaling-up of psychotherapy research. We used topic modeling to identify topics discussed in psychotherapy sessions and explored (a) which topics best identified clients’ functioning and alliance ruptures and (b) whether changes in these topics were associated with changes in outcome. Transcripts of 873 sessions from 58 clients treated by 52 therapists were analyzed. Before each session, clients self-reported functioning and symptom level. Af...
Source: Psychotherapy: Theory, Research, Practice, Training - March 18, 2021 Category: Psychiatry & Psychology Source Type: research

Dismantling weight stigma: A group intervention in a partial hospitalization and intensive outpatient eating disorder treatment program.
We present the group’s overarching framework of destigmatizing language and intersectional discussions of weight stigma. We also discuss clinical processes that unfolded during this group including simulated dialog from the group. Finally, we present relevant client quotes that provide preliminary support for future exploration in this area, as client subjective experiences of the group were positive. Our preliminary pilot experience suggests that delivering a group of this nature in a PHP/IOP eating disorder treatment setting is feasible and that further work is needed to build upon this antiweight stigma framework as a...
Source: Psychotherapy: Theory, Research, Practice, Training - March 18, 2021 Category: Psychiatry & Psychology Source Type: research

Windows of cultural opportunity: A thematic analysis of how cultural conversations occur in psychotherapy.
A cultural opportunity is 1 of 3 pillars within multicultural orientation framework; it is defined as a moment in therapy when aspects of a client’s background emerge, which can be deeply explored to better understand the salient aspects of a client’s cultural identities. Research on cultural opportunities provides evidence that clients desire cultural conversations. However, no study to date has examined what cultural opportunities sound like in therapy and how therapists and clients utilize these opportunities. Accordingly, the purpose of this study was to examine the ways in which cultural conversations emerge durin...
Source: Psychotherapy: Theory, Research, Practice, Training - March 18, 2021 Category: Psychiatry & Psychology Source Type: research