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Alliance predicting progress in couple therapy.
The therapeutic alliance has gained status as a common factor in psychotherapy due to its robust predictive relationship with outcome. The current challenge in our field is to gain a more nuanced understanding of alliance’s impact on the progress of treatment over the course of therapy. In the current study, alliance was measured on 3 dimensions: (a) the individual’s as well as the couple’s joint perception of alliance with the therapist (“self/group-therapist”), (b) each partner’s perception of the alliance between the spouse and the therapist (“other-therapist”), and (c) the couple’s assessment of allia...
Source: Psychotherapy: Theory, Research, Practice, Training - February 4, 2021 Category: Psychiatry & Psychology Source Type: research

How couple therapists manage asymmetries of interaction in first consultations.
The study demonstrates how asymmetries in therapists’ affiliations with spouses emerge and are addressed in couple therapy. A total of 4 video-recorded couple therapy first sessions were subjected to conversation analysis. The moment-by moment interactions that contribute to one sided affiliation, as well as the therapists’ ways of managing such asymmetry, are described in detail. Asymmetries of affiliation regularly co-occur with the exclusion of 1 spouse from the interaction. Asymmetries of affiliation and participation can be addressed by 2 types of action by the therapist: (a) In counterbalancing moves, the therapi...
Source: Psychotherapy: Theory, Research, Practice, Training - February 4, 2021 Category: Psychiatry & Psychology Source Type: research

Insight as a dual-perspective construct: Convergence between patients’ and professional evaluators’ perspective on baseline level of insight and on changes in insight.
Insight gained by patients during treatment has been theorized to be a central mechanism of change in psychotherapy, but empirical studies examining the association between patients’ insight and psychopathological symptoms have produced mixed results. The present study addresses these inconsistencies by investigating convergence between the perspectives of patient and professional evaluator on insight and disentangling two potentially distinct components of insight: pretreatment individual differences and changes in insight during treatment. A sample of 393 patients receiving psychodynamic psychotherapy completed pre- an...
Source: Psychotherapy: Theory, Research, Practice, Training - February 4, 2021 Category: Psychiatry & Psychology Source Type: research

Relationships of biomedical beliefs about depression to treatment-related expectancies in a treatment-seeking sample.
We examined, in a treatment-seeking sample, whether attributing one’s depression to biomedical causes would be associated with pessimistic psychotherapy treatment expectancies. Individuals seeking psychotherapy for depression rated their endorsement of biomedical explanations for their symptoms, expectations regarding treatment outcome, and expectations about forming a working alliance with a therapist. We found that treatment seekers’ endorsement of biomedical explanations for their symptoms was associated with pessimism about treatment being successful. This pessimism was, in turn, associated with holding more negati...
Source: Psychotherapy: Theory, Research, Practice, Training - February 4, 2021 Category: Psychiatry & Psychology Source Type: research

Patient, therapist, and relational antecedents of hostile resistance in cognitive��behavioral therapy for panic disorder: A qualitative investigation.
Hostile resistance (clients’ openly combative behavior directed at therapists) predicts poor outcomes in cognitive–behavioral therapy (CBT) for panic disorder, but its origins are poorly understood. It is important to have a holistic understanding of the etiology of hostile resistance that incorporates the therapeutic context if these behaviors—and their negative consequences—are to be prevented and effectively addressed. Of the 71 adults who received CBT for panic disorder as part of larger trial, 8 exhibited hostile resistance. Grounded theory methodology was used to develop a theoretical framework to understand ...
Source: Psychotherapy: Theory, Research, Practice, Training - February 4, 2021 Category: Psychiatry & Psychology Source Type: research

How are expert therapists similar, different, and integrative in the treatment of borderline personality disorder?
This study examined the use of therapeutic skills by different, well-known experts in psychology who have published extensively on the treatment of borderline personality disorder to ascertain areas of technique similarity, difference, and integration. Initial videotaped sessions from these expert therapists working with the same patient were independently rated, using an established measure, on cognitive–behavioral and psychodynamic-interpersonal techniques by 6 trained clinicians. These raters also independently identified what they believed were the most clinically significant segments of each session. The 6 raters de...
Source: Psychotherapy: Theory, Research, Practice, Training - February 4, 2021 Category: Psychiatry & Psychology Source Type: research

Application of the unified protocol for transdiagnostic treatment of emotional disorders among homeless women: A feasibility study.
This study aims to examine the feasibility of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders among homeless women, in relation to its quantitative effects on attendance, satisfaction, usefulness, emotional state, and group cohesion. The trial was registered at clinicalstrials.gov as NCT04392856. We use a one-group pretest–posttest design. The program consisted of 12 group sessions of approximately 90 min each. Treatment was provided to 54 homeless women, who were recruited from four different shelters in Madrid (Spain). The average attendance rate was 69.44%. Participants reported high levels o...
Source: Psychotherapy: Theory, Research, Practice, Training - February 4, 2021 Category: Psychiatry & Psychology Source Type: research

Patient, therapist, and relational antecedents of hostile resistance in cognitive–behavioral therapy for panic disorder: A qualitative investigation.
Hostile resistance (clients’ openly combative behavior directed at therapists) predicts poor outcomes in cognitive–behavioral therapy (CBT) for panic disorder, but its origins are poorly understood. It is important to have a holistic understanding of the etiology of hostile resistance that incorporates the therapeutic context if these behaviors—and their negative consequences—are to be prevented and effectively addressed. Of the 71 adults who received CBT for panic disorder as part of larger trial, 8 exhibited hostile resistance. Grounded theory methodology was used to develop a theoretical framework to understand ...
Source: Psychotherapy: Theory, Research, Practice, Training - February 4, 2021 Category: Psychiatry & Psychology Source Type: research

The relationship between self-observed and other-observed countertransference and session outcome.
In this study, we focused on the relationship between countertransference when measured by therapists and external observers and its impact on session quality. We analyzed 69 counseling sessions, held by 23 in-training psychotherapists with 23 patients. We used the Therapist Response Questionnaire and three external observers (who used the Countertransference Behavior Measure) to measure psychotherapists’ countertransference. We rated the session impact perceived by patients and psychotherapists using the Session Evaluation Questionnaire and by patients through the Session Impact Scale. Psychotherapists’ and observers�...
Source: Psychotherapy: Theory, Research, Practice, Training - January 28, 2021 Category: Psychiatry & Psychology Source Type: research

“Group therapy for schizophrenia: A meta-analysis”: Correction to Burlingame et al. (2020).
Reports an error in "Group therapy for schizophrenia: A meta-analysis" by Gary M. Burlingame, Hal Svien, Lars Hoppe, Isaac Hunt and Jenny Rosendahl (Psychotherapy, 2020[Jun], Vol 57[2], 219-236). In the article, the Orfanos et al. (2015) meta-analysis was missing from Burlingame et al. (2020) and should have appeared as Footnote 1 at the end of the abstract. Consistent with Orfanos et al. (2015), the Burlingame et al. (2020) findings support the notion that group treatments can improve negative symptoms of schizophrenia, across active and passive controls. Unlike Orfanos et al.’s (2015) study, Burlingame et al. (2020) al...
Source: Psychotherapy: Theory, Research, Practice, Training - December 10, 2020 Category: Psychiatry & Psychology Source Type: research

The perceived effects of emotional labor in psychologists providing individual psychotherapy.
Existing literature examining burnout in psychotherapists has not adequately considered the contributing role of emotional labor. Similarly, emotional labor research has not sufficiently explored how this construct operates in the context of psychologists who provide individual psychotherapy. To address these existing gaps in the literature, thematic analysis was conducted on interviews with 24 psychologists who provide individual psychotherapy to determine the perceived consequences of emotional labor identified by the participants. Participants discussed personal growth, feeling depleted and exhausted, and craving space ...
Source: Psychotherapy: Theory, Research, Practice, Training - December 3, 2020 Category: Psychiatry & Psychology Source Type: research

Unifying treatment for mild anxiety and depression in preadolescence.
Anxiety disorders in children and adolescents are prevalent and, if left untreated, can lead to comorbid psychological disorders, substance use, poor socioemotional functioning, and academic and occupational underachievement. Subthreshold presentations of anxiety in youth could become problematic if overlooked, resulting in the aforementioned negative outcomes. Thus, it is important to treat such presentations, including with evidence-based treatments such as cognitive–behavioral therapy (CBT). However, because of not meeting the diagnostic criteria for which many CBT protocols were developed, subthreshold presentations ...
Source: Psychotherapy: Theory, Research, Practice, Training - November 30, 2020 Category: Psychiatry & Psychology Source Type: research

Therapists’ cultural comfort and clients’ distress: An initial exploration.
The extent to which therapists are comfortable discussing clients’ cultural identities in psychotherapy has been considered a valuable component of how therapists integrate clients’ cultures into treatment. Cultural comfort specifically reflects a therapist’s way of being at ease, relaxed, and open when discussing clients’ cultural identities in treatment. Some initial research has demonstrated the relationships between cultural comfort and clinical outcomes, yet this work has relied largely on cross-sectional designs. The purpose of this preliminary study was to use longitudinal psychotherapy data to explore the r...
Source: Psychotherapy: Theory, Research, Practice, Training - November 19, 2020 Category: Psychiatry & Psychology Source Type: research

A moderating factor for patients with vindictive interpersonal problems.
Individuals high in vindictive interpersonal problems tend to experience and express anger and irritability. In treatment, they have poor prognosis for alliance and outcome. We propose that positive expectation may serve as a moderating factor for these patients. In the current study, we examined the ability of expected alliance to act as a moderating factor in the early process and early progress of treatment for patients with vindictive interpersonal problems. A sample of 65 patients received short-term dynamic psychotherapy. At intake, before meeting the therapist, participants completed assessments for vindictive inter...
Source: Psychotherapy: Theory, Research, Practice, Training - November 12, 2020 Category: Psychiatry & Psychology Source Type: research