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Trajectories of change in well-being during cognitive behavioral therapies for anxiety disorders: Quantifying the impact and covariation with improvements in anxiety.
Cognitive behavioral therapy (CBT) has been found to be very effective in reducing many forms of mental illness, but much less is known about whether CBT also promotes mental health or well-being. The goals of the present study were to (a) quantify the magnitude and timing of changes in overall well-being and specific facets of well-being during different CBTs for anxiety disorders, (b) determine whether these effects vary across transdiagnostic and disorder-specific CBT, and (c) examine how changes in well-being during treatment relate to changes in anxiety. A total of 223 adults (55.6% female, Mage = 31.1 years) were ran...
Source: Psychotherapy: Theory, Research, Practice, Training - February 6, 2020 Category: Psychiatry & Psychology Source Type: research

The impact of brief dynamic interpersonal therapy (DIT) on veteran depression and anxiety.
This study represents the first evaluation of DIT in the United States, implemented at a veterans affairs medical center for veterans with depression and/or anxiety. Electronic medical records of veterans receiving DIT from 2012 to 2018 at a New York-based veterans affairs medical center were reviewed. Linear mixed-effects models were used to analyze depression and anxiety scores collected at each session from the Patient Health Questionnaire and the Generalized Anxiety Disorder seven-item scale. Following DIT, patients presenting with clinically significant depression and/or anxiety reported a 46% reduction in Patient Hea...
Source: Psychotherapy: Theory, Research, Practice, Training - January 30, 2020 Category: Psychiatry & Psychology Source Type: research

From cosmetics to compassion: A case study of goal focused positive psychotherapy.
This case study describes the progress of a client receiving goal focused positive psychotherapy over 34 sessions, capturing the subtlety and responsiveness of the theory in action. The client self-identified as a Mexican American heterosexual female in her early 20s who had experienced intense anxiety and recurring bouts of depression since elementary school. The primary therapeutic principles of goal focused positive psychotherapy- including hope, strengths, virtuous approach goals, incremental change, and culture- are described alongside germane interventions (one good thing, capitalization, and self-compassion). The cl...
Source: Psychotherapy: Theory, Research, Practice, Training - January 30, 2020 Category: Psychiatry & Psychology Source Type: research

Do positive features of mental health change together with symptoms and do they predict each other?
In a previous study, it was found that several constructs derived from a positive definition of mental health had changed during psychotherapy. It remains unclear whether they change as part of a single process together with symptomatic change, as part of separate processes, or whether a change in one of the variables predicts change in another variable. Our objective in this study was to examine the relationship between the observed changes and to establish temporal precedence that constitutes a necessary condition for causation. Sixty-two clients who underwent psychotherapy in a naturalistic setting completed questionnai...
Source: Psychotherapy: Theory, Research, Practice, Training - January 30, 2020 Category: Psychiatry & Psychology Source Type: research

Relational savoring: An attachment-based approach to promoting interpersonal flourishing.
Our purpose is to introduce a novel technique for evoking emotions associated with moments of closeness with another person (relational savoring), to describe its theoretical grounding, specifics of treatment targets and outcomes, as well as to provide the preliminary evidence for its efficacy in promoting flourishing. We rely on attachment theory, the broaden-and-build theory of positive emotions, and emotion-focused therapy as foundations for our understanding of how secure relationships are built and maintained and for proposing how relational savoring can promote flourishing through strengthening relationships. To illu...
Source: Psychotherapy: Theory, Research, Practice, Training - January 30, 2020 Category: Psychiatry & Psychology Source Type: research

The perniciousness of perfectionism in group therapy for depression: A test of the perfectionism social disconnection model.
Half a century of theoretical accounts, case histories, and evidence implies perfectionism limits the success of psychotherapy and makes it hard for people to participate in and benefit from close relationships. Likewise, intimate relationships are crucial determinants of the success of treatment. However, the extent to which specific types of relationships explain why perfectionism leads to a poorer treatment outcome is unclear. We addressed this by, first, testing whether the perfectionism traits of self-oriented, other-oriented, and socially prescribed perfectionism hindered symptom reduction in group psychotherapy for ...
Source: Psychotherapy: Theory, Research, Practice, Training - January 30, 2020 Category: Psychiatry & Psychology Source Type: research

Virtue, flourishing, and positive psychology in psychotherapy: An overview and research prospectus.
Researchers have increasingly called for the examination of both mental health symptoms and well-being when providing and evaluating psychotherapy, and although symptoms and well-being are typically inversely related, these appear to be distinct constructs that may require distinct intervention strategies. Positive psychology interventions, virtue-based treatments, and psychotherapies explicitly focused on promoting well-being have emerged in response to, or perhaps in concert with, the calls for attention to symptoms and well-being. Our review of the relevant and vast research pockets revealed that these treatments demons...
Source: Psychotherapy: Theory, Research, Practice, Training - January 27, 2020 Category: Psychiatry & Psychology Source Type: research

Use of common and unique techniques in the early treatment phase for cognitive-behavioral, interpersonal/emotional, and supportive listening interventions for generalized anxiety disorder.
This study observed therapist common factor and model-specific interventions in three treatment approaches from a randomized control trial for generalized anxiety disorder across the entire early phase of treatment (i.e., first five sessions). The parent randomized control trial compared two treatment conditions, using an additive design where patients were randomized to receive either interpersonal/emotional processing interventions or supportive listening after receiving a session of cognitive–behavioral therapy. The first five video-recorded sessions of N = 40 randomly sampled participants were observationally coded w...
Source: Psychotherapy: Theory, Research, Practice, Training - January 16, 2020 Category: Psychiatry & Psychology Source Type: research

Efficacy of a two-session repetitive negative thinking-focused acceptance and commitment therapy (ACT) protocol for depression and generalized anxiety disorder: A randomized waitlist control trial.
This parallel randomized controlled trial aimed to evaluate the effect of acceptance and commitment therapy (ACT) focused on disrupting repetitive negative thinking (RNT) versus a waitlist control (WLC) in the treatment of depression and generalized anxiety disorder (GAD). Forty-eight participants with a main diagnosis of depression and/or GAD were allocated by means of simple randomization to a 2-session RNT-focused ACT intervention or to the WLC. The primary outcomes were emotional symptoms as measured by the Depression, Anxiety, and Stress Scales–21. Process outcomes included ACT- and RNT-related measures: general RNT...
Source: Psychotherapy: Theory, Research, Practice, Training - January 16, 2020 Category: Psychiatry & Psychology Source Type: research

Parallel process in psychodynamic supervision: The supervisor’s perspective.
Nine postdoctoral-level experienced psychodynamic supervisors were interviewed about working with a supervisee on a case involving parallel process (PP) that started in therapy and was enacted in supervision. Consensual qualitative research was used to analyze transcripts of the interviews. The general pattern that emerged from the analysis of the supervisors’ reports was that clients behaved unusually in session, therapists “got hooked” by this change, therapists enacted the client’s behavior in supervision, supervisors “got hooked,” supervisors reflected on their reactions and intervened in a different way; r...
Source: Psychotherapy: Theory, Research, Practice, Training - January 16, 2020 Category: Psychiatry & Psychology Source Type: research

When adolescents stop psychological therapy: Rupture–repair in the therapeutic alliance and association with therapy ending.
This study investigated whether markers of rupture–repair in the alliance were indicative of different types of treatment ending in adolescents receiving psychological treatment for depression. Data were from the IMPACT study, a trial investigating the effectiveness of therapies for adolescent depression. Participants were randomly allocated to receive a brief psychosocial intervention, cognitive–behavioral therapy, or short-term psychoanalytic psychotherapy. The sample (N = 35) comprised adolescents who had either completed their treatment (n = 14) or dropped out (n = 21) according to their therapist. Dropout cases we...
Source: Psychotherapy: Theory, Research, Practice, Training - January 13, 2020 Category: Psychiatry & Psychology Source Type: research

Iw.apiya American Indian pilot clinical trial: Historical trauma and group interpersonal psychotherapy.
American Indians face pervasive trauma exposure, collective histories of communal suffering, and elevated risk for depression and posttraumatic stress disorder. In addition to socioeconomic barriers, access to culturally responsive treatment is limited, which may compromise treatment engagement. The Iw.apiya study piloted the Historical Trauma and Unresolved Grief Intervention (HTUG), combined with Group Interpersonal Psychotherapy (IPT), to reduce symptoms of depression and related trauma and grief. The study hypothesized that HTUG + IPT would lead to greater group engagement and decreased depression and related symptoms ...
Source: Psychotherapy: Theory, Research, Practice, Training - December 2, 2019 Category: Psychiatry & Psychology Source Type: research

Reflective functioning, psychotherapeutic alliance, and outcome in two psychotherapies for bulimia nervosa.
This study investigated mentalization in psychoanalytic psychotherapy (PPT) and cognitive behavior therapy (CBT) through a secondary data analysis of findings from a randomized controlled trial for bulimia nervosa. It was hypothesized that mentalization would predict alliance and outcome in both treatments, whereas increase in mentalization was only expected after PPT. Furthermore, it was investigated whether change in mentalization predicted symptom change. A total of 70 participants with bulimia nervosa were randomized to PPT or CBT. Participants were assessed at 3 time points with the Eating Disorder Examination and the...
Source: Psychotherapy: Theory, Research, Practice, Training - October 10, 2019 Category: Psychiatry & Psychology Source Type: research

Computer use in mental health treatment: Understanding collaborative documentation and its effect on the therapeutic alliance.
This study explores how CD is being implemented in psychotherapy and examines how both the frequency of computing and the use of CD affects the therapeutic alliance. Psychotherapists in this study engaged in an average of 42 (SD = 38.5) computing episodes. CD was present in 39% of sessions (N = 21). Regression models found that among providers, increases in computing frequency predicted decreases in alliance (ß = −.18, p (Source: Psychotherapy: Theory, Research, Practice, Training)
Source: Psychotherapy: Theory, Research, Practice, Training - October 10, 2019 Category: Psychiatry & Psychology Source Type: research

How do supportive techniques bring about therapeutic change: The role of therapeutic alliance as a potential mediator.
In this study, we propose and investigate a model according to which the mechanism of change underlying the effect of supportive techniques on therapeutic improvement is the strengthening of the therapeutic alliance. According to the proposed mediation model, the implementation of supportive techniques brings about strengthening in the alliance, which in turn results in subsequent reduction in symptoms. The present study was designed to test the proposed mediation model. Analyses were conducted on a sample of 61 patients diagnosed with major depressive disorder and enrolled in an ongoing psychotherapy trial. For each patie...
Source: Psychotherapy: Theory, Research, Practice, Training - October 3, 2019 Category: Psychiatry & Psychology Source Type: research