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Psychodynamic art psychotherapy for the treatment of aggression in an individual with antisocial personality disorder in a secure forensic hospital: A single-case design study.
This study uses a single-case design with pretreatment, treatment, and posttreatment follow-up assessment of symptoms using multiple methods reported by the therapist, other staff members, and the patient. Treatment progress was assessed by (a) repeated self-report symptom measurements, (b) continuous assessment of observed aggressive behavior and risk incident reports in the hospital, (c) pre–post treatment assessment of relationship patterns and interpersonal schemas, and (d) interviews with the patient and his nurse at 9-month follow-up, retrospectively assessing the change. The patient showed a clinically significant...
Source: Psychotherapy: Theory, Research, Practice, Training - May 30, 2019 Category: Psychiatry & Psychology Source Type: research

Comparing the treatment process in successful and unsuccessful cases in two forms of psychotherapy for cluster C personality disorders.
Different forms of psychotherapy are effective for cluster C personality disorders, but we know less about what in-session processes promote change. Contrasting successful and unsuccessful cases may elucidate processes that facilitate or impede outcome and offer suggestions for clinical practice and future research. In this exploratory outcome–process study, 10 successful and 10 unsuccessful cases were selected from a randomized trial comparing cognitive therapy and short-term psychodynamic psychotherapy for cluster C personality disorders. Videotaped sessions were rated with the Psychotherapy Process Q-Set (PQS). The tr...
Source: Psychotherapy: Theory, Research, Practice, Training - May 30, 2019 Category: Psychiatry & Psychology Source Type: research

Psychotherapy for depressed youth in poverty: Benchmarking outcomes in a public behavioral health setting.
Research demonstrating the effectiveness of treatment with youth from low socioeconomic backgrounds is limited. To address this limitation, we evaluated pre–post psychotherapy treatment outcomes with youth presenting with depression-related diagnoses (N = 469) at a public behavioral health agency after they implemented a systematic client feedback approach as a quality improvement strategy. Clients were ethnically diverse youth at or under the poverty line. Treatment outcome was measured with the Outcome Rating Scale (Miller, Duncan, Brown, Sparks, & Claud, 2003) and the Child Outcome Rating Scale (Duncan, Sparks, Miller...
Source: Psychotherapy: Theory, Research, Practice, Training - May 30, 2019 Category: Psychiatry & Psychology Source Type: research

Keeping psychologists in the driver’s seat: Four perspectives on quality improvement and clinical data registries.
Performance accountability—also frequently referred to as quality improvement in the fields of medicine and public policy—is under growing scrutiny in mental and behavioral health care. As one high-profile example, psychologists and other mental health providers will be deemed “eligible clinicians” under the 2015 Medicare Access and Children’s Health Insurance Program Reauthorization Act starting in 2019. This will incentivize psychologists to track their Medicare patients’ clinical outcomes and report them in data registries, and those who do not will suffer a reimbursement penalty. However, many psychologists...
Source: Psychotherapy: Theory, Research, Practice, Training - May 23, 2019 Category: Psychiatry & Psychology Source Type: research

Dynamic-relational group treatment for perfectionism: Informant ratings of patient change.
Although now there is accumulating research on the effectiveness of psychotherapy for perfectionism, this research has been based almost exclusively on self-report data. In this article, we describe analyses from the University of British Columbia Perfectionism Treatment Study assessing close other informant ratings of change in perfectionism traits and perfectionistic self-presentation. A total of 61 close other informants of patients who participated in a 10-week dynamic-relational treatment for perfectionism completed measures of patient trait and self-presentational facets of perfectionism at pretreatment, at posttreat...
Source: Psychotherapy: Theory, Research, Practice, Training - May 20, 2019 Category: Psychiatry & Psychology Source Type: research

Psychotherapy preferences of laypersons and mental health professionals: Whose therapy is it?
What do patients prefer in their psychotherapy? Do laypersons and mental health professionals (as patients) want the same, or different, things? The authors systematically examined patients’ psychotherapy preferences and quantitatively compared two samples of laypersons (N = 228, 1,305) with one sample of mental health professionals (N = 615) on the four dimensions of the Cooper–Norcross Inventory of Preferences: Therapist Directiveness Versus Client Directiveness, Emotional Intensity Versus Emotional Reserve, Past Orientation Versus Present Orientation, and Warm Support Versus Focused Challenge. On average, laypersons...
Source: Psychotherapy: Theory, Research, Practice, Training - May 16, 2019 Category: Psychiatry & Psychology Source Type: research

The relationship between trainee therapist traits with the use of self-disclosure and immediacy in psychotherapy.
The goal of the present study was to explore how self-disclosure (SD) and immediacy relate to trainee therapists’ personal characteristics. A prospective multitrait multimethod assessment approach was utilized to assess a wide range of trainee characteristics at the beginning of graduate school. Results showed a significant, positive relationship between trainee interpersonal problems and SD for trainees (n = 33) in their third psychotherapy session with their first patient. Moreover, greater use of SD correlated with less session depth, as rated by the trainee. Greater use of immediacy was positively related to trainee ...
Source: Psychotherapy: Theory, Research, Practice, Training - April 25, 2019 Category: Psychiatry & Psychology Source Type: research

Relationships and responsiveness in the psychological treatment of trauma: The tragedy of the APA Clinical Practice Guideline.
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 practic...
Source: Psychotherapy: Theory, Research, Practice, Training - April 22, 2019 Category: Psychiatry & Psychology Source Type: research

"Alguien abrió la puerta:” The phenomenology of bilingual Latinx clients’ use of Spanish and English in psychotherapy.
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. To this end, we interviewed eight bilingual Latinx people (seven of Mexican descent and one Puert...
Source: Psychotherapy: Theory, Research, Practice, Training - April 18, 2019 Category: Psychiatry & Psychology Source Type: research

Design feasibility of an automated, machine-learning based feedback system for motivational interviewing.
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.g., transcripts). The system automatically provides a report of session-level metrics (e.g.,...
Source: Psychotherapy: Theory, Research, Practice, Training - April 8, 2019 Category: Psychiatry & Psychology Source Type: research

An interactive view of countertransference: Differentiation of self and client presentation.
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. Overall, therapists lower in DoS reported significantly more overinvolved CT b...
Source: Psychotherapy: Theory, Research, Practice, Training - March 28, 2019 Category: Psychiatry & Psychology Source Type: research

Examining mental health practitioners’ perceptions of clients based on social class and sexual orientation.
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 o...
Source: Psychotherapy: Theory, Research, Practice, Training - March 25, 2019 Category: Psychiatry & Psychology Source Type: research

Group psychotherapy for borderline personality disorder: A meta-analysis of randomized-controlled trials.
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). Twenty-four studies with 1,595 participants met eligibility criteria for interpretative analysis. Group psychother...
Source: Psychotherapy: Theory, Research, Practice, Training - March 14, 2019 Category: Psychiatry & Psychology Source Type: research

Therapists’ responses toward dependent (anaclitic) and self-critical (introjective) depressed outpatients: A multilevel approach.
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. Consistent with our predictions, multilevel regression analyses showed that therapists e...
Source: Psychotherapy: Theory, Research, Practice, Training - March 14, 2019 Category: Psychiatry & Psychology Source Type: research

The motivating role of recovery self-disclosures from therapists and peers in eating disorder recovery: Perspectives of recovered women.
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.e., recovery self-disclosures [RSDs]). Of our 13 participants, 11 spontaneously rep...
Source: Psychotherapy: Theory, Research, Practice, Training - March 14, 2019 Category: Psychiatry & Psychology Source Type: research