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Working with dreams and nightmares: A review of the research evidence.
Psychotherapy, Vol 60(3), Sep 2023, 383-395; doi:10.1037/pst0000484In this article, we describe methods for working with dreams and nightmares in individual psychotherapy, provide clinical examples, and review research evidence of immediate and distal outcomes of each method. An original meta-analysis of eight studies using the cognitive-experiential dream model with 514 clients showed moderate effect sizes for session depth and insight gains. In the nightmare treatment literature, a previous meta-analysis of 13 studies with 511 clients showed moderate to large effects in reducing nightmare frequency and small to moderate ...
Source: Psychotherapy: Theory, Research, Practice, Training - April 27, 2023 Category: Psychiatry & Psychology Source Type: research

Integrating between-session homework in psychotherapy: A systematic review of immediate in-session and intermediate outcomes.
This article reviews the evidence for between-session homework (BSH) in individual psychotherapy. Whereas previous reviews have demonstrated a positive association between-client compliance with BSH and distal treatment outcomes; here, we pay particular attention to therapist behaviors that may promote client engagement with BSH assessed as immediate (in-session) and intermediate (session-to-session) outcomes, and moderators of these effects. For our systematic review, we identified 25 studies with 1,304 clients and 118 therapists, mostly on cognitive behavioral therapy such as exposure-based treatments with depression and...
Source: Psychotherapy: Theory, Research, Practice, Training - April 27, 2023 Category: Psychiatry & Psychology Source Type: research

Consensus on the perceived presence of transtheoretical principles of change in routine psychotherapy practice: A survey of clinicians and researchers.
Psychotherapy, Vol 60(2), Jun 2023, 219-224; doi:10.1037/pst0000489Goldfried (1982) hypothesized that there are five transtheoretical principles of change that guide routine psychotherapy practice. This survey investigated if there is consensus on the perceived presence of these principles in the approaches of a professionally diverse pool of psychotherapy clinicians and researchers. One thousand nine hundred ninety-eight participants, aged 21–85 years (M = 50.4 years, SD = 15.59) and representing a wide variety of theoretical orientations, completed an online survey. For consensus to be indicated, 95% confidence interva...
Source: Psychotherapy: Theory, Research, Practice, Training - April 20, 2023 Category: Psychiatry & Psychology Source Type: research

Skills and methods that work in psychotherapy: Observations and conclusions from the special issue.
Psychotherapy, Vol 60(3), Sep 2023, 407-416; doi:10.1037/pst0000487We draw recommendations and conclusions from the articles presented in this special issue and the companion special section in Psychotherapy Research on evidence-based therapist skills and methods. For distal (end-of-treatment) outcome, 10 skills/methods were judged to be demonstrably effective (affirmation/validation, paradoxical interventions, homework, routine outcome monitoring, strength-based methods, emotional regulation, imagery rehearsal therapy and exposure relaxation and rescripting therapy for nightmares, meditation/mindfulness/acceptance, behavi...
Source: Psychotherapy: Theory, Research, Practice, Training - April 10, 2023 Category: Psychiatry & Psychology Source Type: research

Silences in psychotherapy: An integrative meta-analytic research review.
Psychotherapy, Vol 60(3), Sep 2023, 320-341; doi:10.1037/pst0000480There is research evidence, from both qualitative and quantitative studies, that silences in psychotherapy have established associations with good and poor outcomes that include and extend beyond symptom measures to processes such as insight, symbolization, and disengagement. Research also has demonstrated that therapists attend to clients’ silences, seeking to comprehend the processes therein and intentionally support productive silent processes. This chapter synthesizes this research and examines features of silence processes to provide psychotherapists...
Source: Psychotherapy: Theory, Research, Practice, Training - April 6, 2023 Category: Psychiatry & Psychology Source Type: research

A systematic review of the association between interpretations and immediate, intermediate, and distal outcomes.
Psychotherapy, Vol 60(3), Sep 2023, 266-282; doi:10.1037/pst0000479Interpretations are a hallmark of psychodynamic treatment and a method used in other theoretical orientations as well. Therapists use interpretations to increase patients’ insight concerning unconscious and preconscious elements in their lives, with the ultimate aim to reduce mental pain and suffering and improve mental health. This systematic review focuses on the association between the therapists’ use and accuracy of interpretation and immediate (within-session), intermediate (between-session), and distal (end-of-treatment) outcomes. This synthesis o...
Source: Psychotherapy: Theory, Research, Practice, Training - April 6, 2023 Category: Psychiatry & Psychology Source Type: research

The sum of competing parts: Religious and sexual identity disparities in therapist effectiveness.
This study sought to investigate therapist variability in facilitating change with clients depending on the interaction of their sexual orientation and the role of religion in their life (RR). We analyzed the depression scores of clients (n = 1,792) who received care at a university counseling center. After controlling for clients’ pretherapy depression scores, the association between their sexual orientation and their posttherapy depression varied across therapists; however, the association between their RR and posttherapy depression did not. We also found that the association between the interaction of clients’ sexua...
Source: Psychotherapy: Theory, Research, Practice, Training - March 30, 2023 Category: Psychiatry & Psychology Source Type: research

Group psychotherapy for chronic pain: A meta-analysis.
Psychotherapy, Vol 60(2), Jun 2023, 194-205; doi:10.1037/pst0000485Chronic pain is common among adults and frequently interferes with regular functioning while reducing quality of life. Though pharmacological approaches are used most frequently to treat pain-related issues, the side effects often lead to other problems. Group therapy has been used and studied for decades in treating pain although its general efficacy in this is not clear. We conducted a meta-analysis to determine group therapy’s effectiveness in reducing pain intensity and improving adjacent issues. Potential randomized clinical trials were selected from...
Source: Psychotherapy: Theory, Research, Practice, Training - March 30, 2023 Category: Psychiatry & Psychology Source Type: research

A systematic research review of collaborative assessment methods.
Psychotherapy, Vol 60(3), Sep 2023, 355-369; doi:10.1037/pst0000477Collaborative assessment methods (CAMs) involve working with clients during all phases of the assessment process, from goal definition to interpretation of the testing results to the recommendations and conclusions. In this article, we define CAMs, provide clinical examples, and then meta-analyze the published literature to assess their effectiveness on distal treatment outcomes. Our meta-analytic results indicate that CAMs have positive effects on three outcome domains: a moderate effect on treatment processes, a small-to-moderate effect on personal growth...
Source: Psychotherapy: Theory, Research, Practice, Training - March 27, 2023 Category: Psychiatry & Psychology Source Type: research

Examining between- and within-person effects of the self-stigma of seeking psychological help on the therapeutic working alliance: The moderating role of psychological distress.
Psychotherapy, Vol 60(2), Jun 2023, 206-211; doi:10.1037/pst0000482The self-stigma (i.e., shame) associated with psychotherapy is a prominent barrier to seeking psychological help, but less is known about its effects after treatment begins. Evidence suggests that self-stigma may interfere with the formation of the therapeutic alliance, but no studies have examined this throughout the course of psychotherapy. Self-stigma’s erosion of the alliance may be most pronounced when clients experience heightened psychological distress, but this also has not been examined. Therefore, the present study addresses these omissions amon...
Source: Psychotherapy: Theory, Research, Practice, Training - March 23, 2023 Category: Psychiatry & Psychology Source Type: research

Introduction to special section: Addressing racism, anti-blackness, and racial trauma in psychotherapy.
This article introduces the special section on “Addressing Racism, Anti-Blackness, and Racial Trauma in Psychotherapy.” The special section was organized to highlight research and clinical practices on addressing racism, anti-Blackness, and racial trauma in psychotherapy. We provide an overview of the special section with attention to future research to continue to advance practice and scholarship on addressing racism, anti-Blackness, and racial trauma in psychotherapy. (PsycInfo Database Record (c) 2023 APA, all rights reserved) (Source: Psychotherapy: Theory, Research, Practice, Training)
Source: Psychotherapy: Theory, Research, Practice, Training - March 23, 2023 Category: Psychiatry & Psychology Source Type: research

Measurement-based care professional practice guideline: Don’t forget the therapists!
Psychotherapy, Vol 60(1), Mar 2023, 20-23; doi:10.1037/pst0000464Boswell et al. (2022) professional practice guideline builds an excellent, evidence-driven argument in favor of the routine implementation of measurement-based care (MBC). Nonetheless, as learned from the attempted implementation of evidence-based psychotherapies, presenting empirical evidence does not affect therapist behavior. As such, we argue for an actionable and practical professional practice guideline. We review some of the most hindering barriers to the implementation of MBC, and we offer guidance introducing some of the efforts needed to overcome th...
Source: Psychotherapy: Theory, Research, Practice, Training - March 23, 2023 Category: Psychiatry & Psychology Source Type: research

Measurement-based care professional practice guideline: Fine, but guidelines do not make good therapy.
Psychotherapy, Vol 60(1), Mar 2023, 17-19; doi:10.1037/pst0000450Boswell et al. (2022) persuasively make the case for and propose professional practice guidelines (PPG) for measurement-based care (MBC). Although the evidence for MBC is robust, implementing MBC effectively in practice requires skills and processes not discussed in the PPG. We discuss five problems with the PPG for MBC: The “what’s in a name?” problem, lack of actionable actions problem, the stopwatch problem, the stock market problem, and looking for the keys under the light problem. (PsycInfo Database Record (c) 2023 APA, all rights reserved) (Source...
Source: Psychotherapy: Theory, Research, Practice, Training - March 23, 2023 Category: Psychiatry & Psychology Source Type: research

Psychotherapist advice, suggestions, recommendations: A research review.
Psychotherapy, Vol 60(3), Sep 2023, 295-305; doi:10.1037/pst0000476Psychotherapists provide at least some advice, suggestions, and recommendations (ASR) in most treatment approaches. We define ASR, offer clinical examples, and review the research evidence for the immediate in-session, immediate delayed, and intermediate effects of ASR, as well as for the moderators of these effects in individual psychotherapy. In seven studies with 327 clients and 131 therapists, we found evidence of neutral immediate in-session outcomes (e.g., client experiencing levels), neutral immediate delayed outcomes (e.g., client-rated helpfulness ...
Source: Psychotherapy: Theory, Research, Practice, Training - March 16, 2023 Category: Psychiatry & Psychology Source Type: research

Paradoxical interventions: A meta-analysis.
This article outlines the evidence base for the use of paradoxical interventions (PIs) in individual psychotherapy. Often misunderstood, PIs have shown long-term (distal) impacts on clinical outcomes, yet a review of the existing literature on these interventions illustrates a trending decline in consideration and use within both research and applied settings. Definitions of PIs and their constituent elements are presented along with clinical examples. We conducted one meta-analysis comparing PIs with a placebo or control and another comparing PIs to other therapeutic methods. PIs demonstrated a large effect (d = 1.1, k = ...
Source: Psychotherapy: Theory, Research, Practice, Training - March 16, 2023 Category: Psychiatry & Psychology Source Type: research