Abstract Background Patients with Major Depressive Disorder (MDD) have been found to have restricted capacity for mentalization, and it is possible that this constitutes a vulnerability factor for developing depression. Due to its focus on linking depressive symptomatology to emotions and interpersonal relations, it was hypothesized that Interpersonal Psychotherapy (IPT) would improve mentalization

Abstract Objective: Despite increasing research on psychotherapy preferences, the preferences of psychotherapy trainees are largely unknown. Moreover, differences in preferences between trainees and their patients could (a) hinder symptom improvement and therapy success for patients and (b) represent significant obstacles in the early career and development of future therapists. Method: We compared

Abstract Objective: The aims of this study were to develop a revised version of the Meaning In Life Measure (MILM; Hill et al., 2019) and investigate its multilevel measurement invariance at the between-person and within-person levels and multi-group measurement invariance across gender, age, and cultural groups. Methods: We analyzed an international dataset including data from 1600 sessions with 384

ABSTRACT Objective As changes in mental representations have been discussed as mechanisms of change in psychotherapy, the question arises whether recollections of childhood abuse and neglect are altered as well and how they relate to symptom changes. Method Individuals in psychosomatic inpatient treatment (N = 488, 60.5% women) filled out the Childhood Trauma Questionnaire (CTQ) and Patient Health

ABSTRACT Objective This study explores how ageism in therapists is manifested in psychotherapy with older adults and how therapists deal with its impact on their therapeutic work. Method: Semi-structured interviews were conducted with 14 therapists and analyzed using grounded theory methodology. Results: Findings clustered around two themes: (i) maintaining openness to change while acknowledging limitations;

ABSTRACT Objective Negative effects (NEs) in group treatments remain an under-researched area. This study aimed to explore the prevalence of various types of NEs in a multicomponent group-based treatment and to determine their predictors. Method: A total of 330 patients participating in a multicomponent group-based treatment were recruited across seven clinical sites. At the end of treatment, the Negative

Abstract Objective: Transgender and gender diverse (TGD) people face various challenges when seeking therapy. Given this, we wanted to understand more about TGD people’s perceptions of providers and how these compare to researcher ratings of providers on metrics of affirming practice. Method: The sample included 158 TGD adults (Mage = 33.06); 57.6% were in therapy. Participants completed measures about

Abstract Objective Despite the importance of spoken language in psychotherapy processes with clients whose native language is distinct from the language of therapy, there is a dearth of research on mental health practitioners (MHPs) language competence. This research aimed to develop the Perceptions of Cross-lingual Practice (PCLP) scale designed to aid MHPs’ cross-lingual practice. Method Study 1

ABSTRACT Objective Despite a proliferation of virtual partial hospital programs (PHP) during the COVID-19 pandemic, there is a dearth of research on such programs. In the current study, we compared treatment outcomes and patient satisfaction between an in-person and a virtual PHP. Further, we examined patients’ qualitative feedback about the virtual PHP. Method Participants included 282 patients attending

Abstract Objective: The literature regarding dropout from psychotherapy has suffered from issues of diverse operationalization of the construct. Some have called for a more uniform definition to aid in generalization across research; this study aimed to assess the viability of such a definition by examining the rate of occurrence for three distinct definitions simultaneously. In addition, therapist

Abstract Objective. Although somatic symptoms are common among mental health patients, their association with symptom severity and inpatient treatment outcomes is not yet well understood. Methods. Using a pre–post design and latent class analysis (LCA), 641 inpatients (63.4% female) were classified based on their self-reported somatic symptoms. We examined how the resulting somatic symptom classes

Abstract Objective: Internalised shame has been linked to psychopathology and consistently identified as a predictor of poor treatment outcomes and premature therapy termination. We conducted a scoping review of therapist-delivered psychosocial interventions to reduce internalised shame to learn how to improve outcomes for individuals experiencing shame. Method: Six bibliographical databases were searched

ABSTRACT Objective: Given its interpersonal underpinnings, relational factors may be salient in psychotherapy for generalized anxiety disorder (GAD). Supporting this point, research has indicated a positive total alliance-improvement correlation in cognitive behavioral therapy (CBT) for GAD. However, less research has disaggregated this correlation into within- and between-patient components, or examined

ABSTRACT Objective We aim to examine how different trajectories of symptom change and working alliance in early psychotherapy predict treatment outcomes. Method We performed a growth mixture model (GMM) to examine trajectories of symptom change and working alliance in the first five therapy sessions in a sample of 272 outpatients and tested the association of early symptom trajectories and alliance

ABSTRACT Objective: To investigate whether there are different antecedents and consequences of different types of therapist questions as this has implications for conducting psychotherapy and for training therapists. Method: We examined the antecedents and consequences of questions for 88 clients working with 33 doctoral student therapists in psychodynamic psychotherapy. Questions were coded into open

Abstract Objective The purpose of this study was to provide some definition of rupture repair in a cognitive–behavioral therapy (CBT) for personality disorders, specifically how treatment tasks or goals are renegotiated. Method: Following a task analysis, a rational model was developed with the support of an expert panel. An empirical analysis was conducted on six CBT cases sampled from a clinical

ABSTRACT Objective The aim of this proof-of-concept study is to develop a predictive model based on deep learning algorithms to predict working alliances after the first therapeutic session and to provide a basis for clinical decisions. Methods Using a sample of 325 patients and 32 psychotherapists from three university counseling centers, a deep learning algorithm known as fully connected neural networks

Abstract Objective Studies examining the unique contribution that the therapist has on outcomes (i.e., “therapist effects”) have increased in recent years. Therapist effects are believed to occur via how the therapist’s interpersonal and intrapersonal qualities influence the therapeutic relationship, which in turn influences outcomes. The current study focused on the extent to which professional self-doubt

Abstract Objective: This study tested whether emotion-focused therapy’s (EFT) emotion processing theory serves as a predictor of 18-month post-therapy outcomes for major depressive disorder (MDD), independent of experiential therapy received. Method: We examined sequences of emotion episodes using the THEME™ sequential analysis of emotional processing in 55 clients who provided 18-month post-therapy

Objective: This study tested whether emotion-focused therapy's (EFT) emotion processing theory serves as a predictor of 18-month post-therapy outcomes for major depressive disorder (MDD), independent of experiential therapy received. Method: We examined sequences of emotion episodes using the THEME™ sequential analysis of emotional processing in 55 clients who provided 18-month post-therapy Beck Depression

Abstract Objective: While the CORE-10 inventory for Clinical Outcome Routine Evaluation has shown good psychometric properties in cross-sectional assessment, the feasibility of generic, short, and easy-to-use longitudinal assessment of a broadband construct such as the targeted “general psychological distress” remains to be psychometrically demonstrated. Therefore, we investigated longitudinal measurement

Abstract Objective: Several studies have shown that the quality of the working alliance predicts symptomatic improvement session-by-session, including in cognitive–behavioral therapy (CBT). We wanted to explore what characterizes CBT sessions with high and low alliances further using qualitative analysis. Method: Ten CBT-sessions were selected from eight patients’ therapies in a larger research project

Abstract Research showing that caregivers’, adolescents’ and therapists’ perceptions of the therapeutic alliance become more similar over time has not examined conceptual models, like emotional contagion and interdependence, that are theorized to account for this convergence. Objective: We modeled codevelopment in systemic family therapy to examine mutual influence and shared environment processes

ABSTRACT Objective: Psychotherapy randomized trials rarely have tested for the best fitting model for time effects. We examined the fit of different statistical models for examining time when repeated assessments of depressive symptoms are the primary outcome. Method: We used data from three studies comparing psychotherapy treatments for major depressive disorder. Outcome measures were self-report

Abstract Objective: Little is known about the occupational health of psychotherapists treating displaced people. Therefore, the literature was explored regarding job demands, job resources, as well as work- and health-related outcomes. The Job Demands-Job Resources model (JD-R model) according to Bakker and Demerouti served as theoretical framework. Method: This scoping review followed the methodological

Abstract Objective Community belongingness has been shown to be related to mental health outcomes in college students; however, little work has evaluated whether community belongingness impacts treatment change, especially during the COVID-19 pandemic, when social isolation and mental health concerns are exacerbated. Accordingly, the current study evaluated community belongingness as a predictor of

ABSTRACT Objective: This study explores in cognitive-behavioral therapy (CBT) for generalized anxiety disorder (GAD) to what degree therapists’ perceptions of their patients as interpersonally challenging (IC) is explained by the therapist or patient effects, if baseline patients’ characteristics predict IC, and if IC is related to outcome. Method: Eighty patients diagnosed with GAD and treated by

Abstract Objective Psychotherapies for depression are similarly effective, but the processes through which these therapies work have not been identified. We focus on psychological process changes during therapy as predictors of long-term depression outcome in treatment responders. Method: Secondary analysis of a randomized trial comparing cognitive therapy (CT) and interpersonal psychotherapy (IPT)

OBJECTIVE This study explores in cognitive-behavioral therapy (CBT) for generalized anxiety disorder (GAD) to what degree therapists' perceptions of their patients as interpersonally challenging (IC) is explained by the therapist or patient effects, if baseline patients' characteristics predict IC, and if IC is related to outcome. METHOD Eighty patients diagnosed with GAD and treated by 20 therapists

OBJECTIVE Psychotherapies for depression are similarly effective, but the processes through which these therapies work have not been identified. We focus on psychological process changes during therapy as predictors of long-term depression outcome in treatment responders. METHOD Secondary analysis of a randomized trial comparing cognitive therapy (CT) and interpersonal psychotherapy (IPT) that focuses

Abstract Objective: Understanding psychological mechanisms of change is essential to advance treatments for patients suffering from medically unexplained physical symptoms (MUPS). This study aimed to test the role of selected change mechanisms (incl. interoceptive awareness, emotional regulation skills, symptom acceptance, relational needs satisfaction, clarification of meaning, working alliance, and

ABSTRACT Most research on alliance rupture-repair processes in psychotherapy has been carried out with adults and little is known about the alliance dynamics with adolescents, especially in psychodynamic treatments. Objective: This study aimed to better understand the process of alliance rupture–resolution and its role in a good-outcome case of a depressed adolescent treated with short-term psycho

Abstract Patient ambivalence towards change is a central therapeutic target in the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP). However, we do not know if and how patients resolve ambivalence across the sessions and modules of the UP. Previous studies have identified two types of ambivalence resolution—dominance and negotiation—and different patterns of resolution for

ABSTRACT Internet-based psychodynamic psychotherapy (iPDT) for adolescents has been found to be effective for treating depression, but not much is known about its active ingredients. Objective: To explore the techniques used in chat sessions in an iPDT program for depressed adolescents, and to investigate whether they predicted improvement in depression symptoms. Method: The study uses data collected

ABSTRACTInternet-based psychodynamic psychotherapy (iPDT) for adolescents has been found to be effective for treating depression, but not much is known about its active ingredients. Objective: To explore the techniques used in chat sessions in an iPDT program for depressed adolescents, and to investigate whether they predicted improvement in depression symptoms. Method: The study uses data collected

Abstract Objective Therapeutic process factors including alliance and motivation are considered to play a key role in the treatment of post-traumatic stress disorder (PTSD). Yet, our understanding of change processes in therapy is mostly based on theoretical considerations with limited empirical evidence. In order to identify process characteristics of successful inpatient treatments of PTSD, we investigated

ABSTRACT Objective Many patients with personality disorders (PDs) present with problematic interaction patterns. These may also manifest in the therapeutic relationship. For successful treatment, therapists must therefore find effective ways to address such problematic interaction patterns. Methods: A total of 382 patients with PDs were recruited within a naturalistic setting and received integrative

Abstract Objective Although clients’ hostile behavior directed at therapists (hostile resistance) predicts worse outcomes in cognitive–behavioral therapy (CBT) for panic disorder, the process by which this happens remains unknown. This study examines two putative mechanisms: working alliance and therapist adherence. Method: Seventy-one adults with primary panic disorder received CBT in a larger trial

ABSTRACT Objective: The Relational Depth Frequency Scale (RDFS) is a 6-item measure to assess the impact of relational depth experiences on psychotherapeutic outcomes. To date, the RDFS has only been validated in online samples of clinical and non-clinical individuals. This study aimed to examine the psychometric properties of the RDFS in clinical dyads of clients and psychotherapists. Method: A total

Abstract Objective to identify and describe trajectories of change in general psychopathology (p) levels among depressed adolescents who received one of three types of short-term therapies (namely Cognitive–Behavioural Therapy, Short-Term Psychoanalytic Psychotherapy, and a Brief Psychosocial Intervention). Method Participants were 465 adolescents with MDD who participated in an RCT comparing three

Abstract Objective: This qualitative survey aimed to explore schema therapists’ perceptions of how their early maladaptive schemas are activated in their therapeutic work, and how they manage their reactions. Method: An online qualitative survey was conducted with 22 schema therapists. Following brief demographic questions, participants were asked three open-ended questions about their schema activation

Abstract Objective Previous studies have established a connection between therapy and healthcare cost: an increase in cost prior to therapy and a maintained decrease post therapy. There is, however, a lack of studies examining the combined effects of psychotherapy and pharmacotherapy on healthcare cost. Method Healthcare cost was examined quarterly in 1,213 patients (28,776 observations) in a naturalistic

ABSTRACT Background Major depression is clinically heterogeneous. We aimed to identify classes of depressed adolescents with different symptom presentations and examine if these were differentially associated with illness severity, functioning, engagement with treatment, and clinical outcomes. Method Baseline depression symptoms of 454 depressed adolescents (age 11–17) from the IMPACT trial were subjected

Abstract Objective: Measurement-based care (MBC), which encompasses routine outcome monitoring (ROM) and measurement feedback systems (MFSs), is an evidence-based practice (EBP) supporting treatment personalization and clinical responsiveness. Despite MBC's effectiveness, clinicians report reservations regarding its utility, which may be a function of overreliance on nomothetic (i.e., standardized)

Abstract Objectives: Many clients do not return after intake. We speculated that similarities between therapists and clients in terms of interruptive behaviors would predict whether clients returned after intake (engaged). Methods: Trained judges coded therapist and client interruptive behaviors (interruptions, overlaps of speech, and sentence completions) for one engager (client returned for at least

ABSTRACT Objective: The objective of this study was to analyze the effect of adherence to both specific technique factors and facilitative condition variables (e.g., therapists’ involvement, understanding and support) in Cognitive Behavior Therapy (CBT) and Interpersonal Psychotherapy (IPT). In addition, we were interested in whether the effect of therapist adherence would depend on the level of the

Abstract Objective: Identifying predictors of dropout is an important step in improving treatment outcomes. The alliance is the most frequently studied psychotherapy process variable, but its relation to dropout in cognitive behavioral therapy (CBT) of depression is not well understood. Methods: We evaluated the alliance at session one as reported by clients and therapists as predictors of dropout

ABSTRACT Objective The ability to trust one’s own perceptions is crucial for psychological well-being and growth. The relevance of its opposite, self-invalidation (SI), to the psychopathology of borderline personality disorder (BPD) is emphasized in many contemporary theories of evidence-based treatments for BPD. Empirical research on this topic remains scarce, however. This study aimed to describe

ABSTRACT Objective: Gaining a deeper understanding of how focused parent–infant psychotherapy (fPIP) works by asking mothers about their experiences. Method: Purposeful sampling was used to select participants who before had participated in an RCT on fPIP. Nine mothers of infants with early regulatory disorders who had received fPIP were interviewed. Eight cases received full-protocol treatment, one

ABSTRACT Objective Transdiagnostic psychotherapies have been proposed as an effective means for addressing the needs of patients with multiple, comorbid disorders. Yet, it remains unknown whether transdiagnostic approaches empirically outperform disorder-specific psychotherapies for patients with comorbid disorders. Thus, this study tested whether comorbidity moderated the efficacy of transdiagnostic

ABSTRACT Objective: In view of the persisting conceptual confusion related to the convergence of attachment measures, we investigated several common measures within a clinical and a non-clinical sample, tested the convergence/divergence of different measures, and tried to find a dimensional model. Method: 175 patients with panic disorder/agoraphobia and 143 matched non-clinical individuals completed

Abstract Obesity is one of the most important health problems nowadays. In addition to the direct physical consequences, it is also a risk factor in the development of psychological (Eating disorders, body dissatisfaction, depression, anxiety, etc.) and social problems. Among there, body dissatisfaction is key for development and maintenance of such problems. Objective: to deepen the effectiveness

ABSTRACT Objective: Systematic client feedback (SCF), the regular monitoring and informing of patients’ progress during therapy to patient and therapist, has been found to have effects on treatment outcomes varying from very positive to slightly negative. Several prior studies have been biased by researcher allegiance or lack of an independent outcome measure. The current study has taken this into

ABSTRACT Objective Does the rater-perspective of youths’ therapeutic alliance matter? To answer this, we evaluated the relationships between four perspectives of youths’ alliance, then, we examined whether each perspective and potential discordance between the perspectives predicted outcomes. Method Participants were 65 youth (M age = 15.11, SD = 2.14; 76.9% girls) undergoing trauma-focused cognitive

ABSTRACT Objective : A growing body of empirical evidence suggests that psychotherapy is more effective when therapists tailor interventions to fit their specific clients’ needs, a concept referred to as therapist responsiveness in the psychotherapy literature. However, the question of how therapists learn to become responsive rarely has been examined. Method : The central question of this study, put

Abstract Objective Preliminary evidence suggests the efficacy of Dialectical Behavior Therapy (DBT) to reduce clinical symptoms in Partial Hospital (PH) programs. However, less is known about DBT in Intensive Outpatient (IOP) programs, or in PH to IOP step-down models. The current study examined changes in depression, anxiety, stress, hopelessness, and mindfulness skills acquisition, from intake and

Abstract Objective Understanding the client perspective is important for the provision of psychotherapy. The significant events paradigm, within which clients report on the most significant events of a therapy session immediately after the session, represents a useful means to explore clients’ in-session experience. Method The aim of this study was to investigate what types of client-identified impacts

Abstract Objective: To investigate (1) whether expert clinicians within psychodynamic therapy (PDT), mentalization-based treatment (MBT), cognitive-behavioral therapy (CBT), and interpersonal psychotherapy (IPT) agree on the essential adolescent psychotherapy processes using the Adolescent Psychotherapy Q-Set (APQ); (2) whether these four session prototypes can be empirically distinguished; and (3)

ABSTRACT Objective Innovative moments (IMs) are moments in which the previous problematic pattern of meaning is challenged. Studies have shown that IMs are associated with good psychotherapy outcomes. A three-level hierarchy of IMs was observed in recent studies, with level 1 IMs being more elementary and levels 2 and 3 being more complex and associated with treatment success. However, studies with

Abstract Objective Although therapist supportive, rather than directive, strategies have been particularly indicated during client resistance, little systematic research has examined how therapists responsively navigate resistance in different therapy approaches and how this responsiveness is related to outcome. Method In the context of disagreement episodes in cognitive–behavioral therapy (CBT) for