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1176 to 1200 of 1,623Severe Illness Anxiety Treated by Integrating Inpatient Psychotherapy With Medical Care and Minimizing Reassurance.
Illness anxiety disorder (IAD, formerly hypochondriasis) is characterized by preoccupation with fear of serious illness despite medical reassurance. IAD is common, debilitating, challenging to treat, and results in high healthcare utilization. Outpatient management of IAD is challenging because patients can compulsively seek reassurance from numerous providers, which interferes with learning more productive coping skills. We present the case of a woman with severe IAD who presented to the emergency room with increasing frequency over several months, despite regular outpatient medical visits and escalating psychiatric care. We made the unusual decision to hospitalize her for IAD for 1 month, in the absence of typical hospitalization criteria. This hospitalization allowed us to consolidate all medical and psychiatric care into a single provider team and train all staff and family to commun…
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British Muslims' perceptions of therapy with non-Muslim therapists: A qualitative analysis of survey responses.
Objectives: Accessing psychological therapy presents unique challenges for Muslims, who are underrepresented in primary care mental health services in the United Kingdom. This qualitative study sought the narratives of British Muslims to gain insight into the perceived barriers and facilitators to engagement with therapy.
Methods: Eighty participants responded to an online free-text survey question enquiring about their views on therapy with a non-Muslim therapist after completing a short experimental study. A structured tabular approach grounded in reflexive thematic analysis was used to analyse data.
Results: Three main themes were identified in our analysis: 'Fundamental differences', 'It's not worth the risk' and 'Overcoming barriers'. Within these themes we explore perceived interpersonal and systemic tensions, as well as facilitators to engagement with psychological therapy.
Conclu…
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Meaning of Life Therapy: A Pilot Study of a Novel Psycho-Existential Intervention for Palliative Care in Cancer.
Intervention in Palliative Care aims to provide physical, psychosocial, and spiritual relief for patients and family members. Brief interventions with a psycho-existential approach have shown positive responses; however, cultural adaptations are needed. This pilot study aimed to develop the Meaning of Life Therapy (MLT), a novel psycho-existential intervention, rooted in the Dignity Therapy, Life Review, and Meaning-Centered Psychotherapy. MLT was culturally adapted to the Portuguese context to include questions about forgiveness, apology, reconciliation, farewell, and a legacy document, i.e., the Life Letter. Nine PC cancer patients answered a 14-question MLT protocol, intended to help patients find purpose and meaning in life. Eight themes emerged: Family, Preservation of Identity, Life Retrospective, Clinical Situation, Achievements, Socio-Professional Valorization, Forgiveness/Apolog…
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Development of the Brief Spirituality/Religiosity Functional Competency Scale.
Spiritual and religious competence in psychotherapy is increasingly recognized as essential for supporting patients facing religious and spiritual struggles, though there is a lack of reliable objective measures to evaluate clinician competence in this area. This study aimed to develop and provide preliminary validation for the Brief Spirituality/Religiosity Functional Competency Scale, an observational tool designed to assess functional spiritual/religious competencies, and to examine the relationship between these competencies and therapeutic alliance. Participants were 105 doctoral trainees enrolled in clinical or counseling psychology programs across the United States. Using data from objective-structured clinical examinations, we assessed the scale's internal consistency, interrater reliability, convergent and discriminant validity. The observational design evaluated participants' f…
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Training clinicians to deliver spiritual psychotherapy for inpatient, residential, and intensive treatment (SPIRIT).
We designed and implemented a multimodal training program for clinicians in how to deliver spiritual psychotherapy for inpatient, residential, and inpatient treatment (SPIRIT), a group-based, spiritually integrated psychotherapy for acute psychiatric settings. The overall goals for this project were to facilitate competency in spiritually integrated psychotherapy among clinicians and meeting established needs for spiritual psychotherapy among patients presenting for acute psychiatric treatment. Our training program in SPIRIT includes the following elements: (a) a training manual, (b) 80-min training video, (c) brief competency exam, and (d) practice component involving the provision of SPIRIT to at least 12 groups of patients. This article provides an overview of the training program and describes its initial dissemination with a multidisciplinary cohort of 17 clinicians within the Massa…
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Therapy without faith: Muslim clients' experience of religious exclusion and minimisation in therapy.
Objective: The integration of religious beliefs is considered an essential component of evidence-based practice; however, clients from faith-based communities frequently report that their beliefs are overlooked in therapy. While existing research primarily centres on therapists' perspectives, there is limited understanding of how Muslim clients themselves make sense of therapy when their religious identity is not acknowledged, particularly within mental health systems often grounded in Western psychological models. This study, therefore, aimed to explore the mental healthcare experiences of Muslim therapy users in the UK who received therapy where their religion was perceived as minimised or excluded, despite its personal significance.
Design: A qualitative approach was adopted, underpinned by a critical realist epistemology. Semi-structured interviews were conducted with 25 Muslim parti…
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Improving psychotherapists' spiritual and religious competencies: Evaluation of a live videoconferencing training program.
This study evaluated the effectiveness of a live videoconferencing training program in spiritually integrated psychotherapy offered by ACPE: The Standard for Spiritual Care and Education (ACPE). We used a quasi-experimental one-group pretest-posttest group design to investigate whether participants' religious/spiritual competencies (self-efficacy, attitudes, and skills) improved and whether their use of spiritual interventions increased after completing the training program. We also assessed whether their perceptions of the barriers to practicing spiritually integrated treatment in their practice setting changed after training. The research participants were 84 adult men and women from diverse spiritual backgrounds, mental health specialties, and geographic locations who completed the measures before and after the training program. A repeated measures multivariate analysis of variance an…
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Meaning-centered psychotherapy for Chinese caregivers of patients with advanced cancer: Cultural and linguistic adaptation.
Purpose: Cancer incidence is rising in Hong Kong, with over half of common cancers diagnosed at advanced stages, placing substantial demands on families and driving high caregiver distress. Meaning-centered psychotherapy for cancer caregivers (MCP-C) shows promise in Western settings but requires cultural tailoring for Chinese caregivers whose values are shaped by Confucian ethics. This study aimed to culturally and linguistically adapt MCP-C for Chinese caregivers of patients with advanced cancer in Hong Kong to enhance acceptability, relevance and conceptual equivalence.
Methods: Guided by the ORBIT model and Bernal's ecological validity model (EVM), we conducted semistructured interviews with nine cancer caregivers and eight healthcare professionals (oncologists, nurses, social worker and clinical psychologist). The manual was translated and transcreated into traditional Chinese. Anal…
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Galpin K, He S, Shaw J, Dhillon H, Nelson C, Beatty L, Kelly M, Carey M, Conrad A, Bartczak A, Kelly B (2026)MEDLINE-indexed journal, not yet read by usPsycho-oncology1 citations Cancer and Ageing Reflections for Elders (CARE): Australian Adaptation of a Psychotherapy for Older Adults With Cancer.
Background: Depression is common among older adults with cancer. The USA-developed CARE (Cancer and Ageing: Reflection for Elders) psychotherapy intervention, specifically addresses the unique needs of older people (≥ 70 years) navigating the challenges of ageing, depression, and cancer.
Aims: To review and tailor the CARE resources to ensure they are culturally appropriate and acceptable for older Australians.
Methods: Semi-structured cognitive 'think aloud' interviews were conducted with older Australians (≥ 70 years) diagnosed with cancer. Participants reviewed the intervention resources for each session providing feedback on content relevance and understandability. Content analysis was used to analyse the interviews.
Results: We completed 20 cognitive interviews. Participants had a mean age of 74 years (range 70-79) and most with a diagnosis of blood (55% n = 11) or breast cancer (45…
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Spiritual struggles drive psychological distress in psychotherapy: Replication of findings using a practice-research network.
Longitudinal evidence indicates struggles with spirituality/religion (S/R; e.g., feeling distant or abandoned by God, guilty for not attaining standards of moral perfection, judged by one's family or community) may cause distress and hinder recovery from mental health challenges. However, research has not examined temporal associations between spiritual struggles and psychological distress in spiritually integrated psychotherapies (SIPs). In total, 175 practitioners of SIPs from 38 clinics and other settings in a practice-research network assessed these outcomes with 1,404 clients over the first 6 weeks of treatment (Time 1 [Weeks 1-2], Time 2 [Weeks 3-4], and Time 3 [Weeks 5-6]). In keeping with findings from other samples (e.g., Cowden et al., 2022, 2024; Currier et al., 2015, 2018), cross-lagged panel analyses across the three time points revealed spiritual struggles predicted clients…
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Rosa WE, Pessin H, Gilliland J, Behrens MR, Foxwell AM, McAndrew NS, Schlak AE, Applebaum AJ, Lichtenthal WG, Saracino RM, Breitbart W, Roberts KE (2025)MEDLINE-indexed journal, not yet read by usTranslational behavioral medicine5 citations Adaptation of meaning-centered psychotherapy for healthcare providers to buffer work-induced distress and improve wellbeing.
Healthcare providers (HCPs) face high rates of distress, experienced as burnout, moral distress, compassion fatigue, and grief. HCPs are also experiencing a crisis in meaning whereby distress is associated with disconnection from meaning in work and, in turn, a lack of meaning in work can further perpetuate distress for HCPs. Although scalable systems-level solutions are needed to tackle multidimensional HCP distress, it is also necessary to address HCP suffering at individual, team, and institutional levels. Targeted interventions to alleviate HCP distress are limited. Meaning-centered psychotherapy (MCP), a brief, evidence-based, intervention first developed for persons with advanced cancer, holds promise to mitigate HCP distress. This study adapted MCP for HCPs through feedback from a multidisciplinary sample of clinicians trained in MCP and working in healthcare settings. A survey wa…
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Topçu MT, Mösko M (2025)MEDLINE-indexed journal, not yet read by usInternational journal for equity in health1 citations Building trust and relationship across language barriers: a qualitative study of interpreter-mediated psychotherapy with therapists, interpreters and patients.
Background: Among a variety of barriers to accessing and providing mental health care for migrant and refugee populations, language barriers play a crucial role. Interpreter-mediated psychotherapy (IMP) has emerged as an effective approach to overcoming these challenges and promoting equitable access to mental health care. However, IMP also introduces a more complex relationship structure: the classical therapist-patient dyad evolves into a triad. Relational qualities such as trust, empathy, and mutual understanding are known to be key indicators of a positive therapeutic relationship. Despite the utilisation of interpreters, research on the relational qualities of IMP remains limited. While several qualitative studies have explored relational dynamics in IMP, few have examined these from the perspective of all parties, particularly by incorporating patient's perspectives. Therefore, thi…
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The evolution of feedback: Toward a multicultural orientation.
There have been great strides in psychology regarding diversity, equity, inclusion, and multicultural competence, but a need remains to translate these values into actionable practices in psychotherapy. While the case has been made that measurement-based care is an evidence-based intervention that improves outcomes and reduces dropouts (de Jong et al., 2021) and recently that it provides a transparent collaborative process to engage clients in treatment (Boswell et al., 2023), it has not been widely considered as a methodology for multicultural competence. We trace the evolution of what was once called "patient-focused research" (Lambert, 2001) and identify a significant change in recent writings to include important clinical and collaborative processes, a transition from a strictly normative or nomothetic understanding of the value of feedback to an appreciation of its communicative or …
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Bennemann ACK, Paiva CE, Julião M, Chochinov HM, Marques C, Costa RFA, Oliveira LC, Uchida Miwa M, Trevizan FB, Valentino TCO, Paiva BSR (2024)MEDLINE-indexed journal, not yet read by usPalliative & supportive care2 citations Translation and cross-cultural adaptation of the Posthumous Dignity Therapy Schedule of Questions to Brazilian Portuguese.
Objectives: Dignity Therapy (DT) is a brief form of psychotherapy that helps people with life-threatening illnesses and their loved ones cope with emotional pain and demoralization. Unfortunately, not everyone has the opportunity to receive DT during their lifetime. Posthumous Dignity Therapy (PDT) was then devised to be administered to bereaved family members. However, PDT has not yet been validated or studied in the specific cultural and linguistic context of Portuguese-Brazilians. This study aims to fill this gap by validating PDT for the Portuguese (Brazilian) context.
Methods: Using Beaton's methodology, including the processes of translation, synthesis, back-translation, evaluation by an expert committee, and pre-testing, the PDT Schedule of Questions underwent validation and cultural adaptation. The research was conducted in a Palliative Care Unit at a tertiary cancer hospital in …
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Predicting resistance management skill from psychotherapy experience, intellectual humility and emotion regulation.
Objective Resistance management in psychotherapy remains a foundational skill that is associated with positive client outcomes (Westra, H. A., & Norouzian, N. (2018). Using motivational interviewing to manage process markers of ambivalence and resistance in cognitive behavioral therapy. Cognitive Therapy and Research, 42(2), 193-203). However, little is known about which therapist characteristics contribute to successful management of resistance. Research has suggested that psychotherapy performance does not improve with experience (Goldberg, S. B., Rousmaniere, T., Miller, S. D., Whipple, J., Nielsen, S. L., Hoyt, W. T., & Wampold, B. E. (2016). Do psychotherapists improve with time and experience? A longitudinal analysis of outcomes in a clinical setting. Journal of Counseling Psychology, 63(1), 1-11), that psychotherapists lack humility (Macdonald, J., & Mellor-Clark, J. (2015). Corre…
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Exploring Spiritually Integrated Psychotherapy as a Modality: How it is Evolving in the Ontario, Canada Context and the Relevance of Contributions from the Fields of Theology and Spiritual Care.
This paper surveys the current understanding of spiritually integrated psychotherapy (SIP) and connects the historical role of religious training to better understand how SIP is developing as a psychotherapy modality in Ontario, Canada. The paper clarifies how SIP is defined and proposes three levels of practice: spiritually conscious therapy, spiritually informed therapy, and spiritually integrated therapy. As evidence-based and practiced-based literature expands, more consensus is needed in how SIP terminology is used.
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Reflections on experiential training in meaning-centered psychotherapy: How MCP ended up facilitating professional wellbeing.
Objective: Meaning-centered psychotherapy (MCP) principles may provide a framework for engaging healthcare professionals in meaning-centered exploration as a novel approach to prevent burnout and enhance wellbeing in healthcare professionals through heightening personal meaning. This case study aimed to teach MCP to masters-trained social workers for use with medical patients. While the primary aim was to teach MCP to masters-trained social workers, this proof-of-concept project and this paper focus on a secondary aim of enhancing meaning and connection in the virtual workplace.
Methods: A group of social workers participated in a 7-session MCP pilot from October 13th to November 24th, 2020. After each session, participants were asked to complete an anonymous continuing education evaluation with questions regarding clarity, organization, and relevance of the presentation related to use w…
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Koenig HG (2023)MEDLINE-indexed journal, not yet read by usJournal of religion and health6 citations Person-Centered Mindfulness: A Culturally and Spiritually Sensitive Approach to Clinical Practice.
Mindfulness meditation is rapidly being integrated into many different forms of counseling and psychotherapy, and there is a growing evidence base for its effectiveness. It is important to understand the spiritual roots of mindfulness, and to apply it in a patient-centered manner, sensitive to the patient's own faith tradition rather than taking a one-size-fits-all approach, assuming that mindfulness-based practice is a purely secular approach. The philosophical underpinning of mindfulness lies squarely in the Buddhist faith tradition. Indeed, mindfulness is the 7th step on the Eightfold Path, which is the heart of Buddhist teachings. Many practitioners, however, may not realize that there are Western meditative techniques that are very similar to mindfulness and that have deep roots within Christian, Jewish, and Muslim faith traditions. Patient-centered mindfulness involves the use of m…
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Schleider JL (2023)MEDLINE-indexed journal, not yet read by usJournal of consulting and clinical psychology32 citations The fundamental need for lived experience perspectives in developing and evaluating psychotherapies.
This article discusses the fundamental need for lived experience perspectives in developing and evaluating psychotherapies. The primary professional goal of clinical psychology is to serve individuals and communities living with or at risk of mental illness. To date, the field has fallen persistently short of this goal, despite decades of research on evidence-based treatments and myriad innovations in psychotherapy research. Brief and low-intensity programs, transdiagnostic approaches, and digital mental health tools have all challenged long-held assumptions of what "psychotherapy" can be, pointing toward novel pathways to effective care. And yet, population-level rates of mental illness are high and rising, access to care remains abysmally low, early treatment dropout among people who do access care is common, and science-backed treatments rarely make it into everyday practice. The auth…
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Restore and Rebuild (R&R) - a feasibility pilot study of a co-designed intervention for moral injury-related mental health difficulties.
Background: Moral injury can significantly negatively impact mental health, but currently no validated treatment for moral injury-related mental health difficulties exists in a UK context. This study aimed to examine whether the Restore and Rebuild (R&R) treatment was feasible to deliver, acceptable and well tolerated by UK military veterans with moral injury related mental health difficulties.
Method: The R&R treatment was delivered to 20 patients who reported distress related to exposure to a morally injurious event(s) during military service. R&R is a 20-session psychotherapy with key themes of processing the event, self compassion, connecting with others and core values. Treatment was delivered online, weekly, one-to-one by a single therapist. Qualitative interviews with patients and the therapist who delivered R&R were conducted to explore acceptability and analysed using thematic a…
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An Integrated Developmental Approach to Personality Disorders in Adolescence: Expanding Kernberg's Object Relations Theory.
This article is a tribute to Dr. Otto F. Kernberg and his contribution to the theoretical understanding of personality pathology in adolescence. In his object relations theory of the structure of personality, an integrated identity is considered central to healthy personality functioning and is contrasted with identity diffusion, which is posited to underlie the maladaptive interpersonal functioning of patients with severe personality disorders. His work provided an early theoretical foundation for the understanding and treatment of personality disorders in adults, but a need remained for a deeper understanding of the development and treatment of personality disorders during adolescence. During the past 10 years, Kernberg has led a group of clinicians and developmental researchers focusing on childhood and adolescence to elaborate an understanding of the development, assessment, and trea…
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Examination of perceived religion in Muslim women's access to counseling and psychotherapy services: An audit study.
Across the United States and Canada, the marginalization of Muslims has contributed to many Muslim women having mental health difficulties, making it essential that services are available and accessible. An email correspondence audit design research study was used to investigate whether mental health practitioners demonstrate implicit bias in the form of aversive prejudice against Muslim women during a request for counseling/psychotherapy services. A total of 450 counselors or psychologists participated. Practitioners received an email from either a Muslim or non-Muslim woman, signified by name and a religious quotation, requesting an appointment. Based on the Aversive Racism Framework, it was hypothesized that practitioners would (a) respond more frequently to the Muslim woman and (b) respond faster to the Muslim woman but (c) offer services to the Muslim woman at a lesser or similar fr…
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Predicting dropout from psychological treatment using different machine learning algorithms, resampling methods, and sample sizes.
Objective: The occurrence of dropout from psychological interventions is associated with poor treatment outcome and high health, societal and economic costs. Recently, machine learning (ML) algorithms have been tested in psychotherapy outcome research. Dropout predictions are usually limited by imbalanced datasets and the size of the sample. This paper aims to improve dropout prediction by comparing ML algorithms, sample sizes and resampling methods. Method: Twenty ML algorithms were examined in twelve subsamples (drawn from a sample of N = 49,602) using four resampling methods in comparison to the absence of resampling and to each other. Prediction accuracy was evaluated in an independent holdout dataset using the F1-Measure. Results: Resampling methods improved the performance of ML algorithms and down-sampling can be recommended, as it was the fastest method and as accurate as the oth…
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Importance of Integrating Spiritual, Existential, Religious, and Theological Components in Psychedelic-Assisted Therapies.
Importance: Mounting evidence supports the role of spiritual, existential, religious, and theological components in mediating psychedelic-assisted therapy, yet integration of these elements into the clinical setting is lagging.
Observations: Although psychedelic-assisted therapy commonly produces spiritually, existentially, religiously, or theologically relevant experiences for patients, these have not been systematically integrated into the psychotherapies that accompany therapeutic uses of psychedelics. As a key feature and potential mediator of therapeutic effects, evidence-based psychedelic-assisted therapies should include these topics in the treatment model. Research across multiple diagnostic targets and treatment contexts suggests that spiritually integrated psychotherapies are effective, feasible, and produce add-on benefits in spiritually, existentially, religiously, and theolo…
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Binge eating disorder.
Binge eating disorder (BED) is characterized by regular binge eating episodes during which individuals ingest comparably large amounts of food and experience loss of control over their eating behaviour. The worldwide prevalence of BED for the years 2018-2020 is estimated to be 0.6-1.8% in adult women and 0.3-0.7% in adult men. BED is commonly associated with obesity and with somatic and mental health comorbidities. People with BED experience considerable burden and impairments in quality of life, and, at the same time, BED often goes undetected and untreated. The aetiology of BED is complex, including genetic and environmental factors as well as neuroendocrinological and neurobiological contributions. Neurobiological findings highlight impairments in reward processing, inhibitory control and emotion regulation in people with BED, and these neurobiological domains are targets for emerging…
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