Talking treatment in general.
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Research library, full list
1276 to 1300 of 1,623Adapting an evidence-based intervention to REACH Forgiveness for different religions and spiritualities.
The REACH Forgiveness intervention has been used in psychoeducational groups, couple and individual counseling and psychotherapy, and workbooks. It has been investigated in over 20 randomized clinical trials (RCTs) worldwide. It has been accommodated to treat Christians and shown to be effective in RCTs. But most research has established it to be effective when not accommodating it to religious or spiritual clientele. In this article, we will claim that it can be accommodated to a variety of religious clients. We describe guidelines about what is essential to the treatment and what might be effectively modified to be acceptable to religious and spiritual clients embracing a variety of beliefs and practices.
matched on Psychotherapy (mesh), psychotherapy (text)
Is dropout after a first psychotherapy visit always a bad outcome?
Objective: The authors compared outcomes reported by patients who did or did not return for treatment after an initial psychotherapy visit.
Methods: Members of a group health plan were surveyed about initial psychotherapy visits occurring between March and September 2010. The survey assessed satisfaction with care and therapeutic alliance during the visit and later clinical improvement.
Results: Of the 2,666 members who returned surveys, 906 (34%) did not return for a second visit within 45 days. The distribution of satisfaction, therapeutic alliance, and self-rated improvement scores between patients who did and did not return differed significantly (p<.001). Patients who did not return were more likely to report the most favorable and the least favorable outcomes.
Conclusions: Failure to return after an initial psychotherapy visit can represent successful and satisfying treatment. Syst…
matched on Psychotherapy (mesh), psychotherapy (text)
Adler JM (2012)MEDLINE-indexed journal, not yet read by usJournal of personality and social psychology142 citations Living into the story: agency and coherence in a longitudinal study of narrative identity development and mental health over the course of psychotherapy.
Narrative identity is the internalized, evolving story of the self that each person crafts to provide his or her life with a sense of purpose and unity. A proliferation of empirical research studies focused on narrative identity have explored its relationship with psychological well-being. The present study is the first prospective, multiwave longitudinal investigation to examine short-term personality change via an emphasis on narrative identity as it relates to mental health. Forty-seven adults wrote rich personal narratives prior to beginning psychotherapy and after every session over 12 assessment points while concurrently completing a measure of mental health. Narratives were coded for the themes of agency and coherence, which capture the dual aims of narrative identity: purpose and unity. By applying in-depth thematic coding to the stories of participants, the present study produce…
matched on Psychotherapy (mesh), psychotherapy (text)
Early dropout from psychotherapy for depression with group- and network-model therapists.
Administrative data were used to examine early dropout among 16,451 health plan members calling to request psychotherapy for depression. Compared to members referred to group-model therapists, those referred to network-model therapists were more likely to drop out before the initial visit (OR 2.33, 95% CI 2.17-2.50) but less likely to drop out after the first visit (OR 0.45, 95% CI 0.43-0.48). These differences were unaffected by adjustment for neighborhood income and educational attainment, antidepressant use, or generosity of insurance coverage. Efforts to increase the effectiveness of psychotherapy may required different strategies in group- and network-model practice.
matched on Psychotherapy (mesh), psychotherapy (text)
Early maladaptive schemas and child and adult attachment: a 15-year longitudinal study.
Objectives: To examine the relation between early maladaptive schemas (EMS), as defined in schema therapy, and both child and adult attachment.
Design: A 15-year longitudinal design in which child attachment groups (secure, avoidant, ambivalent, and disorganized) were compared in early adulthood on their profile of scores across EMS domains. A similar strategy was used to examine EMS profiles as a function of adult attachment groups (secure, preoccupied, and fearful).
Methods: Sixty participants, recruited from Montreal day-care centres, were assessed at 6 (Time 1) and 21 years of age (Time 2). Time 1 attachment was assessed using a separation-reunion procedure and Time 2 attachment, using the Experiences in Close Relationships questionnaire. EMS were evaluated with the Young Schema Questionnaire (Time 2).
Results: There were more signs of EMS among young adults with either an insecure a…
matched on Psychotherapy (mesh), psychotherapy (text)
An eating disorder randomized clinical trial and attrition: profiles and determinants of dropout.
Objective: This study sought to determine whether differential treatment effects in the targeted mechanisms of change and eating disorder (ED) symptoms are associated with patterns of attrition from a RCT.
Method: The main study was a RCT of a psychotherapy designed to alter the non-weight related self-cognitions as the means to promote recovery and health in a sample of 69 women with AN or BN. Four groups based on point of dropout were compared on demographic, self-cognitions and ED symptoms using logit and piecewise mixed effects modeling.
Results: Attrition was highest during treatment phase but no significant predictors were found. During the measurement phase, the direction and amount of change in self-cognition interrelatedness and body dissatisfaction differed according to point of dropout and treatment group.
Discussion: Attention to changes both in symptoms and mediating factors…
matched on Psychotherapy (mesh), psychotherapy (text)
Therapist effectiveness: implications for accountability and patient care.
Significant therapist variability has been demonstrated in both psychotherapy outcomes and process (e.g., the working alliance). In an attempt to provide prevalence estimates of "effective" and "harmful" therapists, the outcomes of 6960 patients seen by 696 therapists in the context of naturalistic treatment were analyzed across multiple symptom and functioning domains. Therapists were defined based on whether their average client reliably improved, worsened, or neither improved nor worsened. Results varied by domain with the widespread pervasiveness of unclassifiable/ineffective and harmful therapists ranging from 33 to 65%. Harmful therapists demonstrated large, negative treatment effect sizes (d= -0.91 to -1.49) while effective therapists demonstrated large, positive treatment effect sizes (d=1.00 to 1.52). Therapist domain-specific effectiveness correlated poorly across domains, sugg…
matched on Psychotherapy (mesh), psychotherapy (text)
What works for whom: Tailoring psychotherapy to the person.
This article introduces the issue of the Journal of Clinical Psychology: In Session devoted to evidence-based means of adapting psychotherapy to the patient's (transdiagnostic) characteristics. Practitioners have long realized that treatment should be tailored to the individuality of the patient and the singularity of his or her context, but only recently has sufficient empirical research emerged to reliably guide practice. This article reviews the work of an interdivisional task force and its dual aims of identifying elements of effective therapy relationships (what works in general) and identifying effective methods of adapting treatment to the individual patient (what works in particular). The task force judged four patient characteristics (reactance/resistance, preferences, culture, religion/spirituality) to be demonstrably effective in adapting psychotherapy and another two (stages …
matched on Psychotherapy (mesh), psychotherapy (text)
Fears of compassion: development of three self-report measures.
Objectives: There is increasing evidence that helping people develop compassion for themselves and others has powerful impacts on negative affect and promotes positive affect. However, clinical observations suggest that some individuals, particularly those high in self-criticism, can find self-compassion and receiving compassion difficult and can be fearful of it. This study therefore developed measures of fear of: compassion for others, compassion from others, and compassion for self. We also explored the relationship of these fears with established compassion for self and compassion for others measures, self-criticism, attachment styles, and depression, anxiety, and stress.
Method: Students (N= 222) and therapists (N= 53) completed measures of fears of compassion, self-compassion, compassion for others, self-criticism, adult attachment, and psychopathology.
Results: Fear of compassion …
matched on Psychotherapy (mesh), psychotherapy (text)
Dropout and therapeutic alliance: a meta-analysis of adult individual psychotherapy.
This meta-analytic review of 11 studies examined the relationship between psychotherapy dropout and therapeutic alliance in adult individual psychotherapy. Results of the meta-analysis demonstrate a moderately strong relationship between psychotherapy dropout and therapeutic alliance (d = .55). Findings indicate that clients with weaker therapeutic alliance are more likely to drop out of psychotherapy. The meta-analysis included a total of 1,301 participants, with an average of 118 participants per study, a standard deviation of 115 participants, and a range from 20 to 451 participants per study. Exploratory analyses were conducted to determine the influence of variables moderating the relationship between alliance and dropout. Client educational history, treatment length, and treatment setting were found to moderate the relationship between alliance and dropout. Studies with a larger pe…
matched on Psychotherapy (mesh), psychotherapy (text)
Amplifications and applications of Pennebaker's analogic to digital model in health promotion, prevention, and psychotherapy.
This article expands on James Pennebaker's original model in expressive writing, going from an Analogically unclear and unspecified experiential mass (A) to a Digital specification in words (D). Amplifications of this model are found in philosophy, psychodynamic theory and in Salience learning theory. Applications of this model involve expressive writing, going from ambiguous experiences (A) to using the Dictionary (D), and responding to Sentences with strong psychological impact (S). The undefined and ill-defined analogical mass is constituted by traumas in Pennebaker's work and hurt feelings in L'Abate's and Vangelisti's works. Implications of these approaches for the practice of health promotion, prevention and psychotherapy are discussed.
matched on Psychotherapy (mesh), psychotherapy (text)
Muslim views on mental health and psychotherapy.
Objectives: The aim of this research was to explore with a heterogeneous Muslim population their understanding of the concept of mental health and how any mental distress experienced by an individual can best be addressed.
Design: A qualitative approach was taken. Participants were interviewed, and data analysed thematically.
Methods: A sample of 14 Muslims was interviewed according to a semi-structured interview schedule. Participants were recruited via electronic mailing lists, and communications with local Muslim organizations. Interviews were transcribed verbatim, and data were analysed using thematic analysis.
Results: Thematic analysis identified seven operationalizing themes that were given the labels 'causes', 'problem management', 'relevance of services', 'barriers', 'service delivery', 'therapy content', and 'therapist characteristics'.
Conclusions: The results highlight the in…
matched on Psychotherapy (mesh), psychotherapy (text)
Sellman D (2010)MEDLINE-indexed journal, not yet read by usAddiction (Abingdon, England)33 citations The 10 most important things known about addiction.
If you were asked: 'What are the most important things we know about addiction?' what would you say? This paper brings together a body of knowledge across multiple domains and arranged as a list of 10 things known about addiction, as a response to such a question. The 10 things are: (1) addiction is fundamentally about compulsive behaviour; (2) compulsive drug seeking is initiated outside of consciousness; (3) addiction is about 50% heritable and complexity abounds; (4) most people with addictions who present for help have other psychiatric problems as well; (5) addiction is a chronic relapsing disorder in the majority of people who present for help; (6) different psychotherapies appear to produce similar treatment outcomes; (7) 'come back when you're motivated' is no longer an acceptable therapeutic response; (8) the more individualized and broad-based the treatment a person with addict…
matched on Psychotherapy (mesh), psychotherapy (text)
The role of psychotherapy in bipolar disorder.
Adjunctive psychosocial interventions for bipolar disorder target many of the issues that are not addressed by medication alone, including non-adherence, efficacy-effectiveness gap and functionality. Psychosocial interventions have been found to reduce relapse, particularly for the depressive pole, and improve functionality. Approaches such as psychoeducation, cognitive behaviour therapy, interpersonal and social rhythm therapy, and family therapy have shown benefits as adjunctive treatments. Each of the various psychosocial interventions has a unique emphasis, but they share common elements. These include: providing information and education; developing a personal understanding of the illness, such as triggers and early warning signs; having prepared strategies in place for early intervention, should symptoms of illness develop; and promoting a collaborative approach. Evidence to date s…
matched on Psychotherapy (mesh), psychotherapy (text)
Predictors of early dropout from psychotherapy for depression in community practice.
Objective: Data from a managed care health system were used to examine demographic, clinical, and health system predictors of early dropout from psychotherapy for depression.
Methods: A total of 238 members of a mixed-model health plan calling to request an initial psychotherapy visit for depression completed a brief survey regarding depression severity, perceived need for treatment, and expected benefit. Claims records were used to assess therapy visits attended over the following 90 days.
Results: Dropout rates before the first therapy visit were somewhat higher among women (p=.041) and younger members (p=.017), moderately higher among those with lower depression severity (p=.012), and markedly higher among callers referred to network-model psychotherapists (compared with those given appointments with group-model therapists at health plan clinics) (p<.001). By the second visit, however…
matched on Psychotherapy (mesh), psychotherapy (text)
Salamina G, Diecidue R, Vigna-Taglianti F, Jarre P, Schifano P, Bargagli AM, Davoli M, Amato L, Perucci CA, Faggiano F, VEdeTTE Study Group (2010)MEDLINE-indexed journal, not yet read by usSubstance use & misuse31 citations Effectiveness of therapies for heroin addiction in retaining patients in treatment: results from the VEdeTTE study.
Treatment is effective in reducing heroin use and clinical and social problems among heroin addicts. The effectiveness is related to the duration of treatment. "VEdeTTE" is an Italian longitudinal study funded by the Ministry of Health to evaluate the effectiveness of treatments provided by the National Health Services. The study involved 115 drug treatment centers and 10,454 heroin users. Clinical and personal information were collected at intake through a structured interview. Treatments were recorded using a standardized form. Survival analysis and Cox Proportional Hazard model were used to evaluate treatment retention. Five thousand four hundred and fifty-seven patients who started a treatment in the 18 months of the study were included in the analysis: 43.2% received methadone maintenance therapy (MMT), 10.5% therapeutic community, and 46.3% abstinence-oriented therapy (AOT). The li…
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Leichsenring F, Hoyer J, Beutel M, Herpertz S, Hiller W, Irle E, Joraschky P, Konig HH, de Liz TM, Nolting B, Pohlmann K, Salzer S, Schauenburg H, Stangier U, Strauss B, Subic-Wrana C, Vormfelde S, Weniger G, Willutzki U, Wiltink J, Leibing E (2009)MEDLINE-indexed journal, not yet read by usPsychotherapy and psychosomatics38 citations The social phobia psychotherapy research network. The first multicenter randomized controlled trial of psychotherapy for social phobia: rationale, methods and patient characteristics.
This paper presents the Social Phobia Psychotherapy Research Network. The research program encompasses a coordinated group of studies adopting a standard protocol and an agreed-on set of standardized measures for the assessment and treatment of social phobia (SP). In the central project (study A), a multicenter randomized controlled trial, refined models of manualized cognitive-behavioral therapy and manualized short-term psychodynamic psychotherapy are compared in the treatment of SP. A sample of 512 outpatients will be randomized to either cognitive-behavioral therapy, short-term psychodynamic psychotherapy or waiting list. Assessments will be made at baseline, at the end of treatment and 6 and 12 months after the end of treatment. For quality assurance and treatment integrity, a specific project using highly elaborated measures has been established (project Q). Study A is complemented…
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Barber JP (2009)MEDLINE-indexed journal, not yet read by usPsychotherapy research : journal of the Society for Psychotherapy Research80 citations Toward a working through of some core conflicts in psychotherapy research.
The author discusses the evidence for six basic statements that many, but not all, psychotherapy researchers adhere to: (1) The therapeutic alliance has a causal role in outcome, (2) therapeutic techniques explain patients' outcome, (3) therapists determine outcome, (4) patients determine therapy outcome, (5) randomized controlled trials (RCTs) provide valuable data, (6) data from RCTs are almost worthless. These "truths" combine to form three core conflicts: Is psychotherapy about the alliance or techniques? Does the patient or therapist determine the outcome? Are RCTs a blessing or a curse? After showing that these statements oversimplify the research of the therapeutic process, the author recommends keeping both sides of the conflict in awareness and endorses a pluralistic methodological approach for the study of both efficacy and the mechanisms of psychotherapy.
matched on Psychotherapy (mesh), psychotherapy (text)
Worry, generalized anxiety disorder, and emotion: evidence from the EEG gamma band.
The present study examined EEG gamma (35-70 Hz) spectral power distributions during worry inductions in participants suffering from generalized anxiety disorder (GAD) and in control participants without a history of psychiatric illness. As hypothesized, the EEG gamma band was useful for differentiating worry from baseline and relaxation. During worry induction, GAD patients showed higher levels of gamma activity than control participants in posterior electrode sites that have been previously associated with negative emotion. Gamma fluctuations in these electrode sites were correlated with subjective emotional experience ratings lending additional support to interpretations of negative affect. Following 14 weeks of psychotherapy, the GAD group reported less negative affect with worry inductions and the corresponding gamma sites that previously differentiated the clinical from control grou…
matched on Psychotherapy (mesh), psychotherapy (text)
Untangling the alliance-outcome correlation: exploring the relative importance of therapist and patient variability in the alliance.
Although the therapeutic alliance is a consistent predictor of psychotherapy outcomes, research has not distinguished between the roles of patient and therapist variability in the alliance. Multilevel models were used to explore the relative importance of patient and therapist variability in the alliance as they relate to outcome among 331 patients seen by 80 therapists (therapist average caseload was 4.1). Patients rated both the alliance and outcome and all models adjusted for baseline psychological functioning. The results indicated that therapist variability in the alliance predicted outcome, whereas patient variability in the alliance was unrelated to outcome. Reasons why therapist variability as opposed to patient variability predicted outcome are discussed. Clinical implications include therapists monitoring their contribution to the alliance, clinics providing feedback to therapi…
matched on Psychotherapy (mesh), psychotherapy (text)
Vasquez MJ (2007)MEDLINE-indexed journal, not yet read by usThe American psychologist53 citations Cultural difference and the therapeutic alliance: an evidence-based analysis.
The research on positive psychotherapy outcome consistently indicates that the quality of the alliance is important across different models of psychotherapy (D. E. Orlinsky, M. H. Ronnestad, & U. Willutzki, 2004; B. E. Wampold, 2000). Social psychological research has documented how "unintentional bias" can produce barriers to university admissions, employment, and advancement of well-qualified members of ethnic minority groups (J. F. Dovidio, S. L. Gaertner, K. Kawakami, & G. Hodson, 2002). Neuroscience is further confirming social psychological responses associated with race (J. L. Eberhard, 2005). Unintentional bias identified in social psychological research may be part of the psychotherapist/client interaction, interfere with the therapeutic alliance, and partly account for the high dropout rates and underutilization of psychotherapeutic services by people of color. The purpose of t…
matched on Psychotherapy (mesh), psychotherapy (text)
Perceived barriers to treatment and psychotherapy attendance in child community mental health centers.
Poor psychotherapy attendance is a major problem facing most child community mental health centers. However, post-treatment perspectives on reasons for premature termination are rarely sought from either families or clinicians. In the present study, we collected parent data and clinician data regarding 72 and 153 clients, respectively, from four child and adolescent community mental health centers serving diverse families. Problems regarding (a) the perceived relevance of treatment and (b) the quality of the therapist-family relationship emerged as the two most consistent factors related to premature dropout. Possible interventions to increase psychotherapy attendance are highlighted.
matched on Psychotherapy (mesh), psychotherapy (text)
Interpersonal sensitivities: their links to mood, anger and gender.
This paper explores two interpersonal sensitivities (to rejection and to social put-down) in a group of 54 depressed men and 50 depressed women. Measures of anhedonia, anxiety, anger, social comparison, and submissive behaviour were also obtained. We found no differences in rejection sensitivity, anger, anhedonia, or anxiety between the sample of depressed men and women. Depressed women rated themselves as more submissive and more inferior than depressed men, and blamed themselves more for being criticized and put-down by other people. Principal components analysis (PCA) revealed three underlying factors: mood (including anxiety and depression), internalization (related to self-blame and feelings of low rank), and externalization (related to anger and blaming others for criticism). For both men and women internalization was significantly correlated with depression. However, externalizati…
matched on Psychotherapy (mesh), psychotherapy (text)
Does the quality of the working alliance predict treatment outcome in online psychotherapy for traumatized patients?
Background: The provision of online counseling and online therapy is steadily increasing. The results of a number of controlled trials investigating the efficacy of online approaches indicate that some of these new treatment alternatives might indeed be effective. Yet, little is known about how the therapeutic relationship (or working alliance) evolves over the Internet and whether it influences treatment outcome as it does in traditional face-to-face therapy. The working alliance has been defined as the extent to which a patient and a therapist work collaboratively and purposefully and connect emotionally.
Objective: The aim of the study was to investigate the quality and predictive relevance of the therapeutic alliance for patients receiving a short-term, Internet-based, cognitive-behavioral therapy program for posttraumatic stress reactions.
Methods: After rigorous screening for exclu…
matched on Counseling (mesh), psychotherapy (text)
Positive psychotherapy.
Positive psychotherapy (PPT) contrasts with standard interventions for depression by increasing positive emotion, engagement, and meaning rather than directly targeting depressive symptoms. The authors have tested the effects of these interventions in a variety of settings. In informal student and clinical settings, people not uncommonly reported them to be "life-changing." Delivered on the Web, positive psychology exercises relieved depressive symptoms for at least 6 months compared with placebo interventions, the effects of which lasted less than a week. In severe depression, the effects of these Web exercises were particularly striking. This address reports two preliminary studies: In the first, PPT delivered to groups significantly decreased levels of mild-to-moderate depression through 1-year follow-up. In the second, PPT delivered to individuals produced higher remission rates than…
matched on Psychotherapy (mesh), psychotherapy (text)