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Don E Davis, Cirleen DeBlaere, Jesse Owen, Joshua N Hook, David P Rivera, Elise Choe, D R Van Tongeren, Everett L Worthington, Vanessa Placeres
After several decades of slow progress, researchers are beginning to make advances in linking constructs based on the multicultural competencies tradition-especially those focused on qualities of the therapist-to therapy outcomes. The multicultural orientation framework was developed in response to several trends within the multicultural competencies tradition, with a particular emphasis on integrating the multicultural competencies tradition into research on psychotherapy process. We provide a narrative review of studies that include one of the three constructs (i...
March 2018: Psychotherapy
Tabina K Choudhury, Kimberley Stanton, Steve Balsis
Alexithymia, characterized by deficits in recognition or expression of emotional experiences, has been demonstrated to be associated with depressive symptoms. In psychotherapy, alexithymia can partly manifest as stunted, disfluent speech when an individual attempts to describe his or her subjective experiences. However, similarly stunted, disfluent speech can be observed in individuals with limited English proficiency who are not diagnosed with a depressive disorder. For individuals who present with both symptoms of depression and limited English proficiency, it can be difficult to determine if disfluent speech is a clinical symptom secondary to depression or simply a byproduct of a language barrier...
March 2018: Psychotherapy
Hector Y Adames, Nayeli Y Chavez-Dueñas, Shweta Sharma, Martin J La Roche
Culturally responsive and racially conscious psychotherapeutic work requires that therapists recognize the ways clients are impacted by their multiple marginalized identities and by systems of oppression (e.g., racism, ethnocentrism, sexism, heterosexism, and nativism). Attending exclusively to clients' marginalized identities (i.e., weak intersectionality) may drive therapists to only focus on internal, subjective, and emotional experiences, hence, missing the opportunity to consider and address how multiple sociostructural dimensions (i...
March 2018: Psychotherapy
Matthew D Skinta, Brandon Hoeflein, Amanda M Muñoz-Martínez, C Lucía Rincón
Despite an overwhelming literature detailing the impact of societal bias on the well-being and relationships of gender and sexual minority clients, as well as greater rates of help-seeking from mental health professionals, recent advances in minority stress research have not been fully incorporated into clinical practice. Minority stress factors such as internalized stigma, rejection sensitivity, and concealment interfere with vulnerable and intimate relationships, and likely contribute to the transdiagnostic challenges that GSM clients report, such as loneliness and social isolation (Mereish & Poteat, 2015)...
March 2018: Psychotherapy
Christopher A Pepping, Anthony Lyons, Eric M J Morris
Lesbian, gay, bisexual, and transgender (LGBT) people seek psychotherapy at high rates, and the importance of providing culturally appropriate and LGBT-affirmative psychotherapy has been widely acknowledged. Despite this, remarkably little research has investigated the effects of therapist training in LGBT-affirmative psychotherapy. Here we examined the effectiveness of a training protocol for LGBT-affirmative psychotherapy with 96 mental health professionals, ranging in therapeutic experience from <1 year to 37 years (M = 6...
March 2018: Psychotherapy
Mark Beitel, Laurelle L Myhra, Joseph P Gone, Jacques P Barber, Alyssa Miller, Aaron Rasband, Christopher J Cutter, Richard S Schottenfeld, Declan T Barry
The aim of the project was to conduct psychotherapy research in American Indian mental health clinics. To date, very little psychotherapy research has been conducted in this area. We report the findings from a multisite investigation of psychotherapy techniques used with American Indians. Psychotherapists, working in three American Indian clinics, were asked to self-report the therapeutic interventions that they used in sessions with 93 separate adult American Indian outpatients. Each therapist rated each client exactly once, and thus data on 93 sessions were collected...
March 2018: Psychotherapy
D Martin Kivlighan, Norah A Chapman
Multicultural group work has received growing attention over the past two decades; however, there is a lack of conceptual frameworks to guide therapists' cultural processes within group therapy at present. As such, we extend the multicultural orientation (MCO) to group therapy in an effort to provide a conceptual framework for group therapists to effectively engage multicultural group work. The MCO framework was developed in an effort to operationalize therapists' cultural processes of cultural humility, cultural comfort, and cultural opportunity...
March 2018: Psychotherapy
Rayna D Markin, Sigal Zilcha-Mano
This paper argues that there is a cultural taboo against the public recognition and expression of perinatal grief that hinders parents' ability to mourn and their psychological adjustment following a loss. It is proposed that this cultural taboo is recreated within the therapy relationship, as feelings of grief over a perinatal loss are minimized or avoided by the therapist and parent or patient. Importantly, it is suggested that if these cultural dynamics are recognized within the therapy relationship, then psychotherapy has the immense opportunity to break the taboo by validating the parent's loss as real and helping the parent to mourn within an empathic and affect-regulating relationship...
March 2018: Psychotherapy
Katherine Morales, Brian TaeHyuk Keum, Dennis M Kivlighan, Clara E Hill, Charles J Gelso
Using data from 3,263 sessions nested within 144 clients, nested within 19 therapists, we examined client- and therapist-rated working alliance (WA) and real relationship (RR) at Session 3 and growth in WA and RR across the course of open-ended psychodynamic psychotherapy for clients who identified as racial/ethnic minority (REM) or as White. To be included in the analyses, therapists had to work with at least 2 REM and 2 White clients. There were no significant therapist effects for the interaction between client- or therapist-rated WA and client REM status at Session 3, or for client- or therapist-rated RR and client REM status at Session 3...
March 2018: Psychotherapy
Brien J Goodwin, Alice E Coyne, Michael J Constantino
Psychotherapist competence in attending to cultural processes has long been considered an ingredient of successful treatment. Although some research findings support a positive association between clinician multicultural competence (MCC) and client improvement, others suggest that MCC may not be a skill that therapists uniformly acquire and then stably maintain. Rather, MCC is likely more fluid and contextualized, potentially rendering within-therapist variability across their patients and within-dyad variability across different moments in a given case...
March 2018: Psychotherapy
Jesse Owen
This article introduces the special issue on cultural processes in psychotherapy. The special section was organized to highlight both the clinical and research aspects of the cultural processes in psychotherapy from a variety of different theoretical orientations, perspectives, and methodologies. Additionally, I discuss some ideas for a future culturally focused psychotherapy scholarship. (PsycINFO Database Record
March 2018: Psychotherapy
Matthew J Cohen, Crystal E Schiller
Between 10% and 20% of women will experience depression in the perinatal period, which begins during pregnancy and extends into the first year after delivery. Perinatal depression (PD) is associated with significant emotional and social impairments that impact women, their children, and their partners. Although the majority of women with PD do not seek treatment, a considerable proportion of those who engage in treatment do not achieve remission. The couples and depression literature suggests that interpersonal processes are central in the development and maintenance of depressive disorders and thus, as researchers seek safe and effective treatments for perinatal populations, there may be therapeutic benefit in examining the role that partners play in women's recovery...
December 2017: Psychotherapy
Amy Wenzel
Cognitive-behavioral therapy (CBT) is a system of psychotherapy in which an individualized case formulation drives the strategic delivery of therapeutic interventions that target cognition, emotion, behavior, and the therapeutic relationship. It has the potential to be effective for women who have experienced pregnancy loss, as pregnancy loss often carries profound meaning that disrupts many layers of a woman's belief system, and the associated emotional consequences cannot always be managed using their typical repertoire of coping skills...
December 2017: Psychotherapy
Irving G Leon
Pregnancy termination for fetal anomaly is a unique reproductive loss with many issues distinct from spontaneous pregnancy loss, as typically addressed in the current literature. After providing a brief overview of this loss and the impact of stigma, some of the therapeutic tasks particular to this loss will be identified, including absorbing the impact of learning about the anomaly, defining what or who has been lost, deciding whether to continue or terminate the pregnancy, and deciding who to tell what. These therapeutic tasks are discussed using the available research literature, but primarily illustrated through clinical vignettes and therapist-client dialogue...
December 2017: Psychotherapy
Joann M O'Leary, Lindsey Henke
Pregnancy following the loss of a baby is a complex journey that often requires supportive intervention to support attachment to a baby that follows. This article offers guidance in supporting parents during their pregnancy that follows a perinatal loss. Content is based on using the continued bond/attachment theories in a therapeutic educational group setting and in individual therapy sessions in clinical practice. Practical guidelines in working with parents to support their parenting relationship with a deceased baby while risking attachment to a new unborn baby are offered...
December 2017: Psychotherapy
Janet Jaffe
The reproductive story offers a unique way to conceptualize pregnancy loss and infertility. This article describes the development of the reproductive story from early childhood on, and focuses on the devastating losses when the story does not unfold as originally hoped. Regardless of the type of reproductive trauma that clients experience, the underlying psychological constructs of grief are the same. The goal is to help clients work through their grief and loss, accept that their story can be edited and rewritten, and come away with a positive new ending...
December 2017: Psychotherapy
Rayna D Markin
This introduction article to the special section on psychotherapy for pregnancy loss reviews important societal and psychological issues, key clinical processes and recommendations, and future research directions. Differences and similarities among the articles in the special section are discussed along with each article's contribution to the higher order goal of viewing pregnancy loss through a psychological rather than solely medical lens. Each article in this section reviews different therapeutic modalities, interventions, and key clinical process issues when working with patients who have suffered the loss of a pregnancy...
December 2017: Psychotherapy
Ladislav Timulak, James McElvaney, Daragh Keogh, Elaine Martin, Peter Clare, Elena Chepukova, Leslie S Greenberg
Among psychological therapies for generalized anxiety disorder (GAD), cognitive-behavioral therapy has a dominant position as the most studied therapy. However, some researchers have recommended that to increase treatment options and broaden choice for clients, non-cognitive-behavioral therapy models for GAD should be examined. The present study was an exploratory study, assessing pre-post outcomes and 6-month follow-up of emotion-focused therapy for GAD, supplemented by qualitative posttherapy client accounts of helpful and unhelpful aspects of therapy and changes reported since therapy started...
December 2017: Psychotherapy
Robert Johansson, Thomas Hesslow, Brjánn Ljótsson, Angelica Jansson, Lina Jonsson, Smilla Färdig, Josefine Karlsson, Hugo Hesser, Ronald J Frederick, Peter Lilliengren, Per Carlbring, Gerhard Andersson
Social anxiety disorder (SAD) is associated with considerable individual suffering and societal costs. Although there is ample evidence for the efficacy of cognitive behavior therapy, recent studies suggest psychodynamic therapy may also be effective in treating SAD. Furthermore, Internet-based psychodynamic therapy (IPDT) has shown promising results for addressing mixed depression and anxiety disorders. However, no study has yet investigated the effects of IPDT specifically for SAD. This paper describes a randomized controlled trial testing the efficacy of a 10-week, affect-focused IPDT protocol for SAD, compared with a wait-list control group...
December 2017: Psychotherapy
Bernhard Strauss, Susan Koranyi, Uwe Altmann, Tobias Nolte, Manfred E Beutel, Jörg Wiltink, Stephan Herpertz, Wolfgang Hiller, Jürgen Hoyer, Peter Joraschky, Björn Nolting, Ulrich Stangier, Ulrike Willutzki, Simone Salzer, Erik Leibing, Falk Leichsenring, Helmut Kirchmann
This study investigated whether partner-related attachment characteristics differentially predict premature treatment termination as well as posttreatment and 1-year follow-up outcome in patients with social anxiety disorder treated with a manualized cognitive-behavioral therapy (CBT) or short-term psychodynamic therapy (PDT) in the SOPHO-NET (Social Phobia Psychotherapy Network) trial. Participants were 412 patients with social anxiety disorder (57% female) with a mean age of 35.4 years (SD = 12.1) who were randomized to either CBT or PDT...
December 2017: Psychotherapy
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