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Majse Lind, Carsten René Jørgensen, Torben Heinskou, Sebastian Simonsen, Rikke Bøye, Dorthe Kirkegaard Thomsen
Patients with borderline personality disorder (BPD) display disturbances in self and other understanding, which is also evident when they narrate events from their own and significant others' lives. In a recent study, we found that patients described both their own and their parents' life stories as more negative and with fewer themes of agency and communion fulfillment. Hence, we examined whether 12 months of psychotherapy would change how patients described their own and their parents' life stories. At baseline, 30 BPD patients and 30 matched control participants described and answered questions about their personal and their parents' life stories...
August 16, 2018: Psychotherapy
Noa Tsvieli, Gary M Diamond
A growing body of research suggests that emotional processing is a central and common change mechanism across various types of therapies (Diener & Hilsenroth, 2009; Foa, Huppert, & Cahill, 2006; Greenberg, 2010), including attachment-based family therapy (Diamond, Shahar, Sabo, & Tsvieli, 2016). The purpose of this study was to examine which therapist interventions facilitated productive emotional processing in a sample of 15 young adults receiving attachment-based family therapy (Diamond, Diamond, & Levy, 2014) for unresolved anger toward a parent, and which therapist interventions led to a discontinuation of productive emotional processing once it had begun...
September 2018: Psychotherapy
Rayna D Markin
Pregnancies after loss are often characterized by feelings of depression, anxiety, trauma-like symptoms, and problems bonding to the fetus. Difficulties bonding to the unborn baby during pregnancy are of clinical importance because they are predictive of problems in the mother-infant attachment relationship, perhaps explaining why some studies show a higher risk of insecure attachment for babies born after loss. O'Leary (2004) has proposed that problems in prenatal bonding during pregnancies after loss are the result of the challenge these mothers face of having to grieve the loss of one baby while bonding to another...
September 2018: Psychotherapy
Patrícia Pinheiro, Inês Mendes, Sara Silva, Miguel M Gonçalves, João Salgado
The association between clients' higher capability of emotional processing and good therapeutic outcome has been consistently observed in different therapeutic approaches. Despite previous studies that have reported an association between emotional processing and pre- to posttherapy change in symptoms, the session-by-session relation between emotional processing and therapeutic change needs further research. The current study explored, in a good-outcome case of depression, the session-by-session longitudinal association of the level of emotional processing with (a) clinical symptoms and (b) type of emotions aroused (adaptive or maladaptive)...
September 2018: Psychotherapy
Travis L Osborne, Jason B Luoma
Practice-based research is an important means of bridging the gap between the science and practice of psychotherapy. Unfortunately, numerous barriers exist for clinicians who want to conduct research in practice settings. One specific barrier that has received minimal attention in the literature-lack of access to institutional review board (IRB) oversight for independent ethics review-can impede the ability to carry out and disseminate research projects. This article identifies reasons that practice-based researchers may want to seek IRB review even when not required, reviews the pros and cons of a range of strategies that some practice-based researchers have used to try and address lack of access to an IRB, and describes a novel solution for this problem: the creation of the Behavioral Health Research Collective IRB, a nonprofit IRB whose mission is to provide ethical oversight to practice-based researchers...
September 2018: Psychotherapy
Tomas F Langkaas, Bruce E Wampold, Asle Hoffart
A fundamental part of professional practice is to monitor case progress to inform basic clinical decisions about when to discontinue interventions, when to adjust interventions, and when to proceed as planned. When interpreting observed change, there are at least five distinct types of clinical difference that can occur independently, and mistaking one for another can lead to misinformed clinical decisions. We introduce a distinction between observed difference, detected difference, predicted difference, attainment difference, and induced difference, and use these to analyze current systems for routine outcome monitoring (ROM) in clinical practice...
September 2018: Psychotherapy
Liat Leibovich, Aviv Nof, Smadar Auerbach-Barber, Sigal Zilcha-Mano
Supportive-expressive psychodynamic psychotherapy builds on the core conflictual relationship theme (CCRT) as a framework for case formulation and interpretations. Much has been written on how interpretive techniques should be implemented in the treatment sessions to bring about therapeutic change, but less is known about implementing supportive techniques for strengthening the alliance using this framework. The present article uses CCRT formulations to articulate clear and concrete supportive techniques that clinicians can use in clinical practice...
September 2018: Psychotherapy
Vicky Mesrie, Marc J Diener, Adam Clark
Clinical supervision is often considered to be one of the important tasks in training psychotherapists. The present study investigated the relation between trainees' attachment to their supervisors and trainees' perceptions of their own counseling self-efficacy (CSE), as potentially moderated by trainee level of experience. Results indicated that trainees with greater avoidant attachment to their supervisors demonstrated lower levels of CSE. Although the results of the moderator analyses were not statistically significant, levels of avoidance significantly predicted levels of CSE even when controlling for level of experience, whereas levels of anxiety were not found to significantly predict levels of CSE...
September 2018: Psychotherapy
Isabelle Rek, Johannes C Ehrenthal, Bernhard M Strauss, Henning Schauenburg, Christoph Nikendei, Ulrike Dinger
Interpersonal characteristics contribute to therapists' ability to form helpful working alliances with their patients. But how are attachment styles and interpersonal motives distributed among therapist trainees? This study examines attachment styles and interpersonal motives of therapist trainees by comparing them with matched reference samples from representative surveys. A total sample of 285 trainees, who were enrolled in either cognitive-behavioral or psychodynamic therapy training programs, was recruited via their training institutes...
September 2018: Psychotherapy
Irene Messina, Carolina Solina, Alice Arduin, Virginia Frangioni, Marco Sambin, Charles Gelso
Therapists' unresolved conflicts might be the source of countertransference phenomena. To investigate the origins of countertransference, the aim of this supervision single-case study was to identify conflictual areas that characterize private life relationships and therapeutic relationships of one therapist in training. With this aim, we applied the core conflictual relationship theme method to the analysis of the therapist's relationship episodes with patients, as emerged spontaneously during clinical supervision sessions, and to the analysis of relationship episodes concerning his personal life, collected using the relationship anecdotes paradigm interview...
September 2018: Psychotherapy
Martyn Whittingham, Larry Graham
Over a 2-year period, quality measures were instituted in the behavioral health services of Mercy Health (Ohio and Kentucky), one of the largest not-for-profit health systems in the United States. More than 25,000 patients were seen during this period across two states, in inpatient, partial hospitalization and intensive outpatient units. The Outcome Questionnaire 30.2 (Lambert, Finch, Okiishi, & Burlingame, 2005) was used at admission and discharge for the purposes of quality improvement, and results were integrated into quality improvement processes such as group supervision, telepresence supervision, and site accountability...
June 2018: Psychotherapy
Derek Griner, Mark E Beecher, Loren B Brown, Austin J Millet, Vaughn Worthen, R D Boardman, Kristina Hansen, Jonathan C Cox, Robert L Gleave
Practice-based evidence (Burlingame & Beecher, 2008) is an approach to evidence-based practice that addresses treatment efficacy to remediate clinicians' inability to predict treatment response (Chapman et al., 2012; Hannan et al., 2005). The Group Questionnaire (GQ; Bormann, Burlingame, & Straub, 2011; Johnson, Burlingame, Olsen, Davies, & Gleave, 2005) is one practice-based evidence measure that supports clinical judgment to enhance psychotherapy outcomes by measuring 3 important group constructs: Positive Bond, Positive Work, and Negative Relationship...
June 2018: Psychotherapy
Dana Tzur Bitan, Sigal Zilcha-Mano, Ori Ganor, Lior Biran, Yuval Bloch
Support groups for parents of children with Autistic Spectrum Disorders (ASD) are very common in public mental health settings. These groups have been found to be helpful in reducing parental stress and providing parents with professional knowledge as well as peer support. Clinical experience, as well as parents' verbal feedback, often indicates that within these groups there are occasionally unmet needs that are not expressed during sessions. In this article we describe the benefits of using routine measurement and feedback as means to identify and address such needs...
June 2018: Psychotherapy
Martyn Whittingham
Focused brief group therapy (Whittingham, 2015) is an integrative interpersonal approach to brief group therapy that uses formal assessment to guide and inform treatment. By utilizing assessment as a key part of real-time clinical feedback throughout treatment, multiple therapeutic goals are enhanced. This article addresses 2 specific uses of assessment within focused brief group therapy-to focus treatment around interpersonal subtype distress and to inoculate clients against self-sabotage. (PsycINFO Database Record...
June 2018: Psychotherapy
Paul L Hewitt, Samuel F Mikail, Gordon L Flett, Silvain S Dang
In this article, we describe how individualized feedback, in the form of a clinical formulation, is used in our dynamic-relational group treatment of perfectionism (Hewitt et al., 2015), a core vulnerability or transdiagnostic personality factor. The authors discuss briefly their conceptualization and assessment of perfectionism as well as other aspects of patients' functioning, and the use of both psychodynamic and interpersonal models to derive, for individual patients, their unique formulation or idiosyncratic model of their perfectionistic and related behavior...
June 2018: Psychotherapy
Nicole Obeid, Samantha Carlucci, Agostino Brugnera, Angelo Compare, Genevieve Proulx, Hany Bissada, Giorgio A Tasca
Eating disorders (EDs) are chronic mental illnesses with high levels of psychological, social, and health burden. Day treatment programs (DTP) are effective group-based partial hospital models that have been used to treat EDs for several decades. However, few studies have examined the factors associated with reduced distress in ED patients who participate in DTP groups. Related to this is whether change in distress is preceded by change in positive group processes, or vice versa. In this study, we examine the reciprocal relationship between growth of group therapeutic factors and change in distress in an ED sample...
June 2018: Psychotherapy
Paul B Gold, Dennis M Kivlighan
Experienced leaders of psychotherapy groups are surprisingly inaccurate in their judgments about their members' perceptions of positive bonding relationships with the leader and other group members. The practical implication is worrisome: the lower the leader's degree of accuracy, the worse the member therapeutic outcomes tend to be. A promising approach to improving leaders' appraisals of their members' perceptions of positive bonding relationships is to provide them, after each session, feedback about their own and their members' bonding relationship perceptions...
June 2018: Psychotherapy
Marjolein M W Koementas-de Vos, M Annet Nugter, Fabiana Engelsbel, Kim De Jong
There is evidence that progress feedback combined with a clinical support tool (CST) improves treatment outcome in individual psychotherapy. This study examined the effect of feedback in combination with a CST in outpatient group psychotherapy. A prospective cohort study was performed with patients meeting diagnostic criteria for a major depressive disorder or an anxiety disorder. Patients received cognitive-behavioral group therapy or interpersonal group therapy and completed the Outcome Questionnaire-45 on a session by session basis...
June 2018: Psychotherapy
Jennifer Jensen, Gary Burlingame
There is a constant tension between having measures short enough for daily practice and long enough to provide useful information. Although shorter measures are more convenient for clients, fewer items necessarily mean less information, a loss of psychometrics, and possible floor and ceiling effects. This study examined the effects of shortening the Group Questionnaire (GQ) on its clinical utility and psychometric integrity. Creation of a 12-item GQ (GQ-12) was done using archival data with 1,087 participants gathered from counseling centers, nonclinical process groups, outpatient psychiatric hospitals, and an inpatient state hospital...
June 2018: Psychotherapy
Kaitlyn E Whitcomb, Sean C Woodland, Gary M Burlingame
The use of feedback based on outcome and process measures to inform treatment is gaining ground as one form of evidence-based treatment. However, little is known regarding how therapists actually use feedback, particularly from process measures, to affect treatment. This two-part qualitative study used session-by-session and treatment-episode narratives from group therapists to define how they acted on process feedback from a member-completed measure of the therapeutic relationship: the Group Questionnaire (GQ)...
June 2018: Psychotherapy
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