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Christoph Flückiger, A C Del Re, Bruce E Wampold, Adam O Horvath
The alliance continues to be one of the most investigated variables related to success in psychotherapy irrespective of theoretical orientation. We define and illustrate the alliance (also conceptualized as therapeutic alliance, helping alliance, or working alliance) and then present a meta-analysis of 295 independent studies that covered more than 30,000 patients (published between 1978 and 2017) for face-to-face and Internet-based psychotherapy. The relation of the alliance and treatment outcome was investigated using a three-level meta-analysis with random-effects restricted maximum-likelihood estimators...
May 24, 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
Gary M Burlingame, Kaitlyn E Whitcomb, Sean C Woodland, Joseph A Olsen, Mark Beecher, Robert Gleave
Routine outcome monitoring (ROM) systems that identify clients at-risk for treatment failure using outcome and therapeutic process measures are a recognized evidence-based practice. However, only 3 empirical studies have tested ROMs in group therapy, producing mixed results. This randomized clinical trial tested the Outcome Questionnaire System, the ROM system with the most empirical support for individual therapy patients, with 430 group therapy patients who were randomly assigned to 2 experimental arms (Group Questionnaire [GQ] + Outcome Questionnaire-45 [OQ-45] vs...
June 2018: Psychotherapy
Rebecca A Janis, Gary M Burlingame, Joseph A Olsen
The use of outcome monitoring systems to identify clients that are at-risk for treatment failure has now become part of daily clinical practice, shown in >25 empirical studies to improve client outcomes. These promising findings have led to outcome monitoring systems being recognized as evidence-based. Feedback systems based on client perception of therapeutic processes are recent additions to the monitoring literature, and the research suggests that these too lead to improved outcomes. Unfortunately, feedback systems and research have been primarily limited to individual therapy, creating a knowledge gap for multiperson treatment...
June 2018: Psychotherapy
Cheri L Marmarosh
The current issue highlights the necessity of feedback in group psychotherapy-both monitoring group member feedback during treatment and providing feedback to group members before and during group therapy. Regardless of the orientation or type of group, collecting members' perceptions and experiences influences how the group leader identifies members who are struggling in the group or are at risk of dropping out. Providing group members with feedback during the pregroup preparation and throughout the therapy process is also helpful to group members as they work to obtain their goals in the group...
June 2018: Psychotherapy
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
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