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Alliance psychotherapy

Barry A Farber
The election and postelection policies of Donald Trump have seeped into the psychotherapy sessions of many clients, in ways that are somewhat unique but also somewhat reminiscent of the ways that other dramatic social-political events, including 9/11 and the social divisions that were characteristic of the 1960s, were brought into the treatment room. The nine articles within this issue-seven papers from practicing psychotherapists, one from an executive coach, and one empirical paper-suggest strongly that the political events surrounding the election of 2016 have become a significant part of psychotherapeutic discourse for many clients, that many therapists have been willing participants in such discussions, and that a focus on political issues (broadly speaking) can have important clinical benefits, facilitating the therapeutic alliance and leading to greater understanding of long-standing client problems and interpersonal functioning...
March 15, 2018: Journal of Clinical Psychology
Nili Solomonov, Jacques P Barber
The primary aim of this study was to investigate the effects of the 2016 United States presidential election and ensuing political climate on patients' experiences in psychotherapy. A sample of 604 self-described Democrat and Republican patients from 50 states participated in the study. Results showed that most therapists disclosed their political stance (explicitly or implicitly) and most patients discussed politics with their therapists. 64% of Clinton supporters and 38% of Trump supporters assumed political similarity with their therapist...
March 14, 2018: Journal of Clinical Psychology
Veronica Kirsch, Ferdinand Keller, Dunja Tutus, Lutz Goldbeck
Background: It has been shown that positive treatment expectancy (TE) and good working alliance increase psychotherapeutic success in adult patients, either directly or mediated by other common treatment factors like collaboration. However, the effects of TE in psychotherapy with children, adolescents and their caregivers are mostly unknown. Due to characteristics of the disorder such as avoidant behavior, common factors may be especially important in evidence-based treatment of posttraumatic stress symptoms (PTSS), e...
2018: Child and Adolescent Psychiatry and Mental Health
Tania Pietrzak, Christina Lohr, Beverly Jahn, Gernot Hauke
We make the case for the possible integration of affect experience induced via embodiment techniques with CBT for the treatment of emotional disorders in clinical settings. Theoretically we propose a possible integration of cognitive behavioural theory, neuroscience, embodied cognition and important processes of client change outcomes such as the therapeutic alliance to enhance client outcomes. We draw from evidence of bidirectional effects between embodiment modes of bottom-up (sensory-motor simulations giving rise to important basis of knowledge) and top-down (abstract mental representations of knowledge) processes such as CBT in psychotherapy...
February 26, 2018: Behavioral Sciences
Fredric N Busch, Elizabeth L Auchincloss
Psychoanalysts have generally avoided discussion of psychoeducational interventions in the context of psychodynamic psychotherapy, despite education being a component of many psychoanalytic techniques. This wariness stems from Freud's early concerns about interventions that could be deemed "suggestion," and a misunderstanding of various aspects of neutrality, including viewing psychoeducational comments as over-gratifying or siding with the ego. Although potential pitfalls exist, the authors review clinical evidence and research that indicate the value of psychoeducational approaches for engaging patients in psychodynamic psychotherapy, considering alternative treatments, providing a psychodynamic formulation, and enhancing the therapeutic alliance...
2018: Psychodynamic Psychiatry
Cathy R Schen, Alecia Greenlee
Addressing race and racial trauma within psychotherapy supervision is increasingly important in psychiatry training. A therapist's ability to discuss race and racial trauma in psychotherapy supervision increases the likelihood that these topics will be explored as they arise in the therapeutic setting. The authors discuss the contextual and sociocultural dynamics that contributed to their own avoidance of race and racial trauma within the supervisory relationship. The authors examine the features that eventually led to a robust discussion of race and culture within the supervisory setting and identify salient themes that occurred during three phases of the conversation about race: pre-dialogue, the conversation, and after the conversation...
2018: Psychodynamic Psychiatry
Jamie K Jones
OBJECTIVE: The purpose of this study was to explore the meaning and uses of the office space among licensed clinical social workers in private practice. BACKGROUND: Previous research suggests the importance of the office space in clinical practice in regard to therapeutic alliance, client behavior, and the well-being of the therapist. However, therapist offices contain much variation in design. This study looked further into specifically how the therapy room is important through the perspective of the licensed clinical social workers in order to identify common themes...
January 1, 2018: HERD
David Kealy, Anthony S Joyce, Rainer Weber, Johannes C Ehrenthal, John S Ogrodniczuk
OBJECTIVES: Limited empirical attention has been devoted to individualized treatment objectives in intensive group therapy for personality dysfunction. This study investigated patients' ratings of distress associated with individual therapy goals - referred to as target object severity - in an intensive Evening Treatment Programme for patients with personality dysfunction. DESIGN: Change in target objective severity was examined in a sample of 81 patients who completed treatment in an intensive, integrative group therapy programme...
February 13, 2018: Psychology and Psychotherapy
Kelly Beck, Jamie Kulzer
To provide the highest quality services, audiologists incorporate counseling into their professional practice. This article, written by professional counselors, highlights the distinction between services provided by professional counselors (i.e., psychotherapy) and counseling microskills used by all health and rehabilitation professionals. Effective application of counseling microskills facilitates a strong therapeutic alliance, which research shows contributes to positive therapeutic outcomes. Counseling microskills should be taught early in graduate programs, because they serve as the foundation for the therapeutic alliance and allow for more effective application of other therapeutic interventions...
February 2018: Seminars in Hearing
Craig Warlick, Kimber P Richter, Delwyn Catley, Byron J Gajewski, Laura E Martin, Laura M Mussulman
Behavioral counseling is effective for smoking cessation and the psychotherapy literature indicates therapeutic alliance is key to counseling effectiveness. However, no tobacco-counseling specific measures of alliance exist that are suitable in most tobacco counseling contexts. This hinders assessment of counseling components in research and clinical practice. Based on the Working Alliance Inventory, and external expert review, we developed two alliance instruments: the 12-item and 3-item Working Alliance Inventory for Tobacco (WAIT-12 and WAIT-3)...
March 2018: Journal of Substance Abuse Treatment
Sigal Zilcha-Mano
Significant progress has been achieved in the last decades in studying two central questions in psychotherapy research: what treatment works for which patient and why does treatment work. This paper delineates central developments in the methods used to study each of these questions. Through targeted examples, the paper discusses several phenomena and trends in psychotherapy research. Regarding the question of what works for whom, the discussion focuses on the progress from the search for one moderator to guide clinical decision-making to the search for a set of such moderators and their interactive effects, to best answer this question...
February 7, 2018: Psychotherapy Research: Journal of the Society for Psychotherapy Research
João F Barreto, Paula Mena Matos
As a construct, the elaboration of countertransference experience (ECE) is intended to depict the implicit and explicit psychological work to which therapists submit their experiences with clients. Through ECE, defined as a mentalizing process of a particular kind, therapists' experiences are presumed to acquire and increase in mental quality and become available for meaning-making and judicious clinical use. In this paper, we claim that such an ongoing process facilitates engagement with common therapeutic factors, such as the therapeutic alliance and countertransference management, enhancing therapist responsiveness in psychotherapy...
February 4, 2018: Clinical Psychology & Psychotherapy
Andrew S McClintock, Timothy Anderson, Candace L Patterson, Edgar H Wing
The association between psychotherapeutic empathy and client outcome is well established, yet the mechanisms underlying this association remain poorly understood. We hypothesized that early experiences of empathy influence outcome through the working alliance. To test this hypothesis, we used archival data collected from 56 clients (mean [M] age = 19.5 years, 83.9% female, 76.8% White) who reported mild, moderate, or severe depressive symptoms at screening and pretreatment assessments and then received five sessions of evidence-based psychotherapy...
January 24, 2018: Journal of Clinical Psychology
Jairo N Fuertes, Michael Moore, Jennifer Ganley
OBJECTIVE: While there has been much research on the role of the working alliance in psychotherapy, researchers only recently began investigating the role of the real relationship in treatment. METHODS: In the current study on therapist and client dyads, we used actor-partner interdependence modeling (APIM) to examine associations between therapists' and clients' ratings of the real relationship, therapist self-disclosure, attachment, and treatment progress. APIM analyses allowed for an examination into how therapists' and clients' views of a particular phenomenon might affect their own ratings (actor), as well as the others' (partner) ratings of that same phenomenon...
January 20, 2018: Psychotherapy Research: Journal of the Society for Psychotherapy Research
Michelle Lawton, Karen Sage, Gillian Haddock, Paul Conroy, Laura Serrant
BACKGROUND: Therapeutic alliance refers to the interactional and relational processes operating during therapeutic interventions. It has been shown to be a strong determinant of treatment efficacy in psychotherapy, and evidence is emerging from a range of healthcare and medical disciplines to suggest that the construct of therapeutic alliance may in fact be a variable component of treatment outcome, engagement and satisfaction. Although this construct appears to be highly relevant to aphasia rehabilitation, no research to date has attempted to explore this phenomenon and thus consider its potential utility as a mechanism for change...
January 18, 2018: International Journal of Language & Communication Disorders
Dennis M Kivlighan, Clara E Hill, Katherine Ross, Kathryn Kline, Amy Furhmann, Elizabeth Sauber
To test a sequential model of psychotherapy process and outcome, we included previous client distress, therapist psychodynamic techniques, dyadic working alliance, and current client distress. For 114 sets of eight-session segments in 40 cases of psychodynamic psychotherapy, clients completed the Outcome Questionnaire-45 and Inventory of Interpersonal Problems-32 after the first and final session, judges reliably coded one middle sessions on the Psychodynamic subscale of the Multitheoretical List of Therapeutic Interventions, and clients and therapists completed the Working Alliance Inventory after every session...
January 5, 2018: Psychotherapy Research: Journal of the Society for Psychotherapy Research
Mark A Lumley, Timothy Anderson, Brett Ankawi, Gregory Goldman, LisaCaitlin M Perri, Joseph A Bianco, Francis J Keefe
OBJECTIVES: The working alliance predicts improvement following general psychotherapy, but how it operates in brief interventions conducted with medically ill patients is unknown. Also, the role of the working alliance may differ in emotion-focused versus educational interventions. METHODS: We report secondary analyses of a randomized clinical trial (Keefe et al.) [35], in which patients with rheumatoid arthritis (RA) received four nurse-provided sessions of either a) Clinician-assisted Emotional Disclosure (CAED), which emphasized the disclosure, expression, and processing of emotions related to stressful events; or b) Arthritis Education (AE), which provided basic education about RA...
January 2018: Journal of Psychosomatic Research
Lior Galili-Weinstock, Roei Chen, Dana Atzil-Slonim, Eran Bar-Kalifa, Tuvia Peri, Eshkol Rafaeli
OBJECTIVE: Self-compassion (SC) has been consistently linked to less psychopathology; however, the link between changes in client's SC levels and psychotherapy outcomes has yet to be explored. METHOD: Clients at a university-based community clinic completed SC and outcome measures session by session (N = 112) as well as pre- to posttreatment (N = 70). RESULTS: Increases in clients' SC levels across the entire therapeutic process were associated with improvement in all posttreatment outcomes...
December 18, 2017: Journal of Clinical Psychology
Felix Wucherpfennig, Julian A Rubel, Stefan G Hofmann, Wolfgang Lutz
OBJECTIVE: Sudden gains are sudden symptom improvements from 1 psychotherapy session to the next. This study investigates the processes that may facilitate treatment outcome after a sudden gain occurred. METHOD: A sample of 211 depressed patients who underwent cognitive-behavioral therapy was analyzed. Sudden gains were identified using a session-by-session self-report symptom measure. Patient ratings of general change factors (therapeutic alliance; coping skills) in the sessions before and after a sudden gain were investigated as predictors of outcome...
December 2017: Journal of Consulting and Clinical Psychology
Clara Dittmann, Meike Müller-Engelmann, Ulrich Stangier, Kathlen Priebe, Thomas Fydrich, Nora Görg, Sophie Rausch, Patricia A Resick, Regina Steil
Although the assessment of therapeutic competence in psychotherapy research is essential for examining its possible associations with treatment outcomes, it is often neglected due to high costs and a lack of valid instruments. This study aimed to develop two therapeutic competence scales that assess disorder-specific and treatment-specific therapeutic competence, and to examine these scales' psychometric properties along with those of the already established Cognitive Therapy Scale (CTS) in a posttraumatic stress disorder (PTSD) sample...
December 2017: Journal of Traumatic Stress
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