Client's Symptoms Research Articles

Supervisory working alliance trajectories and client outcome in Chinese trainees

ABSTRACT We investigated the developmental trajectories of supervisory working alliance over time and their correlations with Chinese counseling trainees’ client symptom relief. Participants were 89 beginning counseling trainees from a master’s level training program in China. Results showed three clusters of developmental trajectories, including “Stable and Increasing,” “Rupture and Repair,” and “Bonding and Distancing.” Trainees with the first trajectory had greater client symptom relief. These results suggested the possible distinct clusters of developmental trajectories of SWA across beginning counseling trainees, and highlighted the potential benefit of maintaining a stable and strong SWA with trainees that could facilitate better client outcomes.

The "dyadic dance": Exploring therapist-client dynamics and client symptom change using actor-partner interdependence modeling and multilevel mixture modeling.

[Correction Notice: An Erratum for this article was reported in Vol 69(4) of Journal of Counseling Psychology (see record 2022-76740-001). In the article, the scale for the Working Alliance Inventory-Short Revised (WAI-SR) was incorrectly described in the Measures section as a "5-point scale ranging from 1 to 5." The WAI-SR used the original 7-point scale ranging from 1 to 7. All versions of this article have been corrected.] Using longitudinal actor-partner interdependence modeling and multilevel mixture modeling, the aims of this study were to investigate the therapist-client dyadic dynamic patterns (i.e., therapist and client consistency and their mutual influences in perceptions of working alliance) and how these dynamic patterns related to client symptom change with varied treatment lengths. Data set included 1,520 sessions conducted by 85 master's level therapist trainees with their 283 clients in China. Before every session, clients reported their symptom; after every session, both therapists and clients rated their working alliance. (a) Therapist consistency was positively associated with greater client symptom improvement, especially in relatively longer therapy course. (b) Client consistency and therapist-client mutual influence dynamics did not individually relate to client symptom improvement. (c) Two subgroups of therapist-client dyads with distinct dyadic dynamic patterns were identified: one subgroup (Dyadic Independence) showing significant self-consistency and nonsignificant mutual influence and the other subgroup (Mutual Influence) showing significant self-consistency as well as mutual influence. (d) The mutual influence subgroup was associated with greater client improvement than the dyadic independence subgroup, especially in shorter therapy. A dyadic dynamic pattern characterized by the presence of therapist and client self-consistency as well as mutual influence may be conducive to positive therapeutic outcome in terms of client symptom improvement. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

"The 'dyadic dance': Exploring therapist-client dynamics and client symptom change using actor-partner interdependence modeling and multilevel mixture modeling": Correction to Li (2021).

Reports an error in "The "dyadic dance": Exploring therapist-client dynamics and client symptom change using actor-partner interdependence modeling and multilevel mixture modeling" by Xu Li (Journal of Counseling Psychology, Advanced Online Publication, Dec 02, 2021, np). In the article, the scale for the Working Alliance Inventory-Short Revised (WAI-SR) was incorrectly described in the Measures section as a "5-point scale ranging from 1 to 5." The WAI-SR used the original 7-point scale ranging from 1 to 7. All versions of this article have been corrected. (The following abstract of the original article appeared in record 2022-06134-001.) Using longitudinal actor-partner interdependence modeling and multilevel mixture modeling, the aims of this study were to investigate the therapist-client dyadic dynamic patterns (i.e., therapist and client consistency and their mutual influences in perceptions of working alliance) and how these dynamic patterns related to client symptom change with varied treatment lengths. Data set included 1,520 sessions conducted by 85 master's level therapist trainees with their 283 clients in China. Before every session, clients reported their symptom; after every session, both therapists and clients rated their working alliance. (a) Therapist consistency was positively associated with greater client symptom improvement, especially in relatively longer therapy course. (b) Client consistency and therapist-client mutual influence dynamics did not individually relate to client symptom improvement. (c) Two subgroups of therapist-client dyads with distinct dyadic dynamic patterns were identified: one subgroup (Dyadic Independence) showing significant self-consistency and nonsignificant mutual influence and the other subgroup (Mutual Influence) showing significant self-consistency as well as mutual influence. (d) The mutual influence subgroup was associated with greater client improvement than the dyadic independence subgroup, especially in shorter therapy. A dyadic dynamic pattern characterized by the presence of therapist and client self-consistency as well as mutual influence may be conducive to positive therapeutic outcome in terms of client symptom improvement. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

"The 'roller coaster ride': A longitudinal investigation of the dynamic relationship between Chinese counseling trainees' self-efficacy and their clients' outcome and the mediating effects of working alliance and session evaluation": Correction to Li et al. (2021).

Reports an error in "The "roller coaster ride": A longitudinal investigation of the dynamic relationship between Chinese counseling trainees' self-efficacy and their clients' outcome and the mediating effects of working alliance and session evaluation" by Xu Li, Feihan Li, Chaihua Lin, Shitao Chen and Yuge Han (Journal of Counseling Psychology, Advanced Online Publication, Nov 29, 2021, np). In the article, the scale for the Working Alliance Inventory-Short Revised (WAI-SR) was incorrectly described in the Measures section as a "5-point scale that ranges from 1 to 5." The WAI-SR used the original 7-point scale ranging from 1 to 7. All versions of this article have been corrected. (The following abstract of the original article appeared in record 2022-06516-001.) Based on the social-cognitive theory, this study investigated the dynamic association between counseling trainees' self-efficacy and their clients' outcome (i.e., symptom distress), and the mediating effects of therapist- and client-rated working alliance and session quality. Data set included 1,352 sessions conducted by 87 master's level therapist trainees with their 317 clients in China. Before every session, therapists completed a measure of self-efficacy and clients reported their symptom distress; and after every session, both therapists and clients rated their working alliance and session quality. Results showed that, (a) over the course of therapy, the initial level of therapist self-efficacy did not predict how quickly client symptom declined; (b) the initial level of client distress did not predict how quickly therapist self-efficacy increased; and (c) client distress decline was not related to therapist self-efficacy increase over the course of therapy. However, at the session-to-session level, higher therapist self-efficacy before one session significantly predicted lower client distress before the next session, and higher client distress before one session significantly predicted lower therapist self-efficacy before the subsequent session. Therapist and client perceptions of working alliance were both significant mediators, while their session quality ratings were not. Findings supported the dynamic and reciprocal relationship between therapist self-efficacy and client distress at the immediate session-to-session level rather than the overall trajectory level, and revealed its specific mediating mechanism through the relationship building between therapist and client. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The "roller coaster ride": A longitudinal investigation of the dynamic relationship between Chinese counseling trainees' self-efficacy and their clients' outcome and the mediating effects of working alliance and session evaluation.

[Correction Notice: An Erratum for this article was reported in Vol 69(4) of Journal of Counseling Psychology (see record 2022-76740-002). In the article, the scale for the Working Alliance Inventory-Short Revised (WAI-SR) was incorrectly described in the Measures section as a "5-point scale that ranges from 1 to 5." The WAI-SR used the original 7-point scale ranging from 1 to 7. All versions of this article have been corrected.] Based on the social-cognitive theory, this study investigated the dynamic association between counseling trainees' self-efficacy and their clients' outcome (i.e., symptom distress), and the mediating effects of therapist- and client-rated working alliance and session quality. Data set included 1,352 sessions conducted by 87 master's level therapist trainees with their 317 clients in China. Before every session, therapists completed a measure of self-efficacy and clients reported their symptom distress; and after every session, both therapists and clients rated their working alliance and session quality. Results showed that, (a) over the course of therapy, the initial level of therapist self-efficacy did not predict how quickly client symptom declined; (b) the initial level of client distress did not predict how quickly therapist self-efficacy increased; and (c) client distress decline was not related to therapist self-efficacy increase over the course of therapy. However, at the session-to-session level, higher therapist self-efficacy before one session significantly predicted lower client distress before the next session, and higher client distress before one session significantly predicted lower therapist self-efficacy before the subsequent session. Therapist and client perceptions of working alliance were both significant mediators, while their session quality ratings were not. Findings supported the dynamic and reciprocal relationship between therapist self-efficacy and client distress at the immediate session-to-session level rather than the overall trajectory level, and revealed its specific mediating mechanism through the relationship building between therapist and client. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Integrating the CARD (Comfort Ask Relax Distract) system in a mass vaccination clinic to improve the experience of individuals during COVID-19 vaccination: a pre-post implementation study

ABSTRACT Many people have negative experiences with vaccination due to stress-related reactions including fear and pain. We used a pre-post study design to evaluate the impact of implementing a modified version of the CARD (Comfort-Ask-Relax-Distract) system on stress-related reactions in individuals aged 12 y or older undergoing COVID-19 vaccinations in mass vaccination clinics. Vaccine recipients reported their level of pain, fear and dizziness during vaccination. Clinic staff reported their attitudes about CARD and use of CARD interventions. CARD improved client symptoms across genders and ages with an average reduction in needle pain, fear and dizziness of 75%, 40% and 44%, respectively. CARD was more effective in younger individuals. Clinic staff reported positive attitudes about CARD and uptake of selected CARD interventions. In summary, the modified CARD system reduced stress-related responses in a general population undergoing COVID-19 vaccinations in a mass vaccination clinic, was feasible and acceptable to staff. Future implementation efforts are recommended that include more diverse cultural contexts and incorporate education of individuals about CARD ahead of time.

Comparative effectiveness of in-person vs. remote delivery of the Common Elements Treatment Approach for addressing mental and behavioral health problems among adolescents and young adults in Zambia: protocol of a three-arm randomized controlled trial

BackgroundIn low- and middle-income countries (LMIC), there is a substantial gap in the treatment of mental and behavioral health problems, which is particularly detrimental to adolescents and young adults (AYA). The Common Elements Treatment Approach (CETA) is an evidence-based, flexible, transdiagnostic intervention delivered by lay counselors to address comorbid mental and behavioral health conditions, though its effectiveness has not yet been tested among AYA. This paper describes the protocol for a randomized controlled trial that will test the effectiveness of traditional in-person delivered CETA and a telehealth-adapted version of CETA (T-CETA) in reducing mental and behavioral health problems among AYA in Zambia. Non-inferiority of T-CETA will also be assessed.MethodsThis study is a hybrid type 1 three-arm randomized trial to be conducted in Lusaka, Zambia. Following an apprenticeship model, experienced non-professional counselors in Zambia will be trained as CETA trainers using a remote, technology-delivered training method. The new CETA trainers will subsequently facilitate technology-delivered trainings for a new cohort of counselors recruited from community-based partner organizations throughout Lusaka. AYA with mental and behavioral health problems seeking services at these same organizations will then be identified and randomized to (1) in-person CETA delivery, (2) telehealth-delivered CETA (T-CETA), or (3) treatment as usual (TAU). In the superiority design, CETA and T-CETA will be compared to TAU, and using a non-inferiority design, T-CETA will be compared to CETA, which is already evidence-based in other populations. At baseline, post-treatment (approximately 3–4 months post-baseline), and 6 months post-treatment (approximately 9 months post-baseline), we will assess the primary outcomes such as client trauma symptoms, internalizing symptoms, and externalizing behaviors and secondary outcomes such as client substance use, aggression, violence, and health utility. CETA trainer and counselor competency and cost-effectiveness will also be measured as secondary outcomes. Mixed methods interviews will be conducted with trainers, counselors, and AYA participants to explore the feasibility, acceptability, and sustainability of technology-delivered training and T-CETA provision in the Zambian context.DiscussionAdolescents and young adults in LMIC are a priority population for the treatment of mental and behavioral health problems. Technology-delivered approaches to training and intervention delivery can expand the reach of evidence-based interventions. If found effective, CETA and T-CETA would help address a major barrier to the scale-up and sustainability of mental and behavioral treatments among AYA in LMIC.Trial registrationClinicalTrials.govNCT03458039. Prospectively registered on May 10, 2021

Influence of client self‐determination on counseling outcome

AbstractAutonomous motivation based on self‐determination theory has been posited as an important common factor. This study tested whether its influence on outcome extended to mildly distressed clients treated by counselor trainees at a university counseling training center. The study was naturalistic and examined 138 clients, who were mildly distressed according to the Outcome Questionnaire‐45 (OQ‐45). Clients completed the OQ‐45 every session and their motivation after the third session. Hierarchical linear modeling revealed that after controlling for autonomous and controlled types of motivation, intrinsic motivation had the strongest impact on reducing client symptoms over time. Findings suggested that the positive influence of autonomous motivation extends to moderately distressed clients treated by novice counselors. However, the positive impact of autonomous motivation may depend on client severity. Implications for future research and counseling practice were discussed.

Assessing practical implementation of modular psychotherapy for youth in community-based settings using benchmarking.

Achieving high quality outcomes in a community context requires the strategic coordination of many activities in a service system, involving families, clinicians, supervisors, and administrators. In modern implementation trials, the therapy itself is guided by a treatment manual; however, structured supports for other parts of the service system may remain less well-articulated (e.g., supervision, administrative policies for planning and review, information/feedback flow, resource availability). This implementation trial investigated how a psychosocial intervention performed when those non-therapy supports were not structured by a research team, but were instead provided as part of a scalable industrial implementation, testing whether outcomes achieved would meet benchmarks from published research trials. In this single-arm observational benchmarking study, a total of 59 community clinicians were trained in the Modular Approach to Therapy for Children (MATCH) treatment program. These clinicians delivered MATCH treatment to 166 youth ages 6 to 17 naturally presenting for psychotherapy services. Clinicians received substantially fewer supports from the treatment developers or research team than in the original MATCH trials and instead relied on explicit process management tools to facilitate implementation. Prior RCTs of MATCH were used to benchmark the results of the current initiative. Client improvement was assessed using the Top Problems Assessment and Brief Problem Monitor. Analysis of client symptom change indicated that youth experienced improvement equal to or better than the experimental condition in published research trials. Similarly, caregiver-reported outcomes were generally comparable to those in published trials. Although results must be interpreted cautiously, they support the feasibility of using process management tools to facilitate the successful implementation of MATCH outside the context of a formal research or funded implementation trial. Further, these results illustrate the value of benchmarking as a method to evaluation industrial implementation efforts.Plain Language Summary: Randomized effectiveness trials are inclusive of clinicians and cases that are routinely encountered in community-based settings, while continuing to rely on the research team for both clinical and administrative guidance. As a result, the field still struggles to understand what might be needed to support sustainable implementation and how interventions will perform when brought to scale in community settings without those clinical trial supports. Alternative approaches are needed to delineate and provide the clinical and operational support needed for implementation and to efficiently evaluate how evidence-based treatments perform. Benchmarking findings in the community against findings of more rigorous clinical trials is one such approach. This paper offers two main contributions to the literature. First, it provides an example of how benchmarking is used to evaluate how the Modular Approach to Therapy for Children (MATCH) treatment program performed outside the context of a research trial. Second, this study demonstrates that MATCH produced comparable symptom improvements to those seen in the original research trials and describes the implementation strategies associated with this success. In particular, although clinicians in this study had less rigorous expert clinical supervision as compared with the original trials, clinicians were provided with process management tools to support implementation. This study highlights the importance of evaluating the performance of intervention programs when brought to scale in community-based settings. This study also provides support for the use of process management tools to assist providers in effective implementation.

Schiffian Reparenting: 15 Years in the Early TA Literature (1961–1975)

Berne’s structural analysis of the personality’s ego states laid the groundwork for the conception of schizophrenia developed by the Schiffs and for their subsequent treatment approach through reparenting. For many years, the transactional analysis (TA) community has grappled with this arguably important aspiration to address the more severe psychological and behavioral symptoms in patients and clients as well as with the concerning ethical dilemmas that also emerged as a result of the practice of reparenting. This article outlines that community contention and struggle as reflected in the early TA literature over the course of 15 years (1961–1975). Yet much research and thinking remain to be done.

Supplemental Material for The “Dyadic Dance”: Exploring Therapist–Client Dynamics and Client Symptom Change Using Actor–Partner Interdependence Modeling and Multilevel Mixture Modeling

Supplemental Material for The “Dyadic Dance”: Exploring Therapist–Client Dynamics and Client Symptom Change Using Actor–Partner Interdependence Modeling and Multilevel Mixture Modeling

Group dynamic interpersonal therapy (GDIT): adapting an individual interpersonal therapy to a group setting in an NHS IAPT service: a pilot study

Dynamic interpersonal therapy (DIT) was developed for individual clients. This pilot project set out to evaluate if DIT could be adapted to group psychotherapy. Three consecutive groups were run in an NHS IAPT service over two years. Twenty-seven clients (10 men and 17 women, median age 34) were offered treatment. Groups were facilitated by accredited DIT therapists. Clients completed the PHQ9 and the GAD7 at assessment and then weekly. Scores were used to evaluate the impact of GDIT on client symptoms. Data collected during routine treatment was later analysed. The delivery of key aspects of the model that included the formulation of the IPAF and the Goodbye Letter were changed. Results suggest that DIT can be adapted to a group setting and that this way of working may have significant benefits for clients. 74% of patients (n = 19) who completed treatment were above Caseness on the PHQ9 (p = < .00001, d = 1.82) and 58% on the GAD7 (p = < .000001, d = 1.63). Only one client (5%) dropped out of treatment. Given the small size of the sample and no control, the reduction in client symptoms cannot be reliably attributed to GDIT. More research is needed.

Effects of Two Alcohol Reduction Interventions on Depression and Anxiety Symptoms of ART Clients in Vietnam.

Little is known about the potential mental health impacts of cognitive behavioral therapy and motivational interviewing interventions that focus on alcohol reduction among people with HIV (PWH). Our study aimed to assess the impact of two evidence-based alcohol reduction interventions on depression and anxiety symptoms of antiretroviral therapy (ART) clients with hazardous alcohol use. We conducted a secondary data analysis of data from a three-arm randomized controlled trial among ART clients in Thai Nguyen, Vietnam that evaluated the impacts of two alcohol reduction interventions in Vietnam. ART clients 18years old or more with hazardous alcohol use (based on the Alcohol Use Disorders Identification Test-Consumption) were enrolled and randomized into one of three arms: Combined intervention, Brief intervention, and Standard of care (SOC). Symptoms of depression, measured with the Patient Health Questionnaire-9, and anxiety, measured with the Generalized Anxiety Disorder-7 scale, were assessed at baseline and 3, 6, and 12months post-intervention. Generalized estimating equations were used to evaluate the effects of the interventions on depression and anxiety symptoms. The prevalence of depression and anxiety symptoms at baseline was 25.1% and 16.1%, respectively. Decreases in depression and anxiety symptoms were observed in all three armsfrom baseline to 12-month follow-up. There were no significant differences in depression and anxiety symptoms among participants receiving either intervention, relative to the SOC. Interventions with a dual focus on alcohol and mental health are needed to achieve more pronounced and sustainable improvements in depression and anxiety symptoms for PWH with hazardous alcohol use.

Effectiveness and equity evaluation of an insurance‐wide telephone‐counseling program for self‐management of chronic diseases: The Health Coach Study

Trajectories of chronic illnesses depend on patient socioeconomic status (SES). This study examines main and equity effects (age, gender, education, region of residence) of a brief telephone self-management intervention on self-rated health and depressive symptoms of health insurance clients with chronic illnesses. Randomized invitation design (n = 2628) with predominantly male (82%) older individuals (modal age = 65-74) with one or more chronic illnesses. Primary outcomes: Self-rated health and depressive symptoms. Intervention: Brief CBT-based telephone counseling. Propensity score matching was used to equate intervention and control groups (n = 1314 pairs). Change score models were used to analyze changes in health-related outcome measures. The intervention resulted in improvements in self-rated health (d = .37) and fewer depressive symptoms (d = .17) over 4 and 6months. There were comparable effects across education and regions, but younger and female participants profited more from the intervention compared with older and male participants. A brief telephone-based intervention led to improved self-rated health and well-being in a large sample of participants with chronic health conditions. This effect was observed over and above regular medical care. The intervention was equitable with respect to education and region, but not age and gender.

Case Study of Congklak Play Therapy for Children to Improve Social Interaction Due to Gadget Addiction

Objective: To see the effectiveness of congklak play therapy in increasing social interaction in children because of gadget addiction. Method: The research design used is a case study research method with a descriptive research type. The research subject used was a school-age child client with social interaction problems due to gadget addiction. Result: Subjectively, the client experiences an increase in interaction with the people around him and a decrease in the intensity of his use of gadgets. Clients can better control their emotions, and there is an increase in learning. Likewise, objectively, the client seems to be able to control his emotions and often interacts with the people around him. Conclusion: After doing research on An. M., the data obtained by the client's mother complains that the client rarely interacts with other people; the client often plays gadgets until he forgets the time; and when the gadget is taken, he often gets angry. The client's mother gets information from the client's school teacher that the client is less cooperative while studying at school. Based on the assessment, the diagnosis that emerged was social interaction disorder. The author conducted an intervention to overcome social interaction disturbances for four days. The intervention that the author has done is to provide congklak play therapy. After the intervention, the client's signs and symptoms of impaired social interaction diminished. The client has often interacted with people around him by using his gadget a little less.

Tuning-in to Clients: The Use of Semiotics in Counselling

Semiotics is about signs, but more so about meaning-making. It therefore has immediate relevance to counselling. The current paper not only seeks to introduce semiotics to counsellors but also to offer skills and methods to enhance the ways in which practitioners see, hear, and understand their clients via the use of signs. In particular, five semiotic practices will be discussed: (1) the clinical relevance of categorising client signs; (2) the value of exploring the connotic meanings of client signs; (3) the effective use of a paradigmatic analysis to uncover hidden meanings; (4) the value of metaphor and irony to therapeutic conversations; and, (5) the necessity of understanding a client’s language code to avoid erroneous clinical judgements. Finally, in adopting the use of semiotics, practitioners are able to reconsider their practice by looking beyond client symptoms to engage meaningfully with entire sign systems, which confer additional and important clinical information.

Effects of Virtual Reality Exposure Therapy on Dentophobia in Clients of Dental Offices in Isfahan, Tehran, and Shahrekord (Iran)

Background: Dentophobia can reduce the number of regular visits to dentists and endanger the oral health of people. New technologies such as virtual reality (VR) can be used in the treatment of psychological problems such as dentophobia. Objectives: The present study aimed to investigate the effectiveness of virtual reality exposure therapy (VRET) on dentophobia in clients of dental offices in the cities of Isfahan, Tehran, and Shahrekord in 2020. Methods: The research method was quasi-experimental with a pre-test, post-test, and follow-up design and a control group. The statistical population of this study consisted of all clients with dentophobia visiting private dental clinics of Isfahan, Tehran, and Shahrekord in 2020. Thirty clients with dentophobia who were willing to participate in the research were selected as the sample using convenience sampling and randomly divided into experimental and control groups (n = 15 per group). The experimental group underwent eight sessions (15-minutes sessions per week) of virtual reality exposure therapy, while the control group received no intervention. The follow-up was performed after 45 days. The research instruments included the Modified Dental Anxiety Scale (MDAS), Samsung Gear 360 (2017 Edition), and HTC VIVE Pro Virtual Reality Headset. Data were analyzed using repeated-measures ANOVA. Results: The results showed that virtual reality exposure therapy effectively decreased dentophobia in clients of dental offices in the experimental group (P = 0.0001). Conclusions: According to research findings, virtual reality exposure therapy was an efficient therapy for improving dentophobia and reducing phobia symptoms in clients of dental offices.

Adjunct Triptorelin in the Treatment of Obsessive-Compulsive Disorder in Clients Receiving Selective Serotonin Reuptake Inhibitors (SSRIs).

Objective: Analog triptorelin is one of the effective agonists for the treatment of reproductive disorders, particularly prostate cancer. Due to results of previous studies, we hypothesized that obsessive-compulsive disorder (OCD can be effectively treated with the long-term administration of a gonadotropin-releasing hormone (GnRH) analog, namely triptorelin. The aim of this study was to evaluate the effectiveness of triptorelin injection in clients with OCD. Method : This randomized single-blind clinical trial was performed on 30 clients with OCD who had a Yale-Brown score of > 17 after 8 weeks of treatment. The participants were randomly assigned into two groups of triptorelin and placebo. The clients in the intervention group were treated with Selective serotonin reuptake inhibitors (SSRIs), including fluoxetine, in addition to triptorelin three times a month for at least 8 weeks. Clients in the control group received injection of distilled water as placebo three times in addition to the routine treatment. The outcome was evaluated by Yale-Brown OCD scale (Y-BOCS) at the baseline, as well as 4, 8, and, 20 weeks after the end of the treatment. Results: The mean scores of Y-BOCS in the intervention and control groups was 30.5 ±67.6 and 30.5 ±67.6, respectively, before intervention, indicating no significant difference between the two groups (P = 0.0.8). The comparison of Y-BOCS scores after the intervention showed a significant difference between the two groups in the scores 4 (P = 0.01), 8 (P < 0.005), and 20 (P < 0.005) weeks after the treatment. With regards to the side effects of the medicine, 6.7% (n = 1) of the clients in the control group developed headache and 66.7% (n = 10) had late period in intervention group. The results revealed a significant difference between the two groups in terms of side effects (P < 0.005). Conclusion: The results of this study showed triptorelin decreased the symptoms of OCD. The effectiveness of triptorelin in the treatment of symptoms in clients with OCD was confirmed in our study. However, due to the limited research addressing this domain, future studies are suggested to clarify this conclusion.

Paving the Path for Tele–Mental Health Services: Transitions in a Student-Led Behavioral Health Clinic During COVID-19

ABSTRACT Attempts to control COVID-19 pushed mental health providers to offer remote services to engage clients. This article discusses transitions in a student-led behavioral health clinic and has three aims: explore experiences transitioning to telehealth services, examine client mental health and quality of life outcomes, and compare client engagement through no-show and cancellation rates. This study is an evaluation and used a nonexperimental design. Data were collected from clinic students and faculty (n=21) and from clients (n=46). Data were analyzed using directed content analysis and univariate descriptive statistics. Students and faculty encountered few barriers moving services to telehealth. During a pandemic, client symptoms remained stable. No-show and cancellation rates declined following telehealth. Implications for student-led clinics and training are discussed.

Describing disorder: The importance and advancement of compositional explanations in psychopathology

Understanding the makeup of mental disorders has great value for both research and practice in psychopathology. The richer and more detailed our compositional explanations of mental disorder—that is, comprehensive accounts of client signs and symptoms—the more information we have to inform etiological explanations, classification schemes, clinical assessment, and treatment. However, at present, no explicit compositional explanations of psychopathology have been developed and the existing descriptive accounts that could conceivably fill this role—DSM/ICD syndromes, transdiagnostic and dimensional approaches, symptom network models, historical accounts, case narratives, and the Research Domain Criteria (RDoC)—fall short in critical ways. In this article, we discuss what compositional explanations are, their role in scientific inquiry, and their importance for psychopathology research and practice. We then explain why current descriptive accounts of mental disorder fall short of providing such an explanation and demonstrate how effective compositional explanations could be constructed.