Contribution Of Therapists Research Articles

More than Meets the “I”: A Panoramic View of Epistemic Trust in Psychotherapy

Introduction: Epistemic trust (ET), the authenticity and personal relevance we assign to interpersonally transmitted knowledge, is considered an essential component of any effective therapy. Despite its clinical significance, comprehensive empirical support is still lacking regarding whether ET is an inherent characteristic of the patient or acts as a catalyst for therapeutic change. Consequently, unlike other critical components, a clear distinction between its aspects – the patient’s attributes, the therapist’s contribution, and their unique therapeutic relationship – remains elusive, leaving our understanding incomplete. The current study examines the constituents of ET in therapy and its related effects through three distinct lenses: a blended snapshot lens, a prognostic lens, and a lens focusing on state-like changes. The constituents of ET were measured as follows: patient attributes were measured using attachment orientation and interpersonal functioning scales; therapist contribution was evaluated through scales assessing the therapist’s use of techniques; and the patient-therapist therapeutic relationship was gauged using the working alliance scale. Methods: We collected and analyzed data from 116 patients who participated in manualized psychodynamic psychotherapy sessions to investigate the trait-like and state-like components of ET. Results: The results offer a comprehensive panoramic view with small to medium, but meaningful, correlations between ET and patients’ attributes (ranging from 0.18 to −0.26); therapists’ contributions (ranging between 0.15 and 0.28); and the patient-therapist therapeutic relationship (ranging between 0.17 and 0.23). Conclusion: While some findings were consistent with our expectations, others were contrary, highlighting the necessity of considering the variations between and within patients as they have distinct theoretical, clinical, and empirical implications. Employing these three distinct lenses helps therapists gain a better understanding of the clinical picture reflected by the patient over different treatment periods. This broad perspective is of prognostic importance and encourages clinicians to adjust the treatment focus to meet the evolving needs of their patients.

Emotional changes and outcomes in psychotherapy: A systematic review and meta-analysis.

This systematic review and meta-analysis summarize current knowledge on emotional change processes and mechanisms and their relationship with outcomes in psychotherapy. We reviewed the main change processes and mechanisms in the literature and conducted meta-analyses of process/mechanism-outcome associations whenever methodologically feasible. A total of 121 studies, based on 92 unique samples, met criteria for inclusion. Of these, 85 studies could be subjected to meta-analysis. The emotional change processes and mechanisms most robustly related to improvement were fear habituation across sessions in exposure-based treatment of anxiety disorders (r = .38), experiencing in psychotherapy for depression (r = .44), and emotion regulation in psychotherapies for patients with various anxiety disorders (r = .37). Common methodological problems were that studies often did not ascertain representative estimates of the processes under investigation, determine if changes in processes and mechanisms temporally preceded outcomes, disentangle effects at the within- and between-client levels, or assess contributions of therapists and clients to a given process. The present study has identified a number of emotional processes and mechanisms associated with outcome in psychotherapy, most notably fear habituation, emotion regulation, and experiencing. A common denominator between these appears to be the habitual reorganization of maladaptive emotional perception. We view this as a central pan-theoretical change mechanism, the essence of which appears to be increased differentiation between external triggers and one's own affective responses, which facilitates tolerance for affective arousals and leads to improved capacity for adaptive meaning-making in emotion-eliciting situations. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Role of physical therapists in providing care to older adults in welfare shelters during the hyper-acute phase of a disaster: lessons learned in Wajima City, Japan, after the 2024 Noto Peninsula earthquake

Natural disasters pose significant challenges to affected communities, particularly vulnerable populations such as older adults. The aftermath of the Great East Japan Earthquake highlighted the necessity of welfare shelters to provide essential care. However, little is known about the specific role of physical therapists in these shelters. The aim of this article is to share the experiences and contributions of physical therapists in a welfare shelter in Wajima, Ishikawa Prefecture, immediately after the 2024 Noto Peninsula earthquake. The earthquake, with a magnitude of 7.6, damaged 76,589 houses, injured over 1,100 people, resulting in 245 deaths. The authors comprised a multidisciplinary team, including physical therapists, that provided short-term medical support at a welfare shelter in Wajima. Through several examples, we describe the contribution of physical therapists to evacuees' health outcomes. Physical therapists played multifaceted roles in the welfare shelter, optimizing living environments, conducting physical screenings, and delivering continuous medical care, including respiratory care and exercise programs. The involvement of physical therapists in post-disaster evacuation shelters is crucial for enhancing emergency health care delivery and promoting community resilience.

The perceptions of nurses and physicians in primary care of rehabilitation for frail older adults

Objectives To investigate the perceptions of primary care nurses and physicians of the potential contributions of physiotherapists (PTs) and occupational therapists (OTs) in the treatment of frail older persons, as well as the obstacles to, and opportunities for, collaboration. Design A qualitative study. Participants and setting Nurses (n = 9) and physicians (n = 8) in primary care in the county council [14 women (82%)] with experience working with older people. Method Interview study conducted with a semi-structured interview guide. Analyses were carried out with content analysis with an inductive approach. Results The analysis resulted in six categories: knowledge of physiotherapy and occupational therapy interventions; what triggers the need for physiotherapy and occupational therapy?; the availability of rehabilitation interventions; teamwork opportunities and difficulties; motivating the patient; the site of the rehabilitation. Conclusions Close and clear collaboration between nurses and physicians and PTs and OTs is an important factor in ensuring that rehabilitation interventions provide the greatest possible benefit to the patient. Improving communication between different healthcare providers and clarifying the contact routes is a prerequisite for patients to be able to get the rehabilitation they need. More research is needed to determine the best approach to achieving this goal.

Therapist contribution, client reflective functioning, and alliance rupture-repair: A microprocess case study of psychodynamic therapy for pregnancy after loss.

Meta-analysis has found a significant relation between rupture-repair and client outcome (Eubanks et al., 2018). Rupture-repair processes may be particularly important in psychotherapy for pregnancy loss wherein ruptures related to client feelings of shame and inadequacy, the societal invalidation of perinatal grief, and reenactments in the therapy relationship of early attachment experiences have been theorized to be common and important events (Markin, 2024). Thus, it is important to understand what occurs on a microlevel during the process of therapy to ultimately explain the rupture resolution (RR) and treatment outcome association. In particular, while both the therapist and client are believed to contribute to ruptures and to their repair (Safran & Muran, 2000), little is known about how therapist contributions impact rupture events, rupture resolution, and treatment progress. Further, client reflective functioning (RF) may represent a set of capacities that contribute to and are increased by rupture resolution yet vary depending on the role of the therapist in the rupture. The current investigation examined how observer-rated therapist contribution to ruptures and client RF were related to rupture events, rupture resolution, and client-reported symptom change and session quality over 22 sessions of psychodynamic therapy for pregnancy after loss. Therapist contribution to ruptures predicted rupture significance, high and steady within-session client RF scores, and symptom change. Client RF and rupture resolution predicted symptom change differently, often depending on type of symptom. Importantly, client RF and rupture resolution may predict successful outcomes through ameliorating commonly reported symptoms during pregnancies after loss. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The Weight of Traditional Therapy in The Management of Chronic Skin Diseases in Donka National Hospital

Chronic skin diseases affect patients’ physical, psychological and social well-being. They lead patients to seek care in conventional and traditional medicine. The aim of this study was to determine the contributions of traditional therapists in the management of patients with chronic skin diseases attending the Donka National Hospital. We have conducted a descriptive cross-sectional study from 10 January 2021 to 15 August 2023 in the Dermatology – STD Department of the Donka National Hospital. We considered a chronic skin disease to be one in which the duration of the disease is greater than or equal to 3 months, with repercussions on the daily life of the patient and/or those around him. Recruitment was exhaustive. A questionnaire was designed for this purpose. The Patient Global Impression Improvement Scale (PGI-I) was used to assess response to treatment. The contribution was considered positive if the patient had been referred by the traditional therapist to the specialist centre. Fifty-three of the 1011 patients suffering from chronic skin diseases were included, i.e. 9.23%. The mean age of the patients was 35.94 years, ranging from 5 to 80 years. The male/female sex ratio of patients was 0.70. Chronic skin diseases were autoimmune in 37.70% of cases. Only 17% of patients had been referred to a dermatologist by their traditional therapist, with good improvement noted in 37% of cases. This positive contribution needs to be reinforced by setting up a formal framework for collaboration between traditional and conventional medicine.

A contribuição de terapeutas ocupacionais no domínio da gestão de risco e desastres: um protocolo de revisão de escopo

Abstract Introduction Disasters bring human, socioeconomic, and environmental consequences and exacerbate situations of vulnerability. Both highly industrialized core countries and those facing economic difficulties are subject to these events. In Brazil, the COVID-19 pandemic and the collapse of dams highlight difficulties in anticipating and responding to these types of events. Actions of occupational therapy in the field of emergencies and disasters are scarce in the literature, notably in the sphere of prevention. Objective To explore the evidence of the contribution of occupational therapists in the field of risk management and disasters based on the characteristics, priorities, and main areas of interest of intellectual production in occupational therapy. Method A comprehensive search will be conducted in the journals Disasters, Hazards & Crisis in Public Policy, International Journal of Mass Emergencies and Disasters, and Risk, International Journal of Risk Reduction, and Journal of Contingencies and Crisis Management, as well as in the databases Occupational Therapy Literature Search Service (OTDBASE), PubMed, and Web of Science. Inclusion Criteria Actions and experiences in the field of occupational therapy, notably those of occupational therapists in risk and disaster management, found in peer-reviewed studies adopting quantitative, qualitative, and mixed methods, in Spanish, English, and Portuguese, without temporal restriction. The approach advocated by the Joanna Briggs Institute (JBI) for study selection, critical appraisal, and data collection and synthesis will be used.

Contribution of occupational therapists to the field of risk and disaster management: a scoping review protocol

Resumo Introdução Desastres trazem consequências humanas, socioeconômicas e ambientais e agravam situações de vulnerabilidade. Tanto países centrais, altamente industrializados, como países com dificuldades econômicas estão sujeitos a esses eventos. No Brasil, a pandemia de COVID-19 e o rompimento de barragens evidenciam dificuldades em se antecipar e responder esses tipos de eventos. Ações da terapia ocupacional no campo das emergências e desastres são escassas na literatura, notadamente na esfera da prevenção. Objetivo Explorar as evidências da contribuição de terapeutas ocupacionais no domínio da gestão de risco e desastres a partir das características, prioridades e principais áreas de interesse da produção intelectual em terapia ocupacional. Método Uma pesquisa abrangente será conduzida nos periódicos Disasters, Hazards & Crisis in Public Policy, International Journal of Mass Emergencies and Disasters, and Risk, International Journal of Risk Reduction e Journal of Contingencies and Crisis Management, assim como nas bases de dados Occupational Therapy Literature Search Service (OTDBASE), PubMed e Web of Science. Critérios de inclusão Ações e experiências no âmbito da terapia ocupacional, notadamente aquelas de terapeutas ocupacionais na gestão de riscos e desastres, encontradas em estudos revisados por pares, que adotem métodos quantitativos, qualitativos e mistos, nos idiomas espanhol, inglês e português, sem restrição temporal. A abordagem preconizada pelo Joanna Briggs Institute (JBI) para seleção de estudos, avaliação crítica, extração e síntese de dados será utilizada.

Associations between learning principles of cognitive remediation and cognitive and vocational outcomes in early psychosis—an exploratory analysis of RCT data

Background : Most cognitive remediation (CR) programs are based on multiple scientific learning principles. The role of those learning principles in the beneficial effects of CR is poorly understood. A better understanding of such underlying mechanisms is important to further tailor the intervention and to learn about optimal contexts. Method : An explorative secondary analysis was conducted of data from a randomized controlled trial (RCT) comparing the effects of Individual Placement and Support (IPS) with and without CR. The present study evaluated how CR learning principles of “massed practice,” “errorless learning,” “strategy use” and “therapist contribution” (therapist fidelity) were associated with cognitive and vocational outcomes within 26 participants in this RCT who were treatment exposed. Results : Cognitive gains after CR were positively associated with “massed practice” and “errorless learning.” Negative associations were found with “strategy use” and “therapist fidelity.” No direct relationship was found between CR principles and vocational outcomes. Conclusions : Results tentatively suggest that CR is most effective and efficient with a good balance between sufficient intensity, of more than 200 tasks, and a limited duration of the training up to 20 h, using tasks that remain both challenging and rewarding, being applied in a context that facilitates real-life practice.

The alliance in mental health care: conceptualization, evidence and clinical applications.

The concept of alliance reflects the collaborative relationship between a clinician and a patient, defined as consisting of three elements: a) the agreement on the goals of treatment; b) the agreement on a task or series of tasks; c) the development of a bond. Although much of the theory and research on the alliance comes from the domain of psychotherapy, the concept is applicable to any practice involving a person seeking help and a socially sanctioned healer. An extensive research evidence suggests that the alliance (typically measured at the third or fourth session) is a robust predictor of the outcomes of various forms of psychotherapy, even when prior symptom improvement and other factors are considered. Both the clinician and the patient bring to the therapy situation different capacities to form an alliance. Factors concerning the patient include, among others, the diagnosis, attachment history and style, motivation, and needs for affiliation. However, the benefits of the alliance have been found to be mostly due to the therapist's contribution, in particular his/her facilitative interpersonal skills, including verbal fluency, communication of hope and positive expectations, persuasiveness, emotional expression; warmth, acceptance and understanding; empathy, and alliance rupture-repair responsiveness. Placebo studies have allowed to experimentally manipulate aspects of the relationship between a therapist and a patient in non-psychotherapy contexts. In these settings, two components of the relationship have emerged: an emotional one (involving being cared for and understood by the clinician) and a cognitive one (including the belief in the competence of the therapist to select and administer an effective treatment). Here we propose a model that describes three pathways through which the alliance creates benefits, named CARE (caring, attentive, real and empathic), EXPECTANCY, and SPECIFIC. Although research and clinical attention have mostly focused on the alliance between a clinician and a patient in face-to-face interactions, there is preliminary evidence concerning the alliance between patients and other clinic staff, systems of care, or the program in Internet-mediated services. These new research areas clearly require further development.

Implementation of occupational therapy within early intervention in psychosis services: Results from a national survey.

Occupational therapy plays an important role in fostering community participation in areas such as education, employment, leisure, and social relationships, yet its added value within early intervention in psychosis services, especially in the United States, remains poorly understood. The purpose of this research was to conduct a national survey of early intervention in psychosis programs to: (1) understand the role and unique contributions of occupational therapists to early intervention teams, and (2) identify barriers and supports to the implementation of occupational therapy services within these programs. Fifty-one senior leaders from U.S.-based early intervention in psychosis programs participated in the national survey. The survey consisted of a series of closed and open-ended questions related to program staffing, the presence of specific services that fall within the occupational therapy scope of practice, and implementation barriers and supports. Despite there being strong interest in employing occupational therapists, a small proportion of programs (31%) reported having them on staff. Occupational therapists supported clients across multiple life areas and were significantly more likely than other team members to promote daily living activities (e.g., cooking) and to address sensory processing needs and challenges. Implementation was influenced by environmental/organizational and staff factors; the primary barrier was funding. Findings support the role occupational therapists may play in facilitating the community participation of clients of early intervention services, but significant barriers to implementation of occupational therapy services remain. Additional research is needed to further identify the impact of occupational therapy services within the early intervention model.

Is it me, is it you or is it both of US? Applying the social relations model to disentangle the components of the therapeutic bond

Objective The study investigated the contribution of therapists and patients to the therapeutic bond and their associations (at the within and between levels) to treatment outcome. On this aim, the social relations model (SRM, aimed to analyze dyadic interpersonal data) was implemented. Method A novel design for individual psychotherapy studies was adopted, a many-with-many asymmetrical block dyadic design, in which several patients interact with several therapists. Hierarchical linear models were computed to study through variance partitioning the different components of the SRM and their association to treatment outcome. Results All SRM components (with significant effects at therapist- and patient- within and between levels) resulted in significant contributions to the bond. However, only components at the within- and between-therapist, and within-patient levels resulted in significant associations with outcome. Conclusion Given the dyadic nature of the bond, our results support not only studying and offering clinical training on interpersonal therapeutic skills but also on constant monitoring and feedback of the relationship at the more idiosyncratic level.

Sex between Body and Mind: Psychoanalysis and Sexology in the German-Speaking World, 1890s–1930s by Katie Sutton

Reviewed by: Sex between Body and Mind: Psychoanalysis and Sexology in the German-Speaking World, 1890s–1930s by Katie Sutton Amy Lynne Hill Katie Sutton. Sex between Body and Mind: Psychoanalysis and Sexology in the German-Speaking World, 1890s–1930s. U of Michigan P, 2019. 364 pp. Cloth, $90.00. Audio download, $9.99. In Sex between Body and Mind, Katie Sutton identifies a critical gap in the historiography of human sexuality: in the study of sexology and psychoanalysis in modern Germany, attention is paid almost exclusively to moments of divergence as each became a professional and institutionalized field of knowledge in the forty years leading to the rise of National Socialism. Sutton argues instead that we turn to moments of encounter between sexologists and psychoanalysis, because of the "crucial impact [they had] not only on modern understandings of human sexuality, but on modern understandings of the self" (2). As she writes in her introduction, Sutton emphasizes the productive and emancipatory potential of Foucauldian thought and, as a result, recuperates the dynamic interdisciplinary history of human sexuality and brings to the fore vital encounters among doctors, scientists, theorists, therapists, and their patients. [End Page 129] Sutton frames her study as a comparative cultural history, and her central premise revolves around debates on nature versus nurture and the core tenet that "matters were always more complex than sexologists coming down on the side of biology and psychoanalysts focusing purely on the workings of the mind" (9). Rather, she emphasizes the importance of "interpenetration," meaning a newly created "knowledge product" previously inaccessible to either discipline, in the production of new sexual knowledge (21). She thus meticulously traces the interpersonal relationships of the most notable representatives from each field—namely, Magnus Hirschfeld on the side of sexology, and Sigmund Freud for psychoanalysis—while richly illustrating how they and their adherents reacted to and critiqued each other in personal correspondence and published scholarship alike. The result is a lively account of how both disciplines vied for credibility and respectability as they reacted to the cultural rupture of the Great War as well as innovative research into the endocrine system. After a thorough yet accessible survey of existing scholarship, Sutton begins by examining the impact of research on early childhood sexuality on modern ideas of the so-called normal subject. She assigns this as the first "trading zone" or "moment of reciprocal dialogue" between sexology and psychoanalysis, as well as a major paradigm shift that acknowledged sexuality before puberty (21); however, it also marked the first significant tension between the two fields in response to Freud's theory of the Oedipus complex. She then traces the increasingly important binary of normal versus perverse that developed during World War I with the case of homosexuality, wherein sexology and psychoanalysis took differing stances on whether sexuality was congenital or acquired. In another paradigm shift, while earlier psychiatric thought believed homosexuality to be a degenerative condition, now psychoanalysis largely conceived of same-sex attraction to be a pathological variation of the norm and therefore capable of being cured in therapy. This positioned psychoanalysis to gain cultural and professional standing in the treatment of so-called war neurotics, and Sutton argues that while this fact is widely acknowledged, the overly simplified narrative of the state of sexology during this time is that it was suffering a setback. She posits that this was a pivotal point of interpenetration as sexologists revised their own beliefs to include more psychoanalytic approaches in response to the trauma of war. Moreover, this marks the beginning of the hormone research that would prove to be a boon to sexologists, as it not [End Page 130] only supported their understanding of congenital factors in human sexuality, but the physiological nature of this research granted sexology new levels of professional and public credibility. This, writes Sutton, was a key moment in reconciling the connection between body and mind when it came to sex, but it ultimately proved to be anything but harmonizing for these two new disciplines. In the final third of her monograph, Sutton highlights the contributions of female theorists and therapists, as well as of members of what would today be considered the trans community...

A systematic review of work-related interventions for breast cancer survivors: Potential contribution of occupational therapists.

A high number of breast cancer survivors need to resume work. Therefore, interventions aimed at effective work-related transitions are important. A systematic review to determine what occupational therapy interventions are effective in work-related transitions of breast cancer survivors. Multiple databases were searched for studies on work-related interventions within the scope of occupational therapy. Studies were included if 70% or more study participants were working age (> 18 years) breast cancer survivors, and work-related transition outcome measures were used. The search yielded 2 872 articles, of which 12 met the inclusion criteria. When classified according to the International Classification of Function Framework, quantitative sources focussed on Body Structures and Functions component and Multicomponents (consists of the Body Structures and Functions Component and the Activities Component) showed positive effects on improving the work-related transitions of BC survivors, however, the effects were statistically insignificant and the strength of evidence was moderate. Participants in a qualitative source reported that after they underwent a physical exercise programme their work performance improved. A Multicomponents intervention study showed statistically significant improvements on self-reported work-related outcomes of BC survivors. Low evidence was found for implementing a vocational rehabilitation case management programme targeting the Activities component, which showed positive effects in reducing the sick leave days of BC survivors, but the effects were statistically insignificant. No evidence was found for programmes focussed on restoring the Participation component. The evidence included in this systematic review were insufficient to recommend occupational therapy interventions that are effective (showing statistically significant improvements) for work-related transitions of BC cancer survivors.

Examining therapist effects in the alliance-outcome relationship: A multilevel meta-analysis.

The relationship between the therapeutic alliance and outcome has been supported consistently over time. More recently, studies have examined therapist effects in the alliance-outcome relationship and came up with somewhat mixed findings. The purpose of this study was to replicate and extend previous meta-analytic work using a much larger data set, permitting not only the verification of the overall impact of the therapists' contribution but, at the same time, controlling for several potential covariates effecting this relationship. We conducted two- and three-level mixed-effects meta-analyses (k = 152; 827 total effect sizes) to examine the significance of several potential moderators of the alliance-outcome correlation. These moderators included (a) Patient-Therapist Ratio (PTR; Patient N divided by therapist N to test therapist effects), (b) Alliance and Outcome Rater's contribution (patient, therapist, observer, and other), (c) Alliance Measures, (d) Research Design (RCT, Other) and (e) Personality Disorder. The PTR, an index of the therapist's contribution to the alliance, was a significant moderator of the alliance-outcome correlation in both the two- and three-level models. When several potential confounds were simultaneously tested in a three-level multipredictor metaregression, including rater of alliance and outcome, research design, alliance measure, and personality disorder, PTR remained a significant moderator of the alliance-outcome correlation. Replicating and extending previous research, this study supported the significance of therapists' impact in the alliance-outcome relationship. These results remained significant even when, using three-level metaregressions, several potential covariates were simultaneously controlled. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Determining the therapist's contribution in therapist multicultural competence process and outcome.

Efforts to help therapists improve their multicultural competence (MCC) rely on measures that can distinguish between different levels of competence. MCC is often assessed by asking clients to rate their experiences with their therapists. However, differences in client ratings of therapist MCC do not necessarily provide information about the relative performance of therapists and can be influenced by other factors including the client's own characteristics. In this study, we used a repeated measures design of 8,497 observations from 1,458 clients across 35 therapists to clarify the proportion of variability in MCC ratings attributed to the therapist versus the client and better understand the extent that an MCC measure detects therapist differences. Overall, we found that a small amount of variability in MCC ratings was attributed to the therapist (2%) and substantial amount attributed to the client (70%). These findings suggest that our measure of MCC primarily detected differences at the client level versus therapist level, indicating that therapist MCC scores were largely dependent on the client. Clinical implications and recommendations for future MCC research and measurement are discussed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

One more time with less jargon: An introduction to "Rupture Repair in Practice".

In this introduction to this issue on Rupture-Repair in Practice, we present our understanding of alliance ruptures using common language to appeal to all theoretical orientations. Specifically, we define withdrawal movements away from another or oneself (efforts towards isolation or appeasement) and confrontation movements against another (efforts towards aggression or control). In addition to these interpersonal markers, we suggest that therapist emotional experiences can be considered as intrapersonal markers indicating rupture. We emphasize understanding ruptures as relational phenomena. Then we present various pathways toward rupture-repair, highlighting renegotiation of therapy tasks or goals and exploration of patient and therapist contributions and needs. We explain how these paths can be understood as critical change processes that can transform obstacles in treatment into opportunities. We finish with some mention of our alliance-focused training for self-development. This issue represents an important step towards demonstrating the transtheoretical and practical potential of rupture-repair.

Therapeutic Mother Tongue and its Implications on the Work of Polyglot Psychotherapists

Psychodynamic psychotherapy occurs in the lingual field. At its core, the “talking cure” uses the power of words to transform the psyche. Questions arise when the psychologist using language as a central means for therapy is a foreign-language speaker. Research and personal contributions of polyglot therapists in recent years show, that practicing psychotherapy in foreign languages effects the therapist’s work on many levels; technical aspects, the therapist’s self-perception and role, the therapeutic relationship, therapist’s experience and understanding of language as an element in therapy, and more. The present study interviewed nine polyglot therapists in different stages of their career using diverse and different languages in their practice. Analysis of the data in the context of Winnicott’s construct of potential space (Winnicott, 1971) and current linguistics theories regarding language embodiment (Pavlenko, 2005) brought about the suggestion of the concept of Therapeutic Mother Tongue, that refers to the language of training. Therapists’ experience of Therapeutic Mother Tongue and other languages are explored.

When adolescents stop psychological therapy: Rupture-repair in the therapeutic alliance and association with therapy ending.

The therapeutic alliance predicts dropout from psychological therapy, and ruptures in the therapeutic alliance may also predict dropout, yet there is a dearth of research with adolescents. This study investigated whether markers of rupture-repair in the alliance were indicative of different types of treatment ending in adolescents receiving psychological treatment for depression. Data were from the IMPACT study, a trial investigating the effectiveness of therapies for adolescent depression. Participants were randomly allocated to receive a brief psychosocial intervention, cognitive-behavioral therapy, or short-term psychoanalytic psychotherapy. The sample (N = 35) comprised adolescents who had either completed their treatment (n = 14) or dropped out (n = 21) according to their therapist. Dropout cases were further classified as dissatisfied (n = 14) or got-what-they-needed (n = 7) based on posttherapy interviews with the adolescent and therapist. Selected recordings of therapy sessions were rated using the Rupture Resolution Rating System and Working Alliance Inventory (observer version). Therapeutic alliance and rupture-repair during therapy were similar for completers and got-what-they-needed dropouts, whereas dissatisfied dropouts had poorer therapeutic alliance, more ruptures, ruptures that were frequently unresolved, and greater therapist contribution to ruptures. Qualitative analysis of sessions led to the construction of three categories of therapist contribution to ruptures: therapist minimal response, persisting with a therapeutic activity, and focus on risk. Results suggest that ruptures, especially when unresolved, could be warning signs of disengagement and dropout from therapy. Future research should investigate how ruptures may be effectively identified and resolved in treatment with adolescents. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Care planning in residential care facilities: the contributions of occupational therapists to the interprofessional team

Interprofessional teams will often meet with residents and their families to coordinate an effective care plan. Occupational therapists provide a unique contribution, supporting resident participation in meaningful and purposeful activities. Kathrine Hammill, Michelle Bissett and Craig Slater consider a variety of strategies to enhance care planning and assist with its successful implementation