Psychotherapy Literature Research Articles

Psychotherapy as a Determinant of Quality of Life among Older Persons

Purpose: This study delves into the experiences of elderly individuals undergoing psychotherapy, evaluating its effects on their quality of life and well-being, and identifying unique challenges and benefits in later life. Theoretical reference: The resilience theory, as explored in this study, highlights a multi-dimensional nature encompassing health, psychology, and social work, emphasizing the importance of examining adversity and outcomes and advocating for interdisciplinary approaches to understand and operationalise resilience across individuals, organizations, and communities. Method: A qualitative approach was utilized to gather deep insights into ten (10) participants’ experiences and the subjective impact of psychotherapy on their lives, highlighting the role of specific interventions in promoting psychological well-being. Results and Conclusion: Findings indicate that psychotherapy significantly enhances older individuals' psychological health, fostering positive self-evaluation, growth, meaningfulness, quality relationships, effective life management, and autonomy. The study further identifies critical challenges in accessing psychotherapy, such as financial, transportation, and mobility barriers. Implications of research: The research emphasizes the necessity for psychotherapeutic interventions that include family and social network support to positively influence older adults' well-being, addressing the identified access challenges. Originality/value: This study contributes unique insights into the psychotherapeutic experiences of the elderly, highlighting its crucial role in enhancing quality of life and addressing specific life stage challenges, thus adding valuable knowledge to geriatric psychotherapy literature.

Exploring the Use of the Therapist’s Self in Therapy: A Systematic Review

Purpose: This systematic qualitative review explored how psychotherapists use their self in therapy within the psychotherapy literature. It sought to examine the key documented ways through which the therapist’s self is intentionally used in therapy and the process of using the therapist’s self. Methods: Following PRISMA guidelines, databases including PubMed, ProQuest, APA PsycArticles, and APA PsycINFO were searched. The review question “How do therapists use their self in therapy?” guided the search using derivative keywords. Of the 149 screened articles, 20 underwent full-text review, and only four studies met inclusion criteria. Findings: All studies that met the inclusion criteria were from the West. Therapeutic self-disclosure (TSD) emerged as the primary way through which therapists used their self in therapy—notably, the only way documented in the studies reviewed. Studies discussed the nature, rationale, influencing factors, and effectiveness of TSD. This article elaborates upon the themes from the reviewed studies. It critically examines existing literature, lists avenues for future research, and discusses implications for psychotherapy practice. Conclusions: The review underscores a significant gap in empirical qualitative research regarding therapists’ use of their self beyond TSD in therapy. There is an urgent need for further exploration in this domain.

Acoustic analysis of clients' expression of self-compassion, self-criticism, and self-protection within emotion focused therapy video sessions.

When it comes to the non-verbal communication of emotions, it is apparent that the human voice is one of the main ways of expressing emotion and is increasingly important in psychotherapeutic dialog. There is ample research focusing on the vocal expression of emotions. However, to date the analysis of the vocal quality of clients' in-sessional emotional experience remains largely unexplored. Moreover, there is generally a gap within the psychotherapy literature in the understanding of the vocal character of self-compassion, self-criticism, and protective anger. In this study we investigated how clients vocally convey self-compassion, self-protection and self-criticism in Emotion Focused therapy sessions. For this purpose we investigated 12 commercially available Emotion Focused Therapy videos that employed a two chair or empty chair dialog. Praat software was used for the acoustic analysis of the most common features - pitch (known as fundamental frequency or F0) and intensity (voice amplitude, i.e., loudness). Results showed that intensity was significantly higher for self-criticism and self-protection than for self-compassion. Regarding pitch the findings showed no significant differences between the three states. More research analyzing acoustic features in a larger number of cases is required to obtain a deeper understanding of clients' vocal expression of self-compassion, self-protection and self-criticism in Emotion Focused Therapy.

The use of religious resources in helping victims of workplace mobbing.

Research shows that in providing assistance to individuals who have experienced psychological traumas, it is beneficial not only to take into account the specific religious spiritual needs but also to employ religious resources. Although the role of religious counsellors using various psychological theories in helping to cope with traumatising experiences is acknowledged, there is still a lack of a conceptualising approach to the possibilities of employing religious resources used in Christian spiritual assistance, seeking to help cope with the effects of workplace mobbing. Therefore, this study aims to conceptualise the perspective of integrating Christian spiritual assistance resources in overcoming the individual consequences of workplace mobbing. This review is based on an interdisciplinary approach and abundant literature of psychology, psychotherapy and theology sciences. The article details the main physical, psychological and social aspects of damage to the person, caused by mobbing, which provide for a corresponding triple assistance perspective. After highlighting the essential resources provided by the Christian religion for coping with traumatic experiences, the necessity to consider the religious needs of the victims of mobbing is reasoned and the possibilities of using religious spiritual resources are discussed. In the context of helping victims of mobbing, two main functions of Christian spiritual assistance are distinguished and discussed: auxiliary and main. The results of this review are a useful resource for lay and religious counsellors and encourage their collaboration. The research findings also provide a basis for further research on the use of religious resources in the context of helping victims of mobbing.

A longitudinal view of an approach to responsiveness: Principles followed and lessons learned

Responsiveness is currently a hot topic in the psychotherapy literature with a large variation in what the term means to colleagues of various orientations. This adds to its popularity but limits the scope of whatever is written or said about responsiveness. The fact that the meaning of responsiveness has developed over time within the approaches adds also to the variation, while an understanding of development has the potential of deepening the understanding of each approach. As a fair description and comparison of even just the most important approaches is by far out of reach for a page-limited article, the development of one approach, which may be termed the “Bernese” approach is described here, along with lessons learnt and general comments. The approach includes Plan Analysis case formulations, the concept of complementary or Motive-Oriented Relationship, a description of a combined qualitative and quantitative assessment, and many methodological and conceptual considerations. Personal development is woven in. Overall, it seems fair to say that this approach, at its core developed long before responsiveness became popular, has turned out to still be useful, with a gain in depth as far as concepts and assessment are concerned.

Understanding the Role of Therapist Quality in Accounting for Heterogeneity of Patient Outcomes in Psychosocial Chronic Pain Treatments

A variety of evidence-based psychosocial treatments now exist for chronic pain. However, on average, effect sizes have tended to be modest and there is a high degree of heterogeneity in treatment response. In this focus article, we explore the potential role that therapist quality in delivering treatment may have in accounting for a degree of this variability in outcome. Therapist quality refers to the skillful delivery of treatment, harnessing both specific and common therapeutic factors during sessions. While recognized as important to assess and report in clinical trials by some reporting guidelines, few randomized controlled trials evaluating psychosocial treatments for chronic pain have reported on therapist factors. We reviewed the clinical trials included in three systematic reviews and meta-analyses of trials of cognitive-behavioral therapy (mainly), mindfulness-based interventions, and acceptance and commitment therapy. We found that of the 134 trials included, only nine assessed and reported therapist quality indicators, with a variety of procedures used. This is concerning as without knowledge of the quality in which treatments are delivered, the estimates of effect sizes reported may be misrepresented. We contextualize this finding by drawing on the broader psychotherapy literature which has shown that more skillful, effective therapists demonstrated ten times better patient response rates. Examination of the characteristics associated with these more effective therapists tends to indicate that skillful engagement of common factors in therapy sessions represents a distinguishing feature. We conclude by providing recommendations for assessing and reporting on therapist quality within clinical trials evaluating psychosocial treatments for chronic pain. PerspectiveTherapist quality in the delivery of psychosocial treatments for chronic pain has rarely been assessed in clinical trials. We propose that therapist quality indicators are an under-studied mechanism that potentially contributes to the heterogeneity of treatment outcomes. We provide recommendations for assessing and reporting on therapist quality in future trials.

The art of supporting identity following a life-limiting diagnosis: a systematic review

ABSTRACT This systematic review of art psychotherapy literature explored how art therapy or artmaking may support patient identity after a life-limiting diagnosis. Background: Previous research shows the value of art therapy and artmaking in reducing physical and psychological symptoms at the end-of-life. Recent reports indicated that disruption to identity is a key challenge to this group of individuals. Aims: This systematic review investigated art therapy and artmaking and examined and built upon previous research undertaken with patients facing identity concerns after a terminal diagnosis. Methods: A robust and rigorous framework of criteria (PRISMA), was followed to select and review suitable research papers in order to gain new insights. Results: The results indicate that many patients struggle to cope with a changing identity alongside the demands of a terminal illness. The key findings are threefold: art therapy and artmaking can help maintain or reconstruct a pre-illness identity and art therapy in particular can help enable a positive identity transformation. Conclusions: Art therapy and artmaking hold benefits for positive identity support such as the re-evaluation and reinstatement of pre-illness roles, psychosocial-interventions and adjustment to major life changes. Implications: It is recommended that art therapy and artmaking are offered to terminal patients at diagnosis, in order to support identity concerns promptly and allow patients to focus solely on their quality of life and limited time left. It is anticipated that the findings of this systematic review will be of benefit to patients, healthcare workers, art therapists and others within the palliative care community.

A grassroots antiracist program: The motivation and perceived growth of participants in a community-based, intergroup dialogue program.

In the United States, racial segregation still organizes the social lives of most people. This segregation of social life continues reinforcing attitudes and behaviors that sustain racial injustice in the United States. Given the longstanding structural forces sustaining the segregated status quo, why do certain individuals seek out opportunities for 'intentional integration'? And what happens when they do? This qualitative study interviewed racially diverse participants in a community-developed, sustained, and strategic intergroup dialogue program called Touchy Topics Tuesday (TTT), located in St. Louis, Missouri. Overall, participants (N = 30) described three interwoven motivations for involvement in the program-a catalytic moment, a long-term commitment mindset, and/or the influence of their social network. Of all these, participants' social network was the predominant motivating force for individuals across racial lines. Participants also reported three main categories of outcomes: intellectual growth, emotional growth, and relational growth. Each of these categories encompass both attitudinal and behavioral changes. The article interrogates these major findings in the context of the intergroup dialogue literature and studies of attitude change and psychotherapy.

Unsettling the ‘master’s house’

Psychology and psychotherapy have long been regarded as a Eurocentric and largely homogenous field primarily dominated by white, socioeconomically privileged/middle-class women. This lack of racial/ethnic diversity and inclusion within the field has become an area of increased focus of discussion within psychological professions due to its significant impact on the care, experience, and outcomes of service users. Individuals from racially minoritised backgrounds face multiple systemic barriers when accessing the profession during their training and as qualified psychological professionals. Extensive research indicates that clinical psychologists from racially minoritised backgrounds experience racism in clinical psychology and this has persisted over the years. Similarly, in the psychotherapy literature, there has been an emphasis on addressing the lack of acknowledgement of racial disparities in psychotherapy training. As a result, it feels imperative that there is a radical shift in psychology and psychotherapy which involves acknowledging its role in creating and perpetuating racism and discrimination, as well as an urgent need to adopt a decolonised, socio-constructionist approach.
 Despite this, there has been little focus or momentum on clinical psychology training programmes to actively address issues of racism and to develop anti-racist practice. The Newcastle University Clinical Psychology Doctorate Programme recently made an active stance to adopt anti-racist practice and implement an approach that supports collective responsibility and accountability. In this article, the authors engage in a critical, radical, and collective dialogue around their experiences, and share their reflections on developing a clinical psychology anti-racism strategy, attending to power, discomfort, and the role of systemic oppression. The diverse voices of trainers, trainees, and aspiring clinical psychologists presented suggest that collective action, solidarity, as well as attending to power and relationality, had a profound impact on the development of the anti-racism strategy, as well as on relationships, trust, and relational safety. The authors offer critical reflections on how these experiences can be helpful in further understanding the complexity and multi-faceted nature of anti-racist praxis in clinical psychology and psychotherapy.

Raving as healing: an autoethnographic study into how raving can inform the use of dance movement psychotherapy in clinical work with substance abusers in recovery

The topic of raving has not yet been addressed in dance/movement psychotherapy (DMP) literature, despite being a meaningful activity shown to facilitate personal transformation. Whilst studies on rave culture have highlighted its therapeutic benefits, none of them focus on recovering substance abusers. This research identifies links between raving and DMP, looking at what each practice can offer this client group. Three key commonalities were identified whilst reviewing the literature on raving, DMP and substance abuse: strengthening spirituality, enhancing one’s sense of self, and creating a sense of belonging. Through analysing data from participant interviews, my embodied responses and my own experiences, five more were revealed. Findings from this study were considered for their relevance in DMP clinical practice.

Recommendations for Self of the Therapist Training: a Modified Delphi Study

ABSTRACT Couple, Marriage, and Family Therapy (CMFT) and other psychotherapy literature acknowledge the importance of therapist self-awareness and self-knowledge and discuss many potential different ways to train the self of the therapist. However, there is no collective expert guidance in the current literature for self of the therapist training. Using a modified Delphi method, this study involved systematically surveying a panel of experts to gain consensus on some of the most important concepts, methods, benefits, and risks of self of the therapist training. The panel endorsed 112 items that focused on specific elements of self of the therapist work, benefits and risks of self of the therapist training, structure and setting of self of the therapist training, expectations for supervisors and trainers, and recommendations for ongoing self of the therapist work. Clinical implications for trainers and training programs are discussed.

Integrating Loss and Processing Grief in Psychotherapy of Psychosis

Objective: While recovery from psychosis is possible, recovery is a multidimensional construct driven by various factors. One relevant factor to recovery from psychosis that has often been overlooked in the psychotherapy literature is the importance of facing loss and processing grief in relation to psychosis. Methods: A review of the existing empirical literature on grief associated with psychosis was conducted. Clinicians with significant therapeutic experience working with persons with psychosis reviewed cases to examine the losses the patients had suffered and how they responded to these losses. The clinicians considered essential principles that are relevant when helping patients with psychosis integrate loss and process grief. Results: Persons who have experienced psychosis often experience the loss of role functioning, interpersonal relationships, cognition, and self-concept. However, when these losses are not fully integrated into the person’s identity, it can result in either more losses due to denial and metacognitive impairments or increased hopelessness and depression due to internalized stigma. Five elements in psychotherapy of psychosis were identified that can facilitate the integration of loss and processing of grief: understand the personal experience of the psychotic episode, attend to feelings of grief and the primary loss, explore the meaning of psychotic symptoms and identity implications, integrate psychotic vulnerabilities into the sense of self, and foster realistic hope in the face of an uncertain future. Conclusion: Psychotherapy can enable persons with psychosis to make meaning of their losses, process their grief, integrate their psychotic vulnerability into their sense of self, and develop realistic hope.

Psychotherapy as making.

Historically, research and practice of psychotherapy have been conducted within conceptual frameworks defined in terms of theoretical models. These models are in turn guided by meta-theories about the purpose of psychotherapy and its place in society. An image of psychotherapy that underpins much contemporary practice is the idea that therapy operates as an intervention that involves the implementation and application of a pre-existing theoretical model or set of empirically validated procedures. The present paper introduces the idea that it may be valuable to regard psychotherapy not as an intervention but instead as a process of making, in the sense of offering a cultural space for the co-construction of meaningful and satisfying ways of living that draw on shared cultural resources. We offer an overview of what a therapy of making might look like, followed by an account of theoretical perspectives, both within the psychotherapy literature and derived from wider philosophical and social science sources, that we have found valuable in terms of making sense of this way of thinking about practice. Our conclusion is that we need something in addition to theory-specific and protocol-driven therapies, in order to be able to incorporate the unexpected, the not-before-met perspective, event or practice of living, and to be open towards the radically new, the given, and the unknown.

A common factors perspective on mindfulness-based interventions.

Mindfulness-based interventions (MBIs) have entered mainstream Western culture in the past four decades. There are now dozens of MBIs with varying degrees of empirical support and a variety of mindfulness-specific psychological mechanisms have been proposed to account for the beneficial effects of MBIs. Although it has long been acknowledged that non-specific or common factors might contribute to MBI efficacy, relatively little empirical work has directly investigated these aspects. In this Perspective, I suggest that situating MBIs within the broader psychotherapy research literature and emphasizing the commonalities rather than differences between MBIs and other treatments might help guide future MBI research. To that end, I summarize the evidence for MBI efficacy and several MBI-specific psychological mechanisms, contextualize MBI findings within the broader psychotherapy literature from a common factors perspective, and propose suggestions for future research based on innovations and challenges occurring within psychotherapy research.

Disability therapy and Valerie Sinason

PurposeThis paper aims to discuss the work of Dr Valerie Sinason and her contribution to working with people with an intellectual disability with psychotherapy.Design/methodology/approachDr Valerie Sinason is a psychoanalyst, and the author is trained in psychoanalytic psychotherapy.FindingsThe author believes there is important value in reading Valerie Sinason's contribution to the literature of psychotherapy with people with intellectual disabilities.Originality/valueIt is a review of Sinason’s contribution, and the author believes she's very original and important thinker.

Center effects, therapist effects, and international student clients' drop out from psychotherapy.

In 2019-2020, 1,075,496 international students pursued higher education in the United States. Many of these students endure unique experiences of psychological distress that accompanies their shared experience of studying abroad in the United States. Researchers have explored clinical experiences within this diverse group, with some suggesting that international students are at greater risk than students from the United States for dropping out of psychotherapy. This issue is underexplored in the extant psychotherapy literature. Therefore, we used a large, national data set and multilevel analyses to test if international students are more likely than students from the United States to drop out of psychotherapy, defined in this study as failure to attend one's last scheduled session. Data from 65,293 clients (n = 3,970 international students), 2,735 therapists, and 131 university/college counseling centers were included in the analysis. Results revealed that (a) international students are no more likely to drop out than United States domestic students, (b) on average, centers (ICC = 0.045) and therapists (ICC = 0.071) are differentially effective at preventing drop out, and (c) therapist effects on drop out differ for international students. We discuss these findings with respect to therapist and center roles in international students' drop out from treatment. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Child and Adolescent Psychodynamic Therapy: Using Q-Methodology in Process Research

ABSTRACT Psychotherapy for children and adolescents has been shown to be generally effective in treating a wide variety of psychological problems. In spite of this success, the field has been slow to identify the key therapeutic processes responsible for changes in psychiatric symptoms, emotional well-being, social relationships, and school functioning observed across theoretically different treatment models. The child and adolescent psychodynamic psychotherapy literature lags far behind the adult literature in assessing the change processes associated with the successful treatment of children and adolescents. This article reviews the rapidly growing literature engaged in the pursuit of articulating the change processes associated with successful treatment outcomes for children and adolescents. Two classes of change processes are reviewed: interaction structures (i.e., patterns of reciprocal therapist-patient interaction) and adherence to “brand-name” treatment models (e.g., child psychodynamic therapy). Researchers have used children’s psychiatric diagnoses most commonly as moderators of significant process-outcome associations. This article will explore the contributions of the Child Psychotherapy Q-Set (CPQ) and Adolescent Psychotherapy Q-Set (APQ) to this field of study, while also reviewing some of the data analytic strategies used. Finally, an outline of the future directions of child and adolescent psychodynamic psychotherapy process research using the CPQ and APQ is suggested.

The Neglected Role of Psychotherapy for Treatment-Resistant Depression.

The Neglected Role of Psychotherapy for Treatment-Resistant Depression.

How to become a responsive therapist: A study of experiences of developing therapists

ABSTRACT Objective : A growing body of empirical evidence suggests that psychotherapy is more effective when therapists tailor interventions to fit their specific clients’ needs, a concept referred to as therapist responsiveness in the psychotherapy literature. However, the question of how therapists learn to become responsive rarely has been examined. Method : The central question of this study, put to eleven graduate student therapist trainees, was, “How did you learn to be responsive to clients as a novice therapist, and in what ways have you become responsive?” A critical-constructivist grounded theory method was employed to generate themes from trainees’ replies. Results : The analysis showed that trainees learned to improve their responsiveness to clients by: (1) becoming more aware of cues that signaled the need to adapt interventions (as related to psychotherapy change processes, client-therapist relational dynamics, clients’ identities and cultural contexts, and the maximizing of clients’ agency); (2) developing attunement to their own emotions and engaging in self-care; and (3) adopting mindsets that facilitated their trying new relational or therapy approaches while also maintaining professionalism. Conclusion Based upon these findings, preliminary suggestions for responsiveness training are presented to guide programs that wish to train responsive psychotherapists .

Process-based and principle-guided approaches in youth psychotherapy.

Process-based and principle-guided approaches in youth psychotherapy.