Model Of Psychotherapy Research Articles

Dismantling amatonormative biases and expanding queer-affirmative psychotherapy: The role of trainers.

The present article aims to provide a pathway for trainers to expand and transform queer-affirmative psychotherapy practice to be more inclusive of queer groups that are underdiscussed in research and misunderstood in therapy settings, namely, people who are asexual, aromantic, and polyamorist. The article begins by outlining findings from a small but growing body of literature focusing on people who identify as asexual, aromantic, and polyamorist, which suggests that these populations face unique challenges and forms of discrimination when navigating their relationships, identity, and community. At the same time, these groups also report negative experiences of psychotherapy, including ignorance, minimization, and lack of understanding empathy on part of therapists. Such gaps may be bridged through cultural and structural changes in the way in which queer-affirmative psychotherapy models are disseminated in training contexts. Building upon models of queer-affirmative psychotherapy, critical theory, and queer theory, the article proposes steps that trainers may take to encourage students to expand their queer-affirmative practice so that it is more inclusive of and responsive to the experiences of asexual, aromantic, and polyamorist populations. The steps involve (a) cultivating criticality among trainees, (b) holding space for "not knowing," (c) providing diverse case examples, and (d) underlining advocacy as central and necessary to queer-affirmative practice. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The conceptual framework for the therapeutic approach used in phase 3 trials of MDMA-assisted therapy for PTSD.

Results from multiple recent studies support further evaluation of 3,4-methylenedioxymethamphetamine (MDMA) in conjunction with psychotherapy (i.e., MDMA-Assisted Therapy) in the treatment of post-traumatic stress disorder (PTSD). In two Phase 3 trials, MDMA-Assisted Therapy comprised a short-term, intensive psychotherapy that included three sessions directly facilitated by MDMA (referred to as "experimental sessions"), as well as a number of non-drug psychotherapy sessions. This treatment model aimed to harness the potential of MDMA to facilitate recall and processing of traumatic memories, and to increase learning in a social context, integrating "top-down" and "bottom-up" approaches to trauma-focused care. To date, the conceptual framework for this treatment has not been described in the scientific literature. This omission has contributed to misunderstandings about both the theoretical underpinnings of this modality and the therapeutic approach that emerges from it. This paper delineates the psychotherapeutic concepts, theories, and historical antecedents underlying the inner-directed approach to MDMA-Assisted Therapy for PTSD. Broadly speaking, this therapeutic framework centered the concept of the participant's inner healing intelligence as the primary agent of change, with the therapeutic relationship being the core facilitative condition fostering the participant's self-directed movement toward recovery and growth. Corollaries to this holistic, self-directed, relational, and trauma-informed framework include a non-pathologizing approach to the participant's embodied experience (including the possibility of intense emotional and somatic expression, experiences of multiplicity, suicidal ideation, and multigenerational and transpersonal experiences), as well as the therapists' own psychodynamic, somatic, and transpersonal awareness, empathic attunement, relational skillfulness, and cultural humility. The use of MDMA in conjunction with this psychotherapy platform outperformed the use of placebo with psychotherapy in Phase 2 and 3 trials, as measured by symptom reduction in participants with PTSD. However, within-group comparisons also identified significant symptom reduction in participants who did not receive MDMA, lending empirical support to the psychotherapy model itself. In addition to comparative efficacy trials, future research should investigate which elements of the conceptual framework and therapeutic approach underlie the clinical benefit in individuals with PTSD.

Working Meaningfully With Older Adults in Psychotherapy: Memory, Autobiography, Self, and the Conversational Model

As the population of older adults increases, a growing number of older people will seek psychotherapy and counselling in the coming years. Therefore, therapists should deepen their understanding of the unique developmental challenges that accompany the later years. While varying approaches and theoretical frameworks exist for how to understand these developmental challenges and work in a way that promotes wellbeing, therapy with older adults remains an under-explored area. This paper outlines my clinical observations while working with a single man in his mid-70s who started seeing me for long-term psychotherapy. It explores the intersection of memory, autobiography, self, and ego integration and contributes to the discussion about how to work meaningfully with older adults. I hypothesise that working with our clients to compose an autobiographical consciousness that can be narrated and witnessed by an empathic other could be an important aspect of ego integration. This is because narrative is a meaning-making tool that facilitates one’s sense of self and promotes the process of reconciliation with the past and direction towards the future. This exploration is situated within the framework of the Conversational Model of psychotherapy developed by Robert Hobson and Russell Meares.

Queering the 7-eyed model of clinical supervision

In this essay, we argue that the 7-eyed model of clinical supervision (as well as most models in psychotherapy) are in need of “queering.” What we mean by “queering” is to make the model adaptable to the wider work with gender, sex, sexuality, erotic, and relationship diversities (GSERD) in clinical supervision. It is applicable to supervisors and/or supervisees and the clients who identify outside the societal heteronormative, mono-normative, and cisgenderist norms. Psychotherapy and psychology, and by extension, clinical supervision, have been criticised for being white, middle-class, heteronormative, and euro-centric. This article will provide a framework and guidance for clinical supervisors on how to adapt the 7-eyed model to diverse populations.

The nursing role in psychedelic-assisted psychotherapy

In this article, we aim to highlight the specific role of nurses in the interdisciplinary model of psychedelic-assisted psychotherapy. We argue that the plural competencies of our profession are at the heart of future issues in psychiatry and the use of psychedelics.

Emotion Regulation, Relationship and Therapeutic Change in Analytical Psychology and Contemporary Psychodynamic Approaches.

All contemporary psychotherapies agree that (failing) emotion regulation is central to psychological disorders and that psychotherapy is about improving emotion regulation. In his research on the "emotion-laden" complex Jung put an emphasis on the role of failing emotion regulation in contributing to psychological disorders as well as to change in the process of psychotherapy, but he left this field of research and took a very different direction in favour of his archetype concept. Psychodynamic approaches generally argue that changes in emotion regulation are accomplished through corrective emotional experiences in the therapeutic relationship. Insights from affective neurosciences and attachment research have had a major influence on how the therapeutic relationship is constructed in contemporary psychodynamic approaches. There is a lack of similar developments in analytical psychology, which leads to substantial differences between the models of Jungian psychotherapy in contrast to other contemporary psychodynamic approaches. The implications of these differences for the practice of psychotherapy and especially the role of the therapeutic relationship are pointed out.

Perceptions of young adult clients treated with time-limited art therapy

ABSTRACT Background This study examined the perceptions of young adult clients undergoing Time-Limited Art Therapy (TLAT) inspired by the Time-Limited Psychotherapy model (Mann, 1973). Twenty-one clients aged 23-35 dealing with typical young adulthood challenges participated in the TLAT intervention. Aims Examine clients' perceptions of the TLAT, how art helped focus on their central issue in therapy, the function of art in therapy, therapy outcomes, and changes in self-image a topic that has yet to be explored in the art therapy literature. Methods Therapy consisted of 26 sessions at a dedicated research clinic, with the termination date announced during the first session. The TLAT consisted of four intake sessions integrating structured art-based interventions, after which the central issue for therapy was formulated. This was followed by 22 sessions during which artmaking arose spontaneously. Semi structured interviews were conducted with all clients at the start and end of therapy. The data analysis adhered to Consensual Qualitative Research (CQR) principles. Results The CQR analysis revealed seven domains: clients' expectations when coming to TLAT, clients' perceptions of the time dimension in therapy, the therapeutic relationship, the significance of the central issue in therapy, the role of art in processing contents in therapy, the termination phase of therapy and the significance of therapy. Conclusions Artmaking in TLAT helps draw attention to the central issue, foster the therapeutic relationship, and facilitate self-exploration. These results indicate the value of short-term individual models in art therapy and the advantages of incorporating art into brief psychotherapy, especially in cases with time constraints.

Psychothérapie assistée par psychédéliques (PAP) : le modèle genevois

BackgroundIn this article, we aim to describe an interdisciplinary model for psychedelic assisted psychotherapy (PAP) that we have developed at the Geneva University Hospitals, in an institutional setting. Our model integrates the collaborative efforts of psychiatrists, psychologists, and nurses establishing a structured framework for administering PAP in a safe, controlled, and standardized manner. IntroductionPsychedelic assisted psychotherapy (PAP) is a psychotherapeutic approach that utilizes the profound alteration of the state of consciousness induced by psychedelic substances to enhance therapeutic outcomes. This innovative approach, which has been neglected due to historical biases rather than empirical evidence, is now experiencing a renewed interest among clinicians. Contemporary research, equipped with advanced methodologies and a rigorous scientific approach, is showing significant therapeutic potential for a range of mental health disorders. In Switzerland, the legal framework authorizes the medicinal use since 2014 for exceptional authorizations for the medicinal use of LSD and psilocybin for therapeutic purposes, under strict regulations. MethodWe provide a comprehensive description of the PAP protocol implemented at the Geneva University Hospitals, beginning with its inception in September 2020. Our methodological outline includes the administrative and clinical selection criteria for patient eligibility; the preparatory sessions designed to introduce the patients with psychoeducation interventions and the analysis of intention and therapeutical objectives; the controlled administration of psychedelics in a supportive environment; and the integration sessions that follow psychedelic experiences. Our protocol emphasizes safety, ethical considerations, and the importance of a supportive therapeutic relationship throughout the process. We also describe questionnaires we use to qualify and assess the alteration in the state of consciousness, namely The Five Dimension Altered States of Consciousness (5AD-ASC) and the Mystical Experience Questionnaire (MEQ). Since the start of the program in September 2020 and up to February 2024, a total of 224 personal authorizations (114 LSD, 110 Psilocybin) have been issued to the Geneva University Hospital PAP team, for a total of 396 individual sessions. DiscussionThe core argument presented in this article is that the psychedelic-induced alteration of consciousness is a novel therapeutic tool, which works as a potent catalyst that can be synergistically combined with traditional dialogue-based psychotherapy. This combination has the potential to support the psychotherapeutic processes and enable breakthroughs in cases where conventional therapy has reached its limits. We discuss the implications of this approach, reflecting on both its challenges and its transformative potential within its clinical application. ConclusionThe conclusion of our article is an endorsement of the continued basic and clinical research on PAP. By presenting a detailed framework of the PAP process, including its preparatory, experiential, and integrative phases, we advocate for a structured and scientifically grounded exploration of its therapeutic efficacy. Our conclusion calls for a broader acceptance and integration of PAP within clinical practice, provided it is underpinned by ongoing research, ethical practice, and institutional support.

Collective Trauma and Political Activism: Learning from the Bereaved Families of Shot Down Ukrainian Airline Flight 752

ABSTRACT On January 8, 2020, Ukraine Airline Flight 752 was shot down minutes after taking off from Tehran, Iran, by an Iranian surface-to-air missile. This happened hours after Iran had launched missiles at US targets in Iraq. Amongst the 176 people killed in this tragedy, many of them children, were 85 Iranian-Canadians who had traveled to visit their relatives in Iran. Over the past two years, families of the victims have struggled to find some healing from this trauma amidst political pressures in their fight to get accountability, transparency and justice for their loved ones. This paper is an account of group therapy sessions conducted over two years with these bereaved families, mostly mothers. I provide a detailed account of how relational psychoanalytic principles were utilized to develop a group psychotherapy model for dealing with this novice complex situation where the trauma is as individual as it is collective. For these families, grief and trauma is complicated by the sociopolitical issues surrounding the incident, including lack of transparency, dishonesty, insensitivity and absence of any attempts at reparations or reconciliation by the Iranian government in the aftermath of this tragedy. I examine how these political moments has come to inform psychological challenges of the group, including their emotions, dreams and fantasies. I further elaborate on how these experiences have transformed these individuals into political activists as observed not only in their individual and collective identities but also in their actual participation in the political arena.

Feminist Liberation Psychotherapy: Re-Politicizing Intersectionality Toward Socially Just Clinical Practice

Mainstream psychotherapy was not developed to address the harmful effects of systemic oppression. In addition to being largely rooted in Eurocentric values and knowledge systems, mainstream psychotherapy risks maintaining an unjust status quo rather than resisting and challenging sociopolitical oppression. Consequently, there is an urgent need for feminist intersectional models of healing that address sociopolitical power. We describe a liberation psychotherapy model that was developed to reconcile intersectional forms of power and foster conscientização, critical consciousness. This liberation psychotherapy model is theoretically grounded in liberation and critical-community psychologies and empirically derived out of qualitative data that explored expert therapists’ responsible navigation of intersectional power dynamics in feminist-multicultural and humanistic-existential psychotherapies. Liberation psychotherapists aim to empower clients’ exploration of their lived experiences through decolonial testimonio that supports liberatory transformation and social justice action. We illustrate examples of how a feminist liberation psychotherapy can be applied toward anti-racism and anti-oppression in clinical practice.

Héctor Fernández-Álvarez (1944-2023).

This article memorializes Héctor Fernández-Álvarez (1944-2023). Héctor was an exceptional mentor, therapist, supervisor, professor, researcher, author, and leader, as well as a beloved brother, partner, father, and grandfather. The consummate renaissance person who embraced all manners of cultural expressions through an intentional wanderlust, he sought to understand all forms of human suffering and to alleviate senseless ones. Héctor's career spanned well over 5 decades. He received a licenciatura degree in 1967 from the University of Buenos Aires and a PhD in 1995 from the National University of San Luis, Argentina. Héctor held multiple academic appointments throughout Latin America and Spain. He authored over 100 journal articles or book chapters, and 16 books, including a novel, La Distancia (The Distance), and Fundamentals of an Integrated Model of Psychotherapy, one of the most respected psychotherapy books in Latin America and Spain. In 1977, Héctor challenged the constraints of a military dictatorship by founding Aiglé (the everlasting flame). Aiglé remains a nongovernmental organization that delivers clinical and community services and prepares mental health practitioners informed by an active research program that evaluates training and psychotherapeutic processes and outcomes. Over the years, Héctor advanced Aiglé as a practice-oriented research clinical setting to investigate psychotherapy as it unfolds in clinical practice. He developed an integrative model of care that resulted in Aiglé's cognitive-integrative model. Aiglé has grown to be a hallmark for research-based, leading-edge psychotherapy training in Latin America. Highlights of Héctor's career and professional contributions are noted. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Psychedelic-assisted psychotherapy: where is the psychotherapy research?

Psychedelic-assisted psychotherapy (PAP) has emerged as a potential treatment for a variety of mental health conditions, including substance use disorders and depression. Current models of PAP emphasize the importance of psychotherapeutic support before, during, and after ingestion of a psychedelic to maximize safety and clinical benefit. Despite this ubiquitous assumption, there has been surprisingly little empirical investigation of the "psychotherapy" in PAP, leaving critical questions about the necessary and sufficient components of PAP unanswered. As clinical trials for psychedelic compounds continue the transition from safety- and feasibility-testing to evaluating efficacy, the role of the accompanying psychotherapy must be better understood to enhance scientific understanding of the mechanisms underlying therapeutic change, optimize clinical outcomes, and inform cost-effectiveness. The present paper first reviews the current status of psychotherapy in the PAP literature, starting with recent debates regarding "psychotherapy" versus "psychological support" and then overviewing published clinical trial psychotherapy models and putative models informed by theory. We then delineate lessons that PAP researchers can leverage from traditional psychotherapy research regarding standardizing treatments (e.g., publish treatment manuals, establish eligibility criteria for providers), identifying mechanisms of change (e.g., measure established mechanisms in psychotherapy), and optimizing clinical trial designs (e.g., consider dismantling studies, comparative efficacy trials, and cross-lagged panel designs). Throughout this review, the need for increased research into the psychotherapeutic components of treatment in PAP is underscored. PAP is a distinct, integrative, and transdisciplinary intervention. Future research designs should consider transdisciplinary research methodologies to identify best practices and inform federal guidelines for PAP administration.

Wellness checks: Piloting a universal intervention for soldiers.

As part of an Army pilot program, mandatory annual wellness checks were initiated to introduce individuals to counseling and to support psychological resilience and thriving. The program was evaluated using a cross-sectional survey completed by 7,831 soldiers. Findings revealed that about half of soldiers who reported a wellness check rated the check at least moderately helpful in their professional and personal lives. Participants receiving a wellness check reported being more likely to report willingness to seek help if they were to have mental health problems and to report higher levels of resilience and thriving even after controlling for rank, age, education, months in the unit, and trait negative affect. Participants were also less likely to report stigma-related concerns compared to those who had not received a wellness check. Consistent with theory on the common factors in counseling and the contextual model of psychotherapy (Laska et al., 2014), feeling listened to and learning new skills partially mediated the association between perceived wellness check usefulness and study outcomes, although acquiring a new perspective about problems did not. While not a randomized trial, this evaluation suggests that wellness checks are associated with programmatic goals: improved attitudes toward care seeking, resilience, and thriving. Future work should consider ways to ensure counselors address therapeutic common factors and should use a randomized, longitudinal design. Study findings have implications for implementing programs like wellness checks for military personnel and others working in high-stress occupations like first responders. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Grammar, cohesion and the co-ordination of the “self” in a current psychotherapeutic technique

Abstract This paper aims to show how concepts and analytical methods of systemic functional linguistics can work congruently with other human practices to improve outcomes for those undergoing the suffering around loss of meaning and the absence of purposeful, self-directed experience. Based on a two-decade collaboration between linguists and psychotherapists in Sydney, Australia, and using the tools of text linguistics as developed by Michael A. K. Halliday and Ruqaiya Hasan in systemic functional theory, the paper presents an indicative selection of intense exchanges between traumatized persons and therapists (centrally the experience of ‘Ruth’). The level by level linguistic descriptions of these exchanges offer opportunities for understanding how progress in the clinical interaction might be achieved. The descriptions can also be evaluated against the theoretical claims of psychotherapy in psychiatry – in particular, the emphasis of the Conversational Model of Psychotherapy developed in England and Australia by Robert Hobson and Russell Meares, whose characterization of disorders involves an emphasis on ‘co-ordination’ and ‘cohesion’ within frontal lobe activity of traumatized patients. In this way the paper also explores conceptual parallels and intellectual antecedents shared between the Conversational Model and Systemic Functional Linguistics, contributing to the broader intellectual history of the human sciences.

Resource-Based Psychotherapy Model Application in the Treatment of Psychological Trauma Consequences.

The ongoing war in Ukraine significantly affects the mental and emotional well-being of its citizens. Consequently, there is an urgent need to explore the use of the resource psychotherapy model to develop effective support methods for trauma victims. The research aims to enrich the understanding of resource-based psychotherapy as an effective tool for supporting people who have experienced psychological trauma and improving their psychological well-being and quality of life. The analytical method, generalization, and systematization were used in this research. A clinical case of psychotherapy of a military man according to the 7-step model of working with the consequences of a psychotraumatic event is considered, which ultimately showed the effectiveness of its application. The study found that the resource psychotherapy model has significant potential for improving the psychological state of victims of trauma, as this approach allows the active use of internal resources of the individual to overcome the consequences of traumatic experiences and restore mental well-being. The results of the study indicate the effectiveness and deep potential of resource-based psychotherapy in working with people facing psychological trauma, helping them to build positive adaptation strategies and strengthen their psychological state. The results of this study may be useful for psychologists and psychotherapists working with people who have experienced traumatic experiences to improve the quality of psychological support and assistance to such people.

Cultural Diversity and Mental Health Care: A Case Study

IntroductionIn today’s world of global migration and cultural diversity, mental health care grapples with persistent challenges. Despite efforts to promote cultural competency and person-centred approaches, it’s vital to delve into the issues surrounding cultural differences and linguistic diversity in mental health care. This exploration highlights the complexities where culture, language, and healthcare intersect (Brisset et al., 2014; Desai et al., 2021).ObjectivesOur aim is to analyse cultural and linguistic barriers in mental health care for migrants and assess their impact on access and quality of care.MethodsLiterature review, drawing from sources such as PubMed, ResearchGate, and Google Scholar. This review will be framed around the case of a 34-year-old man from Bangladesh, who has been residing in Lisbon for a year. His clinical presentation includes depressive symptoms, disorganized behaviour, and psychotic manifestations, such as persecutory delusions. He does not speak Portuguese or English, thereby limiting his access to essential mental health treatment services. Through this review, we intend to elucidate the intricate dynamics surrounding cultural and linguistic barriers in mental health care.ResultsMigrants from diverse backgrounds face many challenges, including the loss of homes, livelihoods, and family, often leading to mental health issues like depression, anxiety, and post-traumatic stress disorder. Two primary challenges include adapting to a new life and experiencing discrimination and marginalization (Amri et al., 2013; Satinsky et al., 2019). Social stigma and mistrust hinder access to mental health services. Limited culturally competent services widen the gap between mental health needs and help-seeking attitudes. Language barriers significantly contribute to disparities in access to services (Amri et al., 2013). Additionally, mental health care providers’ organizational culture often prioritizes ‘ideal’ patients who are native speakers, favouring individual-oriented treatment over community-focused care (Desai et al., 2021).To address these barriers effectively, it is crucial to employ specific strategies. The Multi-Phase Model of Psychotherapy, Social Justice, and Human Rights (MPM) equips mental health counsellors to better serve immigrant communities while addressing social stigma. This comprehensive framework comprises five phases of intervention: psychoeducation, culturally responsive service delivery, cultural orientation, collaboration with local healers, and connecting patients to essential resources (Amri et al., 2013). Additionally, practitioners should receive training in effective collaboration with interpreters to provide multilingual healthcare (Brisset et al., 2014).ConclusionsAddressing cultural and linguistic barriers in mental health care is vital. The Multi-Phase Model of Psychotherapy offers a promising approach, while collaboration with interpreters remains essential.Disclosure of InterestNone Declared

Models of practice and training in psychotherapy: cross-national perspectives from Italy and Canada.

Internationally, there is ongoing concern about accessibility to mental health care and training. The goal of this study was to explore commonalities and differences within models of clinical psychology and psychotherapy in Ontario, Canada, and Lombardia, Italy, respectively, to inform improvements to the accessibility of mental health care and training. Using key informant sampling, we recruited ten students and professionals in Italy and Canada who study or work in psychology for semi-structured interviews. We analyzed the interview content using an inductive approach for thematic analysis within countries and meta-theme analysis across countries. The findings indicated three cross-national meta-themes: the need to integrate evidence with practice, the limited accessibility of training for students and treatment for patients, and the importance of the quality of training programs. Despite some differences regarding the amount of scientific training, personal therapy for trainees, and the prominence of cultural diversity training, Canadian and Italian psychology professionals and students shared experiences of psychotherapy practice and clinical psychology training. The three cross-national meta-themes indicate which issues in training and practice may be relevant worldwide and where to focus resources. The findings can inform international collaborations regarding training model structures that may increase access to psychology training and may increase consensus on professional recognition standards to improve mobility for professionals. These changes could reduce barriers to mental healthcare services for patients.

Pilot Study Dismantling the Cognitive Behavioral Analysis System of Psychotherapy: Identifying the Active Ingredients

BackgroundCBASP is a learning acquisition model of psychotherapy and until this present study, has not been systematically dismantled to identify the active ingredient.MethodsThe present investigation is the first formal dismantling pilot-study conducted to date on the Cognitive Behavioral Analysis System of Psychotherapy (CBASP). The two major treatment components of CBASP, Situational Analysis (SA) and the Interpersonal Discrimination Exercise (IDE), were administered alone and with CBASP treatment-as-usual (the combination of both) to determine if there were active ingredients operative in the model. Secondly, we questioned if the dismantling of CBASP should continue in a larger study in an effort to answer the greater dismantling question of whether to administer both SA and IDE separately based on the active ingredient outcomes.ResultsThe study did achieve visually inspected differential data patterns across the three groups of the dependent measures. Based on these outcomes, a larger dismantling study seems warranted and is recommended.ConclusionsWe strongly urge that a larger dismantling study using a similar design be conducted in an effort to further the dismantling process of the CBASP model.

Translating an integrative metacognitive model of psychotherapy for serious mental illness into a group format: A pilot investigation on feasibility.

Metacognitive reflection and insight therapy (MERIT) is an one-on-one intervention that targets insight with the aim to help people with serious mental illness develop more integrated ideas about themselves and others in order to respond to their psychological and social challenges more adaptively. There is a growing body of evidence on MERIT's effectiveness. Considering the clinical demand for more cost-effective group psychotherapies, we modified the original individual MERIT format to a group-based intervention (MERITg) for application in inpatient and outpatient psychiatric settings. Thirty-one participants (inpatient = 10; outpatient = 21) with serious mental illness were surveyed on their experience of MERITg, which was offered adjunctively to their routine clinical care. Program evaluation measures were used to assess the feasibility and acceptance of the group. Across locations, more than half of all participants attended more than one group. Participants reported attending the group initially because they thought writing would be helpful, and further reported that they liked the group because they enjoyed writing and the discussion, and that they found it interesting to hear the perspectives and writings of others. Findings further support the need for future research on the efficacy and effectiveness of the group and its relationship to changes in metacognitive capacity and recovery. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Process-focused psychotherapy training is evidence-based psychotherapy training: Commentary on Westra and Di Bartolomeo (2024).

Westra and Di Bartolomeo (2024) made a strong case for psychotherapy training to focus more on psychotherapy process rather than content (e.g., manuals). Their recommendations are consistent with the preponderance of the evidence that finds that psychotherapy process variables (and psychotherapist variables related to the process, such as empathy) account for most of the variance in psychotherapy outcomes. Despite the overwhelming evidence, the Great Psychotherapy Debate (Wampold & Imel, 2015) rages on. In this commentary, I emphasize and strive to extend Westra and Di Bartolomeo's recommendations. I describe how and when we might time the training of process monitoring to be most effective in the context of trainee development, and how such process monitoring may be useful both generally, as well as for cultural responsiveness. I begin, however, by addressing the substantial barriers we face in the integration of process-based training approaches given the prevailing avoidance of process. As the authors note, despite the proliferation of psychotherapy models and manuals, client outcomes have not improved in kind. If the field of psychotherapy is to make progress in helping to address the ongoing mental health crisis, it will necessitate that we finally heed the scientific evidence and orient our practice and our training (as Westra & Di Bartolomeo, 2024, recommend) to the process of psychotherapy. (PsycInfo Database Record (c) 2024 APA, all rights reserved).