Practice Of Psychotherapy Research Articles

Nutrition for Mental Health: Guidance for Clinical Practice

Nutritional psychiatry is an emerging field that explores the relationship between diet and mental health. Research focuses on dietary patterns, gut microbiome health, and the impact of individual nutrients on mental health. Nutritional and lifestyle interventions can complement psychopharmacology and psychotherapy in clinical practice. This clinical feature article reviews evidence supporting nutritional interventions for mental health and provides clinical guidance.

Effectiveness of group analytic and psychodynamic psychotherapy in routine secondary-care practice

Group psychotherapy has been shown to be effective across a diverse range of participants and settings. However, few quantitative studies have examined outcomes of Group Analytic Psychotherapy (GAP) specifically, or compared this with alternative treatments. In the present study we compare outcomes of weekly group analytic psychotherapy (GAP) and individual psychodynamic psychotherapy (PPT) at a psychotherapy service within the UK’s National Health Service. The service collected Clinical Outcomes in Routine Evaluation (CORE) outcome measures between 2010 and 2020 as part of routine clinical practice, furnishing a large observational dataset (N=600 clients). We found that clients showed clinically significant improvement following either GAP (Cohen’s d=0.77) or PPT (d=0.68), and the rate of change during therapy exceeded that during a pre-treatment waiting period. There were no clinically significant differences in effectiveness between GAP and PPT, of either short-term (<1 year) or long-term (> 1 year) duration. These results support a conclusion that both GAP and PPT are effective in routine clinical practice. We consider the advantages and limitations of quantitative outcome measurement from a group analytic perspective and highlight the possible pitfalls of attempting to optimise therapy based on overly narrow criteria.

The Role of Safety in Change-Promoting Therapeutic Relationships: An Integrative Relational Approach.

The significance of the psychotherapeutic relationship in promoting psychotherapeutic change is widely recognized. In this paper, we contribute to the relational orientation of psychotherapy through a transtheoretical exploration of safety. We aimed to identify and integrate those relational and change-promoting principles and aspects of safety that are school-independent. We conducted an overview and synthesis of the clinical-theoretical and empirical literature that we believe has significantly addressed the role of safety in regulating change-promoting therapeutic relationships. The relational and change-promoting aspects of safety form a dynamic system involving the therapist, the client, and the relationship. These interact, influence each other, and perform multiple homeostatic functions: they allow to resist change, assimilate small changes that do not disrupt the client's way of functioning, regulate major changes that disrupt and alter the client's way of functioning, and regulate adjustments in the way the therapist and client work together. From an integrative-relational perspective, a safe therapist is a precondition for co-creating a safe environment. This establishes trust and fosters an affective bond that provides additional sources of safety for the therapeutic relationship and the client. To promote change, however, the relational aspects of safety need to be fine-tuned (calibrated and personalized) for each therapy in terms of intensity, duration, timing, scope, and sources, accommodating developmental, individual, and situational differences. Crucially, the safety of the therapist, the client, and the relationship must be neither perfect, steady, or static, but rather safe enough, adaptive, and dynamic, leaving space not only for self-discovery and self-awareness but also for the co-regulation of tolerable frustrations, disappointments, and insecurities that facilitate the client's resilience and adaptation. Focusing on school-independent, safety-based relational principles and understanding how they evolve and adapt over time and across circumstances can make a significant contribution to the current relational orientation in psychotherapy. This has important implications for psychotherapy practice, training, and research.

The use of virtual reality in the treatment of mental disorders such as phobias and post-traumatic stress disorder

Mental disorders, such as phobias and post-traumatic stress disorder (PTSD), are a serious health problem that significantly impacts people's quality of life. These disorders can significantly impair the quality of life of patients, so studying ways to treat them using modern methods is important and relevant. The purpose of this study is to evaluate the effectiveness and potential of using virtual reality (VR) technology in the treatment of phobias and PTSD. The methods used in the study include analytical, comparative, and systematization methods. The study has shown that cognitive behavioural therapy and exposure therapy are the main treatments for these disorders. The use of VR in the treatment of mental disorders, including phobias and PTSD, opens up new opportunities for safe and effective exposure to stressful stimuli. It was found that the benefits of using VR in the treatment of mental disorders include safe exposure, an individualized approach to treatment, and the ability to create realistic simulations of stressful situations. The study confirmed that the use of VR in the treatment of phobias allows patients to gradually get used to phobic stimuli and change their negative perceptions and reactions to them. The use of VR in the treatment of PTSD has significant potential, allowing the application of various techniques, including exposure, gradual desensitization, cognitive behavioural therapy, therapeutic recovery, meditation, and relaxation, to alleviate the symptoms of the disorder and improve the quality of life of patients. The findings of the study can serve as a basis for improving clinical practice in psychotherapy and psychiatry, allowing for more effective and individualized care for patients with disorders.

An exploration of psychotherapists' readiness to join the psychedelic renaissance

AbstractBackgroundResearch on psychedelics centres on two key areas: the action of psychedelics on the brain and the protocol for delivering therapy. There is little research that considers the implications of this novel therapy on the therapist delivering the treatment. This research study sought to explore this.Aim and ObjectivesThe aim of this research was to explore the considerations for psychotherapists interested in delivering psychedelic therapy. Objectives were to examine the therapeutic conditions needed for effective outcomes, to explore the perceived differences between the practice of standard psychotherapy and psychedelic therapy and to determine the challenges for therapists working in the field.MethodSix semi‐structured interviews were conducted with therapists who work in clinical or retreat settings. Interview transcripts were analysed using qualitative thematic analysis.FindingsThree themes emerged that highlight the importance of preparation for effective clinical outcomes, the differences in standard and psychedelic practice and the personal and professional implications for therapists.ConclusionsThe results highlighted challenges and revealed the need for clear protocols for integrating psychedelics into psychotherapy practice.

This is not just a commentary on evidence-based group therapy research: It is important to the future of psychotherapy practice.

This is not just a commentary on evidence-based group therapy research: It is important to the future of psychotherapy practice.

The notion and practice of psychotherapy in Polish psychiatry of the interwar period. Part 2.

The paper further explores the development of psychotherapy in Polish psychiatry in the interwar period. Jaroszyński attempted to sketch out the idea of "emotional psychotherapy". Stryjeński organized a counseling clinic for the mentally ill, using psychotherapy as one of the means of treatment. Bilikiewicz developed oneiroanalysis - a psychotherapeutic method of dream analysis based on modifications of psychoanalysis. Gottliebowa advocated for the use of psychoanalytically influenced psychotherapy in the gynaecologist practice. Markuszewicz considered psychoanalysis the only psychotherapeutic modality aimed at unearthing the real causes of mental illnesses. Henryk Higier proposed to consider psychoanalysis practically as a method of psychotherapy and saw its heterogeneity as its advantage. Critical views on psychoanalysis as a psychotherapeutic method were delivered by Wirszubski and Mikulski. In general, psychotherapy in Polish psychiatry of the interwar period was highly influenced by psychoanalysis. Moreover, the understanding and practice of psychotherapy in public psychiatric facilities differed from that in private practice. In public psychiatric facilities, it was used mainly to deal with psychoses, so it urged clinicians to modify the classic psychoanalytic approach. In private practice, psychiatrists were dealing mainly with cases of neuroses and therefore could apply standard psychoanalytic procedures. Methods of suggestion, persuasion and hypnosis, characteristic of nineteenth-century psychotherapy, were still in use in Polish psychiatry of the interwar period. The main obstacles to the development of Polish psychotherapy in the interwar period were antisemitic attitudes contributing to hostility towards psychoanalysis, as well as the biological orientation of the majority of the Polish psychiatric society.

The notion and practice of psychotherapy in Polish psychiatry of the interwar period. Part 1.

The paper explores the development of psychotherapy in Polish psychiatry in the interwar period from the perspective of Kurt Danziger's historical psychology. Firstly, the organizational and social context of the development of Polish psychiatric care in the interwar period and its impact on the development of psychotherapy is outlined. Then, the most influential in Poland, European psychotherapeutic developments in the interwar period are reconstructed. Finally, the views of psychiatric personnel of three psychiatric facilities proposing psychotherapy as one of the main means of treatment of mentally ill patients are introduced: Dziekanka Psychiatric Hospital, the Jewish Hospital in Warsaw and Psychiatry and Neuropathology Clinic of the Jagiellonian University in Krakow. Psychiatric personnel from Dziekanka Psychiatric Hospital, directed by Aleksander Piotrowski, understood psychotherapy broadly, as the influence of the environment on the patient's psyche. Psychiatrists of the Jewish Hospital in Warsaw, Adam Wizel, Gustaw Bychowski, Władysław Matecki, and Maurycy Bornsztajn developed psychoanalytically influenced psychotherapy of schizophrenia. Bychowski also advocated for the application of psychotherapy in such neglected groups of patients as children and the intellectually disabled. Jan Piltz and Eugeniusz Artwiński pursued psychotherapy in the treatment of war neuroses at the Psychiatry and Neuropathology Clinic of the Jagiellonian University.

Insurance acceptance and cash pay rates for psychotherapy in the US.

Cost and insurance coverage remain important barriers to mental health care, including psychotherapy and mental health counseling services ("psychotherapy"). While data are scant, psychotherapy services are often delivered in private practice settings, where providers frequently do not take insurance and instead rely on direct pay. In this cross-sectional analysis, we use a large national online directory of 175 083 psychotherapy providers to describe characteristics of private practice psychotherapy providers who accept and do not accept insurance, and assess self-reported private pay rates. Overall, about one-third of private practice psychotherapists did not accept insurance, with insurance acceptance varying substantially across states. We also found significant session rate differentials, with Medicaid rates being on average 40% lower than reported cash pay rates, which averaged $143.26 a session. Taken together, low insurance acceptance across a broad swath of mental health provider types means that access to care is disproportionately reliant on patients' ability to afford out-of-pocket payments-even when covered by insurance. While our findings are descriptive and may not be representative of all US psychotherapists, they add to scant existing knowledge about the cash pay market for an important mental health service that has experienced increased use and demand over time.

Envisaging a thriving future: The integration of positive psychology into brief psychotherapy and family therapy practice

Envisaging a thriving future: The integration of positive psychology into brief psychotherapy and family therapy practice

Morita Therapy: Potential Treatment for Borderline Personality Disorder

Borderline personality disorder (BPD) is a cluster-B personality disorder known for its complexity and difficulty to cure, and was once considered untreatable. At present, the mainstream treatment is represented by dialectical behavior therapy (DBT), but there are problems such as the shortage of therapists and the high cost of training. In order to increase the therapeutic possibility of BPD, it is necessary to find a new treatment method. Morita Therapy originated in Japan and is based on eastern philosophy and Buddhism, emphasizing the oneness of man and nature. Due to the lack of clinical data on the direct application of Morita therapy to BPD and the lack of related studies, a definite conclusion cannot be drawn. But the concept and core features of Morita therapy are compatible with the core symptoms of BPD, and the potential efficacy of Morita therapy in the treatment of BPD and the potential as adjuvant therapy are possible. This study explores the potential efficacy of Morita therapy on BPD, and provides a new direction and idea for the research and practice of BPD psychotherapy.

Psychotherapeutic research and practice: Do we need to talk about ‘efficacy’?

ABSTRACT In this article, we address how standardisation in psychotherapeutic research and practice can create a ‘procrustean bed’ which leads to conformity rather than an ethical response to what emerges in the moment. Articulated, three points of conflict in which we discuss how the therapist or researcher may be rendered ‘ineffective’ in the name of ‘efficacy’. We explore some of the implications for idiosyncratic practices in psychotherapy, which are rooted in a foundation of ethics and philosophy, when the paradigm of empirically ‘evidence-based practices’ (EBP), which are rooted in measurement, takes centre stage and are overwhelmingly favoured in the industry of funded therapies. The first point of conflict is in relation to conversation itself; exploring the place of hermeneutics and interpretation within therapeutic dialogue and research. The second point explores what it means to take up a discovery-oriented stance and the implications this has for ‘evidence’; further delving into the way our demand for ‘evidence’ may be impacting how psychotherapeutic research and practice is carried out. The final point aims to explore the infrastructure and work environment of funded therapies in the United Kingdom.

Feasibility of artificial intelligence‐based measurement in psychotherapy practice: Patients' and clinicians' perspectives

Feasibility of artificial intelligence‐based measurement in psychotherapy practice: Patients' and clinicians' perspectives

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.

Historical and contemporary psychotherapy practices in Uganda

Historical and contemporary psychotherapy practices in Uganda

The development of the Moments of Flourishing Experience Scale: a new scale to measure positive, affect-based flourishing state experiences

ABSTRACT Flourishing has been a focus of positive psychology, with increased attention to its translation into psychotherapy practice. Flourishing is an emergent process manifested in momentary experiential states characterized by positive emotions. A conceptualization of flourishing as an innate potential that psychotherapeutic interventions can help cultivate informs the development of this scale. The current study details the development of the Moments of Flourishing Experience Scale (MFES), a 23-item scale. The data were obtained from four different studies involving a total of 1472 adults (normative sample n = 1312; clinical sample n = 160). A bifactor model with four distinct positive affective experience subscales, yielded by factor analysis and then supported by a confirmatory factor analysis, was as follows: Calm & Self-Acceptance; Vitality; Generosity of Spirit & Gratitude; and Connection & Purpose. Across studies, the MFES showed discriminant validity from psychopathology measures and convergent validity with positive psychological functioning measures. The overall scale, as well as each of four subscales, also demonstrated strong reliability in both general and clinical populations. The MFES has initial psychometric support for the study of flourishing and shows promise as a tool to study flourishing as both outcome and process in psychotherapy.

Navigating the 'Pits and Perils' of Analgesic Therapy in Advanced Liver Disease and Cirrhosis.

The role of the liver in drug metabolism makes individuals with hepatic dysfunction more susceptible to adverse drug reactions, necessitating careful consideration in analgesic selection and dosing. Acetaminophen, despite being a common cause of liver failure, is considered safe within recommended dosages. Nonsteroidal anti-inflammatory drugs (NSAIDs), while effective, pose risks in cirrhosis due to complications like renal failure and gastrointestinal bleeding. Cyclooxygenase-2 inhibitors have limited data, and their use is discouraged due to cardiovascular concerns. Opiates, though potent, require cautious use in cirrhosis due to altered metabolism, potential adverse effects, and the risk of addiction. Tricyclic antidepressants like nortriptyline and desipramine can be utilized for neuropathic pain, while SSRIs and SNRIs are not recommended. Anticonvulsants such as gabapentin and pregabalin are preferred for neuropathic pain, with gabapentin being the first-line choice. Topical analgesics, including NSAIDs, lidocaine, and rubefacients, are deemed safe for use in cirrhosis, offering localized relief with minimal systemic effects. Nonpharmacological approaches addressing medical, psychological, and socio-economic factors are crucial adjuvants to analgesic therapy in advanced liver diseases. Physiotherapy, psychotherapy, behavioral therapy, relaxation techniques, acupuncture, and traditional practices like yoga and massage, as well as novel modalities, contribute to a holistic pain management strategy. This review provides healthcare professionals with valuable insights into the complex landscape of analgesic therapy in cirrhosis. Meticulous consideration of drug metabolism, hepatic safety, and individual patient factors is paramount in optimizing pain management strategies for this challenging patient population.

Enhancing supervisory practice in Positive and Transcultural Psychotherapy through Artificial Intelligence.

Enhancing supervisory practice in Positive and Transcultural Psychotherapy through Artificial Intelligence.

Interpreting Differences in Questionnaire Scores in the Context of Cultural Location: A Country Case Study of Symptom Check List -90- Revised Data from Albania, Germany and the USA

This paper explores inter-cultural differences using new SCL-90-R data from Albania and referential data from the USA and Germany. The considerable mean score differences are interpreted in terms of historical, cultural, and political factors in Albania may affect psychometric measures creating large intercultural score differences. The SCL-90-R was administered to a representative population sample in Tirana (N = 501). Global, subscale, and item score values from the Albanian sample were compared, where possible, to those from existing American and German samples. The Albanian data showed markedly higher means on the global scale and all subscales than the American and German values and differences at the item level from the German data (item data were not available for the USA). Differences were most marked on subscales of paranoid thinking, anxiety, and hostility. These findings are interpreted in terms of the cultural context of the country. Considerations are given to implications for therapists working with culturally diverse communities. Current mental health and psychotherapy practices do not sufficiently reflect research indicating complex relations between culture and psychopathology. Studies across cultures in new, concurrently collected data using psychometric methods to explore measurement invariance and its violations, are often not feasible. Simpler methods can be used with historical data to show marked differences and enhance intercultural psychotherapy research. Received: 12 March 2024 / Accepted: 23 June 2024 / Published: 02 July 2024

Expectations versus reality: psychology trainees’ experiences working with men

ABSTRACT Despite increasing engagement with mental health services in Australia, therapy dropout rates for men remain high, most commonly due to a lack of connection with their therapist. Previous studies have examined the challenges men face when attending therapy, the obstacles therapists encounter when working with male clients, and the subsequent recommendations for therapist training that have emerged from these findings. However, to date there has been no investigation into the experiences and needs of trainee therapists working with men. It is unclear how their status as trainees influences their perception and adaptability when providing care for male clients. The current study therefore explored psychology trainees’ expectations, experiences, and preparedness regarding their psychotherapeutic work with men. Qualitative interviews were conducted with 12 students undertaking clinical psychology training from a single Australian University, focusing on their experiences working with male clients throughout their clinical training. Reflexive thematic analysis was undertaken to develop three themes: (1) Mismatched expectations of manspeak, which explored the ways in which students expected and experienced male engagement, (2) Gratifying work, which highlighted elements of therapeutic work with men that shaped participants’ sense of competence, and (3) Working with the “macho man”, which described the challenges of working with men, such as managing boundaries, misogyny, and personal safety. Findings suggest psychology trainees may benefit from additional training in university curriculums which specifically addresses some of the complexities of therapy with men. This training could illuminate how masculine socialisation affects men’s engagement in psychotherapy in practice and provide strategies for trainee therapists to support male engagement.