Practice Of Psychotherapy Research Articles

Attitude Towards Dreams: Associated Factors

Representative surveys indicated that the attitude towards dreams varies greatly: some participants agreed to statements like “Dreams are random nonsense” but others expressed more positive attitudes that dreams might be beneficial. The present online study (N = 1,507 participants) elicited attitude towards dreams, personality (Big Five factors), current psychopathology, and COVID19-related worries. As expected, the present study showed that openness to experiences, but also current psychopathology and worries were associated with more positive attitudes towards dreams. This might indicate that persons with problems might turn to dreams, as they might be beneficial with coping those problems. Longitudinal studies might validate the idea that experiencing beneficial effects of dreams, for example, within a therapeutic setting, might affect the attitude towards dreams in a positive way. And, if persons with problems turn to dreams, it would be very helpful to include the tool of working with dreams in current psychotherapy practice.

Individual-Specific Animated Profiles of Mental Health.

How important is the timing of the pretreatment evaluation? If we consider mental health to be a relatively fixed condition, the specific timing (e.g., day, hour) of the evaluation is immaterial and often determined on the basis of technical considerations. Indeed, the fundamental assumption underlying the vast majority of psychotherapy research and practice is that mental health is a state that can be captured in a one-dimensional snapshot. If this fundamental assumption, underlying 80 years of empirical research and practice, is incorrect, it may help explain why for decades psychotherapy failed to rise above the 50% efficacy rate in the treatment of mental-health disorders, especially depression, a heterogeneous disorder and the leading cause of disability worldwide. Based on recent studies suggesting within-individual dynamics, this article proposes that mental health and its underlying therapeutic mechanisms have underlying intrinsic dynamics that manifest across dimensions. Computational psychotherapy is needed to develop individual-specific pretreatment animated profiles of mental health. Such individual-specific animated profiles are expected to improve the ability to select the optimal treatment for each patient, devise adequate treatment plans, and adjust them on the basis of ongoing evaluations of mental-health dynamics, creating a new understanding of therapeutic change as a transition toward a more adaptive animated profile.

Dynamical Systems Research (DSR) in Psychotherapy: A Comprehensive Review of Empirical Results and Their Clinical Implications

In psychotherapy research, the first applications of dynamical systems research (DSR) date back to the 1990s. Over time, DSR has developed three main lines of research: the study of oscillations in synchronization; the study of oscillations between stability and flexibility of process variables (S–F oscillations); the mathematical modeling to analyze the evolution of psychotherapy process. However, the connections among the empirical results and their implications for psychotherapy practice are unclear. For this reason, for the first time in the literature, this work carries out a comprehensive review of all three lines of research, including the main scientific contributions from the 1990s to the present day. For each line of research, the work critically analyzes the results, proposes future developments, and underlines the connections between empirical results and implications for psychotherapy practice. Furthermore, the work highlights the model of change that emerges from the empirical results, and its clinical correlates. In the conclusions, the author summarizes the results and the evolution of psychotherapy process in accordance with the DSR.

Working with Adults with Intellectual Disability and Clinicians to Advance Mental Health Treatment: Informing Practice Guidelines and Research

ABSTRACT Introduction The current study obtained perspectives on psychotherapy practices from adults with intellectual disability receiving psychotherapy and mental health clinicians serving adults with intellectual disability. The goal was to identify opportunities, successes, and challenges through the perspective of adults with intellectual disability who have received mental health treatment (i.e. clients) and clinicians providing psychotherapy. Method A total of six virtual focus groups, three with clinicians and three with clients with intellectual disability who had experience with psychotherapy, were conducted. Transcripts were coded by two independent reviewers guided by grounded theory. Results Broadly, analyses indicated overlapping themes with rich perspectives from both groups. Both clinicians and clients with intellectual disability identified a number of key aspects that were perceived as foundational to therapy and to improving the therapeutic relationship and comfort of the client with intellectual disability. Themes related to rapport building and self-determination emerged, despite not being directly asked of either group. Both clinicians and clients with intellectual disability discussed the therapeutic process at length, related to general types of treatment modality as well as the importance of individualizing treatment strategies. Clinicians spoke of regularly making accommodations to increase treatment accessibility. Conclusion The focus group results align with and supplement treatment outcome research and have implications for training, practice, and future research.

A refreshing and necessary start: Commentary on Westra and Di Bartolomeo (2024).

Westra and Di Bartolomeo (2024) make a compelling case for integrating "process acuity" skills into routine clinical training. The authors have done the field a service by articulating the need for novel and process-science-informed psychotherapy training and practice. This brief commentary echoes the authors' observations about the status quo of clinical training and expands upon what else will need to be considered to fully realize the goals of their proposal. Specifically, research on negative process signals has outpaced research on the optimal responses to such process signals. Further, process-outcome associations and the relevance of other technical mechanisms vary by the therapist/trainee (and dyad), which will require enhanced training personalization and precision. Future work on implementation will require elucidating responsive clinical strategies based on the accumulation of more sophisticated and contextualized process-outcome and training research. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Perspectives of Applying Principles and Methods of Positive and Transcultural Psychotherapy in Organizations

The purpose of the article is to highlight the areas of business where positive psychotherapy can be applied in order to improve the business environment and to transform it into a more supportive, developing and less damaging area. The author’s experience, which includes more than 20 years of international management, business training and psychotherapy practice, prompted the importance of taking care of mental health not only within psychotherapy, but also during people’s everyday activities – in particular their work. The article can be useful for specialists working within organizations and for practitioners. This article can become a discussion point for formulating guides for further developing of the topic.

Looking and listening in online therapy

ABSTRACT Looking and listening are activities so well integrated into the practice of psychotherapy that we don’t often study what is involved and what we are making together with these sensory activities. The shift into online working and with the rise of social media, we live more of our social lives through screens. In this essay, I share some anecdotes to explore changes I experience in looking and listening between my in-person and online practice relationships. The changes in spatial and technological relations alter our expectations about what therapy can look like. I explore whether psychotherapy is trying to reproduce old, colonised ways of doing in-person therapy in an online environment. I end by asking how embracing online living might affect how we learn more about the possibilities for doing therapy in virtual worlds.

Open notes in psychotherapy: An exploratory mixed methods survey of psychotherapy students in Switzerland.

In a growing number of countries, patients are offered access to their full online clinical records, including the narrative reports written by clinicians (the latter, referred to as "open notes"). Even in countries with mature patient online record access, access to psychotherapy notes is not mandatory. To date, no research has explored the views of psychotherapy trainees about open notes. This study aimed to explore the opinions of psychotherapy trainees in Switzerland about patients' access to psychotherapists' free-text summaries. We administered a web-based mixed methods survey to 201 psychotherapy trainees to explore their familiarity with and opinions about the impact on patients and psychotherapy practice of offering patients online access to their psychotherapy notes. Descriptive statistics were used to analyze the 42-item survey, and qualitative descriptive analysis was employed to examine written responses to four open-ended questions. Seventy-two (35.8%) trainees completed the survey. Quantitative results revealed mixed views about open notes. 75% agreed that, in general open notes were a good idea, and 94.1% agreed that education about open notes should be part of psychotherapy training. When considering impact on patients and psychotherapy, four themes emerged: (a) negative impact on therapy; (b) positive impact on therapy; (c) impact on patients; and (d) documentation. Students identified concerns related to increase in workload, harm to the psychotherapeutic relationship, and compromised quality of records. They also identified many potential benefits including better patient communication and informed consent processes. In describing impact on different therapy types, students believed that open notes might have differential impact depending on the psychotherapy approaches. Sharing psychotherapy notes is not routine but is likely to expand. This mixed methods study provides timely insights into the views of psychotherapy trainees regarding the impact of open notes on patient care and psychotherapy practice.

Introspection, reflection, qualia, & consciousness: Making sense of an 80-hour psychotherapy internship

The following is an introspective report that elaborates on lessons I learned as a trainee psychotherapist during an 80-hour internship at one of Sri Lanka’s state-run hospitals. I have carefully analyzed thoughts, feelings, and emotions associated with three patient cases, and interpreted key learnings via Gibbs reflective cycle. The lessons learned portray a self-realization of a variety of my strengths and weaknesses akin to the practice of psychotherapy. Based on the nature of the content learned, I have identified some of the key areas of professional development that undergird career success. Similarly, making sense of my internal state during these 80 hours through reflective practice displays the mastery of a critical skill for improved training outcomes. This report further highlights the need for more subjective introspective reports from contemporary professionals to establish discourse on consciousness to promote the consideration of subjective accounts of professionals as foundational evidence for more intuitive, logical, and rigorous endeavors of scientific inquiry.

Trainee psychotherapists’ emotion recognition accuracy during 1.5 years of psychotherapy education compared to a control group: no improvement after psychotherapy training

The ability to recognize and work with patients’ emotions is considered an important part of most psychotherapy approaches. Surprisingly, there is little systematic research on psychotherapists’ ability to recognize other people’s emotional expressions. In this study, we compared trainee psychotherapists’ nonverbal emotion recognition accuracy to a control group of undergraduate students at two time points: at the beginning and at the end of one and a half years of theoretical and practical psychotherapy training. Emotion recognition accuracy (ERA) was assessed using two standardized computer tasks, one for recognition of dynamic multimodal (facial, bodily, vocal) expressions and one for recognition of facial micro expressions. Initially, 154 participants enrolled in the study, 72 also took part in the follow-up. The trainee psychotherapists were moderately better at recognizing multimodal expressions, and slightly better at recognizing facial micro expressions, than the control group at the first test occasion. However, mixed multilevel modeling indicated that the ERA change trajectories for the two groups differed significantly. While the control group improved in their ability to recognize multimodal emotional expressions from pretest to follow-up, the trainee psychotherapists did not. Both groups improved their micro expression recognition accuracy, but the slope for the control group was significantly steeper than the trainee psychotherapists’. These results suggest that psychotherapy education and clinical training do not always contribute to improved emotion recognition accuracy beyond what could be expected due to time or other factors. Possible reasons for that finding as well as implications for the psychotherapy education are discussed.

An Advanced Solution Based on Machine Learning for Remote EMDR Therapy

For this work, a preliminary study proposed virtual interfaces for remote psychotherapy and psychology practices. This study aimed to verify the efficacy of such approaches in obtaining results comparable to in-presence psychotherapy, when the therapist is physically present in the room. In particular, we implemented several joint machine-learning techniques for distance detection, camera calibration and eye tracking, assembled to create a full virtual environment for the execution of a psychological protocol for a self-induced mindfulness meditative state. Notably, such a protocol is also applicable for the desensitization phase of EMDR therapy. This preliminary study has proven that, compared to a simple control task, such as filling in a questionnaire, the application of the mindfulness protocol in a fully virtual setting greatly improves concentration and lowers stress for the subjects it has been tested on, therefore proving the efficacy of a remote approach when compared to an in-presence one. This opens up the possibility of deepening the study, to create a fully working interface which will be applicable in various on-field applications of psychotherapy where the presence of the therapist cannot be always guaranteed.

Navigating the Ethical Path: Nonmaleficence and Cultural Humility in Psychotherapy

In this article we explore integrating diversity, equity, inclusivity (DEI), intersectionality, and cultural humility into psychotherapy, guided by the ethical principle of nonmaleficence—the commitment to do no harm. We critique the limitations of traditional Eurocentric psychotherapy and advocate for DEI principles to better address the diverse realities of clients from varied cultural backgrounds. We propose actionable recommendations for psychotherapists to adopt a holistic, inclusive approach, emphasizing valuing each client's unique experiences. This approach is aimed at ensuring that psychotherapy practice is effective, socially just, culturally responsive, and ethically sound, aligning with the Galveston Declaration's values of pluralism, flux, opening space, and responsibility for continued growth in therapeutic practice.

Peer support and psychedelics

LAY SUMMARY The new practices of psychedelic-assisted psychotherapy and state-run psychedelic services need trained facilitators. This article aligns the role of peer support in both the psychedelic and the Veteran communities, displaying core competencies and current practices, while also highlighting further needs in training and supervision. Continued work with peer support in the legal facilitation of psychedelic experiences will deepen understanding of psychedelic peership (i.e., when someone with previous firsthand experience with psychedelics facilitates the psychedelic therapy session of another).

Psychologists conducting psychotherapy in 2022: Contemporary practices and historical patterns of the Society for the Advancement of Psychotherapy.

This study updated and extended investigations from 1981, 1991, 2001, and 2012 on the contemporary psychotherapy practices and historical patterns of United States psychologists in the American Psychological Association Division of Psychotherapy/Society for the Advancement of Psychotherapy. In 2022, 475 psychologists (48% response) completed an online questionnaire regarding their sociodemographic characteristics, professional activities, therapy formats, employment settings, theoretical orientations, personal therapy, and career satisfactions. Results showed an increasingly female and aging membership with primary employment in independent practices and universities. Psychotherapy, research/writing, and administration were the most frequent professional activities. Individual therapy remained the most common format, and the most popular theoretical orientations remained psychodynamic/relational (29%), integrative (27%), and cognitive (19%). Eighty-two percent of psychologists have undergone personal therapy at least once. Career satisfaction, likewise, has remained consistently high across the 40 years. The limitations and implications of these 40-year patterns are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

A virtual frame – how does forensic psychotherapy work remotely?

Psychotherapy has been practised via remote technology since the mid-1990s and has grown in mainstream popularity; yet, it remains controversial, particularly for psychoanalytically informed treatment, and limited research in this area has been published. However, COVID-19 provoked a necessary transition to online working across the psychotherapy profession, including clinicians providing psychoanalytic treatment to a unique forensic outpatient group remotely for the first time. This qualitative research study sought insights from this sample via grounded theory interviews and analysis to inform hypothetical future practice of remote psychotherapy via videoconferencing to forensic populations with limited access to treatment. This generated a substantive theory about how forensic psychotherapy works remotely: In the context of a forced transition to remote working, forensic psychotherapists make attempts to substitute for real by establishing an alternative frame; noticing how differently contact is mediated; adapting technique; and evaluating suitability for remote treatment. An implication of these findings may be that developing a new Virtual Frame for forensic psychotherapy, supported by specialist training and supervision, could increase its reach within settings that provide sufficient containment for the work. Further research is encouraged to support this undertaking and consider which patients, and/or clinicians, might work effectively this way.

Employing dissemination and implementation science to promote mental health equity for transgender youth

BackgroundIn recent years, the United States has witnessed increased transphobic rhetoric and legislation aimed at restricting the rights of transgender youth, ranging from banning transgender youth from school sports, to denying access to gender-affirming care. This climate has a detrimental impact on the mental health of transgender youth- a community that already experiences profound mental health risks due to their exposure to transphobia across multiple levels and in myriad settings. To combat transphobia and its negative effects on transgender youth’s mental health, scientific studies and methods addressing multiple levels and forms of transphobia are needed. DiscussionWe review research on negative impacts of multilevel transphobia on transgender youth mental health and the benefits of gender-affirming psychotherapy practices. We then describe how dissemination and implementation (D&I) science—the scientific study of multilevel strategies and methods that facilitate the uptake of effectives services—can be used to promote the mental health of transgender youth. We call for increased D&I research to support the mental health needs of transgender youth. We recommend two broad domains of D&I research: (1) identify, test, and scale effective services for transgender youth and (2) address contextual barriers to implementing these services- specifically, state-level laws/policies, and lack of access to gender-affirming psychotherapy. Methodological recommendations and example studies are included in each domain. ConclusionsTo enhance mental health equity for transgender youth, we must leverage D&I science to identify, test and scale services that have been shown to be promising (e.g., acceptable and feasible) or effective for transgender youth based on empirical research, including qualitative, observational, and/or pilot studies, as well as randomized controlled trials. These research efforts should also address law/policy barriers through advocacy and policy dissemination research, and overcome lack of access to appropriate care via online/mobile interventions.

Necessity is the mother of invention: Experiences of Israeli women child psychotherapists inexperienced in online therapy regarding the therapeutic space during COVID-19

ABSTRACT This qualitative study explored the experiences of child psychotherapists who were inexperienced in online therapy and transitioned in response to the COVID-19 pandemic. Providing online therapy to children poses distinct challenges due to different factors, including the focus on play and developmental differences. The study aimed to shed light on the therapists’ perceptions of the therapeutic space in online therapy, and the impact of the transition on the practice of child psychotherapy. Twenty experienced child psychotherapists were interviewed in depth to explore their experiences of transitioning to online therapy during the COVID-19 pandemic in Israel. Participants were recruited voluntarily using convenience and snowball sampling. The study was designed and analyzed by two experienced clinical psychologists using qualitative content analysis. The findings revealed that the online space is an integral part of the transformative processes in psychotherapy for children and youth, and psychotherapists can make necessary adjustments to the new setting through adaptability.The study underscored the challenge of finding flexible personal resources to promote adaptation processes to change.

The meaning and feeling of the time and space between psychotherapy sessions and everyday life: Client experiences of transitions

Objective To explore how clients in psychodynamic or psychoanalytic psychotherapy, conducted in the traditional in-person setting, experience the transitions in time and space between psychotherapy sessions and everyday life. Method Twelve semi-structured interviews were analyzed with inductive experiential thematic analysis, focusing on how the participants experience and make sense of the phenomenon in focus. Results The participants described therapy as a sheltered space where they could be open, vulnerable, receptive, and present. Approaching and leaving psychotherapy sessions, the participants established different behavioral patterns and routines dealing with their anxieties and resistances. In this in-between area, the participants could handle interconnections and differences between therapy and everyday life. Participants stressed the clinical impact of transitions: transitions affect both therapy and everyday life; disturbed transitions have an adverse impact; transitions are insufficiently addressed in therapy. Conclusion Transitions between therapy and life appear to be an essential but seldom recognized part of the therapy process beyond the borders of therapy sessions. Implications of these findings for psychotherapy training and practice are discussed, and a tentative transtheoretical framework for further research is proposed.

Yalom’s therapeutic factors in hearing Voices Groups: a facilitator’s perspective

ABSTRACT Over the past 35 years, peer-run Hearing Voices Groups (HVGs) have proliferated across the globe. More recently, research has begun to focus on the precise psychological mechanisms that make groups effective and enable individual psychological change. While important in their own right, theories of peer support are limited in their ability to explain the psychological mechanisms by which complex psychological transformation occurs. As such, it is necessary to look beyond peer support and borrow theories from the psychotherapeutic literature. Yalom and Leszcz’s (2005) seminal work, The Theory and Practice of Group Psychotherapy, may help shed some light on the psychological dynamics that bring about change in HVGs. Peer support and group psychotherapy differ widely in their histories, philosophical underpinnings, and approach to, and understanding of, mental distress. As such, theories of group psychotherapy cannot be broadly applied to HVGs without a nuanced understanding of the differences between HVGs and psychotherapy groups. In this paper, I use my lived experience as an HVG member and facilitator to highlight these differences, and explore where Yalom’s theory may be useful at understanding the change mechanisms at play in HVGs.

Psychotherapies in current clinical psychology and psychiatry in Spain

BackgroundThe practice of psychotherapy in Spain (Europe) continues being a reason for doubts, uncertainty, controversy or confusion. The access to psychotherapy is also controversial. To contribute to clarify all this in order to improve quality and minimise risks is the aim of our work. MethodUpdate of the regulations and legal rules which are applicable in psychotherapy to those graduated in both psychology and medicine. Results and discussionNeuroscience, clinical psychology and psychiatry develop in a parallel and convergent way. It is necessary to emphasise the risks of pseudotherapies, including pseudopsychotherapies, and pseudosciences in general. The practice of psychotherapy as a psychological treatment necessarily implies the healthcare field both for the private and public sectors. In order to practice as a psychotherapist in Spain, it is necessary to be a psychologist specialised in clinical psychology or a doctor specialised in psychiatry. The figure of the sanitary general psychologist is a regulated profession in Spain at present, but that is not equivalent to be a specialist. The former psychologists who have the required legal qualification are also allowed to act for the public sector in the healthcare field. Other doctors who are not psychiatrists, other psychologists or the nurses specialised in mental health are not allowed to name themselves or act as psychotherapists in any field or sector.