Psychotherapy Process Research Articles

How Can Near‐Infrared Spectroscopy (NIRS) Help Understanding of the Psychotherapy Process? A Scoping Review of Therapeutic Interactions

AbstractIn recent years, near‐infrared spectroscopy (NIRS) has garnered significant attention for its potential clinical applications as a non‐invasive and straightforward method for measuring brain functions. While NIRS has become useful in psychiatric contexts by aiding in the differential diagnosis of depression, its application in clinical psychology is still developing. Due to its ecological validity, which allows for measurements in natural settings, NIRS shows promise in revealing the dynamic elements of the psychotherapy process. In this study, we conducted a scoping literature review of the use of NIRS in psychotherapeutic interactions, exploring its potential to unveil the complexities of psychotherapy settings involving interpersonal interactions. Employing a scoping review approach, we systematically searched the PubMed, PsycINFO, and Web of Science databases for articles published through October 19, 2023 about studies using NIRS as a measurement instrument: This yielded various therapeutic interactions. Of the 155 retrieved results that remained after the initial screening, seven met the inclusion criteria. Of these, six studies examined the synchronization of brain functions through the simultaneous brain activity measurements (hyperscanning) of two participants. The review revealed that, despite the anticipated potential of NIRS, it has become evident there is a dearth of research focusing on interactions during psychotherapy. Furthermore, the few available studies have not explored changes in line with the progression of psychotherapeutic interactions. Consequently, future studies should address whether NIRS can effectively assess alterations in brain function resulting from micro‐level events, such as the therapeutic interaction between therapists and clients during psychotherapy.

A Novel Approach to Examining Working Alliance Instability During Psychotherapy for Borderline Personality Disorder.

This study aimed to quantify the instability of psychotherapy process variables by using a novel data-analytic approach. The study explored instability of the working alliance over 10 treatment sessions and its relationship with self-esteem. Data were extracted from a randomized controlled trial, conducted in Switzerland, of a short-term intervention for borderline personality disorder. Sixty clients diagnosed as having borderline personality disorder were randomly assigned to receive either 10 sessions of good psychiatric management-brief version (GPM-BV) or GPM-BV combined with a relational principle called motive-oriented therapeutic relationship. Square successive differences were calculated for client and therapist ratings of alliance instability. Multilevel models were used to test within- and between-person associations of alliance instability with self-esteem. Although some preliminary analyses showed an association between a more stable alliance and higher self-esteem at the start of psychotherapy, the alliance did not become more stable over time. Alliance instability was not associated with self-esteem at either the within- or between-person level. This study highlights the advantages, procedures, and challenges of applying square successive differences to psychotherapy research data. The results suggest that the working alliance develops in complex ways and indicate the importance of continuing to use novel methods to capture dynamic psychotherapy processes.

The complexity of interpersonal physiology during rupture and repair episodes in the treatment of borderline personality disorder: a proof-of-concept multimethod single case study of verbal and non-verbal interactional dynamics.

The aim of this proof-of-concept multimethod exploratory single case study is to increase knowledge of the underlying mechanisms of alliance ruptures and repairs in Borderline Personality Disorder treatment across and within the psychotherapeutic treatment process. The multimethod includes outcome assessment of patient self-reporting questionnaires (the Affect Integration Inventory, the Hopkins Symptom Checklist), observation-based ratings of sessions with the Rupture Resolution Rating System, quantitative analysis of heart rate variability using recurrence quantification analysis, and a qualitative multimodal interaction analysis of within-session dynamics. Results reveal how patterns of heart rate synchrony between patient and therapist reflect periodical patterns of emotional interaction corresponding to key therapeutic alliance processes throughout the treatment process. Particularly, heart rate synchronization and desynchronization correspond with increasing rupture resolution ratings and positive outcome measures in the last part of the therapy process, indicating increased productivity, affectivity, and positive change. The qualitative microanalysis highlights context sensitivity to alliance management within sessions. Physiological arousal is found to underlie important alliance processes, including emotion regulation, relatedness, security, empathic responding, sense-making, and validation in correspondence with different therapist verbal and non-verbal markerbs. Clinical implications and study limitations are discussed. Recommendations are made for future directions in relation to applying multimethod approaches when studying rupture and repair processes in psychotherapy.

Does technique matter? A multilevel meta-analysis on the association between psychotherapeutic techniques and outcome.

The extent to which psychotherapeutic techniques have an impact on outcome has been studied on a regular basis. To date, there are no meta-analytic attempts to clarify the association between techniques and outcome in multi-therapeutic approach measures. This study aims to conduct a meta-analysis of the described association. A three-level meta-analysis and moderator-analysis were used. The meta-analysis revealed 13 studies with a total of 177 effect sizes. There was a significant effect r=.193 (t[176]=4.77, p<.01) with higher use of psychotherapeutic techniques being associated with better outcome. Significant moderator was therapeutic approach-specific subscales. The mean effect of cognitive-behavioral techniques was r=.088 (t[147]=1.50, p=.14, d=0.18; s=11, k=79), and the mean effect of psychodynamic techniques was r=.286 (t[147]=5.06, p<.01, d=0.60; s=11, k=70). The measurements for psychotherapeutic technique (Comparative Psychotherapy Process Scale and Psychotherapy-Process Q-Sort) showed no significant difference related to the association between technique and outcome (F[1, 175]=0.38, p=.54). This meta-analysis showed a positive relation between psychotherapeutic techniques and outcome. This leads to the assumption that specific psychotherapeutic techniques have positive effects on post-treatment outcome.

An Integrative Model to Increase Client Motivation During the Psychotherapy Process

An Integrative Model to Increase Client Motivation During the Psychotherapy Process

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.

Engaging the child-parent relationship to treat early trauma: The challenge and promise of scaling with fidelity.

There is an urgent imperative to scale up access to effective, family-focused mental health services for trauma-exposed infants, toddlers, and preschoolers, who represent the most vulnerable and most underserved sector of the clinical child population. This article describes the process of scaling child-parent psychotherapy, an evidence-based treatment currently used in 39 U.S. states and six countries, as an example of the promise and challenge of large-scale implementation of relationship-based treatments.

Psychotherapists' outcome expectations: How are they established?

Therapists' outcome expectations influence the psychotherapy process and outcomes, but little is known about the factors influencing their development. This study explored therapists' experiences with establishing outcome expectations for their patients. The participants were 35 therapists from a public mental health setting, who were interviewed in five different focus groups. Interviews were transcribed and analyzed using thematic analysis. Three themes and 10 subthemes were identified. In Theme 1 (understanding the problem), participants' expectations were influenced by (a) their patients' diagnoses and the diagnostic process, (b) their perceptions of the complexity of the presenting problem, (c) how stable the patients' symptoms and situations were, and (d) whether they experienced familiarity with the patient or the patients' situation. In Theme 2 (the patient's openness to change), participants' expectations were influenced by (a) the patient's stated reason for seeking treatment, (b) the patient's conceptualization of their problem/situation, and (c) their perception of the patient's willingness to invest in the treatment. In Theme 3 (the fit between the therapist and patient), the participants discussed the factors that influenced whether they felt they were a good fit for working with an individual patient and how this perception of personal and professional fit influenced their expectations. We identify several ways that therapists' situational factors and their recognition of the patient through their own past experiences can influence their expectations. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

How Can We Study Change Processes in Psychotherapy While Addressing Its Interactive Nature

Does the empathy or personality of psychotherapists influence the way they do therapy? Is the therapeutic relationship the key to success? Questions such as these are commonly shared in Change Process Research (CPR) and outcome studies. However, these statements, posed in descriptive cross-sectional terms, often imply the use of strategies grounded in causal-linear explanatory models. The present study offers an alternative tool to measure elements of psychotherapy in dynamic, interactive, and interdependent terms. With nine observational categories defined under analytical-behavioral lens, the Acoveo System is an instrument designed to detect the potential functions of verbal exchanges that take place in the psychotherapeutic context from any theoretical orientation. A guide to its application is provided, and its usefulness is elaborated on two of the pivotal common factors in change process research: empathy and therapeutic alliance.

Learning process in psychotherapy

En este trabajo se expone la necesidad de potenciar la investigación de procesos como el camino más adecuado para conocer y explicar el proceso terapéutico al tiempo que se cuestiona la metodología utilizada en la investigación de resultados, predominante en la actualidad para el estudio de la intervención clínica: la comparación de grupos, la asignación de sujetos al azar o la clasificación con etiquetas diagnósticas que dificultan el estudio del proceso terapéutico y la identificación de los elementos que hacen que un tratamiento tenga determinado efecto. Frente a este tipo de investigaciones, se presentan una serie de trabajos que defienden el uso de metodología observacional para la identificación de los procesos de aprendizaje que serían responsables del cambio en terapia, así como el análisis de la interacción terapéutica desde una perspectiva funcional: teniendo en cuenta que la terapia psicológica es fundamentalmente hablada, se plantea que la forma óptima de analizarla es a partir del estudio del intercambio verbal entre cliente y terapeuta. Se presenta un sistema de codificación de la interacción verbal que los autores proponen como herramienta para identificar las funciones de la conducta verbal del terapeuta durante el proceso de intervención clínica y en los distintos trabajos se analizan, entre otros, el papel que desempeñan las instrucciones, los procesos de reforzamiento y control discriminativo, la transferencia de funciones a través de emparejamientos o el lenguaje como proceso colaborativo.

Benefits of Cognitive Behavior Therapy with Neuroscience-informed Psychoeducation in Young Adult Patients: A Preliminary Study

Background: Psychoeducation often is a recommended augmentation for cognitive behavior therapy (CBT) to enhance patients’ understanding of their clinical condition. But despite providing psychoeducation, there might be a lack of insightful engagement in the therapy process on the part of patients, affecting the therapy outcome. While there are neuroscience-informed psychoeducation models for addiction, there is rarely any literature on neuroscience-informed psychoeducation for CBT. It is postulated that a neuroscience-informed module of psychoeducation can bring better acceptance of CBT and improve its outcome. Methods: In this study, we used a pre- and poststudy design. Using purposive sampling, 30 consecutive young adult patients presented themselves with symptoms of depression and anxiety to receive standard CBT module. Fifteen of these received the CBT module with generic psychoeducation detailing the etiology, signs and symptoms, and treatment requirements for their condition. The other 15 received neuroscience-informed psychoeducation modules having specific inputs about the generic functioning of the human brain, the neuropsychological changes, and processes in the brain during and due to the psychotherapy (CBT) process. Acceptance and outcome of CBT were measured through changes in symptom rating as well as individual feedback, sentiment analysis of the feedback statements, and word cloud. Results: Participants of both the psychoeducation model groups – conventional psychoeducation (p &lt; 0.001) and neuroscience-informed psychoeducation group (p &lt; 0.001) – were found to have significant improvement in their clinical symptoms of the pre- and posttest scores. But the neuroscience-based psychoeducation group was better compliant to sessions and had better follow-up rates compared to conventional psychoeducation. Sentiment analysis of the feedback revealed a higher volume of sentiments in neuroscience-informed group. Conclusion: Neuroscience-based psychoeducation has the potential of changing perception and enhancing the credibility of CBT and can bring better acceptance and outcome for the CBT process.

Physiological activity, severity of neurotic symptoms and personality traits of patients in a psychiatric day ward in the initial and final phases of the psychodynamic psychotherapy process. Quasi-longitudinal pilot study.

Aim of the studyThe aim of the study was to explore HR (heart rate) and EDA (electrodermal activity) activity of patients in the initial and final phase of a 12-week psychodynamic psychotherapy process. The physiological data obtained were corelated with psychological variables (questionnaire results of patients).Subject or material and methodsData from 12 patients with a diagnosis of neurotic disorders and/or personality disorders were analysed. Patients were examined with the MMPI-2 (Minnesota Multiphasic Personality Inventory), KON-2006 (Neurotic Personality Questionnaire) and Symptom Checklist "O". Physiological data were collected using a galvanometer and a pulsometer.ResultsThe results of psychological questionnaires in the final phase of psychotherapy showed a reduction in symptoms in most of the scales compared to the initial questionnaires. Patients' EDA and HR scores decreased in the final phase of psychotherapy compared to the initial phase. Most of scores of personality disorder traits showed a negative correlation with EDA and a positive correlation with HR, neurotic personality traits correlated positively with EDA and negatively with HR. At the end of the psychotherapy process, a positive correlation was observed between personality traits and physiological measures.DiscussionThe obtained results suggest that psychotherapy can lower the intensity of the physiological activity of patients. Psychotherapy probably has the potential to change the direction of physiological responses of patients with personality disorder traits.ConclusionsPhysiological activity can potentially be used as an objective measure of the effectiveness of psychotherapy. The study should be repeated on a larger group of subjects to confirm the results we obtained.

Minding mentalizing - convergent validity of the Mentalization Breakdown Interview.

Mentalizing difficulties are central to borderline personality disorder (BPD), have severe consequences, and are an explicit focus in mentalization-based treatment. The significance of mentalizing capacity as a predictor or mediator of change is however still uncertain due to a scarcity of research. The Mentalization Breakdown Interview (MBI) was developed as a time saving tool for studying psychotherapy processes and outcome in borderline pathology. This study aimed to investigate the convergent validity of reflective functioning (RF) ratings based on the MBI (MBI-RF) by a comparison with the gold standard, i.e., RF assessments based on the Adult Attachment Interview (AAI-RF). A secondary aim was to investigate how MBI-RF relates to core symptoms of BPD, levels of functional impairment and symptom distress compared with AAI-RF. Forty-five patients with BPD or significant BPD traits were included. MBI-RF and AAI-RF were rated using the Reflective Functioning Scale. Levels of MBI-RF and AAI-RF and the correlation between the measures were calculated, as well as their associations with the Difficulties in Emotion Regulation Scale, Levels of Personality Functioning-Brief Form 2.0, Work and Social Adjustment Scale, Patient Health Questionnaire, Depression, Generalized Anxiety Disorder-7, self-harm, suicide attempts, and PD diagnostics. The correlation between MBI-RF and AAI-RF was 0.79 (p<0.01), indicating high convergent validity. There were few significant associations between MBI-RF and AAI-RF and clinical measures. The study provides support for the convergent validity of the MBI as a BPD-focused RF assessment method. The MBI has the potential as a time saving, reliable and valid method to be applied in treatment research on patients with borderline pathology. The results indicate that measures of MBI-RF and AAI-RF are different from clinical symptoms. ClinicalTrials.gov ID NCT04157907.

‘AT LEAST I GET A GLIMPSE’: SOUTH AFRICAN PATIENTS' PERSPECTIVES ON GETTING TO KNOW THEIR THERAPISTS

ABSTRACTThe process of psychotherapy invites the patient to explore their mind and the mind of the other but does so in the context of a therapeutic relationship in which the therapist is at least partly unknown. This article explores how patients, unbeknown to their therapist, explore clues that may disclose some knowledge about their therapists. One route towards exploring the unknown is through the therapist's social identities. The article presents an analysis of interviews conducted with 11 patients attending a free clinic in Johannesburg, South Africa. Their process of exploring the therapist and encountering the unknown, and wondering about whether their therapist can know them, is presented. The therapist's social identities offer a ‘glimpse’ into the therapist's mind. The article offers an alternative way of approaching inadvertent self‐disclosure and invites therapists to be aware of their patients' explorations of them that may remain unknown to therapists. Social identity offers a potential vehicle for alienation but also for connection.

Validation of the Capacity for the Psychotherapy Process Scale for Use in Adolescent Patients.

Although pre-treatment assessments of the capacity for the psychotherapy process can aid in identifying patients experiencing great difficulties in therapy and in tailoring therapies for individual patients, limited information exists for adolescents. To address this gap, this study followed the World Health Organization's age standards for adolescents (younger adolescents aged 10-14 years; older adolescents aged 15-19 years), examined the psychometric properties of the Capacity for Psychotherapy Process Scale (CFPPS; mainly used for adult patients) in these two groups of adolescents, and compared their capacities for the psychotherapy process. The participants were 434 younger adolescent (mean age = 13.00 ± 1.08 years; 70.0% female) and 883 older adolescent outpatients (mean age = 16.68 ± 1.29 years; 62.3% female) at the department of psychiatry of the hospital in Guangzhou, China. The results of exploratory and confirmatory factor analyses validated the 5-factor model (motivation, belief, self-revelation, persistence, and insight) in both groups. The scale also demonstrated good internal consistency. Furthermore, the CFPPS exhibited small or no associations with pre-treatment sleep problems, depression symptoms, or anxiety symptoms but was a significant predictor of working alliance and psychological benefit in therapy. The capacity for the psychotherapy process among younger adolescents was lower than that among older adolescents. The CFPPS appears to be a reliable and validated instrument for measuring the capacity for the psychotherapy process among adolescent outpatients in China. Therapists should provide therapy tailored to the Chinese adolescents' capacity. Future studies are needed to examine the predictive utility of the CFPPS for the whole sessions of the psychotherapy.

Relația dintre stilurile de atașamente, tulburări psihologice și capacitatea de mentalizare

Attachment theory is widely regarded as one of the most significant advancements in psychology. Originally focused on early childhood development, it has expanded to offer insights into a broad spectrum of psychological disorders in adulthood. Additionally, some scholars propose that attachment theory could serve as a unifying framework in psychotherapy. If psychological disorders stem from attachment disturbances, then therapeutic interventions should theoretically impact attachment styles. However, there remains ongoing debate regarding whether attachment styles remain fixed throughout life or can adapt in response to environmental factors or psychotherapy. This theoretical study seeks to provide greater clarity on the malleability of attachment styles, the association between attachment and psychological disorders, and the examination of mentalizationa central concept in the genesis of psychological disorders. Mentalization is not only seen as a core feature of attachment styles but also as a key process in psychotherapy.

STUDY OF ARTISTIC FOLK EDUCATION AS A CONDITION FOR THE MANAGEMENT OF PEDAGOGICAL TEACHING

The article is devoted to the problem of inconsistencies in the implementation of art education in the State Standard of General Secondary Education of Ukraine. To achieve this goal, the task was set to demonstrate the importance of public art education as the basis for the education of young people. The study was conducted using the methods of theoretical, empirical research and general methods of scientific research.The article analyzes the forms of non-formal art education introduced by cultural and artistic figures in 2004. Restoring the experience of ethnic festivals and preserving the traditions of artistic families becomes the basis for the implementation of the state standard of general secondary education. The comparative analysis demonstrates the importance of combining different approaches in the formation of public education in the country, preserving the spiritual, moral and ideological positions of young people. The experience of leading artistic families in popularizing art education in the region is analyzed. The influence of prominent artists on the formation of interest in Ukrainian culture among international partners is studied. An example of the assimilation of individual experience of artists to the challenges of life is given.The conclusions summarize the importance of combining art and public education for the formation of key competencies, harmonious personal development, and the reproduction of the sacred meaning of art education. It has been shown that the art education sector has a number of gaps in its implementation and future development. The task of the teacher is to develop the spiritual and psychological spheres of the individual; actualization of historical, cultural, artistic or ethnographic influence; formation of skills to look for hidden meaning in the language of art: understanding the non-verbal dialogue with the author, learning to decipher the composition code and learning to understand the principle of the universe, the laws of the world continuum through art; creating parallels during lessons, trying to fill the entire educational space with art (musical minutes during breaks, musical accompaniment during intellectual tasks, the use of stimulating visual content in the space of the educational institution, visiting the workshops of artists and sculptors, holding master classes in museums), which enhances informal education.It is assumed that the creation of an artistic educational product should have a gender aspect in the popularization of influence, the economic background that always surrounds the student and determines his or her artistic and aesthetic preferences. A successful combination of didactic tools of influence and the achievements of Ukrainian folk art can become a source for implementing a comprehensive process of psychotherapy for young people in the context of war and postwar.

Mental Flexibility and Epistemic Trust Through Implicit Social Learning - A Meta-Model of Change Processes in Psychotherapy With Personality Disorders.

This position paper follows the call for transtheoretical meta-models of general clinical change by concentrating on severe mental illness such as Personality Disorders (PDs). We have identified a core process of change related to mental flexibility through implicit learning and propose recommendations for stance and technique that are informed by research on Mentalization-Based-Treatment (MBT) and the learning components as represented in the Mediational Intervention for Sensitizing Caregivers (MISC). While the idea of corrective emotional experience as a general change mechanism involves discriminating between an old and new relationship to update relationship knowledge, the capacity to understand and process corrective emotional experiences may be limited and even iatrogenic in patients with PDs. By integrating MBT and MISC, a meta-model of change is created that allows training in and observation of the granular-level, behaviorally anchored, actions taken by the therapist to open up social learning. Here, social learning is conceptualized as epistemic trust, increasing the client's reflective functioning during sessions to ultimately enhance cognitive flexibility outside the therapy room. This opens the possibility to implement and observe micro changes in what should be termed now implicit cognitive and emotional corrective experiences. Thus, we propose to shift towards implicit learning within professional relationships; that is, internalizing a new way of thinking about any life-event that requires adaption thereby creating adaptive capacities via mental flexibility as the general change mechanism of Personality Disorder (PD) treatment.

Changes in mentalization in patients with personality disorders during sequential brief-Adlerian psychodynamic psychotherapy: The role of therapists' technique and countertransference.

The aim of the present work was to study the relationship between therapists' technique, therapists' CT, and patients' mentalization, in a sample of patients with PDs undergoing a 40-session program of sequential brief-adlerian psychodynamic psychotherapy, a psychodynamic therapeutic model specifically developed for the treatment of PDs in public mental health services. Eighty-seven patients with PD and their therapists completed ratings of mentalization (mentalization imbalances scale and reflective functioning questionnaire), CT (therapist response questionnaire), and therapists' intervention (comparative psychotherapy process scale) at five different time points (Sessions 5, 10, 20, 30, and 40). Results showed that patients' mentalizing problematics decreased over time. Moreover, we found a reduction of therapists' disengaged CT, and an increase in positive CT over time. Regarding therapists' techniques, psychodynamic-interpersonal interventions were on average higher than cognitive-behavioral, but both techniques were used increasingly over time. Our results also showed significant and clinically coherent interactions between therapist's CT and techniques and between patient's mentalization imbalance and therapist's response. Our results highlighted the importance of early stages in therapy, since the most significant relationships between the various process variables (patient's mentalizing imbalances, therapist's techniques, and emotional responses) are observed between t₁ and t₂, corresponding to the initial phases of the treatments. Clinical implications will be discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

(O-30) ONLINE GROUP THERAPY ASSOCIATED WITH PAROXETINE HYDROCHLORIDE FOR COMPULSIVE SEXUAL BEHAVIOR DISORDER´S TREATMENT: A CASE REPORT

Abstract Compulsive Sexual Behaviour Disorder (CSBD) is characterized in ICD-11 as a persistent inability to control intense sexual urges resulting in repetitive sexual behaviours and negative effects in personal life. Due to the limited research on CSBD´s treatment, our goal is to report a successful case of 39-year-old symptomatic male patient, treated in a structured closed online group focused on self and CSBD´s knowledge, new habits acquisition, particularities of these patients´ profile, associated with medication use. Method the information in this report were obtained through patient interviews, psychiatric and psychological records and literature review. The treatment took place in an outpatient service specialized in sexuality at a public institution. Following CSBD diagnosis, Paroxetine Hydrochloride (20mg/day) was prescribed with regular psychiatric follow-ups. And was referred to an online psychotherapy group consisting of 4 CSBD participants, 2 therapists, weekly 1-hour sessions held for 10 months. The therapy addressed pertinent issues to the treatment and utilized neuropsychoeducational sessions to establish new habits, along with reflective “homework” tasks. Results Psychotherapeutic treatment enhanced self-knowledge leading to a loss of meaning to his compulsive behaviours, therefore, a decrease in its frequency. The patient developed a healthy sexuality, free from guilt and risky behaviours, improved emotional management and diversified interests. Paroxetine Hydrochloride (20mg/day) facilitated the psychotherapy process (10 months), allowing gradual dosage reduction upon symptom alleviation. Conclusion The combination of themed online group psychotherapy, a well-established group bond, neuropsychoeducation, and medication effectively addressed CSBD symptoms, enhanced emotional management, and improved quality of life. The positive outcome encourages future research into this treatment approach for CSBD. Financing No conflict.