Psychotherapy Approaches Research Articles

A Qualitative Study of Buddhist Counseling on Traumatized Clients: Counseling Practices of Seven Experienced Buddhist Counselors

In the past decade, a number of contemporary psychotherapy approaches for trauma have extracted Buddhist ideas and practices into their treatment models. However, there has been growing criticisms that are primarily rooted in the concern that these practices have been taken out of their original Buddhist context, necessitating the implementation of holistic Buddhist knowledge among mental health professionals. In response, this qualitative study aims to explore the treatment of traumas by utilizing a Buddhist counseling approach that incorporates the wisdom and principles of Buddhism. Seven experts with advanced training in Buddhism and experiences in Buddhist counseling for trauma were interviewed. The results indicate that Buddhist counseling facilitates the development of concentration, enabling clients to cultivate wisdom in addressing their rigid attachment to self-identity or self-notion. Various specific Buddhist counseling interventions were discussed. Initially, the research question aimed to explore the Buddhist conceptualization of trauma. However, the participants encountered difficulties in understanding the Western construct of trauma. To them, trauma was simply suffering associated with concepts such as grief, loss, and challenging life experiences

Anksiyete Bozukluklarında Kişilik Örgütlenmesi: Yaygın Anksiyete Bozukluğu ve Panik Bozukluğu Karşılaştırılması

The objective of this study was to explore the level of personality organization in patients diagnosed with generalized anxiety disorder (GAD) and panic disorder (PD). The study comprised 86 patients undergoing treatment for GAD (n=46) and PD (n=40). Various tools were utilized for data collection including a Sociodemographic Data Collection Form, Personality Organization Diagnostic Form (PODF), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI). A significant difference was observed between the GAD and PD groups regarding the PODF scores for mature defense, anxiety, and depression. However, no significant difference was observed in relation to the PODF identity total score and primitive defense scores. Furthermore, the quality of object relations and the overall level of personality organization according to the PODF did not display any significant differences between the groups. According to the BDI, comorbid depressive symptoms were detected in 67.4% (n=58) of the participants with GAD and PD. There was no significant difference in the PODF scores, quality of object relations, and the overall level of personality organization between the group with comorbid depressive symptoms and the group without it.These findings suggest that while the primary focus of therapeutic interventions should be on targeting the specific type of anxiety disorder, assessing the level of personality organization in patients with GAD and PD could add valuable insights to individual case understanding, selection of psychotherapy approaches, and the treatment process..

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.

“Is my culture influencing me?”: Client experiences of mental illness and psychotherapy in a transitional Indian culture

The client therapy experience has been the focus of many bodies of literature in psychotherapy, even across cultures. While researchers have emphasized on the use of indigenous approaches in Indian psychotherapy, how much of this is applicable in the present scenario? The experience has become increasingly tricky to understand given the complexities arising from the influence of urbanization and westernization. Thus, the present study aimed to explore the experience of mental illness and psychotherapy in modern day India. Using the integrated, holistic idea of the person and their needs, the study conducted semi-structured interviews with ten cis-gender, urban Indian participants between 21 and 39 years of age. Data analysis using thematic analysis uncovered the global theme of “Transitional Culture Impacting the Therapeutic Experience.” The major organizing themes and basic themes have been elaborated as well. In essence, the study concludes that the increased awareness and acceptance of psychotherapy in urban India, combined with the exposure to Western methodologies, may be related to an increase in the expectations for similar therapeutic services. Implications and recommendations have been discussed.

The Evolution of Islamic Counseling: A Bibliometric Analysis of Trends in Publications from 1981-2023

The objective of Islamic counseling is to focus on incorporating religious values into therapy, offering valuable guidance for individuals who are grappling with psychological and social problems. Therefore, this study aimed to examine the trends in Islamic counseling publications from 1981 to 2023. A qualitative bibliometric method was used to collect data from Scopus database on August 25, 2023. Approximately 244 relevant papers were identified as the sample used for the analysis. Data analysis was conducted using software such as Openrefine-3.6.0, VOSviewer 1.6.18, and Biblioshiny R The results showed that the highest topic trend was recorded in 2020, with 26 citations. Beekun and Badawi held the highest position with a combined score of 281 in terms of publication. Additionally, Rothman, A. and Tahlil, T. were the authors who made significant contributions to the field, each with 4 documents. This study examined 6 clusters, discussing the keywords associated with Islamic counseling. The keywords consisted of the Development of Mental Well-being in Adults through Counseling, Ethics, Morality, and Human Rights in Education and Public Awareness. Furthermore, they included Controlled Human Studies with Gender Type Factors, Treatment of Depression with an Islamic Psychotherapy Approach, Health Services for the Elderly Muslim Community, and Islamism's Influence in Alleviating Poverty through Religious Aspects.

The effectiveness of gratitude intervention in reducing negative emotions in sexual abuse victims

Gratitude therapy is a positive psychotherapy approach given to victims of sexual abuse to generate positive thinking by expressing gratitude to the environment, God and other people. This research aims to test gratitude intervention as a religious activity undertaken to reduce negative emotions in victims of sexual abuse. A total of 104 such victims were identified using the snowball sampling method who were divided into an experimental group (N=52) and a control group (N=52). They were diagnosed as having negative emotions based on the child Trauma Questionnaire Shot-Focus (CTQ-SF) and Gratitude Questioner-6 (GQ-6) with triple ANOVA data analysis. The study’s results demonstrate a significant influence of gratitude on negative emotion, with values of F(39,037) = 4.71, p .01, and ηp2 = 0.113. It can increase feelings of gratitude and reduce negative emotions in victims of sexual abuse. Gratitude therapy helps reduce negative emotions and foster positive emotions amongst such victims. The study could be implemented in people who experience negative emotions related to clinical and non-clinical disorders.

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

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

Treating major depression using internal cohesion psychotherapy: A case report

Major depression is the most prevalent mental illness, often treated using different psychotherapy approaches. In this case study, we present a comprehensive account of the intervention process based on the principles of internal cohesion psychotherapy (ICP). We describe the case of a 26-year-old woman from Kosovo who was diagnosed with severe major depression and subsequently engaged in 11 ICP sessions. The ICP intervention mainly focused on the client’s relationship with four systems, corresponding to the core elements of ICP: Intrapersonal, interpersonal, professional, and spiritual, considering three time points – the past, the present, and the future. The second evaluation, conducted during the eleventh session of ICP, found minimal depressive symptoms in the patient. This case study contributes to the ongoing discourse on the effectiveness of ICP as an eclectic approach in the treatment of major depression.

Process-based approach in psychotherapy

ZusammenfassungDer prozessbasierte Therapieansatz stellt ein neues Konzept der Diagnostik, Therapieplanung und zum Therapieprozess dar. Im Zentrum des Verständnisses von psychischen Störungen steht die Auffassung, dass die „Ursache“ psychischer Störungen nicht etwa auf latente „Krankheiten“ zurückgeführt wird, sondern diese in dynamischen Netzwerken von psychischen Prozessen eines Individuums gesehen wird. Durch Erfassung von Variablen in Alltagssituationen, die im individuellen Fall relevant sind, sollen solche zentralen Faktoren („Knoten“), die maladaptive Netzwerke aus sich wechselseitig beeinflussenden Störungsprozessen aufrechterhalten, identifiziert werden. Aus der konkreten Erfassung von störungsrelevanten Prozessen im Problemkontext lassen sich individuell relevante Ansatzpunkte für evidenzbasierte Interventionen ableiten; diese verändern das maladaptive Muster des Störungsnetzwerkes und fördern adaptivere Erlebnis- und Verhaltensweisen. Zusätzlich sind die Interaktionsprozesse in der therapeutischen Beziehung zu berücksichtigen und auf die individuellen Bedürfnisse der Patient*innen anzupassen. Im vorliegenden Beitrag werden auch die gegenwärtig noch offenen Fragen bei der Anwendung prozessbasierter Therapie in der therapeutischen Praxis behandelt.

Cognitive behavioural therapy for psychosis: The end of the line or time for a new approach?

Following its introduction in the early 1990s, cognitive behavioural therapy for psychosis (CBTp) has been evaluated in a large number of clinical trials and is now established as a recommended treatment in the UK National Health Service and elsewhere in the world. Meta-analyses, however, indicate modest effects compared to treatment as usual or comparison therapies such as supportive counselling. Here, we seek to identify factors impacting the effectiveness of CBTp, and avenues for future psychotherapy research that may improve outcomes. We outline two recent umbrella reviews and discuss factors likely to impact the effectiveness of CBTp. Modest effect sizes from meta-analyses mask heterogeneous outcomes, with some people benefiting and others possibly being harmed by therapy. Common factors such as the therapeutic alliance play an important role in determining outcomes but have been largely neglected by CBTp researchers. There is also the promise of improving outcomes by identifying and targeting the psychological mechanisms that either maintain psychotic symptoms (e.g. worry) or are causally implicated (e.g. trauma). It is unlikely that everyone with psychosis will be equally responsive to the same therapeutic protocols. We need a new, personalised psychotherapy approach to CBTp research and practice, and can learn from research for anxiety and depression examining predictors of therapeutic response to inform treatment decisions. Precision psychological therapies informed by a combination of individual characteristics, common factors and a focus on specific mechanisms will require new research strategies and are likely to lead to improved outcomes for people with psychosis.

Guilt and Shame As a Result of Violating Beliefs: “Moral Injury”

This study on moral injury, which has a content as old as the history of humanity, is believed to contribute significantly to the relevant literature. Despite the limited number of sources in the literature on the subject, which are mostly related to veterans with war experience or limited to the field of religious psychology, this study is expected to fill the gap and provide valuable insights. The study attempted to clarify the distinction between moral injury, which involves a psychological injury caused by a dilemma, and post-traumatic stress disorder, which shares similar features with moral injury and arises after experiencing a traumatic event. As part of this study, psychotherapy approaches within the scope of interventions for the symptoms of moral injury were also included and the issue was tried to be addressed from a mental health perspective. In this context, “mindfulness-oriented meditation”, “self- compassion”, “spiritually-oriented counseling”, and “work focused on forgiving oneself and others”, whose effectiveness has been tested, are included. The issue of moral injury was addressed with psychology- spirituality dimensions; the scope of the study was further expanded with intervention-treatment titles. This study summarizes moral injury’s conceptual framework and focuses on interventions and treatment approaches. As a result, the concept of moral injury was addressed holistically and contributed to the conceptual framework.

Models of the Self: The Potential for Developing and Enhancing of Subjectness of Self

The paper presents a distinctive experience of dialogue between two researchers that is comprised of the creative synthesis of their original concepts of Subjectness of Self and ways of enhancing it. Here, the dialogical interaction of scientists is manifested not in academic controversy, but in “integrating”, or connecting, the researchers’ concepts related to a common study object and providing profound insight into this object that is unattainable outside of dialogue. The problems solved by the researchers are associated, firstly, with a new reflection on their relevant research; secondly, with the development of the scientific theory of the Self of Personality; thirdly, with substantiating the possibility of achieving “creative consistency”, or “creative partnership” in theoretical research; and, fourthly, with demonstrating the significance of scientific dialogue in psychology of personality as the art of aligning researchers’ standpoints for the benefit of human cognition. The purpose and original result of the dialogical integration of the presented concepts was deeper and more expanded knowledge about the structure of Self the Subject, about the properties of the Self that determine its subjectness, about the Unknown Self and the active attitude of the personality towards it, about self-identity of the Self and ways to achieve it, and about the self-causality of the Self and methods of its empirical research. The method of conceptual analysis and synthesis, the method of hermeneutics, and reflexive and phenomenological methods were applied for searching, operating and revealing knowledge about the Self and its subjectness. The dialogue was within the space of general personology, a trend in the study of personality that was founded by the researchers. It presupposes the unity of cultural-hermeneutic, theoreticalempirical, practical and self-positing approaches in research, counseling and psychotherapy of personality. The dialogue has resulted in the development of a new field of science, personology of Self. The paper contains the voices of both the authors and all those who have inspired their views and ideas.

Improving mental well-being in psychocardiology-a feasibility trial for a non-blended web application as a brief metacognitive-based intervention in cardiovascular disease patients.

Many patients with cardiovascular disease also show a high comorbidity of mental disorders, especially such as anxiety and depression. This is, in turn, associated with a decrease in the quality of life. Psychocardiological treatment options are currently limited. Hence, there is a need for novel and accessible psychological help. Recently, we demonstrated that a brief face-to-face metacognitive therapy (MCT) based intervention is promising in treating anxiety and depression. Here, we aim to translate the face-to-face approach into digital application and explore the feasibility of this approach. We translated a validated brief psychocardiological intervention into a novel non-blended web app. The data of 18 patients suffering from various cardiac conditions but without diagnosed mental illness were analyzed after using the web app over a two-week period in a feasibility trial. The aim was whether a non-blended web app based MCT approach is feasible in the group of cardiovascular patients with cardiovascular disease. Overall, patients were able to use the web app and rated it as satisfactory and beneficial. In addition, there was first indication that using the app improved the cardiac patients' subjectively perceived health and reduced their anxiety. Therefore, the approach seems feasible for a future randomized controlled trial. Applying a metacognitive-based brief intervention via a non-blended web app seems to show good acceptance and feasibility in a small target group of patients with CVD. Future studies should further develop, improve and validate digital psychotherapy approaches, especially in patient groups with a lack of access to standard psychotherapeutic care.

Eco dance movement psychotherapy (EDMP) and queer embodied kinship with the more than human world

This article interweaves personal and professional experiences of embodied encounters with the more-than-human world. It presents ideas around the benefits of an eco-dance movement psychotherapy (EDMP) approach, particularly emphasising queer experiences and perspectives, interweaving perspectives which situate both embodiment and the climate crisis to be deeply entangled in social and political issues. I will consider how an EDMP approach can disrupt and support the unmaking of these embodied scripts and how situating the body as an embodied ecology can offer new ways of thinking, feeling, perceiving and imagining in kinship with the more human world. Dance movement psychotherapy (DMP), with its attention to the embodiment, felt sense, and relationship, can offer us a radical way to emotionally wake up to our interrelation to the more than human earth.

The effects of psychological flexibility and resilience on psychopharmacological treatment response in patients with obsessive-compulsive disorder.

Obsessive-compulsive disorder (OCD) is a challenging psychiatric condition to treat. Previous research has explored various aspects of treatment response, but limited attention has been given to the significance of psychological flexibility and resilience. This study aimed to investigate the correlation between psychological flexibility, resilience, and different dimensions of OCD, as well as their role in treatment response specifically concerning OCD symptom sub-dimensions. The study involved 50 OCD patients and 42 healthy individuals as controls. Participants completed the Dimensional Obsessive-Compulsive Scale (DOCS), Acceptance and Action Questionnaire (AAQ-2), and Resilience Scale for Adults (RS). Initial scale scores were compared to post-treatment scores obtained after a 3-month follow-up using pharmacotherapy. The patient group exhibited significantly higher AAQ-2 scores and lower RS scores compared to the control group. During the post-treatment follow-up, a reduction in DOCS and AAQ-2 scores was observed, along with an increase in RS scores. The impact of differences in AAQ-2 and RS scores on the change in DOCS total scores was analyzed using mixed model linear regression analysis. The results showed a statistically significant effect of changes in AAQ-2 and RS sub-dimension scores on the change in DOCS total scores. The findings highlight the importance of flexibility and resilience in influencing treatment response among patients with OCD. When conventional pharmacotherapy and psychotherapy approaches prove insufficient, interventions focused on enhancing flexibility and resilience may contribute to improved treatment outcomes.

Pre-treatment amygdala activation and habituation predict symptom change in post-traumatic stress disorder.

Trauma-focused psychotherapy approaches are the first-line treatment option for post-traumatic stress disorder (PTSD); however, up to a third of patients remain symptomatic even after completion of the treatment. Predicting which patients will respond to a given treatment option would support personalized treatments and improve the efficiency of healthcare systems. Although previous neuroimaging studies have examined possible pre-treatment predictors of response to treatment, the findings have been somewhat inconsistent, and no other study has examined habituation to stimuli as a predictor. In this study, 16 treatment-seeking adults (MAge = 43.63, n = 10 women) with a primary diagnosis of PTSD passively viewed pictures of emotional facial expressions during functional magnetic resonance imaging (fMRI). After scanning, participants rated facial expressions on both valence and arousal. Participants then completed eight weekly sessions of prolonged exposure (PE) therapy. PTSD symptom severity was measured before and after treatment. Overall, participants showed symptomatic improvement with PE. Consistent with hypotheses, lesser activation in the amygdala and greater activation in the ventromedial prefrontal cortex during the presentation of fearful vs. happy facial expressions, as well as a greater decline in amygdala activation across blocks of fearful facial expressions at baseline, were associated with greater reduction of PTSD symptoms. Given that the repeated presentation of emotional material underlies PE, changes in brain responses with repeated stimulus presentations warrant further studies as potential predictors of response to exposure therapies.

Positive Psychotherapy and Art

Art therapy and positive psychotherapy have common points of contact, but differ significantly in their respective theoretical and practical concepts. Both are independent therapeutic methods that require extensive training or further education. Art therapy works preferably with artistic media, whereby psychodynamic processes are integrated depending on the therapeutic orientation. Conversely, Positive Psychotherapy has related approaches in a distinct form to art therapy. This applies above all to the creative process of the procedure. Both methods overlap at the point where psychological conflicts are expressed through artistic means or stories. While artistic therapies focus on this process, Positive Psychotherapy is a psychotherapeutic procedure in its own right. In this article, the approach to art therapy is presented against the background of the resource-oriented practice and theoretical approaches of Positive Psychotherapy.

Microaggressions as a Symptom: Understanding and Addressing Subtle Hostility in Positive Psychotherapy

This article examines the history, complexity, and psychotherapeutic approaches to microaggressions, everyday verbal, nonverbal, or environmental slights that convey hostile messages to marginalised individuals. The concept traces back to the works of Derald Wing Sue, with microaggressions often related to discrimination, stereotypes, and prejudices, causing psychological harm. The Positive Psychotherapy (PPT) approach uniquely addresses microaggressions by transforming negative experiences into opportunities for personal development. The article further delves into the interconnectedness of aggression and microaggressions in contemporary society, highlighting the influence of power dynamics, capitalism, and critical social theories. Methodological recommendations and mindfulness-based interventions are also discussed, emphasising self-awareness, non-judgmental acceptance, emotional regulation, empathy, and cognitive flexibility. Addressing microaggressions necessitates a collaborative effort to promote understanding, empathy, and respect for diversity and difference in all aspects of life.

IT 통합예술치료의 CERAT 단계 및 회기 내 구조 OMCA에 나타나는 6가지 심리치료 접근방식의 융합적 활용특성 고찰

The purpose of this study is to examine the convergent utilization characteristics of the six psychotherapy approaches shown in the CERAT stage of IT Integrative Arts Therapy and intra-sessional structure OMCA. As a research method, the characteristics and properties of six psychotherapy theories and each stage of IT Integrative Arts Therapy were phenomenologically analyzed and connected, and the core functions of the therapist required at each stage were derived. The conclusion is that an eclectic and Integrative·Integral Psychotherapy approach is used throughout all stages of IT Integrative Arts Therapy CERAT and OMCA, and that Gestalt, Client-centered, Adlerian Psychotherapy, Behavior Therapy and REBT Psychotherapy approaches are used in each detailed stage. In addition, the core functions and attitudes of the therapist as Moderator, Coordinator, Buffer, Expander, Mediator, Emitter, Contactor, Acceptor, Facilitator, Creator, Director, Connecter, Practice Encourager, Linker, Confirmer, and Supporter are required respectively.

0644 Poor Sleep Quality Predicts Worse Mood Symptoms in Adolescents with Bipolar Disorder: A Longitudinal Randomized Controlled Trial

Abstract Introduction Adolescents with bipolar disorder are at ultra-high risk of suicide and poor psychosocial functioning. Sleep is impaired during periods of depression, mania, and euthymia in adults with bipolar disorder and may be a transdiagnostic risk factor for new onset of mood symptoms. Sleep worsens during adolescence, but less is known about the interrelationships between poor sleep and mood symptoms in adolescents with bipolar disorder. Methods Participants included adolescents with bipolar disorder (n=75, 12-18 years, 65 females) who consented to a randomized controlled trial of Dialectical Behavior Therapy (DBT) vs. Standard of Care (SOC; other evidence-based psychotherapy approaches) at a specialty psychiatric clinic. Participants completed seven assessment visits, five during the year-long treatment period (baseline, 3-months, 6-months, 9-months, 12-months) and two during the post-treatment follow-up (18-months, 24-months). During each visit, participants completed the Pittsburgh Sleep Quality Index (PSQI) and a semi-structured interview to obtain weekly clinician-rated mood symptom ratings for depression, hypomania, and suicidal ideation. Results Most participants (75.9%) had a PSQI score >5 at baseline, reflecting poor sleep quality (M=8.86, SD=4.30). Sleep quality improved between baseline and 3-months (Mdiff=-2.01, p=.006) and remained stable thereafter but did not differ between treatment groups. Lag analyses examined whether sleep quality predicted the next month’s average mood symptom ratings. Across treatment group, sleep quality at 6-months predicted next month depression, hypomania, and suicidal ideation severity (ps<.032). For DBT, sleep quality at baseline predicted next month suicidal ideation severity (p=.047), and sleep quality at 9-months predicted next month hypomania severity (p=.003). For SOC, sleep quality at 6-months predicted next month depression severity (p=.027), and sleep quality at 9-months predicted next month suicidal ideation severity (p=.005). Worse sleep quality predicted worse future mood symptoms for all significant lagged effects. Conclusion Sleep quality is poor among adolescents with bipolar disorder. Sleep quality predicted future mood symptoms, suggesting that poor sleep may causally contribute to worse mood symptoms, particularly mid to late treatment. Thus, poor sleep could be a critical therapeutic target in future treatments to further improve mood symptoms in this population. Support (if any) R01 MH100056.