Psychotherapy For Patients Research Articles

Frequencies and Predictors of Negative Effects in Routine Inpatient and Outpatient Psychotherapy: Two Observational Studies.

Negative effects of psychotherapy (NEP) include side effects, malpractice, and unethical behavior. Its setting-specific frequencies and predictors are mostly unknown. The two presented studies aim to investigate NEP and its predictors systematically across different treatment settings. In study 1, N = 197 patients of a German outpatient center were recruited, on average, 3.76 years after the termination of psychotherapy. In study 2, data from N = 118 patients of two German inpatient clinics were collected at admission (t0), discharge (t1), and 9-month follow-up (t2). All participants evaluated the negative effects of their previous out- or inpatient psychotherapy with the Inventory for the Balanced Assessment of Negative Effects in Psychotherapy and a priori hypothesized predictors. At least one side effect was reported by 37.3% of inpatients (t2) and 15.2% of outpatients. At least one case of malpractice and unethical behavior was reported by 28.8% of inpatients (t2) and 7.1% of outpatients. Inpatients reported significantly more side effects (U = 14347, z = 4.70, p < 0.001, r = 0.26) and malpractice and unethical behavior (U = 14168, z = 5.21, p < 0.001, r = 0.29) than outpatients. Rates of severe malpractice in the form of breaking confidentiality and physical and sexual abuse were less than 1% in both settings. Predictors of side effects were prior experience with psychotherapy and current interpersonal difficulties in the outpatient setting and higher motivation for psychotherapy (t0) in the inpatient setting. Predictors of malpractice and unethical behavior were younger age in the outpatient setting and poor therapeutic alliance, prior negative experience with malpractice and unethical behavior, and higher outcome expectations in the inpatient setting. NEP are common in both, in- and outpatient settings. Inpatients are at higher risk for the NEP than outpatients. To safeguard patients’ wellbeing, the systematic assessment and distinction of side effects and malpractice and unethical behavior should gain more attention in research and clinical practice.

Predictors of outcome during inpatient psychotherapy for posttraumatic stress disorder: a single-treatment, multi-site, practice-based study

Objective: The aims of this study were to determine the effectiveness of a routine clinical care treatment and to identify predictors of treatment outcome in PTSD inpatients. Methods: A routinely collected data set of 612 PTSD inpatients (M = 42.3 years [SD = 11.6], 75.7% female) having received trauma-focused psychotherapy was analyzed. Primary outcome was the clinical symptom severity change score, secondary outcomes were assessed using functional, anxiety, and depression change scores. Hedges g-corrected pre–post effect sizes (ES) were computed for all outcomes. Elastic net regulation as a data-driven, stability-based machine-learning approach was used to build stable clinical prediction models. Results: Hedges g ES indicated medium to large effects on all outcomes. The results of the predictor analyses suggested that a combined predictor model with sociodemographic, clinical, and psychometric variables contribute to predicting different treatment outcomes. Across the clinical and functional outcome, psychoticism, total number of diagnoses, and bronchial asthma consistently showed a stable negative predictive relationship to treatment outcome. Conclusion: Trauma-focused psychotherapy could effectively be implemented in a routine inpatient setting. Some important prognostic variables could be identified. If the proposed models of predictors are replicated, they may help personalize treatment for patients receiving routine clinical care.

To Be or Not to Be Improved: Patients’ Perception of Symptom Improvement – Linking the SCL-90-R to Patient-Rated Global Improvement in a Large Real-World Treatment Sample

Introduction: From both a clinical and research perspective, it is important to determine what constitutes a perceivable change in commonly used outcome measures. Objective: We aimed to do so for the Symptom Checklist-90-Revised (SCL-90-R). Methods: Patients from a large real-world sample treated with inpatient psychotherapy (n = 4,791) rated improvements in symptoms on a global 5-point Likert scale at discharge. These ratings were related to pre-post changes in the Global Severity Index (GSI) of the SCL-90-R by use of equipercentile linking. Results: A patient rating of 5 (“clearly improved”) was found to be equivalent to an absolute pre-post difference in the GSI of 0.67 or to a percentage improvement of 54%, with the latter corresponding to the common definition of response as a 50% reduction in symptoms. A rating of 1 (“clearly worse”) was equivalent to an increase in the GSI >0.50 and to a percentage worsening >55%. “Slightly improved” or “slightly worse” (ratings of 4 or 2) corresponded to pre-post changes in the GSI of 0.07 and 0.50. For severely disordered patients, larger changes were required for ratings of improvement, and for less severely disordered patients, larger changes were required for ratings of worsening. Results for depressive, anxiety, and personality disorders were widely consistent with those of the total sample. Conclusions: This study is the first to link patient ratings of improvement or worsening to changes in the SCL-90-R. Results are relevant to both the interpretation of changes in individual patients and of effect sizes in outcome research. Results require replication.

The importance of sociodemographic characteristics of psychotherapy patients in institutional conditions on the Balkan territory.

The effects of psychotherapy are proven, compelling and far-reaching. The aim was to evaluate sociodemographic characteristics and clinical diagnosis of psychotherapeutic patients who were treated at the Institute of Mental Health in Belgrade. Retrospective clinical study was composed of 334 patients. Patients data related to the gender, age, education, employment, marital status and clinical diagnose were processed by descriptive statistics methods and chi-square test. Psychotherapy services were mostly used by female patients (64.1%), aged 30 to 39 years, majority finished secondary school (47.6%) and were employed (54.8%). Half of the patients were single (49.7%) with unipolar depressive non-psychotic disorder (60.5%). The research of this kind and with this volume of patients, coming from institutional conditions, has never been done among Balkan nationalities and thus represent encouragement for future studies.

Psychometric properties of the Session Rating Scale 3.0 in a Spanish clinical sample

ABSTRACT The Session Rating Scale 3.0 (SRS 3.0) is an ultra-brief measure of the therapeutic alliance, frequently used to provide feedback to the clinician during the therapeutic process (Prescott et al. [2017]. Feedback-informed treatment in clinical practice. Reaching for excellence. American Psychological Association (APA). http://www.apa.org/pubs/books/4317449.aspx). This study describes the psychometric properties of the SRS 3.0 in a Spanish clinical sample of 165 adult psychotherapy patients from different primary care centres of Barcelona (Spain). Results show the measure has good reliability and good convergent and predictive validity. The results are consistent with the findings from studies done in other countries. In summary, the instrument appears to be a valid and reliable tool for monitoring therapeutic alliance during the course of psychotherapy with Spanish-speaking patients. Additional research with the SRS 3.0 in Spanish could provide more evidence of its psychometric properties.

Effectiveness of Inpatient Psychotherapy for Patients With and Without Migratory Background: Do They Benefit Equally?

BackgroundResearch on the effectiveness of inpatient psychotherapy for migrant patients predominantly concludes that they have greater symptom severity at admission and benefit less from psychotherapy. This study aims to compare symptom severity and effects of psychotherapy regarding depression, somatoform disorders, anxiety disorders, and posttraumatic stress disorder (PTSD) in a sample of patients with and without migratory background (MB).MethodsSymptom severity of 263 patients (T0, pretreatment) and 256 patients (T1, posttreatment) was assessed using the Patient Health Questionnaire somatization module (PHQ-15), depression module (PHQ-9), and general anxiety disorder module (GAD-7), and the PTSD Checklist (PCL-5). Calculations were made for a completer sample and an intention-to-treat (ITT) sample. To investigate the effectiveness of psychotherapy, we calculated effect sizes (Cohen's d) and clinically significant changes using the reliable change index (RCI).ResultsPatients with MB showed significantly higher symptom burden at admission for somatization (p = 0.025, d = 0.345) and posttraumatic symptoms (p = 0.008, d = 0.424) than patients without MB. At discharge, patients with MB reported significantly higher severity regarding all assessed symptoms (somatization: p = 0.001, d = 0.507; depression: p = 0.045, d = 0.313; anxiety: p = 0.012, d = 0.428; traumatization: p = 0.040, d = 0.329) compared with non-migrant patients. Patients without MB improved significantly regarding all assessed symptoms (somatization: p < 0.001, d = -0.304; depression: p < 0.001, d = -0.692; anxiety: p < 0.001, d = -0.605; posttraumatic symptoms: p < 0.001, d = -0.204). Patients with MB improved significantly concerning depression (p < 0.001, d = -0.649) and anxiety (p = 0.002, d = -0.441). Occurrence of comorbidity was high (87.1% had more than one psychiatric diagnosis). Neurotic, stress-related, and somatoform disorders (F4) and personality disorders (F6) were more frequent among patients with MB.ConclusionsPatients with MB showed higher symptom severity at admission. Our study demonstrated a significant reduction of depressive and anxiety symptoms among patients with MB receiving psychotherapy. Further research is needed to identify interventions that effectively improve somatization and posttraumatic stress for patients with MB, since these symptoms were not significantly reduced.

Changes in the level of personality functioning in inpatient psychotherapy

Background: The model of Operationalized Psychodynamic Diagnosis and the model of Personality Organization influenced the concept of the Level of Personality Functioning (LPF) in DSM-V. The LPF is becoming a key variable for diagnostics, treatment and outcome measurement, but there are few studies which integrate the LPF in the study design. This study pursues to expand this body of knowledge by investigating the research question: would an inpatient psychotherapy lead to significant improvements in the LPF? Methods: The study included 156 inpatients at the Psychiatric Hospital Münsterlingen, Switzerland. Exclusion criteria were aggression, psychosis, mental retardation, and participation in another study. The LPF was measured with the Operationalized Psychodynamic Diagnosis—Structure Questionnaire (OPD-SQ) and the short version of the Inventory of Personality Organization (IPO-16) at admission and termination of treatment about eleven weeks later. A repeated-measures ANOVA controlled for age, symptom load, treatment duration and gender was conducted. Results: Data revealed significant, medium improvements for OPD-SQ (F(2,88) = 8.24, p < .01, = 0.09) and IPO-16 (F(2,91) = 6.09, p < .05, = 0.06) between admission and termination of psychotherapy and a different change pattern for OPD-SQ and IPO-16. Conclusion: Inpatient psychotherapy is associated with improvements in LPF.

Mental health nurses' experiences of implementing a model to facilitate self‐empowerment in women living with borderline personality disorder in South Africa

In South Africa, various treatment models from abroad have been implemented for patients diagnosed with borderline personality disorder. This report is based on a South African model that has been developed, implemented, and evaluated for mental health nurses to use in facilitating the self-empowerment of women living with borderline personality disorder. The aim of this study was to describe the implementation of a model to facilitate self-empowerment in women living with borderline personality disorder and to describe mental health nurses' experiences of implementing this model. A qualitative, exploratory, descriptive, and contextual research design was used for the study. Participants were mental health nurses working in an inpatient psychotherapy unit in a mental health hospital. Findings revealed that mental health nurses experienced the model as a secure framework to assist women living with borderline personality disorder in making a shift to being self-empowered. The mental health nurses found that they had to adapt the model's timeframe to the women's own pace. Through use of the model, the mental health nurses also gained self-leadership. This report provides evidence from mental health nurses that the model was practical and helpful in working with women living with borderline personality disorder. The mental health nurses saw signs of self-empowerment in women living with borderline personality disorder.

Standardized patients in psychotherapy training and clinical supervision: study protocol for a randomized controlled trial

BackgroundPsychotherapy is highly effective and widely acknowledged for treating various mental disorders. Nevertheless, in terms of methods for teaching effective psychotherapeutic approaches and competencies, there has been a lack of investigation. Training and supervision are the main strategies for teaching therapist competencies, and standardized role-plays with simulated patients (i.e., trained individuals playing someone with a mental disorder) seem useful for evaluating training approaches. In medical education, this procedure is now internationally established. However, so far, little use has been made of standardized role-playing to evaluate training and supervision in the area of clinical psychology and psychotherapy.MethodsIn this study, standardized role-plays are used to evaluate methods for training and supervision. Central cognitive behavioral approaches for treating depression are taught in the training. The first experiment compares an active training approach (i.e., model learning) with a passive one (i.e., reading manual-based instructions). The second experiment compares a direct supervision technique (i.e., supervision based on video analysis) with an indirect one (i.e., supervision based on verbal reporting). In each experiment, 68 bachelor’s and master’s students of psychology will be randomly assigned to the experimental and control groups. Each student takes part in three role-plays (baseline, post and 3-month follow-up), which are all videotaped. Two independent raters assess therapist competencies in each role-play on the basis of a standardized competence scale.DiscussionThe research project aims to contribute to the development of specific training and supervision methods in order to improve psychotherapy training and patient care.Trial registrationISRCTN Registry, ISRCTN19173895. Registered on 10 December 2019.

Why are some cases not on track? An item analysis of the Assessment for Signal Cases during inpatient psychotherapy

Within the Routine Outcome Monitoring system “OQ‐Analyst,” the questionnaire “Assessment for Signal Cases” (ASC) supports therapists in detecting potential reasons for not‐on‐track trajectories. Factor analysis and a machine learning algorithm (LASSO with 10‐fold cross‐validation) were applied, and potential predictors of not‐on‐track classifications were tested using logistic multilevel modeling methods. The factor analysis revealed a shortened (30 items) version of the ASC with good internal consistency (α = 0.72–0.89) and excellent predictive value (area under the curve = 0.98; positive predictive value = 0.95; negative predictive value = 0.94). Item‐level analyses showed that interpersonal problems captured by specific ASC items (not feeling able to speak about problems with family members; feeling rejected or betrayed) are the most important predictors of not‐on‐track trajectories. It should be considered that our results are based on analyses of ASC items only. Our findings need to be replicated in future studies including other potential predictors of not‐on‐track trajectories (e.g., changes in medication, specific therapeutic techniques, or treatment adherence), which were not measured this study.

Development and validation of a scale for measuring cultural beliefs about psychotherapy patients in southern Chile

PurposeNegative cultural beliefs about psychotherapy patients represent one of the barriers in the psychological help-seeking and treatment adherence. In Chile today, there is little research about specific beliefs towards this group, and therefore measuring them represents a challenge. The aim of the present study was to develop and validate an instrument to measure cultural beliefs about psychotherapy patients.MethodsA mixed method design conducted in four stages was implemented. First, 32 semi-structured interviews were carried out to identify beliefs about psychotherapy patients in southern Chile. Then, a scale of beliefs about psychotherapy patients (SBPP) was developed and piloted in an adult sample (n = 109). Subsequently, the factorial structure of the new scale was explored in patients of primary health centres in La Araucanía Region of Chile (n = 201). Finally, the validity of the construct was assessed in adults who were not undergoing psychotherapy (n = 361).ResultsThe results showed the existence of negative cultural beliefs about psychotherapy patients which were included in the construction of the SBPP. The scale had a bifactorial structure (αtransitory situations = 0.81 and αstable characteristics = 0.79), consisting of 15 items with a Likert-type response format, and showed good indicators of validity and reliability on the samples in which were applied.ConclusionsThe present study shows the importance of using mixed methods for the examination of socially shared beliefs by the cultural group under study, in order to construct instruments that are psychometrically robust and culturally pertinent.

The role of stigma during the course of inpatient psychotherapeutic treatment in a German sample.

The current study intends to investigate whether the therapeutic process is impeded by stigma and how stigma develops over the course of cognitive behavioural psychotherapy treatment. Sixty German psychotherapy inpatients were asked on a weekly basis about two facets of stigma: self-stigma and perceived public stigma. That information was linked to additional process as well as outcome variables (therapeutic engagement, working alliance, depressive, and general psychological symptoms). Both facets of stigma decreased over the course of psychotherapy, but only the decrease in self-stigma was significant. In a weekly interval, low (high) self-stigma predicted high (low) levels of working alliance and therapeutic engagement and vice versa. The current study shows that self-stigma is especially subject to change during the course of an inpatient psychotherapeutic treatment. In addition, our results point to the interrelation between self-stigma and other process variables contributing to the effectiveness and success of psychotherapy.

Impact of dual diagnosis in patients with schizophrenia and affective disorders during hospital treatment on the course of illness and outcomes of treatment - a preliminary report.

Comparison of the course of illness and functioning as well as occurrence of somatic diseases between patients with dual diagnosis, alcohol or drug addiction without mental disorders and patients with schizophrenia or affective disorders; drawing attention to the problems of people with dual diagnosis and importance of longer psychiatric inpatient treatment of this group of patients. 108 persons were examined during inpatient psychiatric treatment. Injuries, occurrence of somatic diseases, aggressive behaviors, suicidal attempts, and discharges from hospital on patients' request against medical advice were evaluated. Sociodemographic data and data associated with the course and treatment of an illness were compared between dual diagnosis group (n = 30), group of patients with mental illness (n = 41) and patients with alcohol or drug addiction (n = 37) using questionnaires designed by the authors. In the dual diagnosis (DD) group, patients more often tried to commit suicide, started to use drugs or alcohol in younger age. In this group significantly more people were before marriage or after divorce. In the DD group and the group of patients with mental disorders (C), there were significantly more patients treated in hospitals longer than 180 days during their life. No statistically significant differences were found between groups when comparing incidence of somatic diseases, injuries, discharges from hospitals on patients' request or aggressive behaviors. Due to non-compliance, frequent interruption of treatment, higher suicidal risk in the dual diagnosis group, there is a need of longer inpatient treatment in order to improve mental status, regular pharmacological treatment, provide social support, motivation, and prepare patients for psychotherapy of addiction. It is essential to take actions to create therapeutic standards of treatment and adjust financial funding for this group of patients in Poland.

The art of movement improvisation in psychotherapy. Taking dance-movement improvisation into the intersubjective field

ABSTRACTIn this article the author speaks about the use of movement improvisation within the psychotherapeutic process. Starting with a description of improvisation in the art of dance, the writer arrives to underline how movement improvisation can help both the psychotherapist and the patient in a dance movement psychotherapy’s setting. Contributions from authors from a range of disciplines help the author to put evidence on body – movement improvisation as a tool for improving the therapist’s own capacity of rêverie, giving the patient the possibility to explore non-verbal contents. Different communication codes are shared in the patient-therapist’s relationship, activating a way for a fruitful mentalisation. An example of improvisation during a session with a traumatised woman shows us how a psychobiological attunement between therapist and patient can activate moments of improvisation that contribute to the transformation from non-verbal and non-symbolic material to a symbolic way to share and communicate.

Symptom burden and work-related impairment among patients with PTSD and complex PTSD

ABSTRACT Background: The 11th revision of the International Classification of Diseases includes a new chapter of stress-related disorders and presents two distinct sibling conditions: Posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD). Studies show that PTSD and CPTSD are associated with different levels of symptom burden, comorbidity and functional impairment, but have not yet addressed the qualitative and quantitative differences in work-related impairment between the two diagnoses. Objective: The aim of this study was to replicate differences in symptom severity, global distress, and the number of comorbid diagnoses between three groups that suffer from no PTSD, PTSD, or CPTSD. More importantly, we evaluated whether the three groups differ in indicators of functional impairment such as qualitative and quantitative working capacity. Finally, this study supplies information on prevalence rates of PTSD and CPTSD in a clinical sample suffering from psychosomatic complaints. Methods: Participants were 662 patients of a Psychosomatic Rehabilitation Clinic (age M = 50.99, SD 8.99 years; 70.1% female). Self-report screening instruments were administered to participants at the beginning of their inpatient psychotherapy. Multivariate analysis of variance and Chi Square tests were utilized to assess group differences in symptom severity, comorbidity and work-related impairment. Results: A prevalence of 13.3% CPTSD and 9.5% PTSD was found among the current sample. CPTSD was associated with heightened symptom burden and more comorbid diagnoses. More importantly, CPTSD was associated with a significantly lowered qualitative and quantitative working capacity compared to PTSD and no-PTSD. Conclusions: The high prevalence, greater psychopathological burden and work-related impairments in CPTSD compared to PTSD highlight the need for developing and evaluating new interventions in rehabilitation that address the complexity of the new disorder.

Blended Psychotherapy: Treatment Concept and Case Report for the Integration of Internet- and Mobile-Based Interventions into Brief Psychotherapy of Depressive Disorders

Background: Blended psychotherapy (bPT) is a treatment that integrates internet- and mobile-based interventions into out-/inpatient psychotherapy. It can enrich the therapy by using online-based treatment modules as therapeutic extension that patients use time- and location-independently between face-to-face sessions. It could potentially improve the efficacy of psychotherapy and increase the number of treated persons through saved therapist time. The case report aims to facilitate the understanding of the blended treatment components. Case Report: A 4-month short-time depression treatment with six face-to-face therapy sessions, six online lessons, and app ratings of a 48-year-old female patient is presented based on the CARE guidelines and quantitative and qualitative measures (treatment documentation). Depressive symptoms were clinically significantly reduced (PHQ-9, 0–27: T0 = 17; T1 = 7) from a moderately severe to a subclinical-mild degree, and no diagnostic criteria were met in the 12-month follow-up diagnostic interview. The patient showed a maximum treatment satisfaction (ZUF-8, 8–32: T1 = 32) and adherence and rated the therapeutic working alliance (WAI, 12–60: T1 = 57) highly positive. Conclusion: bPT reduced depressive symptoms for this patient. Strengths of the treatment were the facilitated use of the internet-based elements with a full-time job and the individualization within the face-to-face sessions through the therapist. Treatment success was limited by the predetermined six sessions, which hindered addressing all topics and conducting relapse prevention.

Application of group psychotherapy in young and middle-aged patients undergoing maintenance hemodialysis

Objective To explore the effects of group psychotherapy on posttraumatic growth (PTG) , anxiety and depression of young and middle-aged patients undergoing maintenance hemodialysis (MHD) and to provide a reference for improving patients' PTG and reducing their negative emotion. Methods Totally 78 patients with end-stage renal disease undergoing regular hemodialysis in the Hemodialysis Center of a Class III Grade A hospital in Harbin between April and December 2018 were selected by convenient sampling and randomized divided into control (n=38) and experimental (n=40) groups. Patients in the control group received conventional nursing care and follow-up visits, while patients in the experimental group underwent group psychotherapy for 2 months. Chinese Posttraumatic Growth Inventory (PTGI) , Self-Anxiety Scale (SAS) and Self-Depression Scale (SDS) were used to assess PTG, anxiety and depression of the two groups before and after intervention. A t test was conducted to compare the scores before and after intervention. Results At last, a total of 36 patients in the experimental group and 37 patients in the control group completed the study. After group psychotherapy, the PTGI score of the experimental group was (85.89±11.02) , higher than (73.55±9.14) of the control group, and there was statistically significant difference between the two groups (P<0.05) . The SAS and SDS scores of the experimental group were (47.23±5.18) and (40.38±8.34) , lower than (55.38±6.28) and (44.16±7.09) of the control group, and there were statistically significant differences between the two groups (P<0.05) . Conclusions Group psychotherapy can improve the PTG of young and middle-aged patients undergoing MHD, and reduce their anxiety and depression, which is worthy promoting in clinical practice. Key words: Dialysis; Young and middle-aged; Group psychotherapy; Posttraumatic growth; Anxiety; Depression

Improving the Course of Depressive Symptoms After Inpatient Psychotherapy Using Adjunct Web-Based Self-Help: Follow-Up Results of a Randomized Controlled Trial.

BackgroundWe recently showed in a randomized controlled trial that Web-based self-help as an adjunct improved the effectiveness of multimodal inpatient psychotherapy for depression.ObjectiveThe aims of this study were (1) to determine whether a Web-based self-help adjunctive to multimodal inpatient psychotherapeutic treatment could also improve the course of depressive symptoms and (2) to identify predictors of residual depressive symptoms at follow-up.MethodsOverall, 229 patients were randomized either to the Web-based self-help intervention group (Deprexis) or an active control group (Web-based information about depression and depressive symptoms) in addition to multimodal inpatient psychotherapy. Participants in both groups were able to access their respective Web-based programs for 12 weeks, which meant that they typically had access after discharge from the inpatient unit (mean hospitalization duration: 40 days, T1). Follow-up was performed 6 months after study intake (T3).ResultsAt follow-up, participants of the Web-based self-help group had considerably lower symptom load regarding depressive symptoms (d=0.58) and anxiety (d=0.46) as well as a better quality of life (d=0.43) and self-esteem (d=0.31) than participants of the control group. Nearly 3 times as many participants of the intervention group compared with the control group achieved remission in accordance with less deterioration. The number needed to treat based on the Beck Depression Inventory-II (BDI-II) improved over time (T1: 7.84, T2: 7.09, and T3: 5.12). Significant outcome predictors were BDI at discharge and treatment group.ConclusionsWeb-based self-help as an add-on to multimodal inpatient psychotherapy improved the short-term course of depressive symptoms beyond termination. Residual symptoms at discharge from inpatient treatment and utilization of the Web-based self-help were the major predictors of depressive symptoms at follow-up. Challenges and barriers (eg, costs, therapists’ concerns, or technical barriers) of adding Web-based interventions to inpatient treatment have to be addressed.Trial RegistrationClinicalTrials.gov NCT02196896; https://clinicaltrials.gov/ct2/show/NCT02196896.

Expressive writing - Who is it good for? Individual differences in the improvement of mental health resulting from expressive writing

Objectivewe examined individual differences in the effects of expressive writing. We hypothesized that moderate levels of neuroticism, low levels of experiential avoidance, and highly rated subjective severity would be linked to greater change in well-being post-writing. Designparticipants were randomly assigned to the expressive group (N = 104) who wrote about emotion-laden experiences, or the control group (N = 51) who wrote about everyday events. All completed the IES and BSI pre and 1, 3, and 6 weeks post-writing. Resultsoverall, we replicated the seminal result, with greater reductions in IES scores in the expressive writing group. In addition, in the expressive group, as expected, participants with higher severity scores had greater reductions in BSI scores. Surprisingly, individuals with high rather than moderate neuroticism and high rather than low experiential avoidance scores also experienced more benefit. Conclusionsparticipants who are more aware of, in touch with, and suffer more from negative feelings are those who gain the most from expressive writing. Based on this conclusion, clinical implications relevant to both psychotherapy patients and non-patients are suggested.

4.18 INVESTIGATING THE VALIDITY OF THE READINESS FOR INPATIENT PSYCHOTHERAPY SCALE (RIPS): COMPARISONS WITH THE CHILD BEHAVIOR CHECKLIST (CBCL) AND THE YOUTH SELF-REPORT (YSR) WITH AN ADOLESCENT INPATIENT SAMPLE

This study looked to investigate the construct validity of the Readiness for Inpatient Psychotherapy Scale (RIPS) with an adolescent inpatient sample group. Past research showed that the RIPS was linked to engagement ratings in individual therapy.