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Objective Positive psychotherapy (PPT) stems from the positive psychology movement and is a multicomponent model promoting therapeutic change by developing engagement, pleasure, and meaning. There is some evidence it is effective for depression. PPT is recommended as a flexible model that can be applied to other patient groups alongside other treatments approaches. However, it remains unclear which of the many components are applied. The study aimed to identify how PPT is applied in mental health care. Method We systematically searched online databases, including Medline, Embase, PsycINFO, British Nursing Index, Cumulative Index of Nursing and Applied Health, and Cochrane registers (CENTRAL), and completed complementary hand and citation searches. Narrative synthesis was used for analysis. Results A total of 12 papers (from 9 studies) widely applied some PPT components (e.g., blessings journal, character strengths) and scarcely applied others (e.g., satisficing plan or family strengths tree). However, papers poorly described the intervention and rationale for applying components. Conclusion Given the lack of rationale for applying PPT, further research is needed to establish which components are acceptable and feasible for use in different patient groups and settings. [ABSTRACT FROM AUTHOR]

A failure to maintain improvement achieved during acute treatment, followed by a "revolving door syndrome," is a common phenomenon in eating disorders (EDs). As a result, many patients develop a chronic course that is difficult to treat. To target these difficulties, we established a novel rehabilitation treatment model in Israel for patients with severe and enduring EDs, based on the "recovery theory" in mental health treatment. This paper describes the process of conceiving this model and specifies the components of this rehabilitation house, "Zeida Laderech" (Provisions for the Journey), that aims to provide a home‐like environment, while assisting in developing a healthy and balanced lifestyle. Finally, the model is discussed in light of other residential programs established in the world. With the hope to improve the overall prognosis of individuals with EDs, it is suggested that the similar programs and ongoing innovation will continue to emerge internationally. [ABSTRACT FROM AUTHOR]

The aim of this case study is to illustrate the importance of collaborative care as part of Maudsley Anorexia Nervosa Treatment for Adults (MANTRA). Mothers are often at the foreground of providing support within the family. However, fathers have the potential to play a profound role. In this paper, we describe a patient with anorexia nervosa treated with the MANTRA. The formulation of this case included autistic spectrum traits in both the father and daughter leading to social isolation. We describe how the family members were engaged into treatment and how paternal support was used to promote social connection and an improved quality of life in the daughter. Some details of the case have been altered to maintain confidentiality. [ABSTRACT FROM AUTHOR]

In eating disorders, the denial of the illness is a central phenomenon. In the most severe forms of anorexia, compulsory treatment may be necessary. The professional acceptance of involuntary treatment is controversial due to the fact that the autonomy of the patient is juxtaposed with the obligation of the health care practitioner to save lives. This paper discusses the major practical and ethical considerations surrounding this controversy. In addition, case vignettes are used to illustrate various strategies to diminish client resistance and enhance motivation toward treatment. Involving the family is nearly always essential for the treatment of patients with eating disorders. In some cases, parental consultation (i.e., treatment without the client) can also be an option. Home visits, though rarely used, can reframe the therapeutic relationship and provide information about family functioning. In general, a lower level of treatment coercion can be achieved through transparent client‐parent and client‐therapist communication. [ABSTRACT FROM AUTHOR]

Abstract: This paper addresses how musical metaphors can be useful in understanding the substructure of psychotherapy by considering how our patients resonate inside us, what that resonance does to and for us, and how these acoustic properties seem to be foundational in the construction of the therapist as an instrument of healing. From this perspective, psychotherapy involves “living music” with another person, as the process of psychotherapy always involves the passing of sound back and forth across an interpersonal divide. This requires both psychotherapist and patient to step into the roles of performer and audience member. Additionally, psychotherapists can be meaningfully thought of not only as an “instrument” of healing, but also an “instrumentalist” who produces unique “therapeutic music.” Moreover, the patient and therapist cocreate the concert space in which treatment is performed. This concert space has unique “architectural,” and thus acoustic, properties within which we hear and remember one another. [ABSTRACT FROM AUTHOR]

Abstract: The physical spaces in which we conduct psychotherapy are an important yet underacknowledged aspect of psychotherapeutic work. Although a few contemporary publications have provided suggestions for the creation of welcoming, comfortable, and efficient practice spaces, considerations of what it means to transform a room into a therapeutic space have remained largely absent from recent literature. This paper reviews the existing literature on this subject and describes the ways in which the therapist's office is intimately tied to several processes of the therapy itself, by way of creating an adaptive environment that is able to meet the needs of both therapist and client over the course of their work together. [ABSTRACT FROM AUTHOR]

This article introduces the special issue on recent conceptual, practical, and research developments relevant to men and therapy. The paper reviews the considerable shifts that have emerged in our understanding and measurement of masculinity as it pertains to men's health and therapy. In addition, this introduction outlines the primary focus of each article in this special issue and describes the general guidelines offered to the contributors. Collectively, these special-issue articles describe promising paradigms, provide useful examples, and stress the need for further research on men, masculinity, and the therapeutic process. © 2005 Wiley Periodicals, Inc. J Clin Psychol 61: 627–631, 2005. [ABSTRACT FROM AUTHOR]

This paper describes a 6‐month period of compassion‐focused therapy (CFT) for a client who has a 35‐year history of hearing voices that are threatening, derogatory, and abusive. In this intervention, the client is encouraged to develop compassionate motives toward herself and to her voices, recognizing that her voices may have been functional in the context of difficult early experiences. The client develops a compassionate self‐identity, which becomes the vehicle through which she approaches therapeutic tasks, such as listening and talking to voices, engaging with traumatic childhood pain, and resolving emotional conflicts. The client is an author on this study, so is able to provide valuable first‐hand insights into the experience of working compassionately with her voices, and of experiencing CFT techniques for the first time. [ABSTRACT FROM AUTHOR]

Abstract: This issue of the Journal of Clinical Psychology: In Session contains seven essays that give expression to three basic convictions. The first is that therapists who are consistently able to help their patients make constructive changes in their lives practice psychotherapy creatively, whether or not they conceive of therapy as an applied science or as an art form. The second is that cultivating an aesthetic perspective on the communicative exchanges that take place in therapy can enhance a therapist's capacity to serve creatively as an agent of change. The third is that therapists can make better choices on behalf of their patients if they take inspiration from what artists have to teach us about the aesthetic domain of existence. [ABSTRACT FROM AUTHOR]

This paper reports on the development and validation of an automated referral system. While a complete answer to the question posed earlier requires a demonstration that treatment gains are maximized, the current study only considers the efficacy of an automated procedure relative to clinical staff assignment. In short, the hypothesis examined is that treatment assignment of inpatient alcoholics can be accomplished via automation without a loss of effectiveness and with greater efficiency, when compared to assignment by a clinical treatment team. Establishing the efficacy of an automated referral system is an initial step toward the maximization of treatment benefits and, consequently, is the focus of the discussion.

The article reports on the interaction effects of internal vs. external locus of control and directive vs. nondirective therapy. It examines critically studies that claim that internals are more successful in nondirective therapy and externals in directive therapy. One purpose of the present paper is to review these studies to show that deficiencies either in design, method of statistical analysis, or measures of outcome raise questions as to the real support they lend to the interaction hypothesis.

This article presents information on the application of role playing, as a research technique, in a test of Sarbin's self role congruency theory. The present study attempts to provide further confirmation of Sarbin's congruency theory, in this case within a setting analogous to psychotherapy. It was believed that by using Ss who were playing the roles of therapist and clients it would be possible to obtain information relevant to the effects of self-role congruency and incongruency in the psychotherapeutic interaction. A secondary purpose of the study was to provide data on the validity of pencil and paper tests that purport to measure role-playing aptitude. Forty nine male Ss from various undergraduate classes volunteered to role play either a therapist or a client in a half-hour role-playing session designed to simulate psychotherapy.

The present paper attempts to clarify further the meaning of life style from an Adlerian perspective and to elucidate the manner in which one's life style develops. During therapy the life style becomes the focal point for understanding present behavior. Since Adlerian theory is a here-and-now approach, little time is spent with past history. However, the life style can be used to make educated guesses as to the client's pattern of movement in the future. One whose need is to control will attempt to get into situations in which he can control; he will interact with others in a controlling manner. One of the here-and-now aspects of Adlerian therapy is the therapist's skill in pointing out to the client the manner in which his life style is manifesting itself with the therapist.

This article focuses on the book "Psychotherapy of the Adolescent," by Benjamin H. Balser. This is a collection of papers and interpretations on the treatment of adolescents at different levels of psychiatric practice with special emphasis on the role of the school.

The paper offers a case study with a defective delinquent who was rehabilitated through intensive individual psychotherapy. The subject was selected by the staff of a large colony for male defectives as belonging to the group of "incorrigible" defective delinquents. The procedure of selection and the results of a large scale counseling and psychotherapy program have been described elsewhere. One to three therapeutic sessions of 20-50 minutes each were held weekly for 18 months except for vacation.

The article informs that the selection and validation of criteria to measure psychotherapeutic experience are important problems in current research. In an increasing number of studies the utility of psychological tests as guides to selection of suitable patients for psychotherapy is being investigated. Although the validation of such tests rests, to a large degree, upon the adequate measurement of the success or failure of the patient's therapeutic experience, insufficient research has been directed towards this area. The present paper reports on an empirical investigation of the relationship between the manner in which therapy is terminated and length of treatment and training and experience of the therapist.

The article reports that in the field of psychotherapy, there has been practically no progress in the matter of evaluating the relative efficacy of various methods because of failure to quantify the nature and malignancy of the clinical case materials under study. Adherents of various schools of psychotherapy have made a large number of claims and counter claims which cannot be proved or disproved until the exact nature of the clinical material on which the findings are based has been established. It is the purpose of this paper to outline a method for quantifying the malignancy of case materials by the use of a rating scale which has been called the prognostic index.

This article discusses directive psychotherapy. The purpose of, this paper is to discuss the nature, indications and contraindications of methods of therapy involving pressure or coercion. Pressure is defined as the bringing to bear upon the client of stimulation tending to direct action toward specific goals. Coercion involves restraint or regulation by force, usually by law or authority, compelling or constraining the! client to comply with directions. Pressure will usually involve influences which leave ultimate responsibility for conformance up to the client himself, while coercion requires mandatory conformance.

Objectives A cross-sectional empirical design was used to compare differences in alexithymia between Australian psychiatric and community samples and examine the influence of sample type on the relation between alexithymia and psychological distress. Method Psychiatric outpatients ( N = 151) and a convenience sample of the general community ( N = 216) completed questionnaires measuring alexithymia and psychological distress. Results Alexithymia was several times more prevalent in the psychiatric sample than the community sample. While the psychiatric sample reported greater psychological distress, no difference was found in the strength of the association between alexithymia and psychological distress between the study samples. Conclusion These findings emphasize the pervasive problem alexithymia presents within the Australian psychiatric population and the importance of increasing recognition of alexithymia for the future research about and treatment of psychiatric patients. [ABSTRACT FROM AUTHOR]

The article reports on a self-directed approach to the treatment of a complex neurosis with implosive therapy (IT). It demonstrates or investigates the effectiveness of IT in the treatment of psychological disorders typically have dealt with relatively simple, identifiable fears. This paper describes the self-directed treatment of a "complex" and debilitating neurosis, in which identification of the conditioned stimuli was based upon dynamic inferences. The results of the study support the use of dynamic formulations to develop a behaviorally oriented treatment program.

This article reports a systematic review of engagement measures for psychosocial therapy. MEDLINE, EMBASE, and PsycINFO databases were searched to identify English-language studies (published 1980 to February 2010) that reported on an instrument/rating scale to measure engagement in psychosocial treatment for mental health difficulties. Forty-seven studies were identified, reporting information on 40 measures of treatment engagement. Although our findings suggest that therapeutic engagement appears to be considered an important construct to assess, they also reveal that there is little consensus in the definition of engagement employed. Few measures are generalizable across treatment settings and clinical populations, and limited information is reported on the indices of reliability and validity. It is concluded that further work is required to develop adequate measures of therapeutic engagement. © 2011 Wiley Periodicals, Inc. J Clin Psychol 67:1-15, 2011. [ABSTRACT FROM AUTHOR]

Discusses the benefits of thought field therapy through an uncontrolled study of changes in patients suffering from a variety of psychological disorders through self-reported subjective units of distress. Application of modality across disciplines; Need for controlled studies with standardized measures to evaluate the magnitude and duration of effects; Wide applicability yet specific nature of therapy.

Criticizes the thought field therapy (TFT) postulated by psychologist Roger J. Callahan and the case studies provided by Callahan that are insufficient in establishing the efficacy of the alternative approach. Employment of subjective ratings in the case studies; Pseudoscience nature of TFT; Basis of heart rate variability evaluation on erroneous premises; Insufficiency of case studies in validating efficacy claims.

Criticizes the thought field approach introduced by psychologist Roger Callahan in the October 1, 2001 issue of the periodical 'Journal of Clinical Psychology.' Effectiveness with patients with post traumatic stress disorder; Clarification of the phrase 'power therapy'; Problems in the collection and presentation of verifiable and characteristic data; Issue of openmindedness and respect in the face of alternative approaches.

This article focuses on the usefulness of reception and recall checks in the development and implementation of client pretherapy orientation procedures. Although high scores on such measures do not indicate that the ideas presented in the orientation have been fully grasped or internalized, they do demonstrate that clients have been able to attend to and, in a basic sense, to understand, or receive, the material. Retention of the information can be assessed by readministration at a later point. It is hoped that the employment of manipulation checks of this kind can facilitate the identification of processes through which orientations work.

The article presents a study which aims to evaluate the role of physiological arousal in the Induced Anxiety therapy procedure. 21 normal subjects were assigned to either conventional Induced Anxiety, Induced Anxiety supplemented by the drug ketamine during arousal, or a no-treatment condition. The ketamine group was superior to the conventional group which was superior to the no-treatment group in reducing negative affect experienced during stressful situations. Most of the reduction was in depressive affect. The superior results obtained by increasing physiological arousal could not be accounted for by increased subjective emotional arousal.

The article provides a case study on suicide and systematic desensitization. The present study described a multiple-therapy treatment of suicidal behavior in a 14-year-old female. This treatment involved the pairing of target stimuli with specific muscular states and systematic desensitization of reported disturbing thoughts. Target stimuli were introduced through the use of both photographs and imagery. The treatment successfully reduced the rate of suicidal gestures from a mean of 3 per month to .17 per month. The subject displayed no suicidal behavior during the last 7 months that data were kept.

The article presents a study related to the relationship of socio-econornic characteristics, prior drinking patterns, prior treatment efforts and presents treatment variables to sobriety improvement. The factors which had a significant direct relationship to sobriety improvement in this project were duration of sobriety prior to intake and length of stay in treatr ment. Prior A. A. attendance and the use of Antabuse during treatment were also positive factors, whereas previous psychotherapy and educational level had a negative correlation with increased sobriety. For the most part, these findings, examined for differences among the three therapists for their patients and for their applicants, were consistent with the overall results analyzed by sobriety improvement.

The article presents information on the patient as a constant in psychotherapy. It demonstrates a procedure which enables certain aspects of the psychotherapeutic process to be held constant by using a highly resistant patient. Experimental studies of characteristics of therapists and observers are then possible. In terms of this study, each therapist had his own style and method which was little influenced by conscious attempts to standardize technique. There were individual differences in regard to the degree to which a therapist could alter his approach to the patient. Some tried hard to return occasionally to the agreed upon approach. Others acted as if there never had been any discussion or agreement on the subject.

The article reports on the differential effects of various tranquilizing drugs on speed of tapping. The opportunity for this study arose when 18 newly-admitted male schizophrenics at Coatesville Hospital were designated as part of the nationwide pool of subjects in Veterans Administration Cooperative Studies of Chemotherapy, Project Number 3. No attempt will be made to means for the first and last weeks of medications since the data showed such variations among the individuals in various drug groups as to make comparisons impossible with only three subjects in each drug group.

The article attempts to demonstrate the un-spontaneous basis for what heretofore has been termed "spontaneous" remission. Evidence is presented that a combination of favorable patient expectancies and such nonspecific professional intervention as the intake interview and psychological testing are sufficient for inducing symptomatic change in individuals waiting to participate in formal psychotherapy. Finally, it is suggested that "non-specific therapy remission" be substituted for "spontaneous remission" as a means of describing improvement in wait-list patients not participating in formal psychotherapy.

The article describes the application of a scale for the objective assessment of process or movement in psychotherapy and reports the degree of reliability and validity found in a preliminary investigation. The present scale represents a refinement of the original scale based upon further analysis and study of additional therapy protocols. It seems apparent that satisfactory interjudge reliability can be obtained in using the process scale in its present form, and that ratings derived from it bear a meaningful relationship to other measures of successful change in therapy.

The article presents a study on play therapy in psychology. Using 4,092 statements made in 60 individual nondirective play therapy sessions by 20 normal children aged 4 to 12 years the present experiment found that the use of toys suggested by nondirective play therapists did not seem to encourage children to verbally express themselves to a greater extent than did non-recommended toys or not playing with toys. It is suggested that the nondirective play relationship might not require the creative or dramatic toys of the Freudian diagnostic play relationship.

The article compares a group of 82 post-poliomyelitic subjects on the Rosenzweig P-F Study with Rosenzweig's normative group. Some differences between the post-poliomyelitic group and the Rosenzweig normative group were found at statistically significant levels which at best indicate trends because of the size of the sample. When the postapoliomyelitic male is compared with Rosenzweig's normative group he may be described as one who is less Extrapunitive, more Intropunitive and more Impunitive than the male of the normative group.

This article focuses on group structures in group psychotherapy. The group psychotherapy programs used in these hospitals, as in most contemporary programs, did not start by placing patients in already existing groups, e.g., a family or a club. At the onset there existed only an assemblage of patients, brought together by their doctors' orders and held together by ward attendants and the confines of the room. During the first session, some patients read, some sat listlessly with eyes wandering aimlessly about the room, while others buried their heads in their arms.

Objective: We assessed whether treatment providers specializing in evidence‐based treatment for posttraumatic stress disorder found the Impact of Killing (IOK), a novel treatment for moral injury among combat veterans, acceptable, and feasible. Methods: Ten providers from a large veterans administration (VA) medical center were provided with materials from IOK. We audio‐recorded a semistructured interview with each provider where we elicited open‐ended feedback as well as asked five structured questions about the relative advantage, compatibility, complexity/simplicity, trialability, and observability of IOK. Results: All providers found IOK feasible, acceptable, and something they could incorporate into their existing practice. Providers reported that the spiritual and moral concerns addressed in IOK were novel, and that self‐forgiveness and making amends were critical components promoting healing from moral injury not emphasized in other treatments. Conclusions: Among trauma providers, IOK was found acceptable and feasible, offering a novel approach to addressing moral injury among combat veterans. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: Major depression is increasingly viewed in the United States public as a medical disorder with biological and psychosocial causes. Yet little is known about how causal attributions about depression vary among low‐income racial minorities. This study examined beliefs about causes of depression and their demographic, clinical and treatment correlates in a lower income African American sample. Method: Volunteers (N = 110) aged 24–79 years, who participated in a family study of depression, completed a 45‐item questionnaire on their beliefs about the causes of depression. We used multidimensional scaling (MDS) to cluster items into causal domains and multivariate regression analyses to test associations of causal domains with demographic and clinical characteristics and treatments received. Results: Three causal domains, conceptualized as Eastern culture/supernatural (ECS), Western culture/natural/psychosocial (WCN‐P), and /neurobiological (WCN‐N) attributions, were derived from MDS clusters. WCN‐P was most commonly endorsed (50%–91%) and ECS least endorsed as causes of depression (10‐44%). This pattern held across gender, age, educational levels, and diagnostic category. WCN‐N items were moderately endorsed, with some distinction between genetic causes and other biological causes. WCN‐N was positively associated with medication as opposed to other forms of treatment (B = 1.17; p = .049). Conclusion: Among low‐income African Americans, beliefs about causes of depression are varied but broadly consistent explanatory models that include a combination of psychosocial causes with genetic/biological contributions. For certain individuals, supernatural and natural causal attributions may coexist without dissonance. Causal attributions may be associated with types of treatment accepted and have implications for treatment compliance and adherence. [ABSTRACT FROM AUTHOR]

Abstract: I contend that painting, like psychoanalytic psychotherapy, is an intersubjective process able to connect hearts and minds of painters and viewers alike, because the creative process of making a painting brings painters into more complex and more animated relationship with themselves. My own painting process is largely nonverbal. Interactions between me and my evolving artwork‐in‐process reveal experiences, thoughts, and feelings not yet formulated in words, and so, not available explicitly to conscious awareness until visual representation allows questions of meaning and intention to be thought about and elaborated in the usual, verbal sense. I describe how my particular painting practice provides an experiential frame for the creative process of self‐articulation that goes on in psychotherapy, as well as how the physical and mostly nonverbal dialogue experienced in the painting studio served as a source of listening attitudes and self‐regulation in my work with a patient's inhibited self‐expression and thwarted artistic ambitions. [ABSTRACT FROM AUTHOR]

Abstract: This article describes the author's development of an aesthetic approach to psychoanalytic psychotherapy of patients suffering from traumatic levels of grief by describing her experiences as a patient, a therapist, and a consultant to the design firm that partnered with the National September 11 Memorial and Museum. Using Aristotle's On Poetics as an inspiration, this article explores the ways dialogical storytelling creates a therapeutic “action‐plot” that transforms reversals of fortune. Attending to patients’ first‐person phenomenological experience (without attributing cause), therapists help them transform their losses by listening to their stories. Therapists dwell with them in uncertainties while marking time in regularly scheduled meetings; they accompany their patients on a journey while also orienting to their modes of travel. They simultaneously co‐construct tales of the journey, attentive to the poetic dimensions of sight, sound, and space that they encounter. In so doing, therapists serve not just guides and judges, but artists, bringing meanings to the trail. [ABSTRACT FROM AUTHOR]

Abstract: Insights from the study of literature can inform and clarify concepts to guide psychotherapy practice and research. The author offers instances from narrative fiction (Durrell's Alexandria Quartet) and poetry (Hopkins, Baudelaire) to illustrate how the formulation of experience in words that are evocative (vs. ordinary), original (vs. trite), and precise (vs. approximate) are able to capture attention, move the emotions, and challenge beliefs; and how linkages among experiences, vividly and precisely expressed, create and enhance narrative meaning–revealing the inherent relativity of individual meanings and the need to consider the aggregate of relevant perspectives in every interpersonal situation. [ABSTRACT FROM AUTHOR]

Abstract: Is there an aesthetic dimension to therapeutic action? The author proposes that while the arts, in this example, dance, can serve as a bridge to give form and expression to the ineffable for both the artist and the observer, language, especially metaphorical language, in the context of a resonating therapeutic relationship, similarly gives form and enhanced meaning to what has been felt but not yet understood. Even if the content is painful, the process of mutually creating a common language that reorganizes the mind is aesthetically pleasing. [ABSTRACT FROM AUTHOR]

Context Human-animal interaction (HAI) is widely used as a method of reducing psychological distress. However, research findings in support of HAI have not kept pace with the widespread prevalence in practice. Objective I review and synthesize the quantitative evidence for the influence of HAI on psychological distress and outline future directions for research. Results The evidence suggests that HAI has a small-to-medium effect on distress but does not clarify whether animals account for the treatment effects. Research also has not determined whether positive effects observed in circumscribed HAI programs extend to companion animal ownership. Conclusion HAI research needs to address methodological limitations and expand the focus beyond treatment outcome studies. By increasing our understanding of the processes through which HAI reduces distress, the circumstances under which it is most effective at doing so, and the influence HAI has on the animals, we can enhance the impact of HAI. [ABSTRACT FROM AUTHOR]

Objective In this study, we examined the mechanisms of action of complicated grief treatment (CGT), an efficacious psychotherapy for complicated grief. Method We explored 3 putative mediators (guilt/self-blame related to the deceased, negative thoughts about the future, and avoidance) among treatment completers assigned to either CGT (n = 35) or interpersonal psychotherapy (n = 34) in a previously reported randomized controlled trial. Antidepressant use was examined as a moderator of mediation effects. Results A reduction in guilt/self-blame, negative thoughts about the future, and avoidance behavior each mediated the relationship between treatment group and complicated grief outcomes. Reduction in avoidance emerged as an independent mediator after controlling for all mediators. Conclusion Reducing avoidance of situations and emotions connected to the loss seems to be a key mechanism of change in CGT. Revising counterfactual thinking around troubling aspects of the death may also play a role in facilitating effective adaptation to loss. [ABSTRACT FROM AUTHOR]

Objective Explanatory models (EMs) are a collection of beliefs about a disorder that can help us understand help-seeking and treatment pathways in diverse contexts. In 2 related studies, we explore EMs about depression held among both clinical and nonclinical samples in Uganda. To explore the potential of EMs to predict help seeking, we assessed the relationship between 2 main aspects of the EM: problem conceptualization and treatment. Method In Study 1, we interviewed and assessed EMs of depression for 135 lay community members and 111 professional practitioners using a vignette. In Study 2, we assessed actual EMs among 33 clinically depressed adults. We transcribed all interviews and analyzed and coded the content. In Study 1, we used logistic regression to examine the relationship of problem conceptualization and stigma to treatment choice; in Study 2, we used Fisher's exact tests to examine the relationship between conceptualization and treatment. Sociodemographics such as age, income, and language were also examined. Results Interviews elicited a diverse range of beliefs about the nature of depression and the types of treatment needed. However, problem conceptualization did not predict treatment in either group. Instead, education and interview language predicted treatment in clinical and nonclinical samples. Conclusion Although EMs can be useful for both exploring mental health and treatment-related beliefs in clinical settings and developing mental health services, contextual factors may be more significant predictors of help seeking. [ABSTRACT FROM AUTHOR]

Introduction Internet-based cognitive behavioral therapy for depression (iCBT) has been advanced as a valuable alternative treatment option, generating promising results. However, little is known about its underlying mechanisms of change. Objective We aimed to provide an overview of the state of the art regarding the mechanisms of iCBT for adult depression, in the context of iCBT efficacy. Method We conducted a systematic qualitative review of 37 randomized clinical trials, assessed the risk of bias in the included studies, and used a systematic evaluative framework to establish the scientific status of iCBT, based on evidence regarding clinical efficacy and mechanisms of change. Results Findings indicated that iCBT mechanisms of change are clearly underinvestigated, although iCBT is relatively efficacious, at least in the short term. The quality of iCBT randomized clinical trials proved to be suboptimal. Conclusions The iCBT theory should be clearly specified and adequately investigated to design and implement highly efficacious therapeutic packages. Without considering the iCBT mechanisms of change along with iCBT efficacy, the extent to which iCBT is an empirically validated treatment remains questionable. [ABSTRACT FROM AUTHOR]

Motivation is a key ingredient in the successful treatment of pediatric obsessive-compulsive disorder (OCD). As a first-line treatment, cognitive-behavior therapy (CBT) requires extensive client engagement, including participating in exposures and doing homework tasks. A lack of motivation to comply with these tasks may seriously affect treatment outcome. This case study identifies factors interfering with motivation and illustrates motivational strategies to enhance compliance of a child with OCD. The patient was an 11-year-old boy with severe OCD and symptoms of oppositional defiant disorder (ODD). He had extensive OCD-related avoidance behavior but denied the presence of symptoms or did not acknowledge them as a problem. In this article, we discuss the different techniques used to enhance motivation, which subsequently led to a favorable outcome. [ABSTRACT FROM AUTHOR]

Hoarding in children is associated with more severe ancillary psychopathology, and has poor treatment outcome. At present, there are no empirically established procedures for treating hoarding in youth. The present case illustration is of a 10-year old child ('Grace') who presented for treatment with significant hoarding related to academic concerns and additional unrelated symptoms of obsessive-compulsive disorder (OCD). Grace was treated with cognitive behavior therapy (CBT) primarily comprising exposure with response prevention, behavioral experiments, and cognitive therapy, along with a program of reinforcement delivered by her parents to maintain her motivation for therapy. After 23 sessions and one booster session, Grace's symptoms improved significantly, with gains maintained at 1-year follow-up. In addition to the benefits of the specific interventions chosen, the role of therapist-patient/parent alliance as a contributory factor for good outcome is emphasized. As hoarding is underinvestigated in youth, suggestions for further investigation are offered. [ABSTRACT FROM AUTHOR]

Objective: Dialectical behavior therapy (DBT) was developed for treatment of borderline personality disorder (BPD), and adapted forms of DBT are currently used to treat bipolar disorder, eating disorders, anxiety, and depression. This study was designed to validate the Dialectical Behavior Therapy Ways of Coping Checklist (DBT-WCCL) DBT Skills subscale (DSS) for use in a diagnostically heterogeneous sample. Method: We used naturalistic data from 228 patients receiving treatment at a partial hospital program to assess psychometric properties of the DBT-WCCL DSS. We assessed interitem correlations, internal consistency, factor structure, construct validity and sensitivity to change. Results: Internal consistency, construct validity, and sensitivity to change were good. The measure displayed good convergent and discriminant validity. Factor analysis results were consistent with previous research indicating a 1-factor solution for this subscale. Conclusions: Psychometric properties were similar to the original BPD sample, indicating that this measure can be used as an assessment tool for DBT skill use in a diverse psychiatric population. [ABSTRACT FROM AUTHOR]

Objectives Disorders of behavioral dysregulation often involve more than one dsyregulated behavior (e.g., drug abuse and aggression, alcohol abuse and gambling). The high co-occurrence suggests the need of a transdiagnostic treatment that can be customized to target multiple specific behaviors. Method The current pilot study compared a 20-week, individual transdiagnostic therapy (mindfulness and modification therapy [MMT]) versus treatment as usual (TAU) in targeting alcohol problems, drug use, physical aggression, and verbal aggression in self-referred women. Assessments were administered at baseline, post-intervention, and 2-month follow-up. Results Wilcoxon signed-ranked tests and multilevel modeling showed that MMT ( n = 13) displayed (a) significant and large decreases in alcohol/drug use, physical aggression, and verbal aggression; (b) significantly greater decreases in alcohol/drug use and physical aggression than did TAU ( n = 8); and (c) minimal-to-no deterioration of effects at follow-up. Both conditions showed significant decreases in verbal aggression, with no statistically significant difference between conditions. MMT also displayed greater improvements in mindfulness. Conclusions Preliminary findings support the feasibility and efficacy of MMT in decreasing multiple dysregulated behaviors. [ABSTRACT FROM AUTHOR]

Objective Treatment outcome was compared among non-Hispanic White and racial/ethnic minority participants with trichotillomania (TTM), or hair-pulling disorder. Method Symptom severity, quality of life, and TTM-related disability were compared in a behavior therapy trial with a stepped care approach: web-based self-help and then individual behavior therapy. The sample comprised 72% ( n = 38) non-Hispanic White participants and 28% ( n = 15) minority participants. Results The ethnic groups responded differently to treatment, with fewer minority participants showing improvement during web-based self-help. Response rates were equivalent between ethnic groups during the in-person behavior therapy. These results should be interpreted with caution because of the small sample size of minorities in the study and consequent inability to analyze results for each racial/ethnic group individually. Conclusions Future studies should focus on the investigation of factors that may enable or hinder racial and ethnic minority participants to benefit from online and/or self-help behavior therapy for TTM. [ABSTRACT FROM AUTHOR]