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Objectives: The therapist-facilitative interpersonal skills (FIS) has shown to predict therapy outcomes, demonstrating that high FIS therapists are more effective than low FIS therapists. There is a need for more insight into the variability in strengths and weaknesses in therapist skills. This study investigates whether a revised and extended FIS-scoring leads to more differentiation in measuring therapists' interpersonal skills. Furthermore, we explorative examine whether subgroups of therapists can be distinguished in terms of differences in their interpersonal responses., Method: Using secondary data analysis, 93 therapists were exposed to seven FIS-clips. Responses of therapists using the original and the extended FIS scoring were rated., Results: Three factors were found on the extended FIS scoring distinguishing supportive, expressive, and persuasive interpersonal responses of therapists. A latent profile analysis enlightened the presence of six subgroups of therapists., Conclusion: Using the revised and extended FIS-scoring contributes to our understanding of the role of interpersonal skills in the therapeutic setting by unraveling the question what works for whom., (© 2024 The Authors. Journal of Clinical Psychology published by Wiley Periodicals LLC.)

Objective: There is a strong evidence‐base for a psychodynamic approach, supporting primary theoretical tenets as well as the treatment effectiveness. Additionally, there are increasing calls from the field for more individualized treatment for clients, and the lack of training in multiple orientations limits the ability of students in clinical psychology Ph.D. programs in the United States to personalize their treatments. The accumulated evidence‐base for contemporary relational psychodynamic theory and therapy places it in good standing to return to the standard clinical psychology curriculum, along with other evidence‐based approaches. Methods: We use data from the Insider's Guide (which describes clinical Ph.D. programs in the United States) from three time points over 20 years to document the waning psychodynamic approach in clinical psychology programs. We review the scientific evidence for four primary tenets of a contemporary psychodynamic approach: three related to development—from healthy to psychopathological: (1) unconscious processes; (2) internal representations of self and other; (3) dimensional model of psychopathology, and a fourth tenet that builds on these three and is the foundation for a contemporary psychodynamic approach to psychotherapy: (4) therapeutic relationship as a primary mechanism of change. Results/Conclusions: Based on the review of the evidence, we make specific recommendations for clinical psychology training programs about how to include a psychodynamic approach in the curriculum. [ABSTRACT FROM AUTHOR]

Substance use disorders (SUDs) are highly prevalent and have deleterious effects on one's health and well-being. Inpatient treatment for SUDs reduces patient relapse, which subsequently ameliorates these negative effects on the individual and society. Additionally, those who complete treatment are less likely to relapse compared to those who do not complete treatment. Thus, maintaining patient engagement in treatment and reducing the rates of those leaving against medical advice (AMA) is particularly important. Examining the factors and comorbidities that may contribute to treatment dropout has the potential to identify at-risk patients in need of additional individualized intervention. The current study aimed to examine comorbid anxiety, depression, and posttraumatic stress disorder (PTSD) symptoms as predictors of dropout AMA in a residential substance use treatment population. Results showed that patients with social anxiety were more likely to leave treatment AMA, while those with PTSD were more likely to complete treatment. Findings suggest that PTSD-specific treatment, as offered in this facility, may help with patient retention, while group focused therapy may be distressing to those with social anxiety. Clinical implications of this research may include incorporating evidence-based practice for social anxiety early during inpatient treatment to reduce anxiety such that patients may better engage with SUDs treatment., (© 2024 Wiley Periodicals LLC.)

Objectives: In emotion‐focused therapy (EFT) relational processes between the therapist and client are not normally an explicit focus unless the therapist and client encounter difficulties that interfere with therapeutic work. When this does happen, however, relational dialogue (including meta‐communication) becomes necessary. We present the principles and stages of the EFT task Relational Dialogue for Alliance Difficulties. Methods and Results: After describing this little‐known task, we illustrate its application in the successful treatment of a severely socially anxious female client with complex trauma and emotional fragility. Using transcripts and detailed descriptions we highlight the alliance difficulty marker subtype, relational dialogue principles and the stages of EFT alliance difficulty work. [ABSTRACT FROM AUTHOR]

Objective: The personal self of psychotherapists, that is, experiences of self in close personal relationships and its association with therapists' individual and professional attributes is explored. The study aimed to: (a) describe therapists' self‐ratings on specific self‐attributes; (b) determine their dimensionality; (c) explore demographic, psychological, and professional correlates; and (d) assess the convergence with professional self. Method: Data from the Development of Psychotherapists Common Core Questionnaire were available for > 10,000 psychotherapists of various professions, theoretical orientations, career levels, and nations. Results: Most psychotherapists described themselves in close relationships in affirming terms (e.g., warm/friendly), although a substantial minority also described themselves in negative terms. Factor analyses yielded four dimensions: Genial/Caring, Forceful/Exacting, Reclusive/Remote, and Ardent/Expressive. Being Genial/Caring was associated with life satisfaction. Among professional attributes, personal self‐experiences, and parallel dimensions of relationship with clients correlated strongly. Conclusions: Analyses of > 10,000 psychotherapists revealed meaningful variations in personal self relevant to personal and professional life. [ABSTRACT FROM AUTHOR]

Objectives: Emotion dysregulation is a transdiagnostic factor central to the etiology and treatment of various clinical difficulties. Yet, research in this area has focused almost exclusively on emotion dysregulation stemming from negative emotions. The current study confirmed the factor structure of the Difficulties in Emotion Regulation Scale‐Positive (DERS‐P) and further examined its reliability and validity. Method: Participants in Study 1 were 229 college students (M age = 19.37 years; 66.8% female; 67.2% White). Participants in Study 2 were 353 trauma‐exposed community individuals (M age = 35.77 years; 57.8% female; 71.2% White). Results: Findings supported the three‐factor structure of the DERS‐P. Mean levels of the DERS‐P scales demonstrated convergent and discriminant validity and differentiated individuals with (vs. without) probable posttraumatic stress disorder, depression, alcohol use, and drug use disorders. Conclusions: Findings provide additional support for the factor structure, reliability, and validity of the DERS‐P, thereby adding to its clinical utility. [ABSTRACT FROM AUTHOR]

Objective: The vividness of imagining emotional feelings in positive situations (EFP) in non‐clinically dysphoric and non‐dysphoric individuals and its relation to dysphoric and positive feelings was examined. Method: Participants were university students in Study 1 (N = 106, 84 women; 18–45 years), in Study 2 (N = 43, 39 women; 20–47 years), in Study 3 (N = 109, 92 women; 18–50 years) who filled out a set of questionnaires assessing depressive symptoms, cognition measures, and then completed an affective imagery task, using a cross‐sectional design. Results: Non‐clinically dysphoric participants imagined less vividly EFP than non‐dysphoric participants. The vividness of imagining EFP accounted for group differences in positive feelings beyond positive and negative cognition and negative mood. Conclusions: In addition to deficits in the general imagery of positive events, the attenuation of vividness of EFP in non‐clinical dysphoric individuals warrants attention as a separate pathway by which non‐clinically dysphoric individuals develop deficiencies of conscious positive feelings. [ABSTRACT FROM AUTHOR]

Abstract: Objective: Doctoral training in clinical psychology has undergone substantial changes in recent decades, especially with the increasing heterogeneity of training models and graduate students. To document these changes, we analyzed program, student, and faculty characteristics of American Psychological Association (APA)‐accredited clinical psychology programs over a 23‐year span. Method: We surveyed directors of clinical training about their doctoral programs every 2 years from 1991 to 2013, securing 90%–98% response rates. With minimal exceptions, the survey questions remained constant. Results: Percentages of female and racial/ethnic minority students continued to grow, such that women now comprise about three quarters of trainees and ethnic minorities about one quarter. There has been a decisive shift in faculty theoretical orientation toward cognitive/cognitive‐behavioral and away from psychodynamic/psychoanalytic. Internship match rates were relatively high and stable until the early 2010s but have recently rebounded. Conclusion: We discuss the limitations of these survey results and their implications for the future of doctoral training in clinical psychology [ABSTRACT FROM AUTHOR]

Objective Trends indicate that clinical psychologists' theoretical orientations have changed over the last decades in North America, but research on this topic in Canada is scarce. We analyzed the orientation of psychologists over the last 20 years in the province of Quebec, where 46% of Canadian psychologists are located. Method Data were collected annually through the board registration form of Quebec psychologists' professional order from 1993 to 2013. Univariate statistical analyses were realized on aggregated data. Results In 20 years, the proportion of clinicians choosing cognitive-behavioral therapy (CBT) as their main orientation grew from 18.4% to 38%, while preference for other orientations slightly declined. Existential-humanistic and psychodynamic-psychoanalytic approaches remained the primary orientation for around 21.7% and 21.5%, respectively. In 2013 (N = 8608), when taking into account 2 choices of theoretical orientation, 55.8% of clinicians chose CBT, 34.3% existential-humanistic orientation, 27.9% psychodynamic-analytic theories, and 21.8% systemic-interactional orientation. Conclusions Findings underline trends in Quebec clinical practice characterized by an increase in the number of psychologists identifying cognitive-behavioral approach as their primary self-reported theoretical orientation. [ABSTRACT FROM AUTHOR]

The history of authenticity in psychoanalysis is as old as analysis itself, but the analyst's authenticity in particular has become an increasingly important area of focus in recent decades. This article traces the development of conceptions of analytic authenticity and proposes that the analyst's spontaneous verbalization of his or her unformulated experience in session can be a potent force in the course of an analysis. We acknowledge that although analytic authenticity can be a challenging ideal for the analyst to strive for, it contains the power to transform the experience of the patient and the analyst, as well as the meaning of their work together. Whether it comes in the form of an insight-oriented comment or a simple acknowledgment of things as they seem to be, a therapist's willingness to speak aloud something that has lost its language is a powerful clinical phenomenon that transcends theoretical orientation and modality. [ABSTRACT FROM AUTHOR]

Objective This study examined the relation between identity disturbance and emotion dysregulation in a cross-diagnostic sample. We assessed whether these constructs are related and relevant beyond borderline personality disorder (BPD). Method We recruited 127 participants who completed measures assessing identity disturbance, emotion dysregulation, anxiety, and depression. The sample included primarily depressed adults meeting criteria for multiple diagnoses as well as psychiatrically healthy participants. Results Identity disturbance was significantly higher among psychiatric participants with and without BPD compared to healthy controls. Emotion dysregulation was a significant predictor of identity disturbance, even when controlling for BPD diagnosis, depression, and anxiety. In particular, clarity in emotional situations and problems using emotion regulation strategies were most closely related to identity disturbance. Conclusion The results of this study suggest that future research should examine identity disturbance and its relation with emotion regulation transdiagnostically. [ABSTRACT FROM AUTHOR]

Objectives This study tested and compared three sequential interpretations of Beck's cognitive model of the development of depression (1996). The causal mediational interpretation identifies dysfunctional attitudes as most distal to depressive symptoms, followed by cognitive distortions, the cognitive triad, and negative automatic thoughts, with each construct successively more proximal to depressive symptoms. By contrast, the symptom model reverses the causal chain with negative automatic thoughts as the most proximal consequence and dysfunctional attitudes as the most distal consequence of depression. The bidirectional model merges both interpretations into one model. Previous studies on sequential interpretations of Beck's model have not included cognitive distortions or the cognitive triad and did not test the bidirectional model finding contradictory empirical evidence for the sequential order. Method In the 3-wave longitudinal study, 308 German university students without clinically significant depressive symptoms (245 female, average age: 23.69 years) completed self-report questionnaires measuring their dysfunctional attitudes, cognitive distortions, cognitive triad, negative automatic thoughts, and depressive symptoms. Results The bidirectional model with partial mediation fit the data best and cognitive distortions mediated the relationship between dysfunctional attitudes and negative automatic thoughts and vice versa. Conclusions The findings have important consequences for the prevention of depression. Prevention programs may want to focus on cognitive distortions, the only construct in Beck's model that influences every other construct in the model. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to examine low hedonic responsivity, a facet of hedonic capacity, as a potential explanatory variable in the relationship between attention deficit/hyperactivity disorder (ADHD) symptoms and depressive symptoms. Method: One hundred ninety-eight undergraduate students (mean age = 21.3, standard deviation = 4.6; 59.6% women) from a large, public university completed self-report measures for this cross-sectional study. Results: Results indicated that ADHD symptoms were significantly associated with depressive symptoms, and that low hedonic responsivity partially accounted for this association. This effect was statistically significant for total ADHD symptoms and inattentive symptoms, but not for hyperactive-impulsive symptoms. Conclusions: Findings are consistent with the possibility that impaired hedonic responsiveness may be a common endophenotype for depression and the inattentive symptoms of ADHD. Implications for future research and clinical work are discussed. [ABSTRACT FROM AUTHOR]

Objectives To identify the effectiveness of psychotherapy supervision on therapists' immediate (next session) and long-term (1 year) adherence to time-limited dynamic psychotherapy (TLDP). Method Sixteen therapists from the Vanderbilt II psychotherapy project were assigned new cases in pretraining, training, and booster/posttraining year-long cohorts. Technical adherence to the manual, as well as general therapeutic relational processes, were rated for clinical supervisory sessions in which the third therapy session was discussed. The therapy sessions immediately before and after the supervisory sessions were also rated for technical adherence and relational processes. Results Postsupervision adherence increased from the presupervision session during the training cohort. In supervision, therapists' discussion of techniques and strategies from the manual in supervision was significantly related to technical adherence in the session prior to (but not after) supervision. However, supervisors' discussion of specific techniques predicted therapists' total technical adherence in the therapy session after (but not before) supervision. In terms of the type of techniques, supervisors' influenced postsupervision therapy adherence on TLDP's unique approach to formulation, the cyclical maladaptive pattern, but did not influence technical adherence on the therapeutic relationship. Conclusions In supervision, therapists tend to focus on how they adhered to techniques from the previous session, whereas supervisors' comments about specific techniques predicted how the therapist would adhere to techniques in the next therapy session. The findings provide support for the immediate effects of supervision in shaping therapist techniques as well as highlighting the challenges of altering common relational processes through technical training. [ABSTRACT FROM AUTHOR]