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According to the Dialogical Self Theory, the Self can move along the imaginal landscape of the mind and adopt different I-positions, endowing each position with a voice and enabling dialogical relationships (e.g., agreement, disagreement) among each other. Internal dialogues may have an important role regarding identity construction, self-regulation, and support, among others. However, if internal dialogues are not efficient or meaningful voices are suppressed, they may cause psychological problems. The current study aims to adapt and validate the Portuguese version of the Internal Dialogical Activity Scale - Revised (IDAS-R) and explore its correlations with personality dimensions and psychological indicators. The 397 participants, aged 15-73 years old, completed the IDAS-R and questionnaires to assess Well-Being, Satisfaction with Life, and the Big-Five Personality dimensions. Confirmatory factor analyses identified a factorial structure different than the one originally proposed. The CFA provided a best-fit model with four subscales – Identity Dialogues, Spontaneous Dialogues, Social and Supportive Dialogues, and Distressing Dialogues. All internal dialogues, except Identity Dialogues, correlated negatively with Well-Being and Satisfaction with Life and correlated positively with Neuroticism. We discuss these results, the possibility of assessing such dynamic processes by quantitative methods and point to new directions in the research of internal dialogicality. [ABSTRACT FROM AUTHOR]

This special section contains studies in which innovative moments are used as markers of changes in meaning in psychotherapy. Innovative moments, as an empirical operationalization of the concept of "unique outcomes" from narrative therapy, have been used as a strategy to evaluate changes in meaning in psychotherapy sessions and interviews. Innovative moments are defined as exceptions to the problematic pattern of meaning that is associated with clients' suffering. The emergence of these change markers indicates that flexibility is occurring in the meaning system. This special section contains five studies. Esposito et al. address innovative moments in group intervention by considering the idea that these events are not just individual but also interactional and collective events. Shimshi et al. study shifts between self-states and their relation to innovative moment production in therapy. These shifts are associated with the production of innovative moments, providing further support for the idea that flexibility and the emergence of these change markers are associated. Leeav et al. analyze the relationship between innovative moment production and the therapeutic alliance in a single case study. Fernandez-Navarro et al. interview therapists to understand whether coding innovative moments in sessions may help therapists become more attuned to these events in practice. Finally, Koustafa et al. analyze the evolution of innovative moments in a small sample of individuals with bulimia nervosa. Together, these studies illustrate the potential of this concept as well the domains in which it may be applicable. [ABSTRACT FROM AUTHOR]

Worry is a phenomenon that is present in multiple psychopathologies. Given the widely accepted transdiagnostic role that worry plays in psychopathology, reliable measures for this construct are pivotal for clinical practice. The Penn State Worry Questionnaire (PSWQ) is one of the most widely used and established measures of worry in both clinical and non-clinical populations and it is accepted as a highly reliable measure. The present study aimed to examine the factor structure and psychometric properties of the PSWQ for the Portuguese population. The total sample consisted of 428 participants, 256 from the community, and 172 from the clinical population. Confirmatory factor analysis supported a model of one factor with a method factor containing the negatively worded items. [ABSTRACT FROM AUTHOR]

Patient ambivalence towards change is a central therapeutic target in the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP). However, we do not know if and how patients resolve ambivalence across the sessions and modules of the UP. Previous studies have identified two types of ambivalence resolution—dominance and negotiation—and different patterns of resolution for recovered and unchanged cases. Objectives: This exploratory single case study aimed to describe the frequency of observed ambivalence resolution strategies across UP sessions and evaluate the impact of distinct ambivalence resolution strategies on ambivalence. Method: Sixteen sessions of a recovered case were coded with observational measures of ambivalence and ambivalence resolution. Results: Observed ambivalence significantly decreased; dominance remained highly frequent across sessions, and negotiation increased from the beginning to the middle phase of treatment but not from the middle to the final phase. Negotiation was significantly associated with ambivalence reduction. Conclusion: The progression of ambivalence resolution strategies differed from previous studies with distinct therapeutic approaches; promoting negotiation between the different parts of the client's inner conflict across the whole therapy may be valuable in dealing with patient ambivalence in UP treatment. [ABSTRACT FROM AUTHOR]

Innovative moments (IMs) are moments in which the previous problematic pattern of meaning is challenged. Studies have shown that IMs are associated with good psychotherapy outcomes. A three-level hierarchy of IMs was observed in recent studies, with level 1 IMs being more elementary and levels 2 and 3 being more complex and associated with treatment success. However, studies with manualized protocol treatments are thus far lacking. This study analyzed the longitudinal progression of IMs in the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) and explored its associations with changes in psychological distress. Data were collected from a Portuguese university-based outpatient clinic and included 18 cases with positive outcomes. Nine sessions of each case were coded with the IM coding system (N=162). Multilevel analyses showed a significant increase in all IM levels across treatments. The decrease in psychological distress predicted an increase in level 2 IMs in the same session. The evolution of IMs is similar to what was found previously in other studies. Contrary to what was found in previous studies, IMs did not predict outcomes in the following session, whereas the reduction in psychological distress predicted the emergence of level 2 IMs. [ABSTRACT FROM AUTHOR]

Objective: Prior research, mainly conducted on depression, observed that clients' improved capability to process their emotions predicted better therapeutic outcomes. The current comparative study aimed to investigate whether emotional processing was related to therapeutic change in complicated grief. Method: We analyzed two contrasting cases (good or poor outcome) treated with grief constructivist therapy. In both cases we investigated the association of emotional processing (Experiencing Scale) to (1) therapeutic outcome (Inventory of Complicated Grief), and (2) change in the type of grief-related emotions (Emotions Episodes). Results: The session-by-session growth of clients' emotional processing and the change of grief-related emotions were qualitatively explored throughout both cases. Compared with the poor outcome case, the good outcome case achieved more improvement in the ability to process emotions. Such improvement occurred alongside a deeper change in the type of grief-related emotions aroused, from maladaptive to more adaptive responses. Conclusion: Our findings suggest that a higher emotional processing capability may be associated with the transformation of grief-related maladaptive emotions and with the improvement of complicated grief condition. [ABSTRACT FROM AUTHOR]

Portugal is one of the European countries that implemented early protective measures in the context of the COVID-19 pandemic. Portugal declared a state of emergency on 18 March, and a set of regional and national preventive public health measures was progressively implemented. Studies on the psychological impact of pandemics show evidence of the negative impact on mental health. Of particular concern are individuals with previous fragility (e.g. personal, family or occupational) and those undergoing life transitions. In this paper, we present a telephone-based psychological crisis intervention that was implemented to provide brief, appropriate, and timely psychological help. This intervention follows standard models of crisis intervention and is structured in five phases and five different intervention modules to take into account the impact of the pandemic on the mental health of specific risk groups. With these support services, we hope to help our community better cope with the immediate impact of the pandemic and to contribute to preventing serious mental health problems in the medium and long term. [ABSTRACT FROM AUTHOR]

Emotional processing is an empirically established predictor of pre–post therapy improvement in depression. However, its relationship to symptom alleviation over time requires clarification. To clarify the contribution of emotional processing to gradual symptom improvement, we explored both (1) the effect of emotional processing on pre–post therapy changes in depressive symptoms (final outcome) and (2) its association with the intensity of clinical symptoms across sessions (session-by-session outcome). These relationships were estimated in a sample of 50 depressed clients treated with cognitive–behavioral therapy (CBT) or emotion-focused therapy (EFT). Emotional processing was measured by the Experiencing Scale during Emotion Episodes in five sessions taken across therapy. As expected, we found that a greater increase in emotional processing during treatment predicted a greater pre–post therapy improvement in depressive symptoms. Higher levels of emotional processing predicted next-session lower intensity on clinical symptoms, but the intensity of symptoms contributed to explaining the subsequent level of emotional processing achieved. Our observations suggest that clients' capabilities to process their emotions may both facilitate and be promoted by gradual improvement in symptoms. These results suggest the reciprocal predictive influence of emotional processing and symptoms on the therapeutic change in depression. [ABSTRACT FROM AUTHOR]

The FIND (Feedback Initiated Narrative Development) protocol was designed to foster the availability of clients' resources in psychotherapy. This protocol consists of two brief interviews and an observation of an early psychotherapy session, centered on the elicitation of the client's personal resources. The contents of both the interviews and the observed session are summarized for clients and therapists in the form of therapeutic letters. The theoretical background of this protocol is presented in this paper, which focuses on the first part of the protocol, illustrating it with clinical vignettes. The FIND protocol was developed after more than 10 years of research on innovative moments in psychotherapy and is based on narrative therapy practices and dialogical self theory tenets. Other research and models further contributed to the development of this protocol, such as the hypothesis of capitalization of resources; studies that emphasize clients´ active role in their own change; and research on autobiographical memories and narrative construction of identity. Drawing on these models, the FIND protocol attempts to prime and activate the client´s resources (i.e., potential innovative moments) from the beginning of therapy, with the aim of improving psychotherapy efficacy. [ABSTRACT FROM AUTHOR]

Objectives: Innovative moments (IMs) are exceptions to the maladaptive framework of meaning that causes distress. Dialogically, IMs can be seen as new, neglected or silenced I-positions that can prompt an alternative, more satisfying self-narrative to emerge. Research has suggested that IM production is associated with recovery in psychotherapy and is mediated by relational schemas. This exploratory research aims to study how relational I-positions are organized at the onset of treatment and how they evolve and reorganize along treatment. Method: A thematic analysis approach was used in a case study of a client diagnosed with major depressive disorder treated successfully with cognitive behavior therapy. Results: Three overarching themes (defending myself, being with me, and bonding with others) that encompassed the relational I-positions were expressed in more than half of the IMs. The themes were further divided into subthemes. The subthemes progressively displayed a more adaptive and integrated set of relational I-positions along treatment. Discussion: Relational I-positions are present in the IMs from the beginning of psychotherapy. IMs seem to include progressively more relational I-positions played out in clients' interpersonal encounters. In addition, the relational I-positions became more adaptive as psychotherapy progressed. This exploratory study suggests that the relational I-positions present in IMs are associated with increased flexibility along treatment. [ABSTRACT FROM AUTHOR]

This article applies a dialogical analysis to the change processes involved in moving from engagement with to disengagement from an armed militant group, as well as from radicalization to deradicalization. The findings underline the interplay between different push and pull factors at individual, organizational, and societal levels that played a role in the already mentioned processes in three periods of time—engagement with, life within, and disengagement from an armed organization. The dialogical framework conceptualizes the development trajectory as relationships between a variety of positions of the self (I-positions), which generate different personal meanings involved in processes of disengagement and deradicalization. [ABSTRACT FROM AUTHOR]

Innovative moments are alternative meanings to the problems expressed by clients and are organized into three levels. This study analyzes if these levels are not only change markers related to symptomatology outcomes, but also gradual steps in meaning development. A thematic analysis was carried out in a case of depression treated with narrative therapy. Results revealed three themes that evolved from level 1 to level 3. Levels 1 and 2 corresponded to one specific theme and almost all level 3 integrated different themes (polythematic). Level 3 innovative moments might be an integrative bridge allowing the construction of a more adaptive meaning framework. [ABSTRACT FROM AUTHOR]

Objectives: Innovative moments (IMs) are exceptions to the maladaptive framework of meaning that typically motivates clients to seek psychotherapy, and previous studies have shown that IMs are associated with psychotherapy outcomes. While IMs are exceptions that occur at the level of the therapeutic conversation, relational schemas are more stable patterns, and their increased flexibility may facilitate change during psychotherapy. With this in mind, we tested the hypothesis that IMs contribute to outcomes by improving the flexibility of relational schemas. Method: The Core Conflictual Relationship Theme (CCRT) was used to assess relational schemas. IMs were evaluated using the Innovative Moments Coding System. The sample included 22 clients diagnosed with major depressive disorder. The flexibility of the three components of the CCRT (Wishes, responses of the self (RS), and responses of others (RO)) were tested as mediators between IMs and outcomes. Results: The flexibility of the RS was a mediator between IMs and outcomes, but Wishes and RO were not. Conclusion: These findings align with previous research showing that RS is the component most open to change, whereas the other components seem less sensitive to change during brief therapy. [ABSTRACT FROM AUTHOR]

The innovative moments model was used in a pilot study that aimed to explore the change processes involved in everyday change outside psychotherapy. According to this model, the emergence and development of innovative moments (IMs) as exceptions to a problematic pattern are closely associated with psychological change. A longitudinal design covering 4 months of interviews was implemented with 13 adults who were coping with significant personal problems without clinical psychopathological complaints. Semistructured interviews were used to explore participants' personal accounts of their problems, and change was assessed using a scaling task at the end of the study. A total of 114 interviews were analyzed using the innovative moments coding system. A general linear model showed that higher levels of change were associated with higher proportions of complex IMs over time. Moreover, lower levels of change were associated with an increase in elementary IMs. These results support the idea that successful psychological change in everyday life shares similarities with the change pattern found in psychotherapy using the innovative moments model. [ABSTRACT FROM AUTHOR]

Ambivalence can be understood as a cyclical movement between two opposing positions of the self: one expressed in a novelty—an innovative moment (IM)—and another one conveyed by a return to the maladaptive pattern. If not properly addressed and resolved during therapy, ambivalence can prevent change and lead to psychotherapeutic failure. Two processes of ambivalence resolution have been suggested: (1) the dominance of the innovative position and consequent inhibition of the problematic position and (2) the negotiation between both positions. Objectives: To empirically study both processes of ambivalence resolution in a successful case of emotion-focused therapy. Method: Sessions were independently coded with three coding systems—the IMs, the return to the problem and the ambivalence resolution. Results: Ambivalence tended to be resolved from the initial to the final sessions. Although resolutions through dominance tended to decrease and resolutions through negotiation seemingly increased along treatment, dominance was, nonetheless, the most prominent process of resolution along the whole treatment. Conclusions: Although it has been suggested that integrating opposing parts of the self is a necessary process for psychotherapeutic success, a less integrative process of ambivalence resolution may also be an important resource along the process. [ABSTRACT FROM AUTHOR]

Copyright of Psychotherapy Research is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This study discusses a model of group counseling, the narrative mediation path (NMP), which is a unique narrative, multimodal approach that combines four narrative modes (metaphoric, iconographic, writing, and bodily)and the narrative group. The purpose of the NMP is to foster reflexive processes with underachieving university students and to improve their academic performance. The study analyzes a single case of group counseling for seven underachieving economics students at an Italian university and the process of meaning construction among NMP narrative modes and the follow-up session. It applies the innovative moments coding system, a reliable method for studying change by tracking narrative innovations in sessions. More specifically, we focus on how innovative moments (IMs: action, reflection, protest, and reconceptualization) evolve during the four different narrative modes and the follow-up session. The findings suggest that the NMP fosters narrative innovations, mainly of a reflexive nature (reflection and reconceptualization). Moreover, during counseling and the follow-up session, the pattern of change is primarily characterized by reconceptualization IMs, the most complex form of narrative innovation. [ABSTRACT FROM AUTHOR]

Narrative and dialogical perspectives suggest that personal meaning systems' flexibility is an important resource for change in psychotherapy. Drawn from these theoretical backgrounds, a research program focused on the identification of Innovative Moments (IMs)—exceptions to the inflexible meaning systems present in psychopathological suffering—has been carried out. For this purpose, three process-oriented coding systems were developed: The IMs Coding System, the Ambivalence Coding System, and the Ambivalence Resolution Coding System. They allow, respectively, for the study of change, ambivalence, and ambivalence resolution in therapy. This paper presents these coding systems, the main findings that resulted from their application to different samples and therapeutic models, the main current and future lines of research, as well as the clinical applications of this research program. [ABSTRACT FROM AUTHOR]

Psychotherapy research suggests that therapeutic change is associated with the emergence and development of innovative moments (IMs)—that is, exceptions to the problematic self-narrative that brought the client to therapy. This study compares two recovered cases of major depression, according to symptom measures, that presented contrasting profiles of evolution of IMs: one typical of successful therapy (Barbara), and another typical of unsuccessful therapy (Claudia). The core conflictual relationship theme (CCRT) was used to study narrative change independently of the innovative moments coding system (IMCS). The results suggest a high congruence between the IMCS and the CCRT profiles. Although Barbara presented changes in the IMCS and the CCRT in a similar way, Claudia's self-narratives (IMs and CCRT), despite symptom change, did not change. The results are discussed, considering the importance of narrative changes in recovery from depression and the maintenance of therapeutic gains. [ABSTRACT FROM AUTHOR]

The present study analyzed cross-generational trends in values and family patterns of value association across three generations (grandparents, parents and children). In this study, 101 family triads with adolescent children (N = 303) completed questionnaires assessing personal values. Grandparents’ values (Generation 1) were measured through parents’ perceptions of their own parents. In general, parents prioritize collectivist values, and there is an increased focus on individualist values across generations. Fathers’ individualist values mediate the relationship between their perceptions of grandfathers’ individualist values and grandchildren’s individualist values. There is no family association of collectivist values. The article outlines the implications of the increasing adherence to individualism and hypothesizes that the adherence of individualist values across families with adolescent children is a pathway to maintenance of family cohesion and cooperation. The role of fathers and the paternal lineage on adolescents’ acquisition of values are discussed. [ABSTRACT FROM PUBLISHER]

Objective:The aim of this study is to improve the understanding of self-changes after an intervention for depression focused on implicative dilemmas, a type of cognitive conflict related to identity. As recent research has highlighted the relevance of identity-related dilemmas in clients with depression, we sought to assess the way in which clients resolve such inner conflicts after a tailored dilemma-focused intervention and how this is reflected in the clients’ self-narratives.Method:We used three instruments to observe differences between good (n = 5) and poor (n = 5) outcome cases: (i) the Repertory Grid Technique to track the resolution of dilemmas, (ii) the Change Interview to compile clients’ accounts of changes at posttreatment, and (iii) the Innovative Moments Coding System to examine the emergence of clients’ novelties at the Change Interview.Results:Groups did not differ in terms of the number and relevance of client-identified significantly helpful events. However, between-group differences were found for the resolution of dilemmas and for the proportion of high-level innovative moment (IM) types. Furthermore, a greater self-narrative reconstruction was associated with higher levels of symptom improvement.Conclusions:Good outcome cases seem to be associated with the resolution of conflicts and high-level IMs. [ABSTRACT FROM AUTHOR]

Copyright of Psychotherapy Research is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Psychotherapy Research is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective:Innovative moments (IMs) are moments in the therapeutic dialog that constitute exceptions toward the client's problems. These narrative markers of meaning transformation are associated with change in different models of therapy and diverse diagnoses. Our goal is to test if IMs precede symptoms change, or, on the contrary, are a mere consequence of symptomatic 15 change.Method:For this purpose, IMs and symptomatology (Outcome Questionnaire-10.2) were assessed at every session in a sample of 10 cases of narrative therapy for depression. Hierarchical linear modeling was conducted to explore whether (i) IMs in a given session predict patients' symptoms in the following session and/or (ii) symptoms in a given session predict IMs in the next session.Results:Results suggested that IMs are better predictors of symptoms than the reverse.Conclusions:These results are discussed considering the contribution of meanings and narrative processes' changes to symptomatic improvement. [ABSTRACT FROM PUBLISHER]

This article explores the role of ambivalence in grief therapy within a narrative framework. From this perspective, change starts with the occurrence of innovative moments, which can be nullified by reaffirmation of the problematic self-narrative as a sign of ambivalence. This study analyzed ambivalence in six complicated grief cases using the “Return to the Problem Coding System.” Markers of ambivalence emerged in all cases, with a decreasing profile in cases with greater symptomatic improvement, suggesting an association between clinical change and ambivalence evolution in therapy. Addressing ambivalence may bring to light important aspects of client’s self-reconstruction after a major loss. [ABSTRACT FROM AUTHOR]

Background: Systematic studies of the efficacy of Narrative Therapy (NT) for depression are sparse.Objective: To evaluate the efficacy of individual NT for moderate depression in adults compared to Cognitive-Behavioral Therapy (CBT).Method: Sixty-three depressed clients were assigned to either NT or CBT. The Beck Depression Inventory-II (BDI-II) and Outcome Questionnaire-45.2 (OQ-45.2) were used as outcome measures.Results: We found a significant symptomatic reduction in both treatments. Group differences favoring CBT were found on the BDI-II, but not on the OQ-45.2.Conclusions: Pre- to post-treatment effect sizes for completers in both groups were superior to benchmarked waiting-list control groups. [ABSTRACT FROM AUTHOR]

Copyright of Psychotherapy Research is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The Assimilation of Problematic Experiences Scale (APES) and the Innovative Moments Coding System were applied to transcripts of a successful case of linguistic therapy of evaluation independently by different research groups. Assimilation theory and research suggest that higher APES scores reflect therapeutic gains, with a level of approximately 4.0 separating good from poor outcome cases. The innovative moments (IMs) model suggests that IMs classified as reconceptualization and performing change occur mainly in good outcome cases, whereas action, reflection and protest occur in both good and poor outcome cases. Passages coded as reconceptualization and performing change were rare in this case, but 100% of them were rated at or above APES 4. By contrast, 63% passages coded as action, reflection or protest were rated below APES 4 (Chi-square = 28.62, p <.001). Implications for research are discussed. [ABSTRACT FROM AUTHOR]

Copyright of Psychotherapy Research is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Psychotherapy Research is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

AbstractObjectivesMethodsResultsConclusionsAlthough psychotherapy research suggests that clients’ resources are related to positive outcomes, there is a lack of clinical tools available to consider their integration into psychotherapy. In this exploratory research, we studied the feasibility of a semi-structured interview to identify resources reported by clients at the onset of therapy and the relationship between resources and therapy outcomes.Data consisted of interviews with 30 clients from a clinical trial, in which elicitation of resources and their relationship with the outcomes were the main study objectives.This interview was content analyzed and both adaptative resources and maladaptive resources (dysfunctional coping strategies) were identified. The association between the adaptive resources and the evolution of outcomes throughout treatment was analyzed. Time (i.e. sessions) and resources were negatively correlated with psychological distress. Moreover, resources positively influenced the impact of time on distress.Clinicians should not take at face value resources that are self-reported, as they may reflect the maladaptive functioning of the client. The finding that clients with higher resources at onset have better outcomes points to the need to study how resources may be elicited effectively during therapy, and if this improves psychotherapy outcomes. [ABSTRACT FROM AUTHOR]

Alcohol consumption and Internet use are highly prevalent behaviours among young adults and previous research has suggested that different addictive behaviours might be distinctly associated with personality. This study examined the role of big-5 personality traits in alcohol consumption and Internet use. Alcohol consumption, internet use, and personality traits were assessed on 457 Portuguese university students. Higher levels of neuroticism, and lower levels of conscientiousness and agreeableness were found to be associated both with harmful alcohol use and problematic internet use. Openness to experience was not correlated with either behaviour. Multiple linear regression showed that conscientiousness might be an important predictor of both alcohol consumption and Internet use. There is an important overlap in personality traits related to alcohol and the use of internet, but there are also clear differences in what regards extraversion. Conscientiousness should be promoted as a preventive strategy. [ABSTRACT FROM AUTHOR]

AbstractFor a minority of the bereaved, the loss of a significant other can trigger an overwhelming emotional reaction and impaired functioning across life domains, known as prolonged grief disorder (PGD). Hence, ongoing efforts have been made to refine existing treatments to increase their efficacy and to accommodate the idiosyncrasies of grief reactions. This study presents the results of an open clinical trial of the feasibility and effectiveness of the Meaning in Loss (MIL) protocol in an online format. The brief intervention of 12 to 16 sessions combines constructivist and narrative strategies to explore and work through impediments to meaning reconstruction in loss. The sample included 25 participants diagnosed with PGD who were treated by six therapists. Baseline and post-therapy comparisons showed a significant improvement in all clinical measures (grief symptomatology, depression and general distress) and an increase of meaning making regarding the loss. Meaning making was found to be a prospective mediator of symptomatic improvement in grief across the course of therapy. These findings suggest the effectiveness of the MIL protocol in decreasing grief specific and associated symptomatology and argue for the relevance of further controlled evaluations of its efficacy. Moreover, results confirm previous findings that meaning making is a relevant factor in the evolution of grief reactions, including in the context of psychotherapy. [ABSTRACT FROM AUTHOR]

AbstractObjectiveMethodsResultsConclusionInterpersonal synchronization is increasingly studied as a biomarker of empathy, therapeutic alliance, and treatment outcome. However, most studies average data over sessions, leaving associations between synchrony and actual interactions largely unexplored. We aim to showcase a novel approach examining synchronization during specific micro-processes: Innovative Moments (IM) as markers of exceptions to clients’ problematic patterns of meaning.Electrodermal activity was recorded over 15 sessions of a psychodynamic psychotherapy single case. Moment-to-moment patient-therapist synchrony was calculated using the Adaptive Matching Interpolated Correlations (AMICo) algorithm. The Innovative Moments Coding System was utilized to identify IMs within session transcripts with precise timing. Monte-Carlo permutation tests were conducted to examine the association between physiological synchrony and IM Levels of increasing complexity (Levels 1–3).Higher-than-random synchronization emerged during Level 3 IMs (p = 0.046; d = 0.21) but not in lower Levels. Post-hoc qualitative analyses linked high synchrony to sub-processes of Level 3 IMs, such as positive contrasts and attributions for change.Our findings show it is possible to link moment-by-moment physiological co-regulation to theoretically identified meaning-making processes. While generalization of these observations is undue, this work demonstrates a robust and promising application of a multimodal approach to investigating psychotherapy, providing insights into both the clinical case and the theoretical model adopted. [ABSTRACT FROM AUTHOR]