Search

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]

Given the importance of authenticity in counseling psychology, we used a collaborative autoethnography approach to explore our experiences of authenticity as counseling psychology doctoral students. Six (3 women, 2 men, 1 gender flexible man; 3 European American, 2 Asian American, 1 Asian; 5 3rd-year students, 1 2nd-year student) students in one counseling psychology doctoral program in the Mid-Atlantic United States reflected on the factors that facilitated and hindered our ability to be authentic by writing four one-to-five page journal entries, reading the journals in four three-hour group meetings, receiving non-judgmental feedback, and editing the journal entries. In the journals, we explored our understanding of authenticity, the development of our authentic selves, our experience of authenticity in graduate school, the role of authenticity in our relationships, the way in which our authenticity has been shaped by external forces, and our process of balancing the costs and benefits when deciding whether or not to be authentic in a given situation. Themes that emerged from the data revealed that we had received mixed messages about authenticity in our graduate program and that our ability to be authentic varied depending on whether we were in the role of therapist, teacher, researcher, or student. Further, family and peer relationships, hierarchical structures, and privileged and marginalized social identities enhanced or inhibited our experiences of authenticity in graduate school. Implications for graduate students and recommendations for future research are discussed. [ABSTRACT FROM AUTHOR]

Proponents of evidence-based treatments (EBTs) have directed complaints of potential unethical practice against psychotherapists who refrain from using EBTs as first-line interventions for a range of psychiatric disorders on the grounds that these treatments should be given priority because of their exceptional scientific backing. This article counters these claims and highlights core ethical concerns associated with the research and practice of EBT itself; namely, the appropriateness of saturating the field with short-term models of psychotherapy and the questionable assumption that these can yield meaningful and lasting change; the uncertain relevance of the results of EBT investigations for psychotherapists working with real-world clients; the foreclosure of opportunities to address clients' unmet developmental needs and self-fragility posed by the directive/didactic therapeutic stance inherent in EBTs; and, the reduced quality of psychotherapy offered to the public at large and threats to the clinical competence of early-career mental health professionals caused by overemphasizing training in EBTs over the acquisition of relational skills in graduate schools and postgraduate training sites. [ABSTRACT FROM AUTHOR]

Introduction: Depression is a significant, growing and prevalent issue, one of the chronic disorders and the leading cause of disability worldwide. Aim: The present study aimed to develop a psychological intervention protocol based on systemic theory in depressed individuals. Method: The research method was qualitative content analysis, and the statistical population included various data sources related to the present concepts and therapies in the field of systemic theory, such as Google Scholar, Scopus, Science Direct and …, within 1998 to 2020. The extracted data from these sources were analyzed; an individual systemic psychotherapy protocol was developed based on the obtained results. Then, the content validity of the protocol was determined using the opinions of eight experts in the field of clinical psychology. Sampling in this study was purposeful. The research tool included the written evidence and documents searched in the aforementioned databases, and the data analysis method was Sterling’s content analysis. Results: Therapeutic communication, questions, statements, guidelines, problem identification, problem sequence, types of constraints, and decision matrix, including planning frameworks at different levels, feedback, and feedforward, formed the primary themes of the individual systemic psychotherapy. The content of psychotherapy protocol sessions was adjusted based on the obtained components in 12 weekly sessions. Conclusion: The individual systemic psychotherapy protocol is a comprehensive psychological treatment that includes multiple factors affecting the individual’s system and is valid and efficient. It is recommended to use this protocol for individuals with depression. [ABSTRACT FROM AUTHOR]

Rates of subclinical symptoms and full-blown depression signifcantly increase during adolescence. Hence, understanding how multiple cognitive risk factors are related to depression in adolescence is of major importance. For this purpose, we simultaneously considered multiple cognitive vulnerabilities, as proposed by three major cognitive theories for depression, namely Beck’s cognitive theory, hopelessness theory, and response style theory. In this four-wave study, we investigated the architecture, interplay, and stability of cognitive vulnerability mechanisms, depressive symptoms, and stressors in a large group of adolescents over a period of one year (n=469; mean age=15 years; 64% female). Network analysis was used to shed light on the structure of cognitive vulnerabilities in a data-driven fashion. Analyses revealed that diferent cognitive vulnerabilities were intertwined and automatic thoughts played the role of hub node in the network. Moreover, the interplay among cognitive vulnerabilities and depressive symptoms was already markedly stable in adolescence and did not change over a 12-month period. Finally, no evidence was found that cognitive vulnerabilities interacted with stressors, as proposed by diathesis-stress models. These fndings advance our understanding of multiple cognitive risk factors for depression in adolescence. [ABSTRACT FROM AUTHOR]

Cognitive behavioral therapy (CBT) is the dominant training model adopted by clinical psychology training programs and is commonly reported as the primary theoretical orientation among community therapists. However, few American psychologists receive formal training in supervision to support CBT, despite APA recommendations related to supervision competencies. Graduate training is an optimal time and place for supervision training, and we describe a CBT supervision workshop within a clinical doctoral program. Twenty-three trainees (69.6% Caucasian/White, 73.9% women) reported declarative knowledge of supervision and perceived supervision competencies before and after the workshop. Trainees increased declarative knowledge and perceived supervision competencies. Graduate training in CBT supervision may help develop a well-trained supervisor workforce that can better support the use of evidence-based therapies, such as CBT. [ABSTRACT FROM AUTHOR]

The experience of practising psychotherapy as a clinical psychologist was explored through a small number of in-depth interviews. Using Interpretative Phenomenological Analysis, three main themes were identified: “Feeling there’s something missing”, “Being able to get in there emotionally” and “Needing somewhere to go for support”. This study suggests that training for psychotherapy work can be experienced as piecemeal and fragmented, contributing to professional self-doubt, with clinical psychologists seeking more structured, cohesive training in this area. It also suggests that engagement in personal therapy can contribute to greater emotional capacity as a psychotherapy practitioner, although clinical psychologists can fear engaging in something that is unfamiliar. In addition, the psychologists highlighted the felt necessity of safe and satisfying supervision for resilient practice. [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]

The Wechsler intelligence tests (currently Wechsler, 2008, 2014) have traditionally been part of the multimethod test battery favored by psychodynamically oriented assessors. In this tradition, assessors have used Wechsler data to make inferences about personality that transcend cognition. Recent trends in clinical psychology, however, have deemphasized this psychodynamic way of working. In this article, I make a conceptual and clinical case for reviving and refining a psychodynamic approach to inference making about personality using the Wechsler Verbal Comprehension subtests. Specifically, I (a) describe the psychological and environmental conditions sampled by the Wechsler tests, (b) discuss the Wechsler tests conceptually in terms of assessing vulnerability to breakdowns in adaptive defensive functioning, (c) review a general framework for inference making, and (d) offer considerations for and illustrate pragmatic application of the Verbal Comprehension subtests data to make inferences that help answer referral questions and have important treatment implications. [ABSTRACT FROM AUTHOR]

The article examines psychological treatment for unipolar depression in adult outpatients. Unipolar depression is treated as a major depression which may occurduring the entire life period across various races and ethnic groups. This article also focuses on positive aspects of mental health, research on treatment for depression, how psychological treatments work for depression, and possible new directions for treatment.

The impact of DSM-III-R personality pathology on the Axis I therapy process was studied in 70 outpatients who received cognitive and/or behavioural therapy for an Axis I anxiety disorder. The Axis I therapy process was evaluated by the therapist. DSM-III-R personality pathology was assessed first by an independent rater using a semi-structured interview (Structured Clinical Interview for DSM-III-R Personality Disorders (SCID-II)) and second by the therapist in the course of treatment. Results showed poor diagnostic agreement between SCID- and therapist-derived personality pathology. SCID-derived personality pathology was only weakly related to a dysfunctional Axis I therapy process, as reported by the therapist. Therapist-derived personality pathology, on the contrary, was strongly related to a dysfunctional Axis I therapy process, as reported by the therapist. Possibly, therapists erroneously attributed Axis I therapy failure to assumed personality pathology. This is the first study on the impact of personality pathology, as assessed by an independent semi-structured interview, on the process of cognitive-behavioural therapy for Axis I anxiety disorders. The findings are consistent with studies that show no negative impact of personality pathology, as assessed by independent semi-structured interviews, on therapy outcome of Axis I anxiety disorders. Copyright © 1999 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]