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The most frequently examined aspect of the therapeutic relationship is the working alliance, which reflects the conscious collaborative bond, and agreement on task and goal. In addition to the established importance of the working alliance, the therapists' attunement and responsiveness might reflect another important aspect of the therapeutic relationship that can be considered in relation to session-by-session progress over treatments. Emerging research suggests that the quality of the working alliance not only differs between patients but also within patients over time. However, little is known about the quality of the therapeutic relationship between and within patients in relation to progress in psychotherapy. We examined fluctuations of the working alliance measure (WAI) and the newly developed measure of the Patients' Experiences of Attunement and Responsiveness (PEAR) during treatment in a naturalistic sample of patients in an outpatient psychotherapy clinic. Multilevel modelling was used to examine the respective contribution of these measures to subsequent improvement in psychological functioning longitudinally. Results suggest that the within-patient effect, instead of between-patient effect, was significant for WAI (and did not reach significance for PEAR), indicating that the fluctuation of WAI was predictive of psychological functioning in the subsequent month. Based on these findings, therapists and their patients might benefit from regular tracking of the patient-reported working alliance. The findings underscore the importance of the alliance, specifically at the within-patient level. It also highlights the challenge for research to tap into other aspects of the therapeutic relationship that can help explain progress in therapy. Given the breadth and accessibility of the working alliance construct, more work is needed for researchers to examine the construct of attunement and responsiveness.

Interpersonal guilt often encompasses pathogenic beliefs that imply omnipotent responsibility for others and concerns about abandoning, humiliating or threatening others. This study sought to examine how interpersonal guilt may influence patients' and therapists' ratings of early working alliance and the potential moderating effect of perceived adverse parenting in childhood. Ninety-five patients and their 19 therapists in an outpatient psychotherapy clinic rated their early working alliance after the first and the fifth session in treatment. We conducted separate moderation analyses for patient and therapist-reported working alliance and controlled for psychological distress at baseline. Results suggest that perceived adverse parenting in childhood significantly moderated the effect of interpersonal guilt on the working alliance in such a way that for patients reporting very low levels of perceived adverse experiences, the interpersonal guilt beliefs had a positive effect on working alliance, whereas for those with very high levels of perceived adverse experiences, interpersonal guilt had a negative effect on working alliance. This same pattern of moderation was found for patient- and therapist-reported working alliance at session 1 and therapist-reported working alliance at session 5. Thus, although the effect of interpersonal guilt on the working alliance depends somewhat on the perspective of the working alliance rating (patient or therapist), it mainly depends on developmental experiences of the patient.

We aimed to develop a self-report measure of therapist acceptance of telepsychotherapy based on the Unified Theory of Acceptance and Use of Technology (UTAUT) framework.Using a cross-sectional survey design, 1265 therapists completed the UTAUT-T, as well as additional questions.Confirmatory analysis indicated that the original UTAUT model did not fit the therapist context well. Exploratory factor analysis specified a better-fitting five-factor model, which showed good internal validity fit (χThe 21-item UTAUT-T offers a promising self-report measure of therapist acceptance of telepsychotherapy and intention towards using it in the future. Future studies on the convergent and predictive validity of the UTAUT-T are warranted.

The way that people internalize adverse experiences plays an important role in the development of psychopathology. The Pathogenic Belief Scale (PBS) is intended to operationalize a transtheoretical understanding of repetitive patterns of emotion-laden beliefs that develop in childhood and continue to influence people's current experience. Using a cross-sectional survey design, we recruited a large heterogeneous sample of 246 clinic outpatients and 732 adults in the community. Besides the PBS, measures of adverse parenting experiences and common psychopathology were administered. An exploratory factor analysis of the total sample of 978 participants was conducted followed by a convergent validity analysis for the 246 clinic outpatients. The three-factor solution included “cannot rely on others,” “undeserving,” and “interpersonal guilt,” and it showed good psychometric properties, including convergent validity with the measures of adverse parenting experiences and psychopathology. The 34-item PBS offers a promising self-report measure that could help delineate and understand the pathogenic beliefs that heterogeneous samples of patients may hold. Pathogenic beliefs may be relevant to the psychotherapy process, regardless of model or theoretical context.

Objective: We aimed to develop a self-report measure of therapist acceptance of online therapy via videoconferencing based on the Unified Theory of Acceptance and Use of Technology (UTAUT) framework. Method: Using a cross-sectional survey design, 1,265 therapists completed the UTAUT-T, as well as additional questions. Results: Confirmatory analysis indicated that the original UTAUT model did not fit the therapist context well. Exploratory factor analysis specified a better-fitting five-factor model (Therapy Quality Expectation, Pressure from Others, Ease of Use, Professional Support, Convenience), which showed good internal validity. Of the five factors, four predicted intention to use online therapy in the future. Conclusion: The 21-item UTAUT-T offers a promising self-report measure of therapist acceptance of online therapy and intention towards using it in the future, which, in turn are likely to predict actual future use outside the pandemic context. Future studies on the convergent and predictive validity of the UTAUT-T are warranted.

The way people derive inferences from actual adverse experiences plays an important role in the development of psychopathology. This study aims to examine the mediating role of pathogenic beliefs (i.e., emotion-laden, powerful, painful convictions about self and others) on the relation between perceived adverse parenting behaviors in childhood and subsequent adult psychopathology. Participants (mostly Caucasian and heterosexual) were 204 consecutively admitted patients with a range of psychological difficulties, including depression, anxiety, and interpersonal problems, at a low-fee outpatient clinic. Participants completed standard self-report assessments of perceived parental style, depressive and anxiety symptoms, and a clinically derived measure of pathogenic beliefs. We examined the indirect effects of adverse parenting on anxiety and depressive symptom severity through pathogenic beliefs. Pathogenic beliefs reflecting the unreliability of others significantly mediated the relationship between adverse parenting and anxiety symptoms. The other mediation model is consistent with the theory that perceived adverse parenting contributes to the severity of depressive symptoms through beliefs about not being deserving and other people being unreliable. Within the limitations of the cross-sectional, retrospective, and self-report nature of the data, our results seem to suggest that attending to intermediary subjective beliefs might be important in understanding psychopathology development in the context of childhood adversity. Aiming to modify the beliefs in therapy might modify the symptoms. However, this would remain to be demonstrated through formal intervention research.

The United Kingdom and the United States share several commonalities: both use English at the common language, both use common law based court decision as well as having a constitution as their legal basis rather than code law, and both are predominately Christian countries. These factors have resulted in highly advanced respect in the law for protection of human rights. The British were moving toward acceptance of human rights long before Americans had populated the North American continent and although they became enemies in the years of colonization and shortly after the Establishment of the United States as an independent country, they have reached many of the same positions on human rights such as abolition of slavery, equal rights for all, and protection of the weak against the strong.

This study explored how people perceive the intelligence of a source in relationship to the style of English used. Male and female research participants read a newspaper article that cited a private or public, male or female source on a political issue. Citations were (a) in correct English, (b) in regional dialect, or (c) in incorrect, flawed English. Readers assigned higher intelligence to those individuals cited in correct English. The authors discuss the implications for verbatim or corrected citing of sources.

Diagnosis: Ocular fascioliasis. The shape of the organism, including the cephalic cone, was consistent with Fasciola hepatica (figure 1). FAST-ELISA [1] demonstrated the presence of antibodies to excretory-secretory antigens, and Western blot demonstrated fasciola excretorysecretory antigens. It is likely that the complete paralysis of extraocular movements was the result of retro-orbital tension on nerves and muscles, attributable to inflammation and/or a possible postsurgical arteriovenous fistula. Over the ensuing months, the left cornea become calcified. Triclabendazole was administered at a dose of 10 mg per kg of body weight, and the patient experienced no adverse events. The liver fluke Fasciola hepatica is endemic in many temperate countries, and it primarily infects the biliary tract of sheep and other ruminants. Humans may be an accidental host, and ectopic disease may occur when immature flukes migrate to sites other than the biliary tree. Fascioliasis results from the ingestion of metacercaria encysted on aquatic vegetation, such as watercress. Following encystment in the duodenum, immature flukes usually migrate across the intestinal wall to the liver over a period of 5-6 weeks, with eggs appearing in the feces by ~4 months. This unusual case represents one possible manifestation of ectopic fascioliasis. Other ectopic sites include subcutaneous tissues, he CNS, lung, stomach, and cecum and epididymis. Morphologically, adult flukes are described as leaf-shaped, with a cephalic cone, and are approximately 1.5 x 3 cm in area. In this case, we considered infections with other large migrating helminths, such as Gnathostoma spinigerum, Paragonimus westermanii, and Spirometra mansoni, but the morphology and epid miology were most suggestive of fascioliasis, and this diagnosis was confirmed by the detection of F. hepatica-specific antibodies.