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The Alternative Model of Personality Disorders (AMPD) integrates several theoretical models of personality functioning, including interpersonal theory. The interpersonal circumplex dimensions of warmth and dominance can be conceptualized as traits similar to those in AMPD Criterion B, but interpersonal theory also offers dynamic hypotheses about how these variables that change from moment to moment, which help to operationalize some of the processes alluded to in AMPD Criterion A. In the psychotherapy literature, dynamic interpersonal behaviors are thought to be critical for identifying therapeutic alliance ruptures, yet few studies have examined moment-to-moment interpersonal behaviors that are associated with alliance ruptures at an idiographic level. The current study examined the concurrent and cross-lagged relationships between interpersonal behaviors and alliance ruptures within each session in the famous Gloria films ("Three Approaches to Psychotherapy"). Interpersonal behaviors (warmth and dominance) as well as alliance ruptures (i.e., withdrawal and confrontation) were calculated at half minute intervals for each dyad. We identified distinct interpersonal patterns associated with alliance ruptures for each session: Gloria (patient)'s warmth was positively related with withdrawal ruptures concurrently in the session with Carl Rogers; Gloria's dominance and coldness were related with increased confrontation ruptures in the session with Fritz Perls concurrently, while her coldness was also predicted by confrontation ruptures at previous moments; lastly, both Gloria's dominance and Albert Ellis's submissiveness were positively related with withdrawal ruptures. These interpersonal patterns demonstrated the promise of using AMPD dimensions to conceptualize momentary interpersonal processes related to therapy ruptures, as well as the clinical importance of attuning to repetitive, dyad-specific interpersonal cues of ruptures within each session.

Despite wide recognition of the importance of interpersonal problems in binge eating disorder (BED), the nature of this association remains unclear. Examining the direction of this longitudinal relationship is necessary to clarify the role that interpersonal problems play in the course of binge eating problems, and thus to specify treatment targets and mechanisms. This study aimed to articulate the bidirectional, longitudinal associations between BED and both the general severity of interpersonal problems as well as warm and dominant interpersonal styles. Severity and styles of interpersonal problems and BED symptoms were measured at baseline, 12 weeks, 24 weeks, and 36 weeks in a sample of 107 women in treatment for BED. Results from bivariate latent change score models indicated that interpersonal problem severity and BED symptoms are associated longitudinally but do not directly influence each other. The results indicated a bidirectional interrelation between binge eating symptoms and dominance such that less dominance predicted greater decreases in binge eating problems, and less binge eating symptoms predicted greater increases in dominance. We also found that binge eating symptoms positively predicted changes in warmth (i.e., less binge eating symptoms predicted less increases or more decreases in warmth). These findings highlight the importance of using dynamic models to examine directionality and delineate the distinct roles of interpersonal severity and styles in BED trajectories. (PsycINFO Database Record

Therapeutic realness occurs when therapists express their feelings, thoughts, and desires directly to their clients, even when doing so comes with risk. Previous nonclinical research indicates that realness is a core feature of the more general concept of authenticity/genuineness/congruence. In this article, we examined therapeutic realness in a sample of 691 therapist participants who reported on their typical experiences in therapy. Therapeutic realness was correlated with age and clinical experience and was higher in the treatment of individuals as opposed to couples, families, or groups, and in the use of process-oriented as opposed to cognitive–behavioral therapy techniques. Therapeutic realness was associated with the real relationship, therapy presence, and working alliance. These results suggest that therapeutic realness might play an important role in psychotherapy and point to important directions for future research. Public Significance Statement: This article examines the role of being real in psychotherapy. Being real involves being authentic with clients even when there is pressure not to. This work shows that therapeutic realness is more common under certain conditions and is generally related to positive therapeutic process. [ABSTRACT FROM AUTHOR]

Concrete cracking is one of the important factors affecting the safety and durability of composite bridge structures. While the existing crack width calculation methods cannot accurately predict the crack width of ultrahigh-performance concrete (UHPC), this paper aims to investigate flexural crack performance (e.g., failure mode, crack width, and crack spacing) of an innovative composite deck structure comprising an I-steel beam and glass fiber‒reinforced polymer (GFRP) strips‒UHPC composite deck. Three GFRP‒UHPC composite slabs and two steel‒GFRP strips‒UHPC composite beams are designed to explore the cracking behaviors in transverse and longitudinal directions, respectively. The effects of reinforcement ratio and the steel fiber content on flexural cracking behavior are analyzed. The results showed that increasing the reinforcement ratio restricts the formation and growth of cracks and reduces the crack width and average crack spacing in the UHPC plate. However, the impact of steel fiber content is small. The steel‒GFRP strips‒UHPC composite beams fail owing to the yield of the I-steel beam and longitudinal reinforcement bar in the UHPC plate, while the GFRP‒UHPC composite slabs collapse as a result of the yield of reinforcement bar in the UHPC plate. Based on the existing test results, the formulas are proposed to estimate the reinforcement stresses and the maximum crack width in the steel‒GFRP strips‒UHPC composite deck structure, and the findings have indicated good agreement with the measured ones. [ABSTRACT FROM AUTHOR]

Objective: Although teletherapy is increasingly common, very little is known about its impact on therapeutic relationships. We aimed to examine differences between therapists' experiences of teletherapy and in-person therapy post-pandemic with regard to three variables pertinent to the therapeutic relationship: working alliance, real relationship, and therapeutic presence. Methods: In a sample of 826 practicing therapists, we examined these relationship variables, as well as potential moderators of these perceived differences including professional and patient characteristics and covid-related variables. Results: Therapists reported feeling significantly less present in teletherapy and their perceptions of the real relationship were somewhat impacted, but there were no average effects on their perceived quality of the working alliance. Perceived differences in the real relationship did not persist with clinical experience controlled. The relative reduction in therapeutic presence in teletherapy was driven by the ratings of process-oriented therapists and therapists conducting mostly individual therapy. Evidence for moderation by covid-related issues was also found, with larger perceived differences in the working alliance reported by therapists who used teletherapy because it was mandated and/or not by choice. Conclusion: Our findings might have important implications for generating awareness around the therapists' lowered sense of presence in teletherapy compared to in-person teletherapy. [ABSTRACT FROM AUTHOR]

The usefulness of therapists' self‐disclosure (TSD) in psychotherapy remains controversial, and little is known regarding the potential risks and benefits of TSD in times of global crisis such as the COVID‐19 pandemic and in teletherapy. We examined two independent samples of therapists (N = 1705; Study 1) and patients (N = 772; Study 2) on their perceptions of increases in TSD during the transition to teletherapy early in the COVID‐19 pandemic (spring 2020). Approximately 20% of therapists and 14% of patients reported perceptions of definite increases in TSD. Therapists' top reasons for increased TSD were therapists' heightened distress and an effort to connect with patients in teletherapy. Importantly, therapist perceptions of their increased TSD were positively related to subjective vicarious trauma, real relationship, psychodynamic theoretical orientation and negatively with humanistic orientation, but not with age, race/ethnicity, length of clinical experience, working alliance, or professional self‐doubt. Patients' perceptions of increased TSD were positively related with patient pandemic‐related traumatic distress and their own self‐disclosure, but not with patient‐reported therapeutic relationship variables. Longitudinally, patients' perceptions of TSD increases predicted higher pandemic‐related traumatic distress at 3‐month follow‐up, after controlling for their baseline traumatic distress and other variables. These results highlighted that increased TSD in teletherapy may be a potential marker for heightened distress in both patients and therapists during a global crisis and a transition to teletherapy. The findings also contrasted the literature and emphasized that therapists, but perhaps not patients, may have considered increased TSD as a reflection of genuine therapeutic connection. [ABSTRACT FROM AUTHOR]

Transitions from early childhood education and care (ECEC) to primary education are not only about the quality of children's early learning but also affect the development of children and are of great value in promoting the construction of high-quality education systems in various countries. This study uses incrementalism theory to review the policy content for transitions from ECEC to primary education in China and finds that the policy has evolved through four stages: the gestation period, the initial exploration period, the steady development period, and the system construction period. The evolution of the policy has shown a characteristic step-by-step increase from small to large, seeking changes while maintaining stability. Through the review of China's policy content for transitions from ECEC to primary education, we hope to provide evidence from the Chinese experience to international research in related fields. [ABSTRACT FROM AUTHOR]

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]

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. [ABSTRACT FROM AUTHOR]

One factor that may help avoid treatment failure by premature termination is the therapist's responsiveness to the patient's coaching. Coaching refers to the patient's efforts to inform and guide the therapist about the kinds of therapist behaviors, attitudes, and interventions that would advance the therapy. The case of Barb, from a naturalistic study of time-limited psychotherapy, was examined as a failed treatment due to premature termination. Using a case study approach, descriptive analysis of the therapy process, along with quantitative ratings of coaching and responsiveness, was employed to examine instances of patient coaching with corresponding therapist responsiveness. Analysis indicated that the patient attempted to coach the therapist throughout each session about her plan for treatment and the responses she sought from the therapist. The therapist's responses were only partially aligned––and in some instances not at all aligned––with the patient's coaching. The disparity between the patient's coaching and the therapist's responsiveness was widest in the two sessions immediately prior to termination. This case study indicates that patients may coach therapists in order to avoid treatment failure. Therapists who attend to patient coaching and modify their responsiveness may be better able to sustain treatment and help patients achieve therapeutic goals. [ABSTRACT FROM AUTHOR]