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Although the use of telesupervision (technology-assisted supervision) is increasing in line with trends in digital health, this remains to be an under-researched area. This systematic review sought to evaluate the current state of knowledge about counsellors', psychotherapists' and psychologists' perspectives and experiences of receiving clinical supervision online, and to determine specific gaps in the literature. Five themes emerged within the literature review: comparison of telesupervision with in-person supervision; challenges of telesupervision; benefits of telesupervision; components of effective telesupervision and supervisor characteristics. Overall, evidence suggests that supervisory relationship is the key factor in quality and efficacy of supervision, regardless of delivery modality. Recommendations are made for practice, including training both supervisors and supervisees in telesupervision, and future research directions are discussed. [ABSTRACT FROM AUTHOR]

AbstractObjectiveMethodResultsConclusionWorldwide, the numbers of refugees and displaced people being exposed to traumatic and inhumane experiences are escalating, resulting in an enhanced need for appropriate psychological management of trauma in this at-risk group. This study explores therapists’ perspectives on and preparedness for supporting adult refugees with trauma-related interventions.Therapists (N = 17), with varying ranges of experiences supporting adult refugee clients, were recruited nationally, and participated in semi-structured interviews, exploring their experiences and preparedness for therapeutically supporting refugee clients with trauma-related interventions. Data were analyzed using reflexive thematic analysis. A Patient Public Involvement (PPI) approach was embedded within this study.Five major themes were developed throughout the analysis: (i) Therapists’ Fears and Apprehensions in Meeting Client Complexities, (ii) Preparation and Support for Competency Development, (iii) Adjusting Preconceptions of the Nature of Therapeutic Work, (iv) Humanity Within the Therapeutic Relationship, and (v) Balancing Therapeutic Meaningfulness and Hardships.Therapist training must reflect trauma-informed care and inter-cultural awareness to allow therapists to feel better prepared within mainstream and specialist services. Further, therapists’ well-being needs to be prioritized to prevent vicarious trauma, burn-out and ultimately, improve interventions for clients. [ABSTRACT FROM AUTHOR]

Background Aim and Objectives Method Findings Conclusions Research on psychedelics centres on two key areas: the action of psychedelics on the brain and the protocol for delivering therapy. There is little research that considers the implications of this novel therapy on the therapist delivering the treatment. This research study sought to explore this.The aim of this research was to explore the considerations for psychotherapists interested in delivering psychedelic therapy. Objectives were to examine the therapeutic conditions needed for effective outcomes, to explore the perceived differences between the practice of standard psychotherapy and psychedelic therapy and to determine the challenges for therapists working in the field.Six semi‐structured interviews were conducted with therapists who work in clinical or retreat settings. Interview transcripts were analysed using qualitative thematic analysis.Three themes emerged that highlight the importance of preparation for effective clinical outcomes, the differences in standard and psychedelic practice and the personal and professional implications for therapists.The results highlighted challenges and revealed the need for clear protocols for integrating psychedelics into psychotherapy practice. [ABSTRACT FROM AUTHOR]

An emerging practice amongst lawyers in England and Wales is the use of clinical supervision, as used by counsellors and psychotherapists. This is a very different type of supervision to that traditionally used by lawyers. It is reflective and relational in nature. It aims to support safe, competent and ethical practice, and to contribute to sustainability, support and resilience including in relation to vicarious trauma and burnout. This study uses interviews with lawyers who are using clinical supervision to understanding why it is being sought, how it might be working and what its impacts are. The interviews provide an opportunity to examine interpersonal dynamics of lawyering. The study explores how supervision allows lawyers to develop their understanding of themselves in relation to others, their boundaries and legal professional skills, and how supervision can contribute to the best interests of the client, and to a lawyer’s career sustainability and wellbeing. [ABSTRACT FROM AUTHOR]

This article explores the use of artificial intelligence (AI) in mental healthcare, specifically focusing on its impact on the therapist-patient relationship. AI technologies, such as chatbots, have the potential to provide personalized support and improve access to mental health services. However, there are concerns about transference, where patients may project their feelings onto the AI. It is important to carefully manage transference dynamics to avoid harm and maintain ethical standards. The development of AI systems that can recognize and appropriately respond to transference is necessary, and collaboration between AI developers and mental health professionals is crucial. Additionally, regulatory frameworks and ethical guidelines should be implemented to ensure responsible and effective use of AI in mental healthcare. Interdisciplinary collaboration, cultural sensitivity, and continuous monitoring and evaluation of AI interactions are also emphasized. [Extracted from the article]

Under the assault of disturbing experiences that seem sealed into a bodily discourse, there appears an increased permeability between the dream space and the psychotherapy space. It is in the forensic in-patient hospital environment that I have commonly sat with a calm and compliant patient to find myself grappling with an overwhelming pull toward sleep. Such tiredness in countertransference can be understood as a manifestation of the weight of buried or repressed disturbance which can only seemingly be registered at a bodily level. Forensic patients are usually the subject of vilification from the courtrooms to sensationalist media reports in a system that further bottlenecks their emotional lives. It seems to me that sometimes there can be a fine line between continuing the trend of condemnation and the taking up of clinical responsibility. It is perhaps one of the most helpful aspects of psychoanalytic work, that we consider the projective processes involved in the criminal justice system. That we look to ourselves and our own countertransference for greater clinical clarity, a radar in the darkness. It is with this in mind that I write an introspective paper focussing on the lens of my own dream life and artistic responses to the environment of a forensic institution. [ABSTRACT FROM AUTHOR]

La voix humaine est un outil souvent sous-estimé dans la pratique clinique et les recherches psychosociales, passant fréquemment inaperçue dans le domaine du soin psychique et des dispositifs thérapeutiques, alors qu'elle peut véhiculer des pensées, des affects et raconter l'histoire d'un individu au-delà du langage. Partant de l'intuition clinique selon laquelle les professionnels experts du travail transculturel pourraient être particulièrement attentifs à la voix humaine – étant donné que cette pratique entre les cultures implique souvent une barrière de langue surmontée grâce aux interprètes et invite à s'intéresser à la musicalité des voix et des langues – les chercheurs ont mené une enquête qualitative pour émettre des hypothèses sur le rôle joué par la voix humaine dans le soin psychique. Les résultats de l'étude montrent que la consultation transculturelle est exemplaire pour démontrer l'importance de la prosodie de la voix des soignants, car elle peut être un véritable levier psychique explicite dans ce contexte. Cependant, l'enquête démontre également que la voix du soignant se transforme implicitement alors que le soignant est pris dans la relation avec les patients. La voix humaine joue un rôle primordial pour permettre un accueil bienveillant, une résonance humaine entre le patient et le soignant, et pour signaler l'envie de tisser une alliance thérapeutique suffisamment forte. L'impact de la voix du thérapeute dans le travail clinique n'est pas suffisamment mis en avant dans les recherches psychosociales et cliniques. The human voice is an often underestimated tool in clinical practice and psychosocial studies and research. Paradoxically, despite being a primary means of expressing emotions and sharing intimate feelings, the human voice is often neglected in clinical psychotherapeutic work. Despite its importance for psychotherapists, psychiatrists, and caregivers, a lack of theories and deeper explorations of its potential impedes its explicit utilization in the mental health care environment. This article focuses on the importance of the caregiver's voice when working with patients from different cultures and languages, particularly in transcultural clinics, such as transcultural consultations, which emphasize the therapeutic characteristics of the voice that clinicians often overlook. The authors examined the clinical intuition of experienced caregivers, including nurses, psychologists, and psychiatrists, who work with patients from diverse cultural and linguistic backgrounds. The prosody and musical elements of the spoken voice play a particularly important role in these clinical settings that transcend language barriers. Through a qualitative inductive study involving six experienced clinicians, the authors developed themes highlighting the importance of the caregiver's voice. These themes were based on the experiences and clinical anecdotes of participants specializing in transcultural therapeutic approaches, accustomed to collaborating with interpreters who bridge the language divergence between French and the patients' native languages. The transcultural consultation constitutes a unique therapeutic approach comprising a team of co-therapists with diverse cultural backgrounds and languages, along with patients, their family members, and professionals providing administrative, medical, or psychological help. The principal therapist is responsible for setting the stage for the consultation and may invite co-therapists to share mental images or proposals while listening to the patient. In this group setting, attentiveness to the voice is crucial, as it provides the therapist with direct audible cues from the patient, and it is also what the patient receives from the caregivers. Before language is translated by an interpreter, the patient perceives the sound of the therapist's voice, its musicality, prosody, and conveyed emotions. The results of this qualitative study suggest that the therapist's voice in a transcultural clinical setting is essential in creating a positive work environment, conveying good intentions to patients, and establishing a therapeutic alliance through prosodic elements. Furthermore, the voice plays an important implicit and explicit role for the participants in this study. They note that their voice unconsciously varies, and they can use it explicitly as a therapeutic tool to create an impulse or mood. Important aspects of the patient-caregiver relationship can be exclusively transmitted by the tone of the voice and by the musicality of the linguistic content of statements made by the caregiver, who wields an important clinical tool that is often taken for granted. The study also highlighted the important contrast between the explicit role of the caregiver's voice as a conscious therapeutic tool and the implicit, unconscious influence on the caregiver's voice linked to the relationship with patients. Further interdisciplinary studies of the human voice as a tool in a clinical and psychotherapeutic context are therefore essential, and the transcultural approach could inspire future research. [ABSTRACT FROM AUTHOR]

Cet article se base sur une recherche explorant l'impact de la réalité externe, notamment les multiples crises mondiales telles que la pandémie de COVID-19, les mouvements sociaux et les crises politiques, sur la relation thérapeutique et le cadre analytique. Il met en lumière l'importance de l'improvisation et de la créativité dans le maintien de la continuité du processus thérapeutique dans un environnement marqué par l'imprévu. L'objectif principal de l'article est de saisir l'impact des réalités externes partagées sur le processus thérapeutique, en mettant en évidence les défis rencontrés par les praticiens dans un contexte de crises multiples. La recherche repose sur des entretiens qualitatifs avec des psychanalystes et psychothérapeutes de différents pays confrontés à diverses crises. Les chercheurs ont analysé les réponses des participants pour identifier les thèmes émergents. Les résultats mettent en évidence l'impact profond des crises externes sur la pratique thérapeutique, notamment en termes de remise en question de l'identité professionnelle des praticiens et de la nécessité d'adapter les cadres thérapeutiques pour maintenir la continuité du processus analytique. Les participants ont également fait preuve d'une grande créativité dans l'aménagement de leur lieu de travail et l'exploration de nouvelles approches thérapeutiques. La discussion souligne l'importance de reconnaître et d'aborder les défis posés par les crises externes dans la pratique thérapeutique, tout en mettant en lumière le rôle crucial de l'improvisation et de la créativité dans le maintien de la continuité du processus analytique. Les praticiens doivent être prêts à repenser et à adapter leur cadre thérapeutique pour répondre aux besoins changeants de leurs patients, tout en préservant les principes fondamentaux de la thérapie. This article is based on research exploring the impact of external reality, including multiple global crises such as the COVID-19 pandemic, social movements, and political crises, on the therapeutic relationship and the analytical framework. This collaborative study, carried out by researchers from different countries, took shape in response to the COVID-19 health crisis. It aims to understand how psychoanalysts and psychotherapists have had to adapt their practices in the face of these crises, highlighting the importance of improvisation and creativity in maintaining the continuity of the therapeutic process. The principal objective of the study is to identify the impact of shared external realities on the therapeutic process, highlighting the challenges faced by practitioners in a context of multiple crises. The researchers also seek to explore how psychoanalysts and psychotherapists have had to call into question and adapt their practices and frameworks in order to continue working with their patients in an environment marked by uncertainty and the need to improvise. The research is based on qualitative interviews with psychoanalysts and psychotherapists from different countries facing various crises. The researchers analyzed the participants' responses to identify emerging themes and understand how practitioners navigated these challenges, highlighting coping strategies and adjustments to the therapeutic framework. The findings confirm the profound impact of external crises on therapeutic practice, particularly in terms of challenging practitioners' professional identities and the need to adapt therapeutic frameworks to maintain the continuity of the analytical process. Participants expressed a sense of insecurity, frustration and a loss of rituals associated with the move to working online. However, they also showed great creativity in designing their workplace and exploring new therapeutic approaches. The discussion underlines the importance of recognizing and addressing the challenges posed by external crises in therapeutic practice, while also highlighting the crucial role of improvisation and creativity in maintaining the continuity of the analytical process. Practitioners must be prepared to rethink and adapt their therapeutic framework to meet the changing needs of their patients, while preserving the fundamental principles of therapy. Ultimately, the study highlights the importance of collaboration and ongoing development between practitioners in overcoming the challenges posed by external crises in order to ensure the quality of therapeutic care. [ABSTRACT FROM AUTHOR]

Psychoanalysis involves studying how people maintain not knowing what they "know." As a result, how psychoanalytic psychotherapists orient toward what their patients may be experiencing but cannot say is at the core of psychoanalytic praxis. Jeremy Safran's unique psychoanalytic sensibilities were a model for how to yield to feeling states and relational dynamics that are at the heart of therapeutic action, but which all too frequently get bypassed. This brief recollection highlights how Safran's commitment to open inquiry and mutuality—not just with his patients but also with his students—continues to impact the field. [ABSTRACT FROM AUTHOR]

Objectives: Mindfulness, self‐compassion and compassion for others are often studied among clients seeking psychotherapy. Psychotherapists are also at risk of developing psychological difficulties given that the profession is demanding and can put psychological and emotional pressures on therapists. The aim of this study was to examine (a) the relationship between mindfulness, self‐compassion and compassion for others and (b) whether self‐compassion will mediate the effects of mindfulness on compassion for others. Method: This was a cross‐sectional study conducted among a sample of 152 psychotherapists registered with the Irish Association for Counselling and Psychotherapy in Ireland. Results: Our analysis found a significant relationship between mindfulness, self‐compassion and compassion for others. Mediation analysis showed that the indirect effects of mindfulness on compassion for others was through self‐compassion. We entered age and gender into our model, but they had no impact on the mediated relationship. Conclusion: Findings from this study provide preliminary support for a proposed sequential model, suggesting that mindfulness enhances self‐compassion, which, in turn, can improve compassion for others. Psychotherapists and psychotherapy bodies are recommended to utilise strategies that can improve psychotherapists' mindfulness skills, such as the mindfulness self‐compassion programme and compassion‐focussed therapy, and their capacity for self‐compassion, which can contribute to their ability to develop compassion for the client. Given the limitations of the design of the study, future longitudinal research will enable us to document the directionality of the effects. [ABSTRACT FROM AUTHOR]

Copyright of Zeitschrift für Psychosomatische Medizin und Psychotherapie is the property of Vandenhoeck & Ruprecht GmbH & Co. KG 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 Zeitschrift für Psychosomatische Medizin und Psychotherapie is the property of Vandenhoeck & Ruprecht GmbH & Co. KG 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 Zeitschrift für Sexualforschung is the property of Georg Thieme Verlag Stuttgart 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 most important lesson that I have learned in my half century as a therapist (and therapy researcher) is that principles matter more than processes. I had the great good fortune to arrive in Philadelphia at a time when Beck and colleagues were just beginning to test the efficacy of cognitive therapy for depression and what I learned was that helping clients (and myself) get the better of depression involved two main principles: (1) when in doubt do whatever you would have done if you were not depressed (behavioral); and (2) do not believe everything you think - check it out (cognitive). A third major principle is that the most powerful way to test an existing belief is to use one's own behaviors to test its accuracy, which usually means doing whatever you least want to do in that situation (opposite action). I find that focusing on these principles is wholly liberating in the therapy process; I am free to be myself, to follow any line of inquiry, to respond to any request and to comport myself much as I would with any friend outside of therapy. This focus on principles has been good for my clients and even better for me. [ABSTRACT FROM AUTHOR]

Introduction: This systematic review identified qualitative and mixed-methods empirical studies on psychotherapy from dialogical and narrative approaches, aiming to address the following questions: (1) How are subjectivity and intersubjectivity qualitatively understood in dialogical and/or narrative psychotherapies studied using dialogical and narrative approaches? (2) How do therapeutic changes occur, including their facilitators and barriers? (3) What psychotherapeutic resources are available for psychotherapists in these types of studies? Method: The articles were selected according to the Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the eligibility criteria proposed by the PICOS strategy (participants, interventions, comparators, outcomes, and study design) from 163 records identified in the Web of Science Core Collection databases. Results: The systematic review process allowed the selection of 16 articles. The results provided insights into the understanding of subjectivity, intersubjectivity, change in psychotherapy, its facilitators, and barriers from these perspectives. It also offered some therapeutic interventions that can be implemented in psychotherapies, integrating dialogical and/or narrative aspects. Discussion: The centrality of dialogical exploration of patient/client resources, therapists as interlocutors fostering client agency, polyphony serving as scaffolding for change, and interconnection with the sociocultural environment are discussed. The integration of this latter topic has been a challenge for these types of studies, considering the active construction of shared meanings. The dialogical and narrative approaches focus psychotherapy on transforming meanings through dialogue and re-authoring stories, evolving within cultural and historical contexts. Thus, this study highlights the relevance of these perspectives in contemporary psychotherapy, emphasizing dialogue in co-creation within an intersubjective framework. [ABSTRACT FROM AUTHOR]

Introduction: Psychotherapeutic failures involve situational, relational, and personal factors. Dropout refers to a patient's unilateral termination of treatment without the therapist's knowledge or approval. Premature termination occurs when therapy is discontinued before achieving a sufficient reduction in initial problems. Objective: This study explores the role of therapist's emotional response (countertransference), gender, psychotherapeutic orientation, and patient diagnosis in the context of psychotherapeutic failures. Method: A mixed-method approach was used. Fifty-nine Italian psychotherapists, practicing mostly privately with at least 5 years of experience, were recruited through Italian professional internet websites. The Therapist Response Questionnaire and the Impasse Interview were administered to each psychotherapist. Each therapist was asked to reflect on their last dropout patient. Quantitative (MANOVA) and qualitative analyses (textual content analysis) were conducted with SPSS and T-LAB, respectively. Results: The quantitative analyses revealed that the most frequent countertransference response was Helpless/Inadequate, with female therapists experiencing this more frequently than male therapists. The qualitative analyses identified two main factors explaining most of the variance in countertransference responses: Parental/Protective versus Hostile/Angry, and Positive/Satisfying versus Helpless/Inadequate, with Helpless/Inadequate central. Additionally, the qualitative analysis of treatment interruption methods revealed two factors explaining over 50% of the variance. Lack of communication was linked to negative themes, while mediated and direct communication were associated with positive terms. Direct communication was characterized as useful, while mediated communication was linked to dropout and attachment figures. Conclusion: Under pressure, psychotherapists' anxiety levels increase, often managed ambivalently or avoidantly. These results suggest that awareness of psychotherapist emotional responses is important to limit psychotherapeutic failures. These findings offer valuable insights for clinical practice. [ABSTRACT FROM AUTHOR]

In post war regions, especially in low-income countries, the health care systems often require immediate support. For example, after the terror of the so-called Islamic State of Iraq and Syria (ISIS) in 2014, many internally displaced persons took refuge in the Kurdistan Region of Iraq (KRI). Those displaced by war have had to face the reality that psychotherapy did not exist as a service in the Kurdish health system. Many projects and Non-Government-Organizations (NGOs) that work in post-conflict regions focus on short term and quick response and/or basic psychological services. The implementation of the "Institute for Psychotherapy and Psychotraumatology" (IPP) at the University of Dohuk, follows a long-term approach. The 3-year-program teaches students to become professional psychotherapists, with respect to evidence-based and culturally adapted methods of psychotherapy. To achieve sustainability, the project is working towards handing over the teaching and organizational responsibilities into local hands. This article highlights the chances and challenges during this transition, as well as the importance of cultural understanding and realistic, practical solutions. An honest reflection on existing cultural challenges, e.g. inflexible hierarchical structures or an "old-fashioned" religious view of homosexuality, can then lead to practical solutions. These include winning over local authorities by including them in the process, culturally adapting to customs with the help of educated locals, demonstrating nonauthoritarian forms of leadership, and explicitly promoting newly graduated young lecturers into positions of authority. [ABSTRACT FROM AUTHOR]

ObjectiveMethodResultsConclusion\nKEY POINTSAcross the lifespan, young males in Australia who are experiencing mental health problems report the lowest rates of seeking professional care. The aim of this qualitative study was to explore the experiences of young men and caregivers who received male-friendly counselling from a male-specific service in AustraliaSemi-structured interviews were conducted with 14 young men who had received counselling, and 27 caregivers who facilitated access to Menslink counselling in Canberra, Australia. Inductive thematic analysis was completed to analyse the dataFour themes were developed: (1) engaged out of desperation; (2) appeal of Menslink service; (3) counsellor more like a professional “friend”; and (4) counsellor prioritised my autonomyThe findings confirm the suitability of previously recommended adaptations to counselling to engage young men and emphasise the role of caregivers in facilitating access to support. The themes also provide direction for practical adjustments to service delivery that mental health services and clinicians can make to address personal and structural barriers impacting young men’s service contact and engagement. This study contributes to the growing literature examining the benefits of male-friendly counselling practices in psychological treatment for young men.What is already known about this topic: Adolescent and young men face personal and structural barriers to help-seeking despite experiencing significant rates of mental illness in Australia.In recent years, male-friendly adaptations to clinical practice have been proposed to engage young men in psychotherapy.Little is known about how both young men and caregivers who facilitate access experience male-friendly counselling.Adolescent and young men face personal and structural barriers to help-seeking despite experiencing significant rates of mental illness in Australia.In recent years, male-friendly adaptations to clinical practice have been proposed to engage young men in psychotherapy.Little is known about how both young men and caregivers who facilitate access experience male-friendly counselling.What this topic adds: Male-friendly adaptations akin to those proposed in the literature enriched the counselling experience of young men and their caregivers.Young men valued a counselling service dedicated to them which consequently reduced the stigma associated with seeking support.Low-cost and timely services, the availability of male clinicians, and clinicians who supported the autonomy of young men were salient facilitators to their service engagement.Male-friendly adaptations akin to those proposed in the literature enriched the counselling experience of young men and their caregivers.Young men valued a counselling service dedicated to them which consequently reduced the stigma associated with seeking support.Low-cost and timely services, the availability of male clinicians, and clinicians who supported the autonomy of young men were salient facilitators to their service engagement. [ABSTRACT FROM AUTHOR]

Background and aims: This study explored the associations between symptoms of the Suicide Crisis Syndrome (SCS) at admission and self-harm and death by suicide post-discharge. The association between clinicians' emotional responses toward inpatients at admission and post-discharge self-harm and suicide death was also explored. Methods: Within the first 24-h of admission, patients completed a self-report measure of symptoms of SCS, and clinicians reported their emotional responses toward the patients. Follow-up data were obtained from the Norwegian Patient Registry and the Norwegian Cause of Death Registry. Results: Within 18 months post-discharge, 44 (12.7%) out of 347 patients had self-harmed, and five patients (1.4%) had died by suicide. At admission, patients who later self-harmed reported higher symptoms of SCS compared to the other patients. Clinicians reported more negative emotional responses toward the self-harm group. In a regression analysis, previous suicidal behavior and a diagnosis of "emotionally unstable personality disorder" (EUPD; F60.3) were associated with increased risk of self-harm post-discharge. Conclusion: The results indicated that patients with post-discharge episodes of self-harm are significantly different from patients who do not self-harm in terms of more intense symptoms of SCS during admission. Clinicians' negative emotional responses may be relevant in the assessment of the risk of post-discharge self-harm. [ABSTRACT FROM AUTHOR]

Complex grief patterns are associated with significant suffering, functional impairments, health and mental health problems, and increased healthcare use. This burden may be even more pronounced among veterans. Behavioral Activation and Therapeutic Exposure (BATE-G) and Cognitive Therapy for Grief (CT-G) are two evidence-based interventions for grief. The goal of this study was to use a precision medicine approach to develop a personalized treatment rule to optimize assignment among these psychotherapies. We analyzed data (N = 155) from a randomized clinical trial comparing BATE-G and CT-G. Outcome weighted learning was used to estimate an optimal personalized treatment rule. Baseline characteristics including demographics, social support, variables related to the death, and psychopathology dimensions were used as prescriptive factors of treatment assignment. The estimated rule assigned 72 veterans to CT-G and 56 to BATE-G. Assigning participants according to this rule was estimated to lead to markedly lower mean grief level following 6 months from treatment compared to assigning everyone to either BATE-G (V d opt – V BATE-G = −18.57 [95 % CI: −29.41, −7.72]) or CT-G (V d opt – V BATE-G = −20.89 [95 % CI: −30.7, −11.07]) regardless of their characteristics. Participants were primarily male veterans, and identified with Black or White race. The estimated rule was not externally validated. The estimated rule used relatively simple, easily accessible, client characteristics to personalize assignment to treatment using a precision medicine approach based on machine learning and causal inference. Upon further validation, such a rule can be easily implemented in clinical practice to prescriptively maximize treatment benefits. • The average effect of BATE-G compared to CT-G for grief did not differ overall. • A personalized treatment rule based on individual characteristics was estimated. • The personalized treatment rule performed better than the one-size-fits-all rules. • Upon further validation such a rule can be easily implemented in clinical practice. [ABSTRACT FROM AUTHOR]

Therapists are prone to many occupational hazards, such as compassion fatigue and burnout. Despite much speculation, only a little is known about why therapists choose their profession and what drives them to keep practicing. In a job where the therapist is the main instrument, insight into what makes them tick is paramount to nurture durable therapeutic careers. In this qualitative study, 15 experienced Dutch therapists were interviewed about career choice motivations and how initial—and new—motivations continue to influence them in their daily professional practice. Interview transcripts were subjected to thematic analysis, consensus discussions, and member checks. Ten key career choice motivations emerged, ranging from an empathetic predisposition and interest in humanity to personal experience with symptoms and treatment, inspirational sources, desire for growth, life phase, and coincidental or (partially) subconscious motives. Seven themes that influenced therapists in their daily practice were identified. These included four initial motivations as well as three new themes: a knack for building bridges, going from surviving to thriving, and resilience. The insights gained from this study are a starting point for creating interventions that (re)ignite the spark and improve therapist resilience through regular maintenance, thereby promoting durable careers and mental health among (future) therapists themselves. Public Significance Statement: This Dutch qualitative study revealed 10 career choice motivations of therapists and how their initial—and new—motivations remain influential in their daily professional practice. In a job where many occupational hazards are lurking, such as compassion fatigue and burnout, insight into therapist motivations is paramount. The insights from this study are a starting point for interventions that promote mental health and durable careers among therapists themselves, allowing for the effective and continuous treatment of their patients. [ABSTRACT FROM AUTHOR]

Background: This study is a cost-effectiveness study of two implementation strategies designed to train therapists in college and university counseling centers to deliver interpersonal psychotherapy. Costs of implementing a train-the-trainer (TTT) strategy versus an expert consultation strategy were estimated, and their relative effects upon therapist outcomes were calculated and compared. Methods: Twenty four counseling centers were recruited across the United States. These centers were randomized to either a TTT (experimental) condition, in which an in-house therapist trained other center therapists, or an expert consultation condition, in which center therapists participated in a workshop and received 12 months of ongoing supervision. The main outcome was therapist fidelity (adherence and competence) to interpersonal psychotherapy, assessed via audio recordings of therapy sessions, and analyzed using linear mixed models. Costs of each condition were quantified using time-driven activity-based costing methods, and involved a costing survey administered to center directors, follow up interviews and validation checks, and comparison of time tracking logs of trainers in the expert condition. Mean costs to produce one therapist were obtained for each condition. The costs to produce equivalent improvements in therapist-level outcomes were then compared between the two conditions. Results: Mean cost incurred by counseling centers to train one therapist using the TTT strategy was $3,407 (median = $3,077); mean cost to produce one trained therapist in the control condition was $2,055 (median = $1,932). Therapists in the TTT condition, on average, demonstrated a 0.043 higher adherence score compared to therapists in the control condition; however, this difference was not statistically significant. For the competence outcome, effect size for therapists in the TTT condition was in the large range (1.16; 95% CI: 0.85–1.46; p <.001), and therapists in this condition, on average, demonstrated a 0.073 higher competence score compared to those in the expert consultation condition (95% CI, 0.008–0.14; p =.03). Counseling centers that used the TTT model incurred $353 less in training costs to produce equivalent improvements in therapist competence. Conclusions: Despite its higher short run costs, the TTT implementation strategy produces greater increases in therapist competence when compared to expert consultation. Expanding resources to support this platform for service delivery can be an effective way to enhance the mental health care of young people seeking care in college and university counseling centers. Trial registration: ClinicalTrials.gov Identifier: NCT02079142. [ABSTRACT FROM AUTHOR]

This exploratory study aims to extend and strengthen the empirical base for supervision as a facilitator of professional growth, as outlined in an established conceptual model, by exploring its correlates among psychotherapists across their entire professional career. Ratings of the impact of supervision by 6267 psychotherapists of different professions, theoretical orientations, and career levels in many countries who were currently in supervision were correlated, separately for each of five career cohorts, with aspects of their treatment experience, work situation, and personal characteristics. Large percentages of psychotherapists at all career levels, including senior psychotherapists, engaged in supervision and rated its impact on their development positively. Growth-facilitating supervision was associated broadly but moderately in all career cohorts mainly with interpersonal aspects of therapists’ treatment experience, with supportive work settings, and with caring and expressive personal characteristics. Some differential findings among cohorts also reflected potential developmentally based functions of supervision. The implications of results were considered both for supervisory practice, training and for future supervision research. [ABSTRACT FROM AUTHOR]

The current cross-sectional study aimed to explore burnout in psychotherapists and its associated factors. Certificated psychotherapists and counsellors aged between 20 and 65 were eligible to participate in the present study, and a final sample of 177 psychotherapists and counsellors was obtained. The mean age of participants was 40.32 years (SD = 9.56), and the majority of them were female (142, 80.2%). Participants completed an online survey through a mobile application, including demographics (e.g., age, gender, etc.), workload (the Areas of Worklife Survey), empathy (the Basic Empathy Scale), self-compassion (the Self-Compassion Scale short form), and burnout (the Maslach Burnout Inventory—General Survey). Investigations were conducted to examine self-compassion as a moderator and empathy dimensions as mediators between workload and burnout dimensions. The results confirmed that the associations between workload and emotional exhaustion/cynicism were mediated by emotional contagion, and the association between workload and professional efficacy was mediated by cognitive empathy. However, self-compassion did not buffer the association between workload and burnout dimensions. The findings of the current study indicated that psychotherapists with heavier workloads were more likely to be emotionally contagious and experienced higher emotional exhaustion and cynicism, while their cognitive empathy was also likely to be impaired and experienced lower professional efficacy. Receiving regular supervision might contribute to their professional efficacy. [ABSTRACT FROM AUTHOR]

AbstractObjectiveMethodResultsConclusionAlthough telehealth psychotherapies have been studied for over 20 years, mental health services remained largely delivered in person until the COVID-19 pandemic forced clinics to reconsider the utility of telehealth psychotherapy. This study aims to compare patient engagement in in-person versus telehealth services in outpatient psychotherapy for mood and anxiety disorders.A cohort investigation was conducted, using a propensity score matched sample, extracted from an electronic health record (EHR) to compare engagement in psychotherapy for 762 patients who used in-person services before the pandemic to a cohort of 762 patients who used telehealth psychotherapy after the onset of COVID-19. The authors compared cohorts on initial engagement in psychotherapy services following an initial intake, number of psychotherapy sessions attended, and the rate of missed sessions.There was a 26% increase in the total number of individual psychotherapy sessions attended when the clinics transitioned to telehealth services (p < .001). In addition, patients who received telehealth psychotherapy were five times more likely to not cancel or miss any scheduled sessions (p < .001).These results indicate that telehealth services may result in improved treatment engagement for outpatient centers focused on brief evidence-based psychotherapies for mood and anxiety disorders. [ABSTRACT FROM AUTHOR]

AbstractSurvivors of sexual violence often experience short-and long-term mental and physical health conditions due to the victimization. Rape Crisis Centers are community-based advocacy organizations that provide free supportive services to survivors of sexual assault, such as 24-hour crisis hotlines, medical advocacy, individual and group therapeutic services, and victim advocacy services for those with cases within the criminal justice system. However, the efficacy of these services in assisting survivors is not well known, often due to researchers’ lack of access to clients. In this paper, we investigate the experiences of survivors directly from the survivors receiving psychotherapy services from a Rape Crisis Center in an urban jurisdiction in the Midwestern United States. We qualitatively interviewed nine survivors who attended individual and/or group therapy. In-depth analysis showed that four themes emerged regarding their experiences. Two themes pertain to positive outcomes—emotional processing and group therapy dynamics. One theme concerns obstacles. The final theme relates to suggestions for service improvement. The discussion includes summaries of the reflective findings and recommendations for future practice. This research contributes to informing and improving practices and policies to better serve survivors of sexual assault. [ABSTRACT FROM AUTHOR]

Clients with obsessive-compulsive disorder (OCD) symptoms pose a challenge for psychotherapists. Current evidence-based treatments have limitations in efficacy and client retention. This article reports on 17 cases treated with the Acute Stress Syndrome Stabilization Individual (ASSYST-I) adapted for OCD in an outpatient mental health clinic in Uruguay. The average number of sessions was 16. Clients completed the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) to assess OCD symptom severity before and after treatment. Wilcoxon signed-rank tests found significant differences between pre- and posttreatment on the Y-BOCS total scores (z = −3.624, p <.001), obsessions subtotal scores (z = −3.627, p <.001), and compulsions subtotal scores (z = −3.624, p <.001). This study describes the ASSYST-I Adapted for OCD and discusses its preliminary safety, feasibility, and acceptability. [ABSTRACT FROM AUTHOR]

"Self-experience" is a popular phrase among Chinese psychotherapist professional circles. This article provides a historical overview of the development of this term and explores the underlying social, cultural, and historical elements of the dynamics of this unique lexical choice. We argue that the preference for using "self-experience" instead of "personal treatment" implies a tendency of the Chinese collective consciousness to depathologize the inner feelings of traumatic experience, reflecting the Chinese philosophy of life, that is, emphasizing the upward potential to grow and learn to change. On the other hand, we need to be careful in assessing whether psychoanalysis is comprehending patients' cultural and historical contexts so that we are healing the trauma rather than creating new ones. [ABSTRACT FROM AUTHOR]

Facilitative interpersonal skills (FIS) are a promising variable to explain the so-called therapist effect. We aimed to investigate associations between observer-rated interpersonal skills and self-reported personal characteristics of future therapists. In this cross-sectional observational study, psychology students and trainee therapists completed self-report personality and sociodemographic questionnaires as well as the FIS Performance Task (German version, observer-rated). Mixed multilevel model analysis was conducted with FIS total mean score (mean value of 312 individual ratings [13 video-clips, 8 FIS-items, 3 raters]) as dependent variable, therapist ID and FIS clip ID as random effects and 15 therapist variables as fixed effects. In the present sample consisting of 177 participants (age: M = 29.8 years (SD = 7.3), [18,59]; 79.1% female, 20.9% male) greater therapists' experience level, male gender and lower levels of alexithymia were predictive for higher FIS score when statistically controlling for other therapist variables in the model. Age, self-reported childhood maltreatment, attachment style, emotion regulation and self-concept variables turned out to be unrelated. The results can inform psychotherapy training programs. They specifically support the importance of addressing therapists' potential difficulties in recognizing and verbalizing emotions. This is in line with theoretical literature on alliance ruptures and premises of the Alliance-focused training. [ABSTRACT FROM AUTHOR]

The Impact Message Inventory‐Circumplex (IMI‐C) is a two‐dimensional measure of patient‐induced countertransference. Surprisingly, in a replication study of its circumplex structure, Hafkenscheid and Timmerman could retrieve a third dimension, in addition to the basic dimensions of Affiliation and Control. They tentatively interpreted this preliminary third dimension as representing 'reactance' (oppositional and uncooperative patient behaviours), with 'active' and 'passive' as polarities. This provisional interpretation was no more than plausible and was partly speculative. Therefore, a more systematic empirical approach to the meaning embedded in the third dimension is required. The present empirical study tests the hypothesis that the preliminary third dimension might represent aversiveness rather than reactance. A panel of IMI‐C users (N = 100) independently judged all 56 items of the instrument in terms of the general (i.e., without taking a specific patient in mind) emotional undertone enclosed in the item formulations using a forced choice three point scale format: 'positive emotional undertone' (+), 'neutral' (o) and negative (aversive) undertone (−). Overall, IMI‐C users appeared to evaluate the formulations of items constituting the preliminary third dimension as intrinsically more aversive (negative emotional connotation), compared to the group of IMI‐C items not included in this preliminary third dimension. However, the original octants of the IMI‐C could be discriminated in terms of aversiveness as well. Anyhow, clinical interpretations of IMI‐C profiles may benefit from an examination of the aversiveness component, enclosed within the items and octants themselves, irrespective of the specific patients judged with the instrument. [ABSTRACT FROM AUTHOR]

Objective: Increased attention has recently been paid to the well‐being and flourishing of patients in psychotherapy. This study investigated the occurrence of positive affect (PA) and strength‐based behaviours within psychotherapy sessions contrasting positive versus neutral imagery instructions. Methods: This is a secondary analysis of a randomized controlled trial. Seventy‐eight sessions of cognitive behavioural therapy involving 26 patients (69.23% female; Mage = 40.31) treated by 13 therapists were selected. PA and strength‐based behaviours of patients and therapists were coded on a minute‐by‐minute basis with the Resource‐Oriented Microprocess Analysis. Each session started with a brief mental imagery instruction. Data were analysed using multilevel modelling. Results: Mild levels of PA were very common, whereas stronger expressions were occasional, especially at the beginning and end of sessions. Strength‐based behaviours were employed in one‐fifth of the videos analysed. Therapists in the positive imagery instruction showed more strength‐based behaviours in the beginning phase of sessions, p < 0.05. The two imagery instructions significantly differed in the session trajectories of PA, p < 0.05. A quadratic trend with higher initial values and a sharper decline in PA were found in the positive instruction, whereas the neutral instruction showed a flatter trend. Conclusion: Patients and therapists experience PA and discuss strengths in psychotherapy sessions despite patients' distress. The positive imagery instructions potentially induced a positive focus at baseline for therapists but had a negligible effect on the subsequent session progression. Trial Registration: ClinicalTrials.gov identifier: NCT03767101 (registered December 6, 2018). [ABSTRACT FROM AUTHOR]

The recall of memories of past events, experiences and emotions is a complex process. When experiencing traumatic events, as is the case with sexual violence, a host of additional complexities and difficulties arise. This becomes especially important in court cases which rely mostly or exclusively on the testimony of the victim, where the problem of the fallibility of memory takes center stage. Some research studies emphasize the possibility of inducing, altering or suppressing memories, especially in the context of psychotherapy. This has led to the unfortunate reality that the testimony of victims who have undergone psychotherapy is often considered to be unreliable. This in turn can lead to the impression that a decision has to be made between treatment of the adverse effects of traumatic events and maximizing the chances for a conviction of the perpetrator in court. This article introduces some central concepts of our current understanding of memory and gives an overview of the relevant scientific literature and debate. Following this, it examines the dilemma as it pertains to the different groups of all involved parties (i.e., victims, members of the judiciary and psychotherapists). Lastly, it proposes a framework of how to approach a solution to this problem by focusing on research in critical areas, expansion of therapy guidelines and documentation procedures as well as communication of these efforts to all parties involved. [ABSTRACT FROM AUTHOR]

Research has failed to consistently show that therapists facilitate better client outcomes as they gain more experience. The present study was designed to examine changes in early client retention over the course of extended periods of time among 2591 therapists in private practice. Naturalistic data collected between 2018 and 2022 was extracted from a technology‐enabled practice‐research group (PRG). Therapists displayed an increase in client dropout rates as they gained more experience on the PRG. Additionally, larger caseloads on the PRG were associated with lower increases in client dropout over time. Finally, therapists working with clients paying higher out‐of‐pocket fees (e.g., co‐pays) had higher increases in client dropout over time. These findings provide additional evidence supporting the distinction between clinical experience and expertise. [ABSTRACT FROM AUTHOR]

BIPOC counsellors and psychotherapists share experiences of identity threats their clients of color face. Refugee attempted genocide survivors have faced the most severe identity threats: persecution of their entire ethnic group, yet they have demonstrated remarkable resilience. Vicarious resilience occurs when client resilience following trauma or adversity is transferred onto the counsellor. The purpose of this qualitative study was to examine vicarious resilience in ethnic identity development among BIPOC counsellors who recently worked with a resilient refugee attempted genocide survivor. Five counsellors who were racial/ethnic minority group members participated in semi-structured interviews analyzed via thematic analysis. The counsellors were emotionally activated by the intersections between their own and their clients’ identities, forcing them to face and embrace their ethnic selves, and recognize cultural strengths and values that can function as “Roots of Survival”. Changes in professional practice were also reported, involving empowering clients to further develop their own identities, and engaging in psychoeducation and advocacy related to oppression. [ABSTRACT FROM AUTHOR]

Research on foster youth often focuses on risk, rather than adaptation, strengths, and assets. Some researchers have shifted the narrative by examining resiliency, but there is limited understanding on how to define and measure resilience specifically among current and former foster youth. This study begins with a meta-synthesis of the qualitative research (n = 31, 1990-2020) that discuss resilience with foster youth. We then examine data from twenty-two qualitative interviews regarding resilience with key stakeholders in child welfare. The findings inform an understanding of resiliency that is inclusive and culturally responsive to current and former foster youth. [ABSTRACT FROM AUTHOR]

We found previously that ChatGPT-4 could use 50 stream-of-consciousness thoughts to make the latent construct of narrative identity explicit. We now demonstrate this as a tool for interventions by coaches and therapists. Using five narrative identities, ChatGPT-4 recommended actionable strategies and interventions tailored to the narrative identity. Artificial intelligence (AI) can thus support coaches and therapists by crafting personalized approaches drawing on the person's narrative identity. This new assistive tool may help clients achieve greater insight, growth and well-being. [ABSTRACT FROM AUTHOR]

This article provides a practical guide for general practitioners (GPs) on optimizing referrals for mental health treatment. It emphasizes the importance of clarifying desired outcomes and gathering relevant information before consultations. Strategies for ensuring patient safety, involving family members, and engaging patients in the referral process are discussed. The article also provides a list of reasons for referral, coping strategies while waiting for a specialist appointment, and psychosocial therapies for high-prevalence disorders. It concludes by discussing various therapeutic modalities, including narrative therapy, art therapy, and neurodiversity-specific therapies. Resources for patients and GPs are also included. The document aims to enhance the mental health referral experience for all involved. [Extracted from the article]

Background: Little is known about recovery from opioid use disorder (OUD) or outcomes of detoxification and drug-free treatment of chronic opioid therapy (COT). Harm reduction with medications for opioid use disorder (MOUD) is regarded as the only legitimate treatment. Methods: The Institutional Review Board (IRB) approved reporting deidentified outcomes. Patients seen over a 10-year period whose records suggested recovery were called and interviewed. Results: Overall, 69/86 (80%) confirmed that they had been sober for at least a year, including 41 patients with OUD (75%) and 28 COT patients (90%). 91% were drug-free, and 9% were on MOUD. 79% preferred a psychotherapy approach. 21% preferred MOUD. Coming for more treatment and abstinence from tobacco were significantly correlated with recovery. Conclusion: This is the first report that we are aware of regarding the frequency of recovery from OUD and COT. We have complicated the discussion about what is the best treatment for patients with OUD and patients on COT. Advising that maintenance is the only legitimate treatment for patients who suffer from OUD or who are on COT seems both premature and jeopardizes the ability of treaters to individualize treatment recommendations. [ABSTRACT FROM AUTHOR]

Copyright of Tidsskrift for Psykisk Helsearbeid is the property of H. Aschehoug & Co. (W. Nygaard) AS 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 Psychosozial is the property of Psychosozial-Verlag GmbH & Co. KG 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 emergence of Blended Synchronous Learning Environment (BSLE) as an innovative teaching method has gained traction during the COVID-19 pandemic. While it is mostly used in higher education, its potential to help students with dyslexia has not been explored much. This study delves into the views of educational therapists from the Dyslexia Association of Singapore (DAS) who integrated BSLE during the pandemic. Using interviews and thematic analysis, the research uncovers key themes like BSLE's benefits, challenges, and its impact on therapists. It sheds light on issues like effective teaching, student engagement, and inclusivity. Despite not being ideal for dyslexic students, BSLE offers advantages like ongoing support and flexibility. The study suggests strategies for improvement, such as tailored implementation for older students and better technology support. Future research could explore students' experiences, evaluate training programs, and assess parental support's impact during BSLE for remote learners. [ABSTRACT FROM AUTHOR]

Copyright of Universum is the property of Instituto de Estudios Humanisticos Juan Ignacio Molina, Universidad de Talca 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 principles of CBT emphasize the interactions among cognition, emotion, and behavior. CBT's origins lie in Stoicism philosophy and share similarities with the ideas of Confucianism, Taoism, and Traditional Chinese Medicine (TCM) in China. The idea of mind–body regulation in traditional Chinese culture has laid a cultural foundation for the promotion of CBT in China. This paper analyzes the applicability and challenges of CBT in China based on the current development of CBT in mainland China and the learning and practice of CBT therapists. It also explores the potential further development of CBT in China and the integration of CBT with the Chinese culture. [ABSTRACT FROM AUTHOR]

Online learning has the potential to improve best practice in substance use treatment by facilitating access to high-quality resources. A user-centered design (UCD) approach can identify the needs, motivating factors, and working contexts of learners. Aim: The aim of this study was to identify ways of improving online learning for people working in substance use treatment services in England. Methods: Semi-structured interviews were conducted with 31 substance use professionals in England and 14 other professionals working in the field. Participants were asked about their training needs, working contexts, and current use of online resources. Data were analyzed according to the principles of UCD via Iterative Categorisation. Results: Participants reported "unmet needs" for training in therapeutic relationships and advanced therapeutic techniques. They enjoyed training that demonstrably improved the quality of life for people who use drugs and that provided career and personal development opportunities. Participants completed many mandatory online courses that were short and unpopular. Access to training was limited by time and financial constraints, with online training partially addressing these barriers. Conclusion: If online learning is to be optimized, the needs of substance use professionals must be accommodated; however, online learning that meets the needs of substance use professionals does not always match the best evidence. [ABSTRACT FROM AUTHOR]

Summary: „These have all been innovations that have made it much easier" - Provision of Outpatient Group Psychotherapy After Reforming the German Psychotherapy Directive. Results of a Mixed-Methods Study One objective of reforming the German psychotherapy directive in 2017 was to promote group psychotherapy. The present study examined the provision of group psychotherapy and the reasons for psychotherapists not providing group psychotherapy after the reform. Data from the Associations of Statutory Health Insurance Physicians were used to determine the number of psychotherapists with group license and the number of group psychotherapy sessions provided one year before (2016) and after the reform (2018). Differences were tested with Wilcoxon signed-rank tests. We conducted semi-structured interviews with outpatient psychotherapists about their opinions on the new features for group psychotherapy and analyzed them using qualitative text analysis. The number of psychotherapists with group license increased from 10,432 before to 11,376 after the reform (p = 0.005). However, the number of provided group psychotherapy sessions did not change statistically significant (p = 0.464). Interviews with 41 psychotherapists revealed that group psychotherapy can be provided more flexibly, with less effort, and more financially reliable due to the reform. Reasons for not providing group psychotherapy included missing group license, limited time resources, organizational factors, personal preferences, and low demand from patients. In short, there was not significantly more group psychotherapy provided after the reform than before. Psychotherapists consider the reform to have led to improvements for group psychotherapy, but relevant barriers to providing group psychotherapy remained. [ABSTRACT FROM AUTHOR]

The bicultural nation that is Aotearoa New Zealand is now a multi-ethnic society, home to many non-indigenous ethnic minority communities. This study explored the perceptions and experiences of four self-identifying non-indigenous ethnic minority psychotherapists living in this country. Specifically, it answers the question: "What are the predominant themes that can be identified in the accounts of non-Māori ethnic minority psychotherapists, residing and practicing within the bicultural context of Aotearoa New Zealand?" Semi-structured interviews with participants explored their lived everyday experiences in both personal and professional spheres. Data were analysed using thematic analysis and yielded three themes: (1) "Acculturation to mainstream" captures the personal challenges participants encountered as immigrants in relocating and adapting to mainstream Aotearoa New Zealand culture; (2) "Encountering Indigenous culture" describes participants' experiences of coming into contact with indigenous Māori culture, and ensuing perceptions and understandings; (3) "Relating to biculturalism" describes how the participants understand and make meaning of biculturalism in Aotearoa New Zealand. Understanding these participants' experiences can help non-indigenous ethnic minority psychotherapists become better informed and politically aware, and may empower them to negotiate a more meaningful position in a bicultural nation. [ABSTRACT FROM AUTHOR]

Intimate and sexual feelings are common within psychotherapy, with negative outcomes when not managed adequately. This study aims to investigate the understudied topic of these intimate and sexual feelings in basic education and psychotherapy training programs. In this convergent mixed method study, both a survey (N = 786) and 8 focus groups (N = 36) were conducted among psychotherapists in Flanders, Belgium (November 2016 – June 2018), using inferential and thematic analyses respectively. The majority indicates that dealing with intimate and sexual feelings towards clients was hardly part of either their basic education or psychotherapy training. Talking about such feelings with peers or supervisors remained difficult because of concerns about being judged. Therapists indicating this topic was addressed in some way in their training indicated more often that they did not perceive it as a taboo topic. Therapists advocated a more open discussion and reflection on this topic. Education and training, as well as support from renowned key figures in their field, were regarded as important incentives to initiate change. Psychotherapy training should focus on how to deal with intimate and sexual feelings, referring to introspection and exploration of these feelings in a more integrated way during training. [ABSTRACT FROM AUTHOR]

Lesbian, gay, bisexual and queer people (LGBQ; a sexual minority social group) access counseling and psychotherapy more frequently than heterosexual people, often working with heterosexual therapists (a sexual majority social group). Heterosexual therapists working with LGBQ clients is under-researched which means limited dialogue exists describing a significant yet sensitive area of sexuality difference where therapist and client hold diverging social experiences. To facilitate awareness development in person-centered therapy and beyond, the paper seeks to challenge such limited dialogue, stimulating discussion through considering how four heterosexual person-centered therapists experience working with LGBQ clients. This qualitative research project was designed using Interpretative Phenomenological Analysis as its methodology to explore the experiences of four heterosexual person-centered therapists who work with LGBQ clients. Findings centered upon four themes: shaping and forming, ways of seeing, witnessing clients and relationships with person-centered theory. The discussion considered the data in dialogue with person-centered theory, explored phenomenological therapy practice, intersectionality, power, and witnessing client experiences of social discrimination, and evaluated the non-pathologizing therapeutic potential that person-centered phenomenological practice holds for working with LGBQ clients. For theory development, the paper calls for further person-centered discourse exploring LGBQ experiencing. [ABSTRACT FROM AUTHOR]

During the rapid shift to teletherapy at the start of the COVID-19 pandemic, psychotherapists encountered numerous challenges and reported lower levels of skills in teletherapy compared to in-person therapy. This study aimed to (a) examine psychotherapists' self-rated skills in teletherapy compared to in-person therapy and whether the discrepancy between the two psychotherapy formats has changed since the pandemic and (b) assess psychotherapists' perception of their and their colleagues' compliance with teletherapy guidelines. Using a repeated cross-sectional design, we collected data from two independent national samples of therapists and trainees at two different time points: Spring 2020 (early pandemic; N = 440) and in Summer 2021 (mid-pandemic; N = 345). Although psychotherapists' self-reported skills in teletherapy were significantly lower than those in in-person therapy both during early- and mid-pandemic, the relative differences between the two psychotherapy formats decreased in 2021. Nearly two thirds of the sample (65.22%) self-reported compliance with all teletherapy guidelines (cross-state line practice, informed consent, proper tools, data release, and data storage). Psychotherapists, who were older, were nonstudents, had more years of clinical experience, and worked in private practice were more likely to fail to comply with the teletherapy guidelines. These findings suggest that although psychotherapists' self-reported skills in teletherapy improved over time during the pandemic, the perceived differences between teletherapy and in-person therapy remained. The necessary practice of teletherapy during the pandemic may have allowed familiarity and adaptation of their therapeutic skills. However, intensive and specialized training is needed for psychotherapists to provide teletherapy ethically and effectively. Public Significance Statement: By comparing two independent samples of psychotherapists in Spring 2020 and Summer 2021, this study found that psychotherapists were learning to adapt their therapeutic skills in remote settings. However, psychotherapists continued to report lower levels of skills in teletherapy versus in-person therapy in 2021, albeit to a lesser degree, suggesting that there remains a long race ahead toward full competence in teletherapy. Specialized, intensive, and hands-on training that focuses on skills, techniques, and difficult situations related to teletherapy is urgently needed. [ABSTRACT FROM AUTHOR]

The effects of psychotherapy for men perpetrating violence toward their female partners have been found to be modest or equivocal; therefore, further research is necessary to determine how therapists can intervene to help clients stop acting violently. To obtain a better understanding of successful therapist strategies in a particular case, we conducted an interpretive phenomenological analysis of interactional patterns and change processes during therapy sessions in four carefully selected cases - two cases in which the use of violence ended after the completion of therapy (violence ended) were compared with two cases in which the client completed therapy but continued to act violently (violence continued). The client's use of violence was addressed repeatedly in all four cases, but the scripting of such events varied between the two case types. I) Violence ended: Joint explorations of the script of "the annoying other" led to therapist strategies that fostered new experiences of the states of mind of the client and partner. This seemed to help clients develop more caring and safer ways of relating to their partner. II) Violence continued: Engagement in the script of "hopeless me" was associated with therapist strategies that relied more on explanations of the client's vulnerability to acting violently. This seemed to hinder deeper comprehension of the clients' use of violence and the needs and intentions of their partners. Contrary to expectations, engagement in the script of "the annoying other" facilitated exploration of emotional states in both the client and his significant other. We present some empirically derived principles for moment-to-moment therapist strategies that facilitated in-session change with men acting violently toward their partner. [ABSTRACT FROM AUTHOR]