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Psychotherapy has historically focused on symptom reduction. However, there are calls for increasing our understanding of how psychotherapy impacts clients' flourishing. In this study, licensed mental health professionals and trainees across different clinical settings with diverse therapeutic orientations were interviewed about their perspectives on the cultivation of flourishing in psychotherapy, as well as their own personal experiences with flourishing. We were interested in understanding how therapists define flourishing, how they integrate flourishing into their work with clients, and any barriers or catalysts for engaging in this process. To do so, we conducted eight focus groups, and interviews were analyzed using grounded theory to form a hierarchy of categories. The results were used to create a three-part grounded theory. Results suggested that flourishing is a distinct concept from well-being that involves active engagement, emotional connection and meaning making. Our three-part grounded theory of flourishing elucidates how flourishing can be pursued by guiding clients towards their experiences of suffering in order to engage in meaning making and to identify their values, as well how systemic barriers can be navigated. Themes emerged related to the training of psychotherapists to promote flourishing, and the associated clinical and training implications are discussed [ABSTRACT FROM AUTHOR]

Couple therapy has outperformed control conditions in randomized clinical trials (RCTs). However, there have been some questions whether couple treatment in naturalistic settings is as effective as those with more rigorous controls. The current meta‐analysis examined 48 studies of couple therapy in non‐randomized clinical trials. The pre–post effect size was Hedge's g = 0.522 for relational outcomes and Hedge's g = 0.587 for individual outcomes. However, there was significant heterogeneity in the results. Several moderators explained some of the variance in these estimates. For relationship outcomes, studies who had older couples and longer length of relationship had better outcomes. Studies with a higher percentage of racial/ethnic minority (REM) couples and studies in Veteran Affairs Medical Centers (VAMC) had lower relational outcomes. For individual outcomes, studies that had more sessions, older couples, and VAMC had better outcomes. Studies with a higher percentage of REM couples also had worse individual outcomes. Trainee status was not consistently related to relational or individual outcomes. Implications for research and practice are provided. [ABSTRACT FROM AUTHOR]

Sexual activity occurs among a large portion of young adults and adolescents, including high school students. While about 40% of high school students nationwide have engaged in sexual intercourse, more information is needed about how individual characteristics may relate to larger patterns of adolescent sexual behavior. This exploratory study utilized a latent class analysis (LCA) to identify clusters of high school students (N = 801) based on demographic characteristics, sexual refusal skills, healthy relationship skills, sociosexuality, internalizing symptoms, alcohol use, various forms of social support (i.e., parents, friends, teachers), and sexual activity at baseline to predict their sexual behavior at a 6-month follow-up. Four unique latent classes were identified based on these baseline predictors. Distinctions in the profiles of high schoolers varied significantly by internalizing symptoms, race/ethnicity, sexually conservative attitudes, and social support in the prediction of adolescent sexual activity at 6-months. This study contributes to the investigation of demographic, social, psychological, attitudinal, and behavioral factors that may distinguish high school students from one another in terms of their longitudinal rates of sexual activity. [ABSTRACT FROM AUTHOR]

Jails and prisons commonly offer mental health treatments as many people experiencing incarceration suffer from significant psychological distress and substance use problems. One modality through which individuals who are incarcerated receive care is psychotherapy; however, process and outcome data in this population are limited. More specifically, little is known about how culture and identity impact the development therapeutic relationship in this context. The multicultural orientation framework, which includes three pillars (cultural humility, cultural opportunities, and cultural comfort), aims to operationalize cultural processes in psychotherapy (J. Owen, 2013). We examined the relationship between therapy outcomes and client ratings of their therapist's cultural humility (positive and negative), cultural opportunities, and the working alliance in two jails. Ninety-four clients engaging in routine psychotherapy rated their experience of the therapy process during their third session. Interestingly, we did not find significant associations between therapy outcomes (i.e., psychological distress and relational distress) and negative cultural humility or cultural opportunities. We did find a significant positive association between the working alliance and therapy outcomes. Notably, therapy outcomes were negatively associated with positive cultural humility, suggesting that clients who rated their therapist higher on positive cultural humility had worse therapy outcomes. Therefore, there may be important setting specific factors that contribute to the importance of orienting to culture in psychotherapy. Public Significance Statement: The present study examined therapy with individuals experiencing incarceration and found that therapist expressions of positive cultural humility were associated with worse therapy outcomes. This is significant because the extant literature suggests that expressions of positive cultural humility, a pillar of the multicultural orientation framework, are generally supportive and improve therapy outcomes. [ABSTRACT FROM AUTHOR]