More research is needed on the roles of client feedback, managing countertransference, and other therapist characteristics on treatment outcome with trauma survivors. Understanding the role of EBRs in the treatment of trauma survivors may assist researchers, clinicians, and psychotherapy educators to improve therapist training as well as client engagement and retention in treatment.

As part of a longitudinal mixed-methods investigation on implementation of 2 evidence-based psychotherapies (EBPs) for Posttraumatic Stress Disorder, 164 mental health providers from 38 Department of Veterans Affairs (VA) residential treatment programs across the United States were asked questions about their decision making for using Prolonged Exposure and Cognitive Processing Therapy. Many providers viewed both EBPs as equally efficacious and encouraged veterans to decide for themselves which treatment they wished to engage in. Some providers said that it was hard to know which EBP would be the most effective for a given patient, and that occasionally they started work with a veteran thinking that a particular EBP would work and were surprised when the veteran did not receive the full potential benefit of the intervention. Other providers noted that their decision making regarding which EBP to use depended on the type and nature of the veterans' index trauma, memory of the trauma, and traumatic stress symptoms (e.g., fear vs. guilt). Additional factors that impacted the choice of EBP included whether the patient already had one of the treatments before or if a provider deemed one as more compatible with their previous training. Implications for clinical practice as well as the design and improvement of training and implementation efforts are discussed.

As part of a longitudinal investigation on implementation of 2 evidence-based psychotherapies (EBPs) for posttraumatic stress disorder, psychotherapists from 38 Department of Veterans Affairs residential treatment programs across the United States were asked to complete reflective journals every 4 months for a 1-year time period in regard to their successes and challenges in using prolonged exposure and cognitive processing therapy. This paper provides content analysis on the reflective journals of 24 of these providers. Five main themes were identified: EBPs are great but not sufficient for patients in residential treatment with chronic posttraumatic stress disorder and complicated life circumstances, and thus, more treatment is necessary after discharge. Modifications were made or thought needed for optimal outcome and successful delivery of these 2 EBPs; some providers blended aspects of prolonged exposure and cognitive processing therapy; what happens when providers and patients do not agree on choice of which EBP to first implement; and provider concerns on when to discontinue an EBP. Reflective journaling appears to be a promising way for trainers and treatment developers to gather important information about the clinical application and decision-making process for front-line providers, which may offer insight into how to improve EBP implementation and sustainability. Incorporating reflective journaling and strategies for accomplishing this into training, supervision, and consultation may also be 1 strategy for increasing feedback, expanding implementation, and informing ways to increase sustainability of EBPs in populations with multiple clinical and psychosocial needs.

With the high prevalence of potentially traumatic events and subsequent associated mental health problems and impaired functioning, there is a need for graduate training in trauma psychology. A national survey was conducted of all North American doctoral programs in psychology to ascertain the current status of training in trauma. Training directors were sent email invitations and asked to complete a Web based survey. A total of 151 out of 398 responded with adequate information about their program, and were included in the analyses. Only 1 in 5 offered a trauma psychology course as well as a practicum specifically working with traumatized populations. The most commonly cited barriers to addressing trauma were limited capacity for elective courses and little time and resources. Attention to trauma issues is important for the development of competent professional psychologists. Ways that doctoral programs can facilitate development of knowledge, skills and attitudes in trauma psychology are discussed.

In this systematic review, we synthesized the quantitative and qualitative research examining the role of evidence-based relationship variables (EBRVs) in the treatment of affectional and gender minority (AGM) individuals. A comprehensive search of PsycINFO, Web of Science, and PubMed from 2009 to 2019 yielded 14 unique studies (15 articles in total). Most studies examined the role of empathy and alliance. Positive regard, strong therapeutic alliances, genuineness, and empathy were all associated with improvements in treatment engagement and treatment outcome. There appeared to be no evidence that matching clients on sexual or gender identities improved outcomes. There were methodological concerns in the literature in regard to the use of hypothetical scenarios and variability in study design and measures. In sum, more research is needed to explore how EBRVs may be a necessary component of AGM affirmative care. Clinical Impact StatementThe results of this systematic review indicate that the role of evidence-based relationship variables in working with affectional and gender minorities is an understudied, but clinically necessary, topic. The extant literature suggests that empathy, alliance, genuineness, and positive regard play an integral role in fostering a collaborative therapeutic environment.

The recovery process and social work education share theoretical and practice roots that facilitate a goodness-of-fit between the profession and the empowerment orientation of recovery. This article examines the linkages between the recovery process and social work education, including areas where curricular renewal will assure that master's in social work (MSW) students and graduates embrace the recovery-oriented values that facilitate consumer-driven services. Curricular innovation is also proposed that addresses the need for MSW programs to develop supported education programs that will enable more consumers to pursue and complete graduate social work education.

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In this article, the editor of the Special Issue of Practice Innovations on Evidence-Based Relationship Variables in Working with Affectional and Gender Minorities discusses the conceptualization of evidence-based relationship variables (EBRV) as a foundational component of trauma-informed affirmative care. The article then shares the importance and value of EBRVs as they specifically apply to working with affectional and gender minorities or the lesbian, gay, bisexual, transgender, and questioning (or queer)ϩ community. The article concludes with an examination of the 5 articles included in the Special Issue and how each incorporated EBRVs into affirmative care practice. Clinical Impact StatementThis article describes the integral role of evidence-based relationship variables in providing trauma-informed affirmative care. It also introduces five articles focusing on this topic as part of the special issue on "Introduction to Special Issue on Evidence-Based Relationship Variables in Working With Affectional and Gender Minorities."