Interpersonal isolation has been implicated as a correlate of various negative psychological and psychosocial outcomes. However, less is known about how existential isolation (EI), or the feeling that no one can truly understand your subjective experience, relates to psychological maladjustment and beliefs about, and experiences with, psychosocial treatments. Representing the integration of basic social psychological science on the EI construct and applied psychotherapy-relevant research, the aim of this preliminary, cross-sectional study was to examine the association between EI and (a) specific domains of clinical distress (i.e., depression, anxiety, stress), (b) prospective beliefs about future psychotherapy (i.e., intention to seek therapy, stigma tolerance, therapist expertness), and (c) satisfaction with current mental health treatment (for the subsample of those actively engaged in it). Participants were 500 adults who completed relevant measures via the Amazon Mechanical Turk (MTurk) platform. As expected, EI was positively correlated with depression (p Ͻ .001), anxiety (p Ͻ .001), and stress (p Ͻ .001). Also as expected, and when controlling for general distress and relevant clinical experiences, EI was negatively associated with intention to seek therapy (p Ͻ .001), beliefs about therapist expertness (p Ͻ .001), and satisfaction with current mental health treatment (p Ͻ .001). Results indicated that the negative consequences of high EI extend to clinical symptomatology, more pessimistic beliefs about psychotherapy, and worse experiences when receiving treatment. We discuss tentative implications and recommend future research directions.
Harnessing clinician information to make more personalized and informed treatment decisions could potentially promote better treatment engagement, retention, and outcomes. (PsycINFO Database Record
Context-Responsive Psychotherapy Integration Applied to CBT • 153THERAPIST: (after a pause) When you put it like that, I can really sense that hopelessness. That's indeed a heavy burden to carry, and I can hear in your voice how hard this is for you.
In this chapter, the authors trace the history of psychotherapy integration from the first attempts at rapprochement in the early twentieth century to the recent developments in the twenty-first century. The authors briefly review major contributions to psychotherapy integration from the 1930s to the 1950s, and then focus on rapprochement beginning in the 1960s through the present. In addition to outlining conceptual and theoretical advances, the authors describe structural developments such as societies, journals, and conferences that have facilitated continued research and dissemination of various models of integration. Finally, the impact of ever-changing research, practice, and social climates on rapprochement is discussed.
Corrective experiences (CEs), which suggest transformative experience(s) for the psychotherapy patient, have a rich theoretical history; yet there is little empirical information on patients' own perceptions of what gets "corrected" from therapy, and what is "corrective" (i.e., the mechanisms driving the CE). To address this gap, we investigated 14 patients' posttreatment accounts of both CE elements in the context of naturalistically delivered individual psychotherapy, using a consensual qualitative research methodology. Extending prior research focused on patients' accounts of CEs while still engaged in treatment (Heatherington et al., 2012), the present results revealed that patients retrospectively identified an array of categories that were deemed corrected, such as positive changes in cognitions, interpersonal problems, self-concepts, symptoms, and behaviors. Patients also identified CEs that may have led to those shifts/transformations, including their therapist's actions (especially giving feedback), their own agentic actions (especially engaging in the therapeutic process), and the patient-therapist collaborative and engaged relationship. Clinical practice implications are discussed.
In a trial examining whether cognitive-behavioral therapy (CBT) could be improved by integrating motivational interviewing (MI) to target resistance, MI-CBT outperformed CBT over 12-month follow-up (Westra, Constantino, & Antony, 2016). Given that effectively addressing resistance is both a theoretically and an empirically supported mechanism of MI's additive effect, we explored qualitatively patients' experience of resistance, possibly as a function of treatment. For 5 patients from each treatment who exhibited early in-session change ambivalence, and thus were at risk for later resistance, we conducted interpersonal process recall interviews after a session. Transcripts were analyzed with grounded theory and consensual qualitative research. A salient contrast in patient narratives was a sense of compliance engendered in standard CBT versus connection in MI-CBT. Yet both narratives supported the superordinate category of resistance as an interpersonal process triggered by patient perceptions of therapist beliefs and behaviors. Findings contribute to the conceptualization of resistance from patients' first-hand accounts.
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