An ever-growing number of transdiagnostic processes that maintain psychopathology across disorders have been identified. However, such processes are not consistently associated with psychological distress and symptoms. An understanding of what makes such processes pathological is required. One possibility is that individual differences in rigidity in the implementation of these processes determine the degree of psychopathology. The aim of this article is to examine the relationship between rigidity/flexibility and transdiagnostic maintenance processes. Initial searches were made for research examining relationships between 18 transdiagnostic processes and rigidity/flexibility. Relationships between rumination, perfectionism, impulsivity and compulsivity, and rigidity/flexibility were systemically reviewed; 50 studies met inclusion criteria. The majority of studies indicated that transdiagnostic cognitive and behavioral maintenance processes and rigidity were correlated, co-occurring, or predictive of each other. Findings are consistent with the hypothesis that it is inflexibility in the manner in which processes are employed that makes them pathologically problematic. However, further research is required to test and establish this.

No abstract

To demonstrate the power of integrating three theoretical perspectives (Mentalization Theory, Perceptual Control Theory and the Communicative Impact model), which jointly illuminate the communication challenges and opportunities faced by family carers of people with dementia. To point the way to how this framework informs the design and delivery of carer communication and interaction training. Method: Conceptual synthesis based on a narrative review of relevant literature, supported by examples of family carers. Results: We use the conceptual models to show how the capacity to mentalize ("holding mind in mind") offers a greater sense of control over internal and external conflicts, with the result that they can be deescalated in pursuit of mutual goals. Conclusions: The integrative conceptual framework presented here highlights specific psychological and relational mechanisms that can be targeted through carer training to enhance communication with a person living with dementia.

ObjectivesCommon mental health disorders such as depression and anxiety are highly prevalent and carry significant health care and economic burdens. The UK's improving access to psychological therapies (IAPT) initiative was developed as a cost‐effective way of reducing the pernicious effects of these disorders. IAPT interventions, such as guided self‐help, have been subjected to considerable quantitative evaluation. However, there has been minimal investigation into clients’ experiences of the one‐to‐one low‐intensity interventions (LIIs), which form a key component of IAPT service provision. Qualitative exploration could provide rich data regarding experiences of psychological change and factors affecting therapeutic experiences. This will enable informative, client led insights into how low‐intensity therapy can be improved.MethodsInterpretative phenomenological analysis of eight semi‐structured interviews was used to develop an idiosyncratic understanding of clients’ experiences of one‐to‐one LIIs following entry into a randomized control trial (RCT).ResultsFour superordinate themes were identified from clients’ accounts: goals and expectations of therapy, beneficial aspects of therapy, non‐beneficial aspects of therapy, and the experience of psychological change. A heuristic model of interrelationships between factors is proposed.ConclusionsBoth therapeutic techniques and relationships contribute to beneficial therapeutic experiences. The results reported here can be used to inform practice by harnessing the most beneficial aspects of therapy, such as developing adaptive therapeutic approaches to clients’ clinical needs and facilitating idiosyncratic processes of psychological change. Due to limited qualitative research in this area, further research should be conducted in different service settings to assess differences and similarities in clients’ experiences.Practitioner points Therapists who adapted to clients’ individual needs were perceived as more effective than those who did not.Effective therapeutic experiences were exemplified by a personal therapeutic approach, enough time to discuss issues and normalizing client's experiences.Clients develop idiosyncratic models of change which should be encouraged by therapists over and above clinical models.