An Examination of Perceived Therapeutic Bond as a Mediator of Psychological Outcomes

Tatum, Alexander K.; Vera, Elizabeth

doi:10.1002/jocc.12154

Cited by 2 publications

(2 citation statements)

References 45 publications

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“…Another social determinant of client outcomes is therapeutic relationship quality (Tatum & Vera, 2020). The therapeutic relationship refers to the special connection therapists develop with their clients over the course of psychotherapy (Gelso & Carter, 1994).…”

Section: Therapeutic Relationship Qualitymentioning

confidence: 99%

Let’s get real: Identity concealment, burnout, and therapeutic relationship quality among psychology trainees with concealable stigmatized identities.

Shepherd,

Brochu

2024

Psychotherapy

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Identity concealment thwarts psychological needs of authenticity and belonging, both of which are important for mental health and relationship building. Through the lens of minority stress theory and relational-cultural theory, the present study examined whether identity concealment in the workplace by psychology trainees is indirectly associated with greater burnout and poorer therapeutic relationship quality. To test this hypothesis, a parallel mediation analysis was conducted on data from 335 clinical and counseling psychology doctoral trainees with concealable stigmatized identities using Hayes's (2018) PROCESS macro. As expected, identity concealment at a practicum or internship site was negatively associated with authenticity and belonging, both of which were negatively associated with burnout and positively associated with therapeutic relationship quality. Furthermore, identity concealment was associated with lower therapeutic relationship quality and greater burnout indirectly through lower authenticity and lower belonging. Findings suggest trainees who engage in more identity concealment at their clinical training sites may be at increased risk for burnout and poorer relationships with clients due to limited opportunities for authenticity and belonging. Future research is encouraged to longitudinally examine the impact of identity concealment on professional burnout and relationships, as well as potential protective factors. Such knowledge can support the development of interventions and policies that foster safer, more welcoming work environments for trainees with concealable stigmatized identities. Clinical Impact StatementQuestion: Does identity concealment present a possible barrier to the psychotherapy process among clinical and counseling psychology doctoral students with concealable stigmatized identities, and why? Findings: Psychology trainees with concealable stigmatized identities who engaged in more identity concealment within their practicum or internship reported higher rates of burnout and poorer therapeutic relationship quality, possibly as a function of lower levels of authenticity and belonging. Meaning: Psychology trainees need to be aware of the potential risks of concealing a stigmatized identity within their clinical training sites-as well as their own human need for authenticity and belonging-for the sake of their well-being and the well-being of their clients. Next Steps: These findings underscore the need for the development of structural changes (e.g., the implementation of culturally responsive policies, discussions, and trainings) that reduce identity-based stigma and the likelihood of identity concealment within graduate training programs in clinical and counseling psychology.

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Section: Therapeutic Relationship Qualitymentioning

confidence: 99%

Let’s get real: Identity concealment, burnout, and therapeutic relationship quality among psychology trainees with concealable stigmatized identities.

Shepherd,

Brochu

2024

Psychotherapy

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“…The therapeutic bond has been defined as the collaboration that arises between psychotherapists and their patients focused on the success of psychotherapy (Flückiger et al, 2018). To establish an effective bond, it is important to know how to adapt to each patient in a specific way by being flexible and showing an affectionate attitude (Tatum & Vera, 2020). In this regard, some authors have studied the impact of the therapeutic style on the bond between psychotherapists and their patients.…”

mentioning

confidence: 99%

Efficacy of a mindfulness and compassion-based intervention in psychotherapists and their patients: Empathy, symptomatology, and mechanisms of change in a randomized controlled trial.

Garrote-Caparrós¹,

Lecuona²,

Bellosta-Batalla³

et al. 2023

Psychotherapy

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In recent years, mindfulness and compassion-based interventions (MCBI) have been found to beneficially influence the acquisition of essential skills in psychotherapy and are a promising way to improve relationships with patients. In this regard, new studies are needed to evaluate the effects of MCBI on psychotherapists and their patients and to analyze the influence of these effects on the processes and outcomes of psychotherapy. In this randomized controlled trial, we evaluate the efficacy of an MCBI in psychotherapists’ mindfulness skills and self-reported empathy, as well as its indirect effect on patients (patient-reported psychotherapists’ empathy, therapeutic bond, and symptomatology). Finally, we present a multilevel structural equation model (MSEM) to analyze the relationship between these variables in psychotherapists and their patients. A group of psychotherapists (N = 63) were randomized to an MCBI or an active control group (empathy diary). We assessed psychotherapists and their patients (N = 121) before and after the MCBI and at follow-up evaluation. Psychotherapists’ results showed an increase in psychotherapeutic mindfulness skills (PMS) after the MCBI and at follow-up, whereas self-reported empathy improved at follow-up. Patients’ results showed an improvement in perceived empathy, therapeutic bond, and symptomatology after the MCBI. The improvements in symptomatology were maintained for somatization and anxiety at follow-up. According to the MSEM, the increase in PMS is related to an increase in patient-reported psychotherapists’ empathy, which produces an improvement in therapeutic bond and their symptomatology. These results support the benefits of introducing MCBI in psychotherapists’ training to improve the psychotherapy outcomes.

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An Examination of Perceived Therapeutic Bond as a Mediator of Psychological Outcomes

Cited by 2 publications

References 45 publications

Let’s get real: Identity concealment, burnout, and therapeutic relationship quality among psychology trainees with concealable stigmatized identities.

Let’s get real: Identity concealment, burnout, and therapeutic relationship quality among psychology trainees with concealable stigmatized identities.

Efficacy of a mindfulness and compassion-based intervention in psychotherapists and their patients: Empathy, symptomatology, and mechanisms of change in a randomized controlled trial.

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