Clinical Psychology in Europe (E-Journal)
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The Effects of Mindfulness-Focused Internet-Based Cognitive Behavioral Therapy on Elevated Levels of Stress and Symptoms of Exhaustion Disorder: A Randomized Controlled Trial
No full textBackground: Internet-based Cognitive Behavior Therapy (ICBT) and mindfulness interventions are commonly used to treat elevated levels of stress. There are however few high-quality studies that examine ICBT with integrated mindfulness components for symptoms of stress and exhaustion, and the role of mindfulness exercises in digital treatment. Method: The aim of the present study was to evaluate if a mindfulness-focused ICBT-program could reduce symptoms of stress and exhaustion, and increase quality of life, in a randomized controlled trial including 97 self-referred participants between 18 and 65 years who experienced elevated levels of stress. Results: The intervention group had significantly reduced symptoms of stress and exhaustion, and increased quality of life, compared to the control group. Compared with the controls, participants in the intervention group showed a significant improvement with moderate to large effects on the primary outcome measure perceived stress (d = 0.79), and the secondary outcomes, exhaustion (d = 0.65), and quality of life (d = 0.40). Participants in the ICBT group also increased their level of mindfulness (d = 0.66) during the program. The amount of mindfulness training was significantly associated with an increased level of mindfulness, which in turn was significantly associated with reduced stress symptoms. Conclusions: Mindfulness-focused ICBT can be an effective method to reduce stress-related mental health problems and the amount of mindfulness training seems to be of importance to increase the level of experienced mindfulness after treatment
Psychotherapy Works – An Inclusive and Affirming View to a Modern Mental Health Treatment
No full textPsychotherapy is a highly collaborative and individualized mental health practice developed in (post-) modern societies. The mental health outcomes of psychotherapy cover a broad range of psychological factors including the reduction of suffering/symptoms as well as the promotion of well-being, personal values, and personal strengths. There is extensive meta-analytic evidence that legitimate psychotherapy works remarkably well and robustly for most common mental disorders. In addition, there is a large body of meta-analytic evidence supporting the potential relevance of transdiagnostic relationship principles and transtheoretical psychotherapy factors. Based on this ongoing empirical evidence, we propose four relevant implications for future training and practice in transdiagnostic psychotherapy: 1) the development of a transtheoretical legal framework for psychotherapeutic treatments, 2) the formulation of evidence-based transtheoretical interpersonal skills, 3) an orientation toward transtheoretical therapeutic factors, and 4) the exploration of comprehensive psychotherapy outcomes. We conclude with some more general guidance for future directions
Learning a Practical Psychotherapeutic Skill in Higher Education in Sweden: A Conceptual Paper Concerning the Importance of Constructive Alignment When Teaching Therapeutic Alliance
No full textBackground: In addition to theoretical education, clinical psychology programs should include practical skills training. This skill training may be tied to specific assessment and treatment methods; other skills, such as the ability to create a collaborative alliance with patients, are more generic. Previous research has shown that the ability to build a therapeutic alliance (TA) is often not systematically taught in clinical psychology programs and it is uncertain how this competence is examined. A lack of competence in establishing TA on the part of the psychologist might diminish the effects of psychotherapy. To meet the Bologna Declaration, European universities need to demonstrate constructive alignment, i.e. a relationship between elements of the course content and intended learning outcomes in course documents, and show how the acquired knowledge, abilities, and approaches are assessed. Method: This conceptual paper reviewed the syllabuses for universities in Sweden offering the five-year clinical psychology program to illustrate how higher education in Sweden adheres to the Bologna recommendation on constructive alignment when teaching TA to future clinical psychologists. Results: Only two universities out of all eleven universities in Sweden offering a psychology program described satisfactory constructive alignment concerning TA. Conclusion: This conceptual paper raises awareness of the importance of pedagogic structure when teaching TA in higher education by pointing to the prevailing lack of constructive alignment in teaching TA. The increased awareness will hopefully lead to improved structuring in the teaching of TA
Mind the Gap – Ideas for Making Clinical Research More Relevant for Practitioners and Patients
No full textNo abstract available
Four Versions of Transtheoretical Stances, and the Bernese View
No full textA brief characterization of transtheoretical stances to which existing approaches can be allocated is followed by a description of the "Bernese view", that is, what Klaus Grawe and his colleagues, including the authors of this article have developed: the origins, a model of the multiple constraint satisfaction construction of therapist action, a discussion of psychotherapy integration, the crucial role of supervisors in an integrative multiple constraint satisfaction approach, and a discussion of when and how trainees should be introduced to a transtheoretical stance
Developing a European Psychotherapy Consortium (EPoC): Towards Adopting a Single-Item Self-Report Outcome Measure Across European Countries
No full textBackground: Complementing the development of evidence-based psychological therapies, practice-based evidence has developed from patient samples collected in routine care, addressing questions relevant to patients and practitioners, and thereby expanding our knowledge of psychological therapies and their impact. Implementation of assessments in routine care allows for timely clinical decision support and the collection of multiple practice-based data sets by addressing the needs of patients and clinicians (e.g., routine outcome monitoring) and the needs of researchers (e.g., identifying the impact of therapist variables on outcomes). Method: In this article we describe an initiative developed in Europe, through the European Chapter of the Society for Psychotherapy Research, aimed at creating a consortium that has the potential for collecting data on tens of thousands of patients per year. Results: A survey identified one of the main problems in the development of a common data set to be the heterogeneity of measures used by members (e.g., 87 different pre-post outcomes). We report on the results of the survey and the initial stage of identifying a single-item – the Emotional and Psychological Outcome (EPO-1) – measure and the process of its translation into multiple European languages. Conclusions: We conclude this first stage of the overall project by discussing the future potential of the Consortium in relation to the development of procedures that allow crosswalks of outcome measures and the creation of a task force that may be consulted when new data sets are collected, aiming for new common measures to be implemented and shared
Development and Psychometric Evaluation of the Hope in Medicine Scale
No full textBackground: Hope is an integral, multi-dimensional part of seeking medical treatment. The aim of this study was to develop a self-report scale, the Hope in Medicine (HIM) scale, to measure different modes of hoping in relation to the course of symptoms, the effects of treatment, and supporting medical research. Method: We examined the psychometric properties of the scale in a sample of 74 allergic rhinitis patients participating in a 2-week randomized-controlled trial comparing open-label placebos (OLP) with treatment as usual (TAU). Results: The HIM scale had a Cronbach’s α of .78. An exploratory factor analysis revealed four factors: realistic hope (i.e., hoping for specific positive outcomes such as improvement in symptoms), transcendent hope (i.e., non-directed hoping that things will turn out positively), utopian hope (i.e., hoping to contribute to greater knowledge), and technoscience hope (i.e., hoping for scientific breakthroughs). Speaking to the convergent validity of the scale, realistic hope was moderately related to treatment expectancies (r = .54); transcendent hope was related to optimism (r = .50), treatment expectancies (r = .37), self-efficacy (r = .36), and inversely correlated with pessimism (r = -.43). Hope subscales predicted neither course of symptoms nor impairment. Conclusion: The HIM scale is a questionnaire with adequate internal consistency allowing to assess four modes of hoping. Preliminary results for its convergent validity are promising. Yet, further validation is needed
Effectiveness of Attachment-Based Family Therapy for Suicidal Adolescents and Young Adults: A Systematic Review and Meta-Analysis
No full textBackground: Suicide is a leading cause of death among adolescents and young adults. While only few evidence-based treatments with limited efficacy are available, family processes have recently been posed as a possible alternative target for intervention. Here, we review the evidence for Attachment-Based Family Therapy (ABFT), a guideline-listed treatment targeting intrafamilial ruptures and building protective caregiver-child relationships. Method: PubMed, PsycINFO, Embase, and Scopus were searched for prospective trials on ABFT in youth published up until November 6th, 2023, and including measures of suicidality. Results were independently screened by two researchers following PRISMA guidelines. Risk of bias was assessed using the Cochrane RoB-2 framework. A random effects meta-analysis was conducted on suicidal ideation and depressive symptoms post-intervention scores in randomized-controlled trials (RCTs). Results: Seven articles reporting on four RCTs (n = 287) and three open trials (n = 45) were identified. Mean age of participants was Mpooled = 15.2 years and the majority identified as female (~80%). Overall, ABFT was not significantly more effective in reducing youth suicidal ideation, gpooled = 0.40, 95% CI [-0.12, 0.93], nor depressive symptoms, gpooled = 0.33, 95% CI [-0.18, 0.84], compared to investigated controls (Waitlist, (Enhanced) Treatment as Usual, Family-Enhanced Nondirective Supportive Therapy). Conclusion: Evidence is strongly limited, with few available trials, small sample sizes, high sample heterogeneity, attrition rates, and risk of bias. While not generally superior to other treatments, ABFT might still be a clinically valid option in specific cases and should be further investigated. Clinicians are currently recommended to apply caution when considering ABFT as stand-alone intervention for suicidal youth and to decide on a case-by-case basis
The Relation Between Social Anxiety and Perceptions of Likeability and Friendship in Adolescents
No full textBackground: This study investigated how different social anxiety symptoms (i.e., worrying about negative evaluation versus avoidance tendencies) in adolescents are related to the perception accuracy of likeability by peers and friendships with peers. Method: A community sample of 263 adolescents between 12 and 15 years old reported on their social anxiety symptoms. In addition, they estimated how much their peers liked them, indicated how much they liked their peers, and who their friends were in their classroom. Results: Results showed that socially anxious adolescents who mainly worried about negative evaluations, underestimated their likeability by peers. Adolescents with strong social avoidance tendencies had a more accurate perception of their likeability and friendships; they were less liked by their peers and had fewer friends. Conclusion: The results emphasize the importance of treating avoidance behavior in social anxiety since avoidance tendencies may not only maintain the social anxiety symptoms but are also related to a more negative judgment by others
Feasibility and Acceptability of a Mobile App for Prolonged Grief Disorder Symptoms
No full textBackground: Mobile apps provide a unique platform for mental health assessment and monitoring. They can provide real time, accessible data on symptoms of mental disorders that may yield rich data for detailed clinical assessment and help individuals gain insight into their current mental state. We developed one of the first apps for tracking symptoms of prolonged grief disorder. Method: In this pilot feasibility study, we assess the feasibility and acceptability of a new mobile app mGAGE for use once a day for 3 weeks. 27 participants completed mental health assessments at t1 and t2. Results: Adherence to the app protocol was very high with 100% for the first two weeks of use. A surprising finding was the improvement of grief symptoms at t2. Debriefing interviews revealed general qualitative categories including positive feedback, negative feedback and specific recommendations. Overall, the app was found to be feasible for use for the first two weeks and acceptable for bereaved individuals. Conclusions: This app could provide valuable data for in depth clinical assessment, may support individuals to gain greater insight into their symptoms and may have a therapeutic effect in terms of improved grief symptoms. Implications for future studies including use in larger intervention studies are discussed