Clinical Psychology in Europe (E-Journal)
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A 21st Century Principle-Based Training Approach to Psychotherapy: A Contribution to the Momentum of Transtheoretical Work
No full textBackground: Despite the finding that the majority of psychotherapists adopt a rather process-oriented and integrative stance, it is uncommon that psychotherapy trainings are transtheoretical and transdiagnostic. Considering principles of change that cut across different schools of therapy holds promise for developing truly research-informed psychotherapy trainings. Common principles of change may answer the question what should be trained. Another important question is how to train. In current psychotherapy training programs, transfer of theory into practice relies mainly on role-playing exercises and supervised practice, both of which have their limitations. Aims: A fantasy for the future would be the development, implementation, and evaluation of a complementary 21st century online principle-based and marker-led psychotherapy training: incorporating the concepts of deliberate practice as well as expert training, the huge potential of technologies, and considering the importance of (context) responsiveness. Conclusion: To illustrate this idea, we present a training that we are currently developing, an online Alliance-Focused Training
Web-Based Imagery Behavioral Activation (WIMBA): Study Protocol for a Randomized Controlled Trial Testing the Effects, Acceptability, and Feasibility of a Mental Imagery Activity Scheduling Training Delivered Online
No full textBackground: Behavioral activation (BA) is an effective and efficacious treatment for depression. Activity scheduling is the central treatment component of BA and involves planning of potentially enjoyable and rewarding activities. Evidence from non-clinical studies suggests that mental imagery simulations of planned activities can increase motivation and anticipated pleasure for these activities. Method: We describe a randomized controlled trial testing a mental imagery activity scheduling training delivered online in four weekly sessions (total training duration approximately 90 minutes) in a sample meeting diagnostic criteria of a major depressive episode, as indicated by the Diagnostic Short-Interview for Mental Disorders (Mini-DIPS), and not currently receiving treatment. Participants (N = 140) will be randomized to either mental imagery activity scheduling or a wait-list control condition. Depressive symptoms (BDI-II) and behavioral activation (BADS) are the primary outcomes; BDI-II will be measured at Session 1, Session 4, and at two-week follow-up, BADS at Sessions 1-4 and at two-week follow-up. Discussion: It is discussed how the expected results may reflect mechanisms and effects of a mental imagery activity scheduling training delivered online in a sample of individuals with depression. Concluding we outline next steps for future research and highlight the potential of this novel treatment for dissemination in the wider community and integration into routine care
A Systematic Review of Evidence-Based Cognitive and/or Behavioural Interventions Targeting Mental Health in LGBTQ+ Populations
No full textBackground: Despite a minority stress-related higher risk to develop mental health difficulties, and problematic access to and treatment from healthcare providers, research into LGBTQ+ mental health support is limited. The aims of this systematic review were to explore evidence-based cognitive and/or behavioural interventions and adaptations targeting mental health in LGBTQ+ populations, before providing recommendations for future clinical and research directions. Method: Six databases were searched in February-March 2022 and risk of bias evaluated using the Cochrane RoB 2/ROBINS-I tools. A narrative synthesis following the PICOS framework and the review questions was used to examine the results. Results: Sixteen studies met inclusion criteria, including various interventions and adaptations, mental health difficulties, and other emotion- and minority stress-related processes/constructs. Risk of bias was judged as high, and critical/serious, respectively, in all studies. Outcomes included improvements in symptoms of depression (most statistically/clinically significant effects/large effect sizes), and anxiety, emotion regulation, and internalised homophobia in the pre-post studies. Conclusion: Cognitive/behavioural interventions and adaptations for LGBTQ+ populations feature a range of therapeutic modalities and levels of adaptation, with largely positive effects, in the context of limited and heterogenous literature and risk of bias concerns, as well as limitations related to publication bias and inclusion criteria of the current work. Suggestions for future clinical and research directions include a focus on generic therapeutic competencies and metacompetencies, and affirmative, potentially more holistic approaches, as well as more consistency in methodology, more focus on underserved LGBTQ+ populations and intersectionality, and more detailed investigations into mechanisms of change
The Alliance Negotiation Scale – Therapist Version: Psychometric Properties in a Sample of Portuguese Psychologists
No full textBackground: The transtheoretical conceptualization of the working alliance and the resultant evaluation tools often overestimate the collaboration between therapist and client, while neglecting the negotiation process. The degree to which therapists and clients can negotiate disagreements regarding goals and tasks is an important indicator in establishing and maintaining the alliance. Even though the negotiation concept is not new, there is still a lack of reliable and parsimonious self-report measures of the construct. The purpose of this study was to translate, execute the cultural adaptation and, also, to perform a preliminary psychometric analysis of the Portuguese form of the therapist version of the Alliance Negotiation Scale (ANS-T_Pt). Method: Data were collected online from 100 Portuguese psychologists. Two random sub-samples were used to conduct both exploratory factorial analysis and confirmatory factorial analysis. Convergent validity was assessed through comparison with the Portuguese version of the Working Alliance Inventory. Results: The ANS-T_Pt showed a one-factorial structure, consistent with previous versions, and demonstrated adequate internal consistency. Evidence supporting criterion-related validity was found based on the correlations between ANS-T_Pt and WAI-T scores. The results showed moderate to large associations between the instruments. These results support the usefulness of the scale, construct’s relevance and its transtheoretical nature. Conclusion: These results are a step forward for Portuguese therapists’ and researchers’ ability to evaluate the bond between client and therapist and to compare results from different countries
Psychological Clinical Science: Meeting the Challenge of Public Mental Health
No full textThe purpose of this article is to provide a brief overview of how clinical psychology evolved in the United States as a prelude to discussing the emergence of psychological clinical science in the closing years of the 20th century. Despite the growth of clinical psychology, mental disorders remain highly prevalent, compelling us to envision new ways to deliver services in an effective but efficient manner. Topics include the dissemination gap, the affordable access gap, and the Psychological Clinical Science Accreditation System (PCSAS). Examples of novel methods for addressing the problem of public mental health in the 21st century are discussed. Finally, I close by considering the potential relevance of our experience in America for European clinical psychology
The History of Clinical Psychology in Greece: A Brief Review – Legal Deficiencies, Practical Dimensions and Challenges for the Future
No full textBackground: The history of clinical psychology in Greece spans more than 150 years. However, this branch of psychology concerned with the assessment and treatment of mental illness and psychological problems has not yet acquired the institutional and general recognition to which it is entitled. Aims: This article intends to highlight, chronologically, the basic elements of the history of clinical psychology in Greece, beginning with the important contribution of the work of philologist Panagiota Kazolea-Tavoularis. Results: From the first references in the context of medical studies during the 19th century, clinical psychology gradually develops through its application in pedagogical, laboratory, and clinical contexts to become an independent discipline alongside the consolidation of general psychology. Special mention is made of the scientists who pioneered this direction. Conclusion: The present review highlights historical milestones and concludes with the current situation, in which important steps have been taken. However, significant changes are needed at the institutional level
Worry Postponement From the Metacognitive Perspective: A Randomized Waitlist-Controlled Trial
No full textBackground: Pathological worry is associated with appraisals of worrying as uncontrollable. Worry postponement (WP) with a stimulus control rationale appears to be effective in non-clinical samples. However, preliminary research in participants with generalized anxiety disorder (GAD) does not support its efficacy in reducing negative metacognitions or worry. The aim of this study was to investigate the efficacy of WP with a metacognitive rationale. Method: Participants with GAD (n = 47) or hypochondriasis (HYP; n = 35) were randomly assigned to either an intervention group (IG) or waitlist (WL). The IG received a two-session long WP intervention aiming at mainly reducing negative metacognitions concerning uncontrollability of worrying. Participants were instructed to postpone their worry process to a predetermined later time during the six days between the two sessions. Participants completed questionnaires of negative metacognitions and worry at pre-assessment, post-assessment, and follow-up. Results: We observed a significant Time*Group interaction for negative metacognitions and worry. Post-hoc analyses on the total sample and separately for GAD and HYP revealed significantly lower worry scores in the treated GAD sample compared to the WL, representing the only significant effect. In the GAD group, pre-post-effect sizes were small for negative metacognitions and large for worry. Effects persisted to a four-week follow-up. Conclusion: WP with a metacognitive rationale seems to be effective in reducing worry in participants with GAD. The effectiveness for HYP seems limited, possibly due to the small sample size
Transtheoretical Psychological Therapy – New Perspectives for Clinical Training and Practice
No full textNo abstract available
All I Want for Christmas Is a Loo: Visualizations of Sex and Gender on Toilet Doors
No full textNo abstract available
A Process-Based Approach to Transtheoretical Clinical Research and Training
No full textBackground: The science and practice of psychopathology and psychological intervention of today is more like an island archipelago than it is a single land mass, and connections between different traditions are both limited and fraught with misunderstanding. Method: Our analysis and solution to the problem is process-based therapy (PBT). PBT defines psychopathology as failed adaptation processes to a given context. Therapy involves adaptation through context-dependent or context-altering applications of biopsychosocial strategies that allows a goal to be met. Results: This coherent approach to more transtheoretical and integrative concepts of clinical training and practice provides a firm foundation by targeting biopsychosocial processes of change, analyzing these processes using an idiographic complex network analytic approach, and organizing findings on the intellectual agora of multi-dimensional and multi-level evolutionary science. Conclusion: PBT is a new empirical form of functional analysis, resulting in interventions and trainings that are built on elements or kernels of direct relevance to client’s specific needs. In PBT, case formulation continues as long as treatment persists