The relationship between therapeutic engagement,cognitive errors,and coping action patterns: An exploratory study

Aim: This exploratory study examined the relationship between clients’ involvement in therapy and their cognitive errors (CE) and coping action patterns (CAP). Method: Therapy sessions from N = 26 clients were rated for CE and CP using the CE and CAP methods. Client involvement was measured with the Positive and Negative Affect Schedule, as well as the . Results: The CEs’ ‘magnification of the negative or minimisation of the positive’ and ‘labelling’ were associated with measures of affective therapeutic engagement. The coping styles ‘negotiation’, ‘opposition’, ‘submission’, ‘isolation’, ‘support seeking’, ‘information seeking’, ‘delegation’, and ‘escape’ were found to be associated with affective and behavioural dimensions of therapeutic involvement. Conclusions: These findings provide preliminary supporting evidence that CE and CP are related to the extent to which clients engage in the work of therapy. Implications for researchers and therapists are discussed.     

The relationship between cognitive errors,coping strategies,and clients' experiences in session: An exploratory study

Aim: Cognitive errors (CE) and coping strategies (CS) can bear weight on how individuals relate to others and perceive interpersonal relationships. However, there is little research into how clients' erroneous beliefs and maladaptive coping strategies can interfere with the therapeutic process. This study utilised a sample of healthy clients to explore the relationship between their CEs and CSs and their evaluation of therapy. Method: Therapy sessions of undergraduate student clients (N =26) were rated using the Cognitive Error Rating Scale (CERS – 3rd edition), the Coping Patterns Rating Scale (CPRS;), the Session Evaluation Questionnaire (SEQ) and the Session Impact Scale (SIS). Results: Clients who engaged in dichotomous thinking endorsed problem solving less and were more likely to feel unsupported and misunderstood by the therapist. Clients who discounted the positive tended to feel more pressured and judged by therapists. Conversely, those who engaged in problem solving were more likely to find sessions deeper and more valuable as compared to those who reacted to stressful events by submission, escape, or opposition. Implications: Better understanding how and when a client's cognitive errors and coping mechanisms are at play during therapy can help clinicians to address them and intervene appropriately.     

Single session and walk‐in psychotherapy: A descriptive account of the literature

Over the last several decades single session psychotherapy has become a mainstream psychotherapeutic approach. A steadily increasing demand for psychotherapeutic services and a continuous reduction in mental health care resources worldwide are both largely responsible for this development. This paper describes single session psychotherapy and provides a brief review of the relevant literature. Single session psychotherapy delivered in walk‐in settings is also discussed. Therapists who are unfamiliar with single session psychotherapy will find that this paper provides a concise introduction to the essential processes and outcomes of this psychotherapeutic approach.     

Therapists' positive emotions in‐session: Why they happen and what they are good for

Aim: The therapist's feelings play a remarkable role in contemporary models of psychotherapy. However, these models are biased towards negative feelings. The present study explores therapists' personal experience with positive emotion in‐session. Method: A grounded theory analysis was conducted of interviews with 26 Brazilian psychotherapists. Results: Clinicians derive positive affect from the client's input in treatment, from their own input, and from the personal relationship with the client. Therapist positive emotion adds to the material that can be worked on in‐session by providing interpersonal events in the relationship with the client. It can improve therapist input in treatment by increasing in‐session awareness, resourcefulness and daring and by cuing efforts for professional development. It enhances involvement in the relationship with the client by prompting compassion and closeness in the dyad. Its effects may spill over and contribute to the therapist's personal thriving. Discussion: These results are discussed in light of what positive psychology can add to current work on therapist effects in the treatment process.     

A Primer on Psychotherapy Process Research: A Review of Cognitive Therapy of Depression

Researchers conducting psychotherapy process research aim to understand the process by which efficacious psychotherapies achieve therapeutic benefits. A key challenge in this research is how to maximise what can be learned from naturalistic longitudinal data. We provide a selective overview of research examining the process of change in cognitive therapy of depression. While the efficacy of this treatment is widely recognised, a consensus regarding how the treatment reduces depressive symptoms and provides protection from relapse and recurrence has yet to be reached. We review the current state of the research addressing the process of change in cognitive therapy, highlighting how specific methodological features can be used to better understand the process by which this treatment achieves its effects. We highlight the importance of two key challenges to making causal inferences from a process–outcome relation: (a) establishing the temporal precedence of predictors to outcome variables, and (b) evaluating whether any relations identified could be spurious. We argue that methodologically rigorous studies tend to support key claims of the model underlying cognitive therapy of depression. We conclude by considering future directions. For example, we highlight the importance of efforts to understand patient characteristics that may moderate process–outcome relations and could ultimately prove useful in tailoring treatment to best suit individual patients.     

Group-based problem-solving therapy in self-poisoning females: A pilot study

Aims: The treatment of suicidal behaviour remains limited in efficacy. This pilot study assessed the effectiveness of a time-limited, group-based problem-solving therapy intervention compared with a treatment as usual control group, in females who self-poison. Method: A total of 18 clients were equally randomised to treatment or control groups. All clients were assessed using standardised questionnaires for depression, hopelessness, suicidal ideation and social problem-solving skills, at pre-treatment, post-treatment and two months follow-up. Results: The treatment group experienced significant reductions in levels of depression, hopelessness, suicidal ideation and improvements in self-assessed social problem-solving skills. Improvements in mental health and aspects of self-assessed problem-solving skills for the treatment group continued to be evident at two months follow-up. The control group did not change significantly over time on mental health measures or social problem solving abilities. Conclusion: Although limited by small sample size, the results suggest that group-based problem-solving therapy is effective in the management of deliberate self-poisoning. This paper is a unique contribution in that it examines the implementation of problem solving therapy with a homogenous population and in a group format. Methodological concerns and directions for future research are discussed.     

Traumatisation,psychological defence style,coping, symptomatology,and social support in HIV-positive: A pilot study

This paper examines degree of traumatisation, defence styles, coping strategies, symptomatology, and social support in a small sample of HIV-positive men and women in an effort to ascertain the psychological implications of living with Human Immunodeficiency Virus (HIV). Traumatisation and the potentially mediating effects of defence styles have only been the subject of a few studies of HIV positives. The study is based on a socio-demographic questionnaire, the Impact of Event Scale, the Defence Style Questionnaire, the Coping Styles Questionnaire, the Trauma Symptom Checklist, and the Crisis Support Scale. A degree of traumatisation that warrants treatment was found together with an association between particular coping strategies and symptomatology, and particular defence styles and symptomatology, respectively. Social support had increased over time, which is contrary to other research findings on social support.     

Negotiating ending: A qualitative study of the process of ending psychotherapy

Objectives: When psychotherapy is open-ended, the question of termination is a matter for negotiation. A model based on both content and the process of ending may explain how ‘good enough’ psychotherapies can be brought to ‘good enough’ endings.

Design: Twelve processes of ending were explored through a combination of audio recordings made during therapy sessions and post-therapy interviews with clients and therapists. Therapies had been tailored to the needs of the clients and were based on a broad spectrum of theoretical affiliations.

Methods: A procedure for systematic text condensation was used on a case-by-case basis. Issues surrounding the initiation and negotiation of ending were pointed out in each case and were then compared across cases.

Results: The initiation of ending and exchanges concerned with when and how to end therapy unfolded as a concerted process because both parties seemed to be aware that the theme of ending contained a potential challenge to the alliance. Dual affect regulation, implicit communication and a future-oriented perspective were important features. Structural elements such as schedule changes and temporary breaks served several psychological functions. Therapies seemed to reach ‘good enough’ endings when the client and therapist joined in their efforts to resolve basic ambivalences embedded in the decision to terminate contact with the affirmation of a continuing emotional bond.     

Collectivism and coping: Current theories,evidence, and measurements of collective coping

A burgeoning body of cultural coping research has begun to identify the prevalence and the functional importance of collective coping behaviors among culturally diverse populations in North America and internationally. These emerging findings are highly significant as they evidence culture's impacts on the stress‐coping process via collectivistic values and orientation. They provide a critical counterpoint to the prevailing Western, individualistic stress and coping paradigm. However, current research and understanding about collective coping appear to be piecemeal and not well integrated. To address this issue, this review attempts to comprehensively survey, summarize, and evaluate existing research related to collective coping and its implications for coping research with culturally diverse populations from multiple domains. Specifically, this paper reviews relevant research and knowledge on collective coping in terms of: (a) operational definitions; (b) theories; (c) empirical evidence based on studies of specific cultural groups and broad cultural values/dimensions; (d) measurements; and (e) implications for future cultural coping research. Overall, collective coping behaviors are conceived as a product of the communal/relational norms and values of a cultural group across studies. They also encompass a wide array of stress responses ranging from value‐driven to interpersonally based to culturally conditioned emotional/cognitive to religion‐ and spirituality‐grounded coping strategies. In addition, this review highlights: (a) the relevance and the potential of cultural coping theories to guide future collective coping research; (b) growing evidence for the prominence of collective coping behaviors particularly among Asian nationals, Asian Americans/Canadians and African Americans/Canadians; (c) preference for collective coping behaviors as a function of collectivism and interdependent cultural value and orientation; and (d) six cultural coping scales. This study brings to light the present theoretical and methodological contributions as well as limitations of this body of literature and the implications it holds for future coping research.     

Effects of Cognitive Behavioral Therapy and Vocational Rehabilitation on Metacognition and Coping in Schizophrenia

The Indianapolis Vocational Intervention Program (IVIP) is a cognitive behaviorally based program of group and individual interventions that seeks to help persons with schizophrenia improve vocational function and sustain hope. In this study we compared baseline and follow-up assessments of coping and metacognition among 50 participants with schizophrenia spectrum disorders offered a six-month job placement and randomized to receive IVIP (n = 25) or standard services (n = 25). ANCOVA controlling for baseline suggest that the IVIP group gained greater ability to think about their own thinking and to cope by seeing what were previously perceived as negative stressors in more positive light. An erratum to this article can be found at     

Client perspectives: The therapeutic challenge of domestic violence counselling – a pilot study

Aims: This qualitative pilot study explored the perceptions of four female domestic violence clients regarding counselling they had concluded in order to identify a preliminary client‐preferred domestic violence counselling approach. Method: Semi‐structured interviews asking about significant events during counselling were held. An adapted grounded theory and narrative methodology was used. Results from the analysis were reviewed with two of the participants. Participants were offered additional counselling support if required after the research interview. Results/Findings: Domestic violence clients found starting counselling particularly difficult after years of keeping the abuse to themselves. Participants actively withheld and managed information for several sessions and needed to know they had time to explore their experiences. The counsellor being consistent and non‐judgemental, and understanding domestic violence and its effects was helpful. Having a clear ending was appreciated by the participants. Discussion: The initial development of the therapeutic relationship benefited from active discussion of how domestic violence could affect behaviour and emotions. Good early therapeutic relationships showed elements of the three main psychological schools. Participants benefited from a pro‐active discussion of endings. A key limitation of this research is the small sample size. Implications for practice: The research suggests that counsellors would benefit from knowledge and skills from different psychological schools and specific training in domestic violence. Allowing flexibility on the number of sessions available to clients may be helpful. Conclusions: Further work is required to explore these preliminary findings. However, early indications suggest that domestic abuse clients may benefit from non‐time‐limited specialist counselling services.     

Thriving,burnout, and coping strategies of early and later career counseling center psychologists in the United States

We interviewed seven early career psychologists (ECPs) and seven later career psychologists (LCPs) employed at university counseling centers in the United States about their experiences with thriving, burnout, and coping. We analyzed the data using Consensual Qualitative Research. Typical factors that contributed to thriving included recognition for achievement and the climate of counseling center and campus, although the latter was more important for ECPs than LCPs. Typical factors that contributed to burnout included challenges with tasks and responsibilities and challenges related to professional relationships. Finally, interpersonal support (general), self-care, cognitive strategies, and behavioral strategies (typical) were coping strategies used by both ECPs and LCPs, but only ECPs identified using personal therapy. Implications for counseling centers and for research are presented.     

The influence of need for cognitive closure on the attention‐recognition stage of preventive coping

The current study explored the influence of need for cognitive closure (NFCC) on preventive coping via its effects on the attention‐recognition stage and sought to determine whether this influence was moderated by individuals' existing knowledge. An experiment involving 90 university students used the vignette‐reading paradigm to explore the relationships between NFCC, attention and preventive coping behaviour. The results indicated that when preventive coping situations were consistent with participants' previous knowledge, people with high, relative to low, NFCC were more inclined to use preventive coping strategies. As a stage of preventive coping, gaining awareness of potential stressors mediated the relationship between NFCC and preventive coping. However, when coping situations were inconsistent with participants' knowledge, the relationship between NFCC and preventive coping was non‐significant.     

Cognitive reappraisal and secondary control coping: associations with working memory,positive and negative affect,and symptoms of anxiety/depression

Abstract

The current study examined the relations of measures of cognitive reappraisal and secondary control coping with working memory abilities, positive and negative affect, and symptoms of anxiety and depression in young adults (N=124). Results indicate significant relations between working memory abilities and reports of secondary control coping and between reports of secondary control coping and cognitive reappraisal. Associations were also found between measures of secondary control coping and cognitive reappraisal and positive and negative affect and symptoms of depression and anxiety. Further, the findings suggest that reports of cognitive reappraisal may be more strongly predictive of positive affect whereas secondary control coping may be more strongly predictive of negative affect and symptoms of depression and anxiety. Overall, the results suggest that current measures of secondary control coping and cognitive reappraisal capture related but distinct constructs and suggest that the assessment of working memory may be more strongly related to secondary control coping in predicting individual differences in distress.     

Obstructive sleep apnoea syndrome increases source‐confusion errors: A pilot study

We explored external source monitoring (i.e., discrimination between memories of two externally derived sources) in patients with obstructive sleep apnoea syndrome (OSAS). Our specific aim was to ascertain whether, relative to controls, patients exhibit more source‐confusion errors when there are similarities between two external memory sources. We recruited 22 patients with OSAS and 22 controls matched for sex, age, and education. The experimental procedure we used came in three phases. First, participants viewed a target film. Second, they were shown a mixed set of photographs, some taken from the film (target photographs), others not (photographs taken from other films not viewed by participants; lures). Lures differed either conceptually or perceptually from the target film. Third, the following day, participants were shown a set of photographs and urged to determine whether the photographs were taken from the target film or whether they were images they had seen for the first time in Phase 2. Patients correctly attributed the same number of target photographs to the target film as controls. By contrast, they incorrectly attributed more lures to the target film than controls did, especially when the lures were semantically similar to the film (perceptual lures). Both perceptual and conceptual source‐confusion errors were significantly correlated with oxygen desaturation during sleep. Results suggest that the higher number of source‐confusion errors observed in patients with OSAS was linked to an impaired ability to recollect specific perceptual details of the study items and that hypoxia is the main contributing factor to this deficit.     

Videoconferencing versus face-to-face psychotherapy: Insights from patients and psychotherapists about comparability of therapeutic alliance,empathy and treatment characteristics

Objective

Videoconferencing psychotherapy (VCT) is an effective treatment option. Yet, it is unclear whether a similar therapeutic alliance as in conventional face-to-face psychotherapy (F2F) can be achieved, since previous studies yielded mixed results. Furthermore, surveys about the attitudes towards VCT amongst patients have been missing until now. The current study gathered opinions from patients and psychotherapists about the perceived comparability of VCT and F2F regarding contextual factors and treatment characteristics, focusing on therapeutic alliance and empathy.

Method

An online survey amongst patients (N = 189) and practitioners (N = 57) taking part in cognitive behavioural therapy was conducted after the first lockdown in Germany due to the COVID-19 pandemic and a resulting transition from F2F to VCT for most participants.

Results

While patients experienced therapeutic alliance and empathy as comparable, psychotherapists indicated advantages of F2F. Both groups indicated advantages of F2F for the therapy contents and expressed advantages of VCT for flexibility regarding location and time. More than half of the participants expressed a preference for a combination of analogue and digital therapy.

Conclusion

The perceived disadvantages of VCT can be addressed, for example, with training programmes for psychotherapists targeting communication in VCT and adapting established psychotherapy methods to a digital format to further improve VCT.     

A multi‐process model of self‐regulation: Influences of Mindfulness,Integrative Self‐Knowledge and Self‐Control in Iran

Self‐regulation presumably rests upon multiple processes that include an awareness of ongoing self‐experience, enduring self‐knowledge and self‐control. The present investigation tested this multi‐process model using the Five‐Facet Mindfulness Questionnaire (FFMQ) and the Integrative Self‐Knowledge and Brief Self‐Control Scales. Using a sample of 1162 Iranian university students, we confirmed the five‐factor structure of the FFMQ in Iran and documented its factorial invariance across males and females. Self‐regulatory variables correlated negatively with Perceived Stress, Depression, and Anxiety and positively with Self‐Esteem and Satisfaction with Life. Partial mediation effects confirmed that self‐regulatory measures ameliorated the disturbing effects of Perceived Stress. Integrative Self‐Knowledge and Self‐Control interacted to partially mediate the association of Perceived Stress with lower levels of Satisfaction with Life. Integrative Self‐Knowledge, alone or in interaction with Self‐Control, was the only self‐regulation variable to display the expected mediation of Perceived Stress associations with all other measures. Self‐Control failed to be implicated in self‐regulation only in the mediation of Anxiety. These data confirmed the need to further examine this multi‐process model of self‐regulation.