Relationship between environmental factors and burnout of psychotherapists: Meta‐analytic approach

The present study aims to extend the scope of understanding on the relationships between environmental factors and burnout symptoms by targeting and including more extensive occupational demanding variables related to therapist burnout. The present study includes not only common occupational stressors (e.g., working hours, role overload and role conflict) but also variables reflecting the quality of relationship with clients (e.g., case load and negative clientele) that have not been dealt with before in meta‐analytic studies. A meta‐analysis was conducted on 27 original studies published from the year 2006 to 2018. The findings showed that, among environmental factors, role overload had the most significant positive correlations with exhaustion. In addition, negative clientele had the most significant positive correlations with depersonalisation and reduced accomplishment. Furthermore, caseload and low income had relatively weak relations with therapist burnout. Based on these results, implications and limitations of the study are discussed.     

“A definite feel‐it moment”: Embodiment,externalisation and emotion during chair‐work in compassion‐focused therapy

Chair‐work is an experiential method used within compassion‐focused therapy (CFT) to apply compassion to various aspects of the self. This is the first study of CFT chair‐work and is focused on clients' lived experiences of a chair‐work intervention for self‐criticism. Twelve participants with depression were interviewed following the chair‐work intervention and the resulting data were examined using interpretative phenomenological analysis. Three superordinate themes were identified: “embodiment and enactment,” “externalising the self in physical form” and “emotional intensity.” The findings suggest the importance of accessing and expressing various emotions connected with self‐criticism, whilst highlighting the potential for client distress and avoidance during the intervention. The role of embodying, enacting and physically situating aspects of the self in different chairs is also suggested to be an important mechanism of change in CFT chair‐work. The findings are discussed in terms of clinical implications, emphasising how core CFT concepts and practices are facilitated by the chair‐work process.     

A thematic analysis of practitioners' understanding of domestic abuse in terms of post‐traumatic stress disorder (PTSD) and complex‐PTSD (C‐PTSD)

There is a growing body of evidence suggesting that domestic abuse (DA) should be conceptualised within the complex post‐traumatic stress disorder (C‐PTSD) model. Recently, in the draft of the International Classification of Diseases, Eleventh Revision, produced by the World Health Organization (WHO), C‐PTSD was included as a separate criterion in which DA is incorporated (ICD‐11, WHO, 2018). In this study, a thematic analysis was used to explore to what extent practitioners working with DA survivors are familiar with PTSD and C‐PTSD. Research into such a prevalent and detrimental problem as DA is important to understand whether the development of theoretical knowledge about DA and C‐PTSD is addressed in practice. In a Women's Centre in South London, six semi‐structured interviews with middle‐aged female practitioners were conducted to investigate each counsellor's experiences, knowledge and reflections. Six final themes were constructed to summarise the main results. The findings demonstrate limited practitioner understanding of DA in terms of C‐PTSD, which seems to impact not only the effectiveness of treatment plans with DA survivors, but also counsellors’ own psychological and physical states. It is also indicated that DA can be conceptualised within the C‐PTSD model that corresponds with previous literature indicating the complex nature of DA. The overall results of the current research acknowledge that DA sectors should not be neglected and better funding and effective psychoeducation in this field are needed.     

Resistance and outcome expectations in cognitive‐behavioural therapy for generalised anxiety disorder

Greater client resistance has been consistently found to be negatively associated with outcome in psychotherapy. However, the pathways through which resistance impacts such outcomes are underexplored. Given that client outcome expectation (OE) has been identified as an important common factor in psychotherapy, the goals of the present study were to examine: (a) the impact of resistance on subsequent client and therapist OE (COE & TOE, respectively); and (b) whether COE and/or TOE mediate the relationship between resistance and outcome. These relationships were tested among 44 clients with severe generalised anxiety disorder treated with cognitive‐behavioural therapy in the context of a randomised controlled trial (Westra, Constantino, & Antony, 2016). Resistance was measured at a mid‐treatment session, and COE and TOE were assessed at baseline and immediately after the resistance session. Treatment outcome was measured via client‐rated worry severity at post‐treatment. As predicted, higher resistance was associated with lower subsequent COE and TOE; B = ?.73, p < .001 and B = ?.46, p < .001, respectively. In turn, lower post‐resistance COE predicted higher post‐treatment worry (B = ?.5, p < .001), indicating mediation. In contrast, TOE did not mediate the relationship between resistance and outcome (B = ?.02, p = .876). These results suggest that resistance can be demoralising to both clients and therapists. However, only lower client morale may be detrimental to therapy outcome. This study contributes to understanding outcome pathways through two common therapy processes.     

跨期选择中的年龄差异及其机制

随着老龄化形势日益严峻, 老年人的跨期选择受到越来越多学者的关注。目前关于跨期选择的年老化研究尚存分歧:有研究发现老年人比年轻人更偏好未来获得更大收益; 也有研究发现老年人的选择偏好和年轻人一样, 甚至比年轻人更偏好近期收益。从时间表征和结果价值表征两个维度上的加工过程去分析其对老年人跨期选择的影响, 并进一步阐述认知、动机和情绪因素对两个维度加工过程的影响, 这对于理解当前老年人跨期选择领域研究的分歧有重要科学意义。