“Bridging the Gap”: A reflexive thematic analysis of the experiences of therapy trainees transitioning from psychodynamic counselling to cognitive behavioural therapy

There is limited empirical research and insight into the experiences of therapy trainees who are being taught more than one psychotherapeutic approach during their training. Further understanding is warranted to ensure that a dual modality approach to training (that is, where therapists are trained in two paradigmatically distinct modalities) is experienced as worthwhile and acceptable to trainees and to better understand any challenges faced when transitioning between approaches. The aim of this study was to investigate trainees' experiences of transitioning from psychodynamic counselling to cognitive behavioural therapy (CBT) on a two-year master's degree that offers a dual modality approach to training. Data were collected from a sample of 8 trainees using an online semistructured questionnaire. These data were analysed using Braun and Clarke's (2020) reflexive thematic analysis. Four main themes were identified: (1) perceived competence; (2) preparedness; (3) professional advantages; and (4) external challenges. The findings suggested considerable individual variation in the ease with which participants navigated the transition between therapeutic modalities. Those who found the transition easier used the structure of CBT to provide a framework and point of difference that allowed them to temporarily suspend their psychodynamic learning in order to embrace a new therapeutic approach. Others experienced the move to CBT as posing a threat to their developing identities as counsellors. Recommendations are made on how to prepare trainees for the transition including exploring the psychological impact of transitions, increasing opportunities for reflective practice and facilitating exploration of what it means to be a therapist trained in two distinct therapeutic modalities.     

Early Change Trajectories in Cognitive-Behavioral Therapy for Binge-Eating Disorder

Rapid response is considered the most well-established outcome predictor across treatments of binge-eating disorder (BED), including cognitive-behavioral therapy (CBT). This study sought to identify latent trajectories of early change in CBT and compare them to common rapid response classifications. In a multicenter randomized trial, 86 adults with BED (DSM-IV) or subsyndromal BED provided weekly self-reports of binge eating over the first 4 weeks of CBT, which were analyzed to predict binge eating, depression, and body mass index at posttreatment, 6-, and 18-month follow-up. Using latent growth mixture modeling, three patterns of early change—including moderate and low decreasing—as well as low stable binge eating were identified, which significantly predicted binge-eating remission at 6-month follow-up. Other classifications of rapid response based on Receiver Operating Characteristics curve analyses or on the literature (≥ 10% reduction in binge eating at week 1, ≥ 70% reduction in binge eating at week 4) only predicted posttreatment remission or overall depression, respectively. Latent change trajectories, but not other rapid response classifications, predicted binge-eating frequency over time. A fine-grained analysis of change over the first 4 weeks of CBT for BED revealed different trajectories of early change in binge eating that led to an improved prediction of binge-eating outcome, compared to that of common rapid response classifications. Thorough monitoring of early change trajectories during treatment may have clinical utility.     

Information matrix estimation procedures for cognitive diagnostic models

Two new methods to estimate the asymptotic covariance matrix for marginal maximum likelihood estimation of cognitive diagnosis models (CDMs), the inverse of the observed information matrix and the sandwich-type estimator, are introduced. Unlike several previous covariance matrix estimators, the new methods take into account both the item and structural parameters. The relationships between the observed information matrix, the empirical cross-product information matrix, the sandwich-type covariance matrix and the two approaches proposed by de la Torre (2009, J. Educ. Behav. Stat., 34, 115) are discussed. Simulation results show that, for a correctly specified CDM and Q-matrix or with a slightly misspecified probability model, the observed information matrix and the sandwich-type covariance matrix exhibit good performance with respect to providing consistent standard errors of item parameter estimates. However, with substantial model misspecification only the sandwich-type covariance matrix exhibits robust performance.     

Emotion Regulation Strategies in Cognitive Behavioral Therapy for Panic Disorder

Emotion regulation (ER) has been incorporated into many models of psychopathology, but it has not been examined directly in cognitive behavioral therapy (CBT) for panic disorder with agoraphobia (PD/A). In this study, a preliminary model of ER in CBT for PD/A is proposed based on existing theories, and several propositions of the model are tested. We hypothesized that increases in cognitive reappraisal would precede decreases in biased cognitions, decreases in expressive suppression would follow decreases in biased cognitions, and a reduction in symptom severity would follow decreases in expressive suppression. Twenty-nine patients who received CBT for PD/A completed weekly self-report measures of symptom severity, anxiety sensitivity, reappraisal and expressive suppression. In addition, patients were compared to a matched normal sample. Cross-lagged analyses partially supported the hypotheses. Reappraisal did not change until late stages of therapy and was generally not associated with treatment outcome. Suppression decreased significantly and exhibited a reciprocal relationship with biased cognitions. Symptom reduction followed decreases in suppression as hypothesized. However, patients did not differ in ER from matched controls at either pre- or posttreatment. Results suggest the important distinction between reappraisal and appraisal, and stress the role of session-by-session decreases in suppression as a predictor of symptom reduction.     

Nature vs. nurture is nonsense: On the necessity of an integrated genetic,social, developmental,and personality psychology

The field of behavioural genetics unambiguously demonstrates that heritable individual differences exist and are important in explaining human behaviour. Despite this, some psychological perspectives ignore this research. If we wish to comprehensively understand the impact of parenting, the environment, or any social factor, however, we must engage with genetics. In this article, I review research that reveals that genes affect not only our personalities, but the way that we understand and react to the social world. Studies further reveal that notable life events are in part explained by genetic variance. I detail how this could be the case through active, evocative, and passive genetic correlations, and go on to argue that all complex psychological traits are likely the result of multifaceted gene by environment interactions. A mistaken belief that genetic influence implies genetic essentialism, and is therefore tantamount to prejudice, is raised as possible reason why heritability is often ignored in the social sciences. The article concludes with practical suggestions for how we can embrace behavioural genetics as our methods struggle to match the divine complexity of human existence.     

Against all odds – is a more differentiated view of personality development in emerging adulthood needed? The case of young apprentices

Personality development in emerging adults who do not attend college after high school has been largely overlooked so far. In this study, we investigated personality development in emerging German adults (N_T1 = 1,886, M_ageT1 = 18.01 years, 29% female) undergoing vocational education and training (VET). The trainees were assessed at the start of VET, 1.5 years later, and another 1.5 years after that, just before graduation. Longitudinal latent change score analyses were applied. Bivariate analyses investigated life satisfaction and job strain as social and work‐related aspects that are potentially reciprocally related to personality development. Mean‐level personality changes included increases in neuroticism and decreases in agreeableness and conscientiousness in the first interval. In the second interval, neuroticism decreased and conscientiousness increased. Simultaneously, trainees reported a gradual decrease in extraversion and openness across the 3‐year time span. Personality, especially agreeableness and conscientiousness, emerged as a stronger predictor of changes in job strain and life satisfaction than vice versa. For example, more agreeable and more conscientious trainees subsequently showed increases in life satisfaction. Trainees reporting higher job strain subsequently showed decreases in agreeableness. Trajectories of personality development partly support the maturity principle that has been established in many college student samples.     

(Emotion-centered) problem-solving therapy: An update

Problem-solving therapy (PST) is a psychosocial intervention, typically considered to be a member of the cognitive and behaviour therapies family, and is based on a biopsychosocial, diathesis-stress model of psychopathology. The overarching goal of this approach is to promote the successful adoption of adaptive problem-solving attitudes and the effective implementation of certain behaviours as a means of coping with life stressors in order to attenuate the negative effects of such events on physical and mental well-being. Over the past several decades, in addition to accumulating strong support for its efficacy as a clinical intervention, similar to many other forms of psychotherapy, PST has undergone various evolutionary changes. Developed primarily as a more cognitive-based approach, due to the large body of literature in the field of affective neuroscience that underscores the importance of the impact of affect on problem solving, PST has evolved into emotion-centered problem-solving therapy (EC-PST). This article provides for a brief excursion into the historical roots of PST and why it has evolved into EC-PST, as well as providing support for its characterisation as a transdiagnostic approach. In addition, several meta-analyses that underscore its efficacy are described, as well as the most recent clinical guidelines that comprise EC-PST.     

Comments on the 2018 IAAP Conference on Archetype Theory: defending a non‐reductive biological approach

During the course of the 2018 IAAP conference, a criticism of Jung’s idea of the archetype as inherited predisposition was raised that involved examining a number of dreams and visions and assessing them through developments in genetics and neuroscience. From this comparison it was argued that archetypes cannot be inherited and could more reasonably be argued to derive from early experiences. In this essay, the author responds by showing how this conclusion is flawed due to being based on reductive errors. An alternative, non‐reductive but inherited and biological position on the archetype is defended.     

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.