Cognitive Processing Therapy Versus Supportive Counseling for Acute Stress Disorder Following Assault: A Randomized Pilot Trial

The study tested the efficacy and tolerability of cognitive processing therapy (CPT) for survivors of assault with acute stress disorder. Participants (N = 30) were randomly allocated to CPT or supportive counseling. Therapy comprised six individual weekly sessions of 90-min duration. Independent diagnostic assessment for PTSD was conducted at posttreatment. Participants completed self-report measures of posttraumatic stress, depression, and negative trauma-related beliefs at pre-, posttreatment, and 6-month follow-up. Results indicated that both interventions were successful in reducing symptoms at posttreatment with no statistical difference between the two; within and between-group effect sizes and the proportion of participants not meeting PTSD criteria was greater in CPT. Treatment gains were maintained for both groups at 6-month follow-up.     

Therapist interventions in short-term dynamic psychotherapy: six expert treatments

This paper describes the profile of verbal response modes utilised in the expert application of Short-Term Dynamic Psychotherapy (STDP). One hundred and fifteen randomly selected segments from six treatments of STDP were analysed. Trained raters used a verbal response mode coding system to examine the individual speaking turns of an expert therapist. Based on the profile of therapist interventions reported, it was concluded that the actual conduct of this treatment in routine practice illustrates the empirically informed modifications to STDP technique integrated alongside the common characteristics of STDP based on the therapist (i) adopting an active stance, (ii) maintaining treatment focus using frequent confrontations and the ‘Triangle of Conflict’, and (iii) tailoring treatment to participant functioning using a combination of supportive and expressive interventions. Furthermore, specific differences in therapist activity were observed across treatment phases as well as between participants.     

Therapeutic alliance and progress in couple therapy: multiple perspectives

Therapeutic alliance research in couple therapy using multiple perspectives and longitudinal data has been sparse. This study used structural equation modelling to explore relationships between changes in alliance and in progress from clients' and therapists' perspective in a fairly large sample of couples (N=195) during the initial stage of therapy at an on‐campus training clinic. Self‐rated alliance was measured after sessions 2 through 4 with the Working Alliance Inventory. There was very little change in alliance over the early sessions of therapy, and changes in alliance did not always account for changes in relationship satisfaction. Husbands' perceptions of satisfaction and alliance seem to play an important role in the dynamics of the therapeutic process. Findings suggest a reciprocal relationship between perceptions of alliance and progress in therapy when combining perceptions of therapists and couple clients. Clinical implications and future research are discussed.     

Competences and occupational standards for systemic family and couples therapy

This article reports on the recent government initiative of 2007–2010 to delineate, for the major forms of psychological therapy, expected professional standards of practice and conduct in workplaces (the national occupational standards) and to specify expected levels of competent practice (the competences). The article focuses on the processes and outcomes of this initiative for systemic therapy and its clinical and political relevance. The rationale, research and consultation processes by which these formulations were achieved are described and the outcomes of the work are reported. We also discuss their wider implications, including the various ways in which these achievements might be used and their potential value for the field of systemic family and couples therapy.     

Review and reflections on 40 years of family therapy development in Taiwan

Although the systemic approach is considered to fit Chinese culture, the development of family therapy in Taiwan is recent, starting in 1969, and growing as a treatment modality in Taiwan for the past two decades. To examine this development, this article reviewed 127 locally published family therapy studies published during the years 1969–2009. Content analysis was used to examine these articles and the results clearly showed an increase in the amount of publications during this period. The focus of the studies also shifted from theoretical issues to practical concerns. An analysis of 15 of these articles, which were case reports, suggested a preference for local common practice, for example, a focus on therapist manoeuvres rather than the clients' perspectives, which might have hindered the development of successful practice. The availability of only certain forms of training might also have contributed to the clinical focus of family therapy in Taiwan. The article suggests that greater interest in the therapy process in future will enhance local practitioners' clinical efficacy.     

Social and political perspectives on the psychotherapy and counselling profession: Returning caravelles

The counselling and psychotherapy profession is changing. For the first time in its history, it has begun to receive substantial Government funding in the UK and it also has to contend with the principles of evidence-based practice and the policies of the New Public Management systems in many countries. This paper argues that such recent developments present challenges to the profession’s historical apolitical standpoint. More importantly, it argues that the present social and political climate offers many opportunities such as the possibility of learning from psychosocial practices in other countries. The paper will look, in particular, at what can be learned from Latin America and India where mental health care and psychological therapy have adopted grassroots involvement, health-focused approaches and innovatory therapeutic methods.     

Narrative vignettes and online enquiry in researching therapist accounts of practice with children in schools: An analysis of the methodology

Aims: This article reviews a research methodology that uses an Internet mediated qualitative, narrative approach to provide in‐depth analysis of vignettes. The research sought to investigate the ways in which dramatherapists, based in different countries, understood the nature of therapeutic change in their work with children. Method: The article describes a qualitative approach to the generation of data by a combination of therapist‐authored vignettes, live, synchronous Internet mediated communication (aMSN Messenger) and email. Participants kept a diary of their response to the research and the article draws on this data within its analysis of the methodology. Findings: Samples of the data are used to analyse how such innovative, online methodology can develop effective access and relationships with geographically dispersed participants and as an effective way of investigating therapist practitioners' understanding of their practice.     

Mitigating the Mental Health Impact of Marginalization and Discrimination

In honor of the life and work of Aaron T. Beck, this paper describes the application of cognitive therapy to management of marginalization stress among minoritized communities. Collaborative empiricism, cognitive restructuring, and behavioral interventions are highlighted as being particularly useful in a contemporary multicultural approach for the anxiety, depression, stress, and other sequelae of marginalization due to a stigmatized identity. Although primarily illustrated through recent work with transgender and gender diverse adults, the discussion extends to other groups including racial, ethnic, and sexual minorities and immigrants. This work illustrates the power of Dr. Beck’s approach to address the presenting concerns of contemporary clinical work.     

Implementing and Adapting the SAFETY Treatment for Suicidal Youth: The Incubator Model,Telehealth, and the Covid-19 Pandemic

The Safe Alternatives for Teens and Youth (SAFETY) treatment was developed to decrease the risk of repeat suicidal and self-harm behavior in youth presenting with elevated suicide risk. This paper uses case illustrations to demonstrate the SAFETY treatment, building upon the companion paper describing our “incubator” treatment development model and process (Asarnow et al., 2022). As illustrated in the second case illustration, the incubator model approach was particularly useful during the COVID-19 pandemic switch to telehealth. SAFETY specifically targets suicide and self-harm risk reduction using an individually tailored principle-guided approach, grounded in a case conceptualization that identifies cognitive-behavioral processes and reactions that contribute to increased suicide attempt risk and explains the youth’s suicidal/self-harm behavior within the context of his or her broader social systems. The SAFETY treatment has been tested in two treatment development trials, and results support the efficacy of SAFETY for preventing suicide attempts in adolescents presenting with recent self-harm.