The perceived helpfulness of rendering emotional first aid via email

The present research examined the perceived helpfulness of an increasingly widespread mode of psychological assistance, namely, emotional first aid via email. The sample comprised 62 naturally occurring email interactions between distressful clients and trained volunteers operating within the framework of the Israeli Association for Emotional First Aid. Data were gathered by means of a structured questionnaire and open-ended questions so as to examine the clients' motivation to seek help via email and evaluate their satisfaction with the responses obtained. The results revealed a preference for written communication and the accessibility of assistance to be the most frequent reasons for clients to choose the medium of email. Most clients found the responses to be helpful in providing emotional support, enhancing cognitive change and suggesting practical ways of coping. Women perceived the assistance to be more helpful than men did. The results are discussed in terms of the unique value of email as an agent of mental health assistance.     

Women’s preference of therapist based on sex of therapist and presenting problem: An analog study

An analog study was conducted to examine differences in women’s preference for and anticipated comfort self-disclosing to hypothetical therapists of different sexes based on the type of hypothetical presenting problem. The impact of general level of self-disclosure was also examined. Participants included female college students (n?=?187). Anticipated comfort self-disclosing to male or female therapist was rated by subjects when presented with therapists of each sex with the same qualifications. Women preferred and reported higher levels of anticipated comfort self-disclosing to a female therapist. The type of hypothetical presenting problem and general level of self-disclosure also impacted anticipated comfort self-disclosing. There was an interaction between general level self-disclosure and the sex of therapist on anticipated comfort self-disclosing. General level of self-disclosure only impacted anticipated comfort self-disclosing when the therapist was male. This information is relevant for therapists or organizations that provide psychosocial services to women. Organizations may want to inquire about a client’s preferences about sex of therapist beforehand and, if possible, cater to the client’s preference.     

A comparison of two online cognitive‐behavioural interventions for symptoms of depression in a student population: The role of therapist responsiveness

Objectives: The study aimed to compare the efficacy of eight weekly sessions of a self‐administered online CBT treatment (cCBT; n=51) to a therapist‐assisted email CBT treatment (eCBT; n=50) in University students. Design: The design was a randomised parallel group trial. The study randomised participants with symptoms of depression to one of two available treatments. Method: Participants were offered eight weekly sessions of either cCBT or eCBT. Participants completed the Beck Depression Inventory‐II (BDI‐II) and the Clinical Outcomes in Routine Evaluation – Outcome Measure (CORE‐OM) at pre‐and post‐treatment, at weeks 16 and 32 follow‐up. The Working Alliance Inventory‐Short Form (WAI‐SR) was completed at weeks 2, 4, and 6. Results: For both groups, pre‐post within group effect sizes reported were large for the BDI‐II and the CORE‐OM and these were maintained at follow‐up. Perceptions of working alliance were similar in each group, but Bond was significantly stronger for the eCBT condition. WAI scores correlated more positively with the outcome on BDI‐II for those in the eCBT condition than the cCBT condition, but not significantly. Conclusion: There were no significant differences between the two online treatments, both reduced depressive symptoms and improved general functioning. Similarly, at post‐treatment and follow‐up, clinical improvement and recovery was demonstrated for both groups equally. The study demonstrates the possibility for cCBT in a university setting that may contribute to addressing the shortcomings in meeting increasing demands that mental health services presently face.     

Extended problem solving treatment for depression

Introduction: Effective brief psychological approaches for depression that can be delivered by a variety of health professionals with minimal training increase access to treatment by patients. Problem Solving Treatment (PST) was developed for primary care and was modified for this study (EPST) to better meet the needs of mental health patients. Method: A total of 92 therapists from different professional backgrounds completed EPST workshops and treated 92 patients with major depression with interval clinical and treatment process assessments. Results: EPST achieved a significant reduction in depressive symptom scores, life problem scores, and there were few treatment non‐completers. Treatment outcome was predicted by process and therapist variables. Discussion: EPST is an effective and easy to teach treatment that can be delivered by a variety of practitioners and suitable for busy primary mental health care settings.     

Intraclass Correlation Associated with Therapists: Estimates and Applications in Planning Psychotherapy Research

It is essential that outcome research permit clear conclusions to be drawn about the efficacy of interventions. The common practice of nesting therapists within conditions can pose important methodological challenges that affect interpretation, particularly if the study is not powered to account for the nested design. An obstacle to the optimal design of these studies is the lack of data about the intraclass correlation coefficient (ICC), which measures the statistical dependencies introduced by nesting. To begin the development of a public database of ICC estimates, the authors investigated ICCs for a variety outcomes reported in 20 psychotherapy outcome studies. The magnitude of the 495 ICC estimates varied widely across measures and studies. The authors provide recommendations regarding how to select and aggregate ICC estimates for power calculations and show how researchers can use ICC estimates to choose the number of patients and therapists that will optimize power. Attention to these recommendations will strengthen the validity of inferences drawn from psychotherapy studies that nest therapists within conditions.     

Therapist Awareness of Client Resistance in Cognitive-Behavioral Therapy for Generalized Anxiety Disorder

Clients' resistance relates negatively to their retention and outcomes in psychotherapy; thus, it has been increasingly identified as a key process marker in both research and practice. This study compared therapists' postsession ratings of resistance with those of trained observers in the context of 40 therapist–client dyads receiving 15 sessions of cognitive-behavioral therapy for generalized anxiety disorder. Therapist and observer ratings were then examined as correlates of proximal (therapeutic alliance quality and homework compliance) and distal (posttreatment worry severity) outcomes. Although there was reasonable concordance between rater perspectives, observer ratings were highly and consistently related to both proximal and distal outcomes, while therapist ratings were not. These findings underscore the need to enhance therapists' proficiency in identifying important and often covert in-session clinical phenomena such as the cues reflecting resistance and noncollaboration.     

The Use of Self of the Therapist

This article explores how the Satir model facilitates the development of the self of the therapist, which Virginia Satir strongly advocated. Discovering and developing creative ways to externalize the internal hidden processes of people, she invited therapists to work on their own unresolved issues in their training through various methods such as: family of origin, family reconstruction, ingredients of an interaction, and parts party. Her goal was to increase self-esteem, foster better choice making, increase responsibility, and facilitate personal congruence through a therapeutic process. Although very relevant in the training and professional development of therapists, there has been little exploration or research of this topic.     

Is how it is said important? The association between quality of therapist interventions and client processing

This study examined the association between the quality of therapist interventions and client in‐session processing using the York Therapist Process Measure (YTPM; Toukmanian and Armstrong, 1998). The instrument's three dimensions — attunement, tentativeness and meaning exploration — were tested separately for their impact on clients' manner of processing and depth of experiencing. For each of the 20 mild‐moderately depressed clients, treated in short‐term experiential therapy, a high and a low client‐process segment was isolated from a session that was judged by an experienced therapist to manifest the greatest amount of “good therapy moments”. Therapist interventions within these segments were then rated on the YTPM. Results revealed significant differences in the quality of therapist interventions between high and low segments. Attunement and tentativeness were associated significantly with greater complexity in manner of processing, and meaning exploration with greater depth in experiencing. The implications of these findings for psychotherapy research and practice are discussed.