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Psychotherapy
Psychologists Interested in the Advancement of Psychotherapy
Psychotherapy

Psychologists Interested in the Advancement of Psychotherapy

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    Enhancing the Evidence Base for Spiritually Integrated Psychotherapies: Progressing the Paradigm of Practice-Based Evidence

    Richards, P. ScottBarkham, Michael
    4页
    查看更多>>摘要：Spiritually integrated approaches to psychological therapies enable practitioners to be responsive to clients' religious and spiritual concerns and have been combined with most mainstream therapeutic approaches. As such, although evidence is required regarding their efficacy, with randomized controlled trials having a privileged status, a single research paradigm is unlikely to deliver both a robust and relevant evidence base for the psychological therapies, that is, embedded in routine practice. The research paradigm of practice-based evidence provides a complementary approach to trials methodology as carried out in routine practice via the application of a myriad of qualitative and quantitative research designs. Accordingly, this article provides the background to a special section comprising 12 articles within a practice-based evidence paradigm that captures a focus on the therapist, the content of sessions and therapist-patient interactions, applications to specific patient populations and therapy modality, and the outcomes of spiritually integrated psychological therapies.
      原文链接:
    • NSTL
    • Amer Psychological Assoc

    Spiritually Integrated Psychotherapies in Real-World Clinical Practice: Synthesizing the Literature to Identify Best Practices and Future Research Directions

    Captari, Laura E.Sandage, Steven J.Vandiver, Richard A.
    14页
    查看更多>>摘要：A comprehensive review of the practice-based evidence for spiritually integrated psychotherapy (SIP) is necessary in order to catalyze research and training in this important diversity area. In this article, we identify and synthesize key findings from 35 studies in six key areas: (a) SIPs in trauma treatment, (b) SIPs in treating eating disorders, (c) SIPs in general psychotherapy, (d) existential concerns as part of SIPs, (e) patients and therapist attitudes about SIPs, and (f) SIP supervision and training models. Building on this, we propose a culturally contextual understanding of this diversity area, drawing from the Relational Spirituality Model (RSM). Finally, we discuss best practices for spiritually responsive clinical care and offer a research prospectus to strengthen the evidence base for real-world effectiveness. Clinical Impact Statement Question: In what ways are clients' spirituality, religion, theology, and/or existential concerns relevant in real-world mental health treatment? Findings: Clients' spiritual and religious context have important implications for their symptom alleviation and well-being, and may intersect with other areas of their identity. Meaning: Therapists should consider spirituality as an important diversity area that may be a source of strength or struggle for clients. Next Steps: Ongoing research is needed to understand the nuances of how clients' spirituality is best integrated into psychotherapy with different populations.
      原文链接:
    • NSTL
    • Amer Psychological Assoc

    Caring for You, Me, and Us: The Lived Experience of Compassion in Counselors

    Quaglia, Jordan T.Cigrand, ClarissaSallmann, Hannah
    11页
    查看更多>>摘要：There is growing interest in compassion within the context of counseling, given its potential to support the well-being of both clients and counselors. For counselors, compassion may improve self-care and protect against various empathy-related stressors, such as empathic distress. Compassion is commonly taught and studied according to a division of self-compassion or other-oriented compassion (also, other-compassion). However, it has long been recognized that the lived experience of compassion is not so neatly divided. The Buddhist traditions that have informed compassion science emphasize the interconnectedness of self and others, such that the lived experience of compassion can occur in more combined and holistic forms that orient toward suffering in both oneself and others. This may be especially important for understanding compassion in counseling, where the clinical utility of empathy for suffering may result in moments of shared suffering. We therefore conducted a qualitative study to explore how counselors with compassion training experience and use both self- and other-compassion, including an exploration of relationships between compassion orientations. Findings revealed self- and other-compassion could be experienced as relatively distinct, with benefits for both counselors and clients. Yet we also found ample evidence for the experience of self- and other-compassion in more interrelated and combined forms, with additional unique benefits. To our knowledge, these findings are the first evidence of combined compassion experiences in counselors, highlighting the need for more research on how self- and other-oriented compassion interrelate, as well as how they can be experienced and employed together in therapy. Clinical Impact Statement Question: How do counselors with compassion training understand and use both self- and other-oriented compassion to support themselves and their clients? Findings: Counselors employ self- and other-oriented compassion in relatively distinct ways, as well as in combined forms that may be mutually beneficial for themselves and their clients. Meaning: To maximize benefits of compassion training, it may be ideal for counselors to train in both self- and other-oriented compassion, including how to experience and use them together. Next Steps: In addition to studies on one orientation of compassion or another, more research is needed to explore various relationships between self-compassion and compassion for others.
      原文链接:
    • NSTL
    • Amer Psychological Assoc

    Mindfulness in Psychotherapy: The Experience of Psychotherapists Who Incorporate Mindfulness Into Their Practice

    Konichezky, AndresGliksberg, AsaReicher-Atir, Rebecca
    7页
    查看更多>>摘要：Clinical Impact Statement Question: How can mindfulness be incorporated within Psychodynamic theories and Cognitive-Behavioral Psychotherapy. Findings: Using mindfulness enhances therapeutic relationship, improves case conceptualization, and enriches technique. Meaning: Mindfulness can be viewed as a tool that strengthens the core aspects of both types of therapies. Next Steps: Validating these findings within a quantitative research design. Mindfulness is most commonly defined as the ability to bring one's attention to experiences occurring in the present moment, with complete acceptance and without judgment. The diverse benefits of mindfulness as a therapeutic tool have been widely explored. Nevertheless, when mindfulness is incorporated into psychotherapy it may influence the relationship between the therapist and the patient in diverse manners. This influence appears in the literature as relational mindfulness pertaining to mindfulness practiced in relationship to other people. The present article attempts to delineate the diverse influences of relational mindfulness within the psychotherapeutic setting through Qualitative analysis of in-depth interviews conducted with eight psychotherapists recruited from an institution for the teaching of mindfulness for psychotherapists. Analysis revealed influences on the therapist's worldview, on technique, on the presence of the therapist and, on the therapeutic alliance. These aspects are discussed from a psychoanalytic and a cognitive-behavioral framework.
      原文链接:
    • NSTL
    • Amer Psychological Assoc

    Jungian Psychotherapy, Spirituality, and Synchronicity: Theory, Applications, and Evidence Base

    Roesler, ChristianReefschlaeger, Gunnar I.
    12页
    查看更多>>摘要：Clinical Impact Statement Question: The paper demonstrates how Jungian psychotherapists use the concept of synchronicity as an example for including a spiritual perspective in their work with clients. Findings: Readers will be able to understand the rationale of Jungian Psychotherapy with special focus on synchronistic experiences (SE) and how it integrates spiritual experiences. Meaning: The paper demonstrates that SE in psychotherapy can be used to support the therapeutic process in a positive way. Next Steps: More research should be conducted on the occurrence of SEs in clinical practice and how other therapists and schools use them, in a prospective design. The aim of this article is to give an introduction to the theoretical model of Jungian psychotherapy (JP) and the role of spirituality in it, with a special focus on the concept of synchronicity (meaningful coincidences), by which the application of a spiritual viewpoint in JP will be exemplified. The paper gives an overview of the empirical studies of the effectiveness of JP and then focuses on the results of an empirical study on the occurrence of synchronistic events in psychotherapy and how they are integrated in the therapeutic process. JP can be called the prototype of a spiritually integrated psychotherapy, since Jung was the first in the development of psychotherapy who put a strong emphasis on a spiritual perspective and who succeeded to integrate spirituality into his psychotherapy approach with a coherent theoretical model in the background. Moreover, Jung's psychology became a major reference point for many other spiritual psychotherapy approaches which developed in the twentieth century. Regarding the studies on the effectiveness of JP it can be said that there is some empirical support pointing to the effectiveness of JP, but there is a strong need for further research, especially with randomized controlled trial designs. The paper presents the results of a study investigating how psychotherapists integrate synchronistic experiences and make use of these to support the therapeutic process.
      原文链接:
    • NSTL
    • Amer Psychological Assoc

    Religious Microaggressions in Psychotherapy: A Mixed Methods Examination of Client Perspectives

    Trusty, Wilson T.Swift, Joshua K.Black, Stephanie WinkeljohnDimmick, A. Andrew...
    12页
    查看更多>>摘要：Clinical Impact Statement Question: What is the prevalence and nature of religious microaggressions in psychotherapy, and what effects do religious microaggressions have on the working alliance and treatment outcomes? Findings: Slightly over one third of religious clients reported experiencing religious microaggressions in treatment (e.g., minimization of the importance of religious issues), and these were negatively associated with treatment outcomes via the working alliance. Meaning: Religious microaggressions may weaken the working alliance, which could result in poorer treatment outcomes for a substantial minority of religious clients. Next Steps: Longitudinal research with diverse client samples is needed to further clarify the effects of religious microaggressions and to test effective ways to repair microaggression-related alliance ruptures. Ethical guidelines state that psychologists should consider clients' religion in their practice. However, some clients have reported negative experiences regarding clinicians' treatment of religion in psychotherapy. These experiences may constitute microaggressions, which have been negatively associated with the working alliance and treatment outcomes among clients with various identities (e.g., those of marginalized racial groups or sexual orientations). The present study used mixed methods to examine religious microaggressions among current and former psychotherapy clients identifying as religious (N = 396). Approximately 39% of participants indicated that at least one religious microaggression occurred during treatment; the most common was minimization or avoidance of religious issues. Religious microaggressions were negatively associated with the working alliance and outcomes. Additionally, the working alliance fully mediated the association between religious microaggressions and poorer outcomes. Thematic analysis of qualitative descriptions of religious microaggressions yielded seven themes: minimization/avoidance of religious issues, assumptions of religious homogeneity, pathologizing religion, unhelpful/inappropriate interventions, pressure to embrace religion, prioritization of therapist's religious beliefs, and lack of expertise. Limitations include a retrospective, cross-sectional design and a majority White, female, and Christian sample. These results provide initial evidence that a substantial minority of religious clients may experience religious microaggressions in psychotherapy, which could impede treatment progress via negative effects on the working alliance. As such, clinicians may be able to enhance client outcomes by increasing awareness of religious microaggressions in their work and addressing microaggression-related alliance ruptures openly when they do occur. Implications for training are also discussed.
      原文链接:
    • NSTL
    • Amer Psychological Assoc

    Task Analysis of a Christian-Integrated Psychotherapy Framework

    Kim, Elena E.Chen, Eric C.
    11页
    查看更多>>摘要：Clinical Impact Statement Question: "Is there a spiritually-integrated sequence of change events within the Christian-Integrated Psychotherapy Framework," "Are these constructs validated by pre-existing, valid, and reliable process measures," and "What does this process look like emotionally, behaviorally, and cognitively?" Findings: Results provided clinicians with a conceptual map that helped guide Christian clients from feeling overwhelmed by their helplessness to receiving compassionate responses from their God images. Meaning: Two important constructs, corrective emotional spiritual experiences with in vivo God images, emerged from this task analysis study. Next Steps: Future research may entail analyzing more clinical cases to stabilize and validate the rational-empirical model. This study aimed to gain a deeper understanding of spiritual change processes by conducting an empirical investigation of clinically meaningful events occurring within the context of a Christian-Integrated Psychotherapy Framework. The discovery phase of task analysis was used to build a rational-empirical model that explicated how clients developed stronger attachments to their God images. A rational model was specified, and five cases were selected for further analysis from a pool of 27 client-participants and 423 video-recorded psychotherapy sessions. Clinical observations and the coding of in-session measures were used to select resolved and unresolved cases, which were then contrasted to create a 10-step rational-empirical model. In this model, clients initially presented with intense feelings of shame, guilt, or helplessness but concluded with heightened levels of love and joy. Clients who reached this resolution all underwent an experience whereby their God images became dynamic, alive, intimate, and authentic. Results are discussed, and implications for the existence of an in vivo God image and corrective emotional spiritual experiences are introduced. Specifically, corrective emotional spiritual experiences appear to have influenced clients to transition from being insecurely attached to more securely attached to their in vivo God images.
      原文链接:
    • NSTL
    • Amer Psychological Assoc

    Why Is Spiritual Psychotherapy for Inpatient, Residential, and Inpatient Treatment (SPIRIT) More Effective When Provided by Nonreligious Clinicians?

    Rosmarin, David H.Pirutinsky, StevenSchuttenberg, Eleanor M.Silveri, Marisa M....
    8页
    查看更多>>摘要：Previous research suggests that patients receiving spiritual psychotherapy may have better outcomes when treatment is provided by nonreligious clinicians, compared to religious clinicians. We examined these effects within a large and clinically heterogeneous sample of patients (N = 1,443) receiving Spiritual Psychotherapy for Inpatient, Residential, and Intensive Treatment (SPIRIT; Rosmarin et al., 2019) by a diverse sample of clinicians (n = 22). In addition to demographics, patients completed a brief measure of their experience in SPIRIT; clinicians completed measures of previous mental health training, previous training in spiritual psychotherapy, and attitudes toward spiritual psychotherapy, and also provided details regarding modalities, clinical interventions, and spiritual interventions utilized at each SPIRIT session. Perceived benefit of SPIRIT was greater when treatment was delivered by non-religious clinicians. Mediating factors on these effects were evaluated using correlations and multiple regression analyses. Of 26 potential explanatory factors, only 4 were significant, all of which related to the therapeutic process. Nonreligious clinicians were more likely to utilize dialectical behavior therapy (DBT), facilitate coping, encourage spiritual coping, and explore the relevance of spirituality to mental health, all of which also predicted better perceived benefit from SPIRIT. All four variables jointly, but not severally, mediated relationships between clinician religion and perceived benefit of SPIRIT. These findings suggest that DBT may be the most effective modality for delivering spiritual psychotherapy to acute patients, particularly in a group setting. Future research should further examine preferences for clinical modalities and techniques among religious and nonreligious clinicians, and effects of such preferences on perceived benefit, in a variety of settings. Clinical Impact Statement Question: We found that a single-session spiritual psychotherapy group for acute psychiatric patients was more effective when provided by nonreligious clinicians. Which factors (e.g., clinician demographics, training, attitudes, or treatment approaches) might account for these counterintuitive findings? Findings: Therapeutic processes were different between religious and nonreligious clinicians: nonreligious clinicians were more likely to utilize dialectical behavior therapy (DBT), facilitate coping, encourage spiritual coping, and explore the relevance of spirituality to mental health, all of which also predicted better perceived benefit from spiritual psychotherapy. Meaning: DBT may be the most effective modality for delivering spiritual psychotherapy to acute patients. Religious and nonreligious clinicians could improve the delivery of spiritual psychotherapy by better attending to therapeutic processes. Next Steps: Future research should further examine the effects of clinical modalities (e.g., DBT, cognitive behavior therapy, psychodynamic approaches) on spiritual psychotherapy, and how these are utilized in practice by religious and nonreligious clinicians, in a variety of settings.
      原文链接:
    • NSTL
    • Amer Psychological Assoc

    Spiritually Incorporating Couple Therapy in Practice: Christian-Accommodated Couple Therapy as an Illustration

    Chen, Zhuo JobRipley, Jennifer S.Worthington, Everett L. Jr JrKent, Vanessa M....
    10页
    查看更多>>摘要：Clinical Impact Statement Question: What is happening in spiritually integrated couple therapy sessions? Findings: Clinicians drew primarily from evidence-based treatments, and couples tended to improve over six sessions-especially those with less initial relational distress. Meaning: Client spirituality was more important in driving outcomes in spiritually incorporating couple therapy (SICT) than therapist spirituality. When therapists used specific spiritual techniques, they tended to discuss hope, forgiveness, and listening to the heart, silently prayed for the couple, and encouraged partners to pray. Next Steps: Highly distressed religious couples may be a special diversity population because they risk disengagement from treatment. Spiritually incorporating couple therapy (SICT)-couple therapy that incorporates spiritual interventions-has a growing research base. Information is limited on how spiritual interventions are used in practice; thus we studied treatment-as-usual (TAU). SICT is treatment that, at a couple's request, sometimes draws upon spiritual resources when addressing relational issues. We tracked 65 couples from 29 couple therapists (who advertised as spiritually incorporating therapists) over 402 sessions of SICT. Couple spirituality predicted use of spiritual interventions more than did therapist spirituality. The most used spiritual interventions included silent prayer for the couple, discussions of hope and forgiveness, and encouragement to consult their heart. In SICT, therapists used evidence-based couple therapy approaches. SICT should (a) treat highly religious couples in high distress as being at risk for early drop out; (b) follow couples' leads in using spiritual methods; and (c) draw on evidence-based couple and spiritual practices.
      原文链接:
    • NSTL
    • Amer Psychological Assoc

    Client Preference Accommodation for Religious/Spiritual Integration and Psychotherapy Outcomes in Naturalistic Practice Settings

    Swift, Joshua K.Bird, Megan O.Penix, Elizabeth A.Trusty, Wilson T....
    8页
    查看更多>>摘要：Clinical Impact Statement Question: Is there a relationship between client preference accommodation for religious/spiritual (R/S) integration in psychotherapy and treatment outcomes in outpatient private practice settings? Findings: Accommodating client preferences for R/S integration was associated with less frequent dropout and a greater likelihood of improvement while in treatment. Meaning: These findings suggest that therapists should seek to assess and accommodate client preferences for R/S integration. Next Steps: Further research in other settings and for specific R/S techniques is needed. The purpose of this practice-research network study was to examine client preferences for religious/spiritual (R/S) integration and test whether preference accommodation in this area is linked to positive treatment outcomes (i.e., less dropout and greater client change). Thirteen independent practice psychotherapists and their 175 clients completed measures of R/S integration preferences and use of R/S techniques and approaches throughout treatment. Psychotherapists also completed an assessment of treatment dropout and change for each participating client. Overall, participating clients expressed moderate preferences for R/S integration, time spent on R/S topics, and an R/S match with their psychotherapists. Preferences in each of these 3 areas were stronger for R/S identifying clients (compared with non-R/S clients) and when clients believed that R/S integration was more essential to produce positive treatment outcomes. Both client R/S identification and client R/S integration preferences predicted psychotherapist's use of R/S techniques in treatment sessions. Importantly, clients' ratings of R/S preference accommodation significantly predicted psychotherapists' ratings of client treatment completion and client change. Specifically, with each unit increase on a 5-point measure of client perceptions of R/S preference accommodation, clients were 1.63 times more likely to be rated as treatment completers and 1.83 times more likely to be identified as having improved while in treatment. Implications for R/S integration in psychotherapy and future research directions are discussed.
      原文链接:
    • NSTL
    • Amer Psychological Assoc