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Objectives: Creating a formulation is one of the key competencies of a clinical psychologist and is understood to be important for guiding therapeutic input and understanding client distress. However, client experience of formulations can vary, with some reporting it is unhelpful and distressing. This novel review explores the experiences of clinicians and clients when creating a formulation, specifically the barriers and facilitators to collaborating on a formulation. This ultimately aims to improve client experience and engagement in formulation. Methods: A systematic search of PubMed, Web of Science, PsycINFO and EMBASE was conducted using PRISMA guidelines. The protocol was registered on PROSPERO. This search was conducted using terms related to 'psychological formulation' and 'experience'. Nineteen qualitative papers met inclusion criteria and were appraised using the Critical Appraisal Skills Programme. Findings that pertained to formulation were thematically synthesised. Results: Three analytical themes were identified: toleration of the formulation process—'a necessary evil', which highlights the potential emotional impact of formulation on the client and indicates the importance of responding to client readiness and expectations of formulation; development of the therapeutic relationship—'it's like a two way thing, isn't it?', which suggests that client empowerment, adapting to client needs and clinicians creating a safe and containing environment facilitated the formulation process; systemic factors—'walking a tightrope', which highlights the constraints of resources and team dynamics in therapists' ability to engage in collaborative formulation. Conclusion: Facilitators to a collaborative formulation include the following: simple formulations, thorough assessment and preparation for formulation, 'doing with' activities such as timelines and diagrams and working environments that include supportive colleagues and time for reflection and training. [ABSTRACT FROM AUTHOR]

It is unknown to what extent mental imagery and auditory verbal hallucinations (AVHs) are related. Trials evaluating this issue used both emotional and non‐emotional mental imagery tools, thereby complicating outcomes comparisons. Therefore, the present study aimed to systematically review the literature on mental imagery in individuals with AVHs to (1) inventory imagery assessment tools used in this population, (2) to collect information on the relation between emotional and non‐emotional mental imagery in all sensory domains and AVHs and (3) to integrate the outcomes of this systematic review in a model of different mental imagery domains and related assessment tools. We conducted a systematic literature search in the PubMed Database. After full‐text screening, 17 papers were included. Findings showed that a variety of assessment methods have been used to assess various aspects of mental imagery in people with AVHs, suggesting that there is a lack of agreed theoretical conceptualization of mental imagery and AVHs. In addition, the studies confirmed as was expected that non‐emotional mental imagery seemed unrelated to AVHs whereas emotional mental imagery was related to AVHs. Lastly, we proposed a model of mental imagery domains and corresponding assessment methods distinguishing between emotional and non‐emotional mental imagery. [ABSTRACT FROM AUTHOR]

Background: Women are more likely than men to experience symptoms associated with psychosis, such as voice hearing, and more likely to seek mental health support. However, little is known about the emotional experiences of girls and young women who seek help for symptoms of psychosis to inform gender sensitive services and access routes. The current review offers the first focused insights into barriers and facilitators relating to help seeking for girls and women experiencing symptoms of psychosis. Methods: OneSearch, PubMed, and PsychINFO databases were searched for suitable papers in relation to the research question between November 2021 and February 2022; 139 papers were found, of which eight met the inclusion criteria for review. Results: Across the eight papers reviewed, participants were aged 15‐ to 71‐years‐old. From the participant numbers available, data from a total of 54,907 participants from a range of demographic groups were included in the review. Results and findings sections from the eight papers were reviewed for themes, and four overarching themes emerged: (1) The emotional cost of seeking help, (2) voice hearing for girls and women, (3) side effects of treatment, and (4) facilitators to accessing support. Discussion: Engagement in talking therapies can be difficult when services minimize the experience of psychosis‐related symptoms. Women may be more likely to have their symptom‐related distress diagnosed as a mood disorder, rather than symptoms of psychosis being identified, preventing timely tailored intervention. Normalization, psychoeducation, social support, and validation were recommended as helpful interventions. [ABSTRACT FROM AUTHOR]

Background: Personal recovery literature has been influential in the conceptualization of emotional distress and service provision. While personal recovery in psychosis has been well‐studied, voice hearing literature has not been reviewed to elucidate recovery processes. Method: Five databases were systematically searched to identify relevant qualitative recovery literature. Twelve eligible studies were included in this review, and an appraisal tool was applied to assess quality. Thematic synthesis was used to examine the results. Results: Three superordinate themes were found relating to 'Recovery Phases', 'Recovery Facilitators' and 'Barriers to Recovery'. Papers included descriptions of finding voices distressing initially yet moving towards integrating and accepting voices. Searching for meaning versus seeking distance from voices were pivotal processes to recovery pathways. Enabling and disrupting recovery experiences are discussed within a proposed model. Conclusions: Recovery in voice hearing is an individual and potentially ongoing process. Future research should seek to examine recovery factors in voice hearing longitudinally and add further evidence to the supportive role services can play in recovery and voice hearing. [ABSTRACT FROM AUTHOR]

Several studies have examined acceptance and commitment therapy's (ACT) effectiveness for addressing physical and psychological distress people with obesity can face. Nevertheless, no review focusing specifically on ACT analysing randomized controlled trials (RCT) has been done up to date in this field. The present systematic review was developed following the PRISMA statement and aimed to examine ACT's effects on weight management and psychological well‐being of adults with overweight or obesity. A conjunction of keywords related to ACT and excess weight was searched in four databases (Medline, PubMed, Psycinfo and Scopus) for articles meeting inclusion criteria. The literature search yielded 2,074 papers, and 16 were included in the review, finally. In 71.43% of the studies, ACT was effective to enhance psychological well‐being; in 50% effectively targeted process variables and health behaviours related to weight management; in 31.82% of studies, physical variables were improved; and 21.38% of studies showed evidence in favour of ACT for eating behaviour modification. The present review supports ACT for promoting emotional aspects of individuals immersed in such weight‐related battles and highlights the benefits of psychological well‐being‐oriented ACT in the context of obesity treatment. More studies targeting psychological well‐being primarily and with longer follow‐ups are required. [ABSTRACT FROM AUTHOR]

Psychological treatment for hoarding problems has historically been associated with poor outcomes. When treated as a subgroup of obsessive–compulsive disorder, individuals with hoarding beliefs were less likely to respond to treatment than individuals exhibiting other obsessive–compulsive beliefs and behaviours. When treated as its own disorder using cognitive behavioural therapy, individuals report approximately 25% improvement in symptoms on average. However, less than a third of people experience clinically meaningful change. Further, changes in functioning and quality of life are not routinely assessed. In this paper, we review the current conceptualization and treatment of hoarding problems to shed light on how treatment for hoarding disorder may be improved. Utilizing a harm reduction approach before administering treatment may be important to ensure the safety of individuals. Research should test whether treatment outcomes improve by including strategies that enhance a client's interpersonal functioning and ability to regulate emotions (i.e., based on dialectal behaviour therapy and mentalization‐based treatments), especially while discarding and organizing belongings. We should also use modern learning theory to improve the delivery of exposure activities. [ABSTRACT FROM AUTHOR]

Determining reliable and clinically significant change is central to evidence‐based practice yet rarely used in routine clinical settings. This paper illustrates these methods in the context of an evaluation of cognitive behaviour therapy for distressing auditory hallucinations ("voices"). We used data from a clinical sample attending Perth Voices Clinic, a transdiagnostic outpatient service for distressing voices, and a previously published reference sample of healthy voice hearers. Our outcomes on the primary measure of voice distress, derived from a previous factor analysis of the Psychotic Symptom Rating Scale‐Auditory Hallucinations subscale, showed that 62.9% of clients were classified as Recovered/Improved, 35.5% were classified as Unchanged, and 0.02% were classified as Deteriorated. Partial support for the validity of these classifications was obtained from the scores on the Depression, Anxiety, Stress Scales (Lovibond & Lovibond, 1995) but not on the Social and Occupational Functional Assessment Scale (Goldman et al., 1992). Clients classified as Recovered showed better emotional functioning on the Depression, Anxiety, Stress Scales compared with those who did not make a clinically significant change in voice distress. A tool is provided to assist practitioners to evaluate whether individual clients have benefited from therapy for distressing voices or not, which can be used to guide future treatment decisions (https://osf.io/gd9e5/). [ABSTRACT FROM AUTHOR]

This paper explores the relationship between dispositional self‐compassion and cognitive emotion regulation capacities in individuals with a history of depression. Study 1 (n = 403) established that self‐compassion was associated with increased use of positive and decreased use of negative strategies, with small to medium sized correlations. Study 2 (n = 68) was an experimental study examining the association between dispositional self‐compassion, use of cognitive emotion regulation strategies, and changes in mood and self‐devaluation in participants exposed to a negative mood induction followed by mood repair (mindfulness, rumination, silence). Individuals with higher levels of dispositional self‐compassion showed greater mood recovery after mood induction, and less self‐devaluation across the experimental procedure, independent of their mood‐repair condition or habitual forms of cognitive emotion regulation. These results suggest that self‐compassion is associated with more adaptive responses to mood challenges in individuals with a history of recurrent depression. [ABSTRACT FROM AUTHOR]

Background Overly negative appraisals of negative life events characterize depression but patterns of emotion bias associated with life events in depression are not well understood. The goal of this paper is to determine under which situations emotional responses are stronger than expected given life events and which emotions are biased. Methods Depressed ( n = 16) and non-depressed ( n = 14) participants (mean age = 41.4 years) wrote about negative life events involving their own actions and inactions, and rated the current emotion elicited by those events. They also rated emotions elicited by someone else's actions and inactions. These ratings were compared with evaluations provided by a second, 'benchmark' group of non-depressed individuals ( n = 20) in order to assess the magnitude and direction of possible biased emotional reactions in the two groups. Results Participants with depression reported greater anger and disgust than expected in response to both actions and inactions, whereas they reported greater guilt, shame, sadness, responsibility and fear than expected in response to inactions. Relative to non-depressed and benchmark participants, depressed participants were overly negative in the evaluation of their own life events, but not the life events of others. Conclusion A standardized method for establishing emotional bias reveals a pattern of overly negative emotion only in depressed individuals' self-evaluations, and in particular with respect to anger and disgust, lending support to claims that major depressives' evaluations represent negative emotional bias and to clinical interventions that address this bias. Copyright © 2016 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Objectives New research-informed methods for case conceptualization that cut across traditional therapy approaches are increasingly popular. This paper presents a trans-theoretical approach to case formulation based on the research observations of emotion. Methods The sequential model of emotional processing (Pascual-Leone & Greenberg, 2007) is a process research model that provides concrete markers for therapists to observe the emerging emotional development of their clients. We illustrate how this model can be used by clinicians to track change and provides a 'clinical map,' by which therapist may orient themselves in-session and plan treatment interventions. Results Emotional processing offers as a trans-theoretical framework for therapists who wish to conduct emotion-based case formulations. First, we present criteria for why this research model translates well into practice. Second, two contrasting case studies are presented to demonstrate the method. Conclusions The model bridges research with practice by using client emotion as an axis of integration. Key Practitioner Message Process research on emotion can offer a template for therapists to make case formulations while using a range of treatment approaches. The sequential model of emotional processing provides a 'process map' of concrete markers for therapists to (1) observe the emerging emotional development of their clients, and (2) help therapists develop a treatment plan. Copyright © 2016 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

The need for novel approaches to understanding and treating anorexia nervosa (AN) is well recognized. The aim of this paper is to describe an integrative bio-psycho-social theory of maintaining factors in AN. We took a triangulation approach to develop a clinically relevant theory with face validity and internal consistency. We developed theoretical ideas from our clinical practice and reviewed theoretical ideas within the eating disorders and wider bio-psycho-social literature. The synthesis of these ideas and concepts into a clinically meaningful framework is described here. We suggest eight key factors central to understanding the maintenance and treatment resistance of anorexia nervosa: genetic or experiential predisposing factors; dysfunctional feelings processing and regulation systems; excessive vulnerable feelings; 'feared self' beliefs; starvation as a maladaptive physiological feelings regulation mechanism; maladaptive psychological coping modes; maladaptive social behaviour; and unmet physical and psychological core needs. Each of these factors serves to maintain the disorder. The concept of universal physical and psychological core needs can provide an underpinning integrative framework for working with this distinctly physical and psychological disorder. This framework could be used within any treatment model. We suggest that treatments which help address the profound lack of trust, emotional security and self-acceptance in this patient group will in turn address unmet needs and improve well-being. Copyright © 2016 John Wiley & Sons, Ltd. Key Practitioner Message The concept of unmet physical and psychological needs can be used as an underlying integrative framework for understanding and working with this patient group, alongside any treatment model., A functional understanding of the neuro-biological, physiological and psychological mechanisms involved in anorexia nervosa can help patients reduce self-criticism and shame., Fears about being or becoming fat, greedy, needy, selfish and unacceptable ('Feared Self') drive over-compensatory self-depriving behaviour ('Anorexic Self')., Psychological treatment for anorexia nervosa should emphasize a focus on feelings and fostering experiences of acceptance and trust., Treatment for patients with anorexia nervosa needs to be longer than current clinical practice. [ABSTRACT FROM AUTHOR]

Aim The aim of the present paper is to open the discourse regarding the unmet needs of specific patients, especially those with substance use disorder and/or personality disorder where 'multimorbidities', and/or 'overdiagnosis' and/or 'diagnosis overlap' are frequent. An additional aim is to review the main therapeutic purpose and concepts of Gestalt therapy which might be appropriate in the treatment of these patients often characterized by their difficulties in being aware and in contact in the 'here and now'. Methods I first start with an overview of Gestalt therapy concepts. Then, I illustrate Gestalt's 'here and now' and awareness concepts applied during 18 sessions with an inpatient diagnosed with substance use and bipolar disorders. In addition, the patient had to face an open criminal charge, was regarded as having an antisocial personality disorder and argued suffering from post-traumatic stress disorder. Results After this two-month therapy period, the patient entered for the first time a daily rehabilitation program in the community, where he was doing well (this after a few prior hospitalizations). The awareness development in the 'here and now' through which different contact styles and cycles of experiences are experienced is a process that allowed the patient to start experiencing contact with himself, his true needs and his environment. This contributed to his well-being improvement, led and supported his rehabilitation and reinsertion within the society and decrease his relapses, either with drugs or criminal activities. Copyright © 2016 John Wiley & Sons, Ltd. Key Practitioner Message People with substance use disorder (where 'multimorbidities', 'overdiagnosis' or 'diagnosis overlap' are frequent), people with personality disorder(s) or people who have difficulties in defining what really disturbs them are the same people who could benefit of GT encouraging awareness and contact development in the 'here and now'., Gestalt therapy should not be regarded as a practitioner's toolbox but as a therapeutic process allowing awareness and I-boundaries development in the 'here and now' through authentic and genuine relationships., The therapist's awareness and contact with themselves and their environment are reflected in the therapist's relaxed but awake and aware state of mind as well as their wise, spontaneous and mindful approach. [ABSTRACT FROM AUTHOR]

The goal of this paper is to show (i) how the moment-to-moment tracking and processing of emotion to completion —in an emotionally engaged patient–therapist dyad where the individual feels safe and known—constitutes a powerful mechanism of therapeutic transformation, and (ii) how positive emotions are sensitive affective markers of that transformational process. Evidence from transformational studies is used to elaborate the vital role of positive emotions in the process of change in general, and, more specifically, in the course of therapeutic work with painful and overwhelming emotional experience. It is proposed that these emergent positive emotions are affective markers which signal the operation of healing transformational processes in psychotherapy. Several types of positive emotion that arise spontaneously during moment-to-moment experiential therapeutic work will be described and their role as markers of different transformational processes will be elucidated. The paper begins with examples of clinical work with emotion in AEDP (Accelerated Experiential–Dynamic Psychotherapy), an emotion-focused and attachment-based model of therapy that places the dyadic regulation of affect at the centre of both theory and practice. Copyright © 2004 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

A major problem for scientific and practical work in many branches of psychology is the reliable access to phenomena under study. Traditional assessment procedures are often reliant on retrospective recall, self report measures and/or laboratory simulations. All these have their strengths and weaknesses. Ideally observations of people's behaviour and interactions, and the monitoring of thoughts and feelings, should be of real events as they occur. This paper focuses on some methodological and reliability issues associated with development in hand-held computer self-recording systems and describes a new computer-assisted self-monitoring system for emotional processes in families with adolescents. The method is based on simultaneous self-observations of family members older than 13 years. The paper describes the procedures involved in using this approach and demonstrates how to obtain indicators for reactivity, reliability and some aspects of validity. Copyright © 2000 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

The current paper introduces the notion of clinically relevant subtypes of emotion regulation behaviours. A new measure of emotion regulation, the Complexity of Emotional Regulation Scale (CERS), was established as psychometrically sound. It was positively correlated with a measure of emotional awareness ( r = 0.28, p < 0.001) and negatively correlated with measures of self-criticism ( r = −0.28, p < 0.001) and depression ( r = −0.35, p = 0.025), among others. Participants were drawn from two samples: clients from a university counselling centre and a non-clinical student sample. Comparisons were conducted between non-clinical and clinical samples to determine the effects of depression and other symptoms of psychopathology on participant's generation of strategies for emotion regulation. Participants in the clinical sample more often identified an intention to soothe but did not follow through as compared with the non-clinical group, F(1, 198) = 4.662, p < 0.04. Furthermore, individuals in the non-clinical sample were more likely to engage in specific, meaning-making strategies when compared with the clinical group, F(1, 198) = 5.875, p < 0.02. Implications from the current studies suggest the possible applicability of the CERS to clinical settings using an interview rather than questionnaire format. Copyright © 2015 John Wiley & Sons, Ltd. Key Practitioner Message: Emotion regulation should be thought of as being on a continuum of complexity, where strategies range from general ('one size fits all') action to specific ('personal and idiosyncratic') meaning. The best emotion regulation strategy depends on a client's presenting difficulty and level of distress. [ABSTRACT FROM AUTHOR]

Emotion-focused therapy (EFT) has increasingly made use of case conceptualization. The current paper presents a development in the case conceptualization approach of EFT. It takes inspiration from recent research on emotion transformation in EFT. The case conceptualization presented here can guide the therapist in listening to the client's narrative and in observing the client's emotional presentation in sessions. Through observing regularities, the therapist can tentatively determine core emotion schemes' organizations, triggers that bring about the emotional pain, the client's self-treatment that contributes to the pain, the fear of emotional pain that drives avoidance and emotional interruption strategies. The framework recognizes global distress, into which the client falls, as a result of his or her inability to process the underlying pain, the underlying core pain and the unmet needs embedded in it. This conceptual framework then informs therapists as to which self-organizations (compassion and protective anger based) have to be facilitated to respond to the pain and unmet needs, so that they might transform it. The conceptual framework can guide the therapist's thinking/perceptions and actions in the session. [ABSTRACT FROM AUTHOR]

This paper outlines a theoretical analysis of current psychological conceptualizations of psychosis that draws on Teasdale and Barnard's (1993) Interacting Cognitive Subsystems (ICS) model of depression. The ICS model differs from Beck et al .'s (1979) model of emotional disorders in that it specifies two qualitatively different levels of meaning. These different levels of meaning play a different role in the production, maintenance and modification of emotion, and indeed, also recognize the distinction between ‘intellectual' belief and ‘emotional' belief. Intellectual beliefs are at the level of specific propositional meaning: they have a truth value which can be assessed and they are not directly influenced by sensory information such as voice tone, arousal and body state, or visual stimuli. Given this, propositional meaning does not have a direct link to the production of emotion. Rather the link to emotion is an indirect one, through the activation of more generic and holistic affect-related schematic models. These latter schematic models are hypothesized to have implicational meaning, and correspond to schematic models derived from emotive experiences. In consequence they do not have a specific truth-value and they reflect contributions from a wide variety of sources, including multiple patterns of specific meanings, and patterns of direct sensory input. This ICS perspective proposes that integration of these two levels of meaning can facilitate the psychological conceptualization of the initiation, acceleration, and maintenance of positive psychotic symptomatology during relapse. This theoretical analysis is illustrated by the use of a case study, which describes the process and application of ICS to facilitating recovery from acute psychosis. This paper also provides a detailed discussion of the implications of this analysis for future research and psychological therapy. In particular, ICS has relevance for tracing the evolution of schematic beliefs during the early episodes of psychosis, which are hypothesized to have a bearing on the future course of psychosis. This has implications for the further development and expansion of psychological treatments for relapse and recovery from psychosis. Copyright © 1999 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Social relationships and communities provide the context and impetus for a range of psychological developments, from genetic expression to the development of core self-identities. This suggests a need to think about the therapeutic changes and processes that occur within a community context and how communities can enable therapeutic change. However, the 'therapeutic communities' that have developed since the Second World War have been under-researched. We suggest that the concept of community, as a change process, should be revisited within mainstream scientific research. This paper briefly reviews the historical development of therapeutic communities and critically evaluates their current theory, practice and outcomes in a systematic review. Attention is drawn to recent research on the nature of evolved emotion regulation systems, the way these are entrained by social relationships, the importance of affiliative emotions in the regulation of threat and the role of fear of affiliative emotions in psychopathology. We draw on concepts from compassion-focussed therapy, social learning theory and functional analytical psychotherapy to consider how members of a therapeutic community can be aware of each other's acts of courage and respond using compassion. Living in structured and affiliative-orientated communities that are guided by scientific models of affect and self-regulation offers potential therapeutic advantages over individual outpatient therapy for certain client groups. This conclusion should be investigated further. Copyright © 2014 John Wiley & Sons, Ltd. Key Practitioner Message Current therapeutic community practice is not sufficiently evidence based and may not be maximizing the potential therapeutic value of a community., Compassion-focussed therapy and social learning theory offer new approaches for a therapeutic environment, involving an understanding of the role, nature and complexities of compassionate and affiliative relationships from staff and members, behavioural change guided by learning theory, a clear formulation based on threat-derived safety strategies, goal setting and positive reinforcement. [ABSTRACT FROM AUTHOR]

Family-based therapy (FBT) is regarded as best practice for the treatment of eating disorders in children and adolescents. In FBT, parents play a vital role in bringing their child or adolescent to health; however, a significant minority of families do not respond to this treatment. This paper introduces a new model whereby FBT is enhanced by integrating emotion-focused therapy (EFT) principles and techniques with the aims of helping parents to support their child's refeeding and interruption of symptoms. Parents are also supported to become their child's 'emotion coach'; and to process any emotional 'blocks' that may interfere with their ability to take charge of recovery. A parent testimonial is presented to illustrate the integration of the theory and techniques of EFT in the FBT model. EFFT (Emotion-Focused Family Therapy) is a promising model of therapy for those families who require a more intense treatment to bring about recovery of an eating disorder. Key Practitioner Message More intense therapeutic models exist for treatment-resistant eating disorders in children and adolescents., Emotion is a powerful healing tool in families struggling with an eating disorder., Working with parent's emotions and emotional reactions to their child's struggles has the potential to improve child outcomes. Copyright © 2013 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Emotion-focused therapy (EFT) is an integrative and experiential treatment approach that views emotions as fundamentally adaptive and privileges attention to, and exploration of, emotional experiences. EFT has been demonstrated to be efficacious with depression, interpersonal trauma and marital discord, but application to anxiety disorders is in its initial stages. The purpose of this paper is to present the main principles of using EFT with socially anxious patients and to make the case that EFT is particularly well suited for working with this patient group. The primary change processes in EFT for social anxiety include improving emotion awareness, reducing experiential avoidance and the activation and transformation of shame that underlies the symptomatic anxiety. Such processes lead to less self-criticism, to more self-compassion and self-soothing and to a more favourable perception of the self. A case example is used to illustrate how these principles were applied with a socially anxious patient. Copyright © 2013 John Wiley & Sons, Ltd. Key Practitioner Message Although cognitive-behavioral therapies (CBT) are effective for social anxiety disorder (SAD), a substantial number of patients do not respond to CBT or remain considerably symptomatic at the end of treatment. Therefore, more treatment options for SAD are necessary in order to improve patient care., Emotion-focused therapy (EFT), which is an efficacious treatment for depression, complex trauma, and couples' distress may also be efficacious for SAD., EFT offers an emotion-based case formulation of SAD, in which social anxiety is conceptualized as secondary to primary maladaptive shame. A primary goal in EFT for SAD is to access and evoke shame in order to transform it. [ABSTRACT FROM AUTHOR]

Although positive emotion research has begun to flourish, the extremes and potential costs of positive emotion remain understudied. This is an ideal clinical model for studying the ways in which positive emotions are disrupted in bipolar disorder. Bipolar disorder is characterized by extreme bouts of expansive and persistent positive feelings. This paper reviews recent experimental studies, selectively examining positive emotion, in individuals at risk for, and diagnosed with, bipolar disorder. As an extension of this body of work, I present an account of positive emotion disturbance in bipolar disorder, referred to as positive emotion persistence. Implications are discussed for the study of bipolar disorder and positive emotion that follow. Copyright © 2011 John Wiley & Sons, Ltd. Key Practitioner Message [ABSTRACT FROM AUTHOR]

There has been little research into the association of shame and other self-conscious emotions in bipolar disorder, although there is evidence linking shame to various psychopathologies. Objectives: This research investigates the levels of shame in individuals with bipolar disorder. Design and Methods: A cross-sectional design was used to compare 24 individuals with a diagnosis of bipolar disorder to a clinical control group of 18 individuals with unipolar depression, and 23 age-matched non-psychiatric controls on measures of mood (Beck Depression Inventory [BDI] and Self Report Manic Inventory [SRMI]) and of self-conscious emotions (Internalized Shame Scale and Test of Self-Conscious Affect). Results: Higher levels of trait shame and lower guilt-proneness were found in the bipolar group. Higher levels of shame-proneness were found in the unipolar group in comparison to the bipolar and control groups. BDI scores positively correlated with trait shame and shame-proneness, and accounted for a large proportion of the variance in these scores. SRMI scores positively correlated with trait (internalized) shame and negatively correlated with guilt-proneness. Conclusions: There was evidence for the presence of shame within bipolar disorder, but this differed to the evidence for shame in individuals with unipolar depression. Clinical implications are discussed. Copyright © 2009 John Wiley & Sons, Ltd. Key Practitioner Message: • Evidence suggests that cognitive–behavioural therapy is not effective in individuals with bipolar disorder with more than 12 illness episodes. • Shame has been elucidated as a factor is some chronic mental health problems, including depression. • Compassionate mind training has recently been developed to address experience of shame and is designed as an adjunct to cognitive–behavioural approaches. • This paper finds evidence for the presence of shame within bipolar disorder, but with a different manifestation than that found in individuals with depression. • This suggests that clinicians should consider shame as a factor for exploration within therapy, possibly using compassionate mind therapy, and its inclusion may improve on therapeutic outcome. [ABSTRACT FROM AUTHOR]

This paper presents a series of cases to explore the development and value of a form of relating therapy for people who hear voices. The therapy is theoretically underpinned by Birtchnell's Relating Theory and offers a therapeutic space where hearers can explore and seek to change the relationship with their predominant voice. Five cases are presented to illustrate the processes of: (1) exploring similarities between relating to the voice and relating socially; (2) enhancing awareness of reciprocity with the voice–hearer relationship; and (3) using assertiveness training and empty chair work to facilitate change. Results were encouraging as change in control and/or distress was apparent for four of the cases. Changes in patterns of relating to voices were also apparent. Copyright © 2009 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

The present paper examines the relationships between relationship quality and three different types of jealousy, including both partners' levels of jealousy and perceptions of relationship quality. It was expected that jealousy in response to a direct threat to the relationship—that is, reactive jealousy—would be positively related to relationship quality, whereas forms of jealousy that may also be triggered in the absence of such a threat would be negatively related to relationship quality. Three studies were conducted among large community samples of heterosexual married and cohabiting couples (a total of 961 couples), using three different operationalizations of relationship quality. In all three studies both partners' levels of reactive jealousy related positively to relationship quality, whereas in all three studies, both partners' levels of anxious jealousy were negatively related to relationship quality. Findings and clinical implications are discussed. Copyright © 2007 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Emotion regulation is an emerging field in psychology concerned with the processes involved in recognizing, monitoring, evaluating and modifying emotional reactions. Few measures have been developed specifically to assess individual differences in the use of emotion regulation strategies. This paper reports on a new self-report instrument designed to assess the frequency with which adolescents use both functional and dysfunctional emotion regulation strategies, which draw on both internal (intrapersonal) and external (interpersonal) resources to regulate emotions. The new measure was used in a cross-sectional survey of 225 adolescents. Factor analyses supported the structure of the measure, which has four scales: ‘internal-functional’, ‘internal-dysfunctional’, ‘external-functional’ and ‘external-dysfunctional’ emotion regulation. The new measure demonstrated good psychometric properties. Frequent use of dysfunctional emotion regulation was significantly positively correlated with parent reports of level of emotional and behavioural problems, and also with self-reported level of psychosomatic health problems. Frequent use of functional emotion regulation was significantly positively correlated with self-reported quality of life across a number of different dimensions. These results provide evidence for the validity of the measure. The results also highlight that assessment of both functional and dysfunctional emotion regulation is important. Copyright © 2007 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

The important influences of the social environment and social support on the course of PTSD are noted. It is argued that the measure of Expressed Emotion (EE), which has been used successfully to predict outcome in a number of psychiatric and psychological disorders most notably schizophrenia, might productively be used to predict outcome in PTSD patients. The aims of this paper are to report on the feasibility of modifying and using the Camberwell Family Interview (CFI), from which EE is rated, with the significant others of PTSD patients, to report on the range and nature of the responses of the respondents, and to investigate whether the EE status of the respondent could be explained as a response to characteristics of the patient such as severity of the disorder. The results from 31 respondents, in this preliminary study, suggest that the modified CFI was appropriate with this population, that EE could be measured with acceptable reliability and that a satisfactory range of responses was obtained. Of respondents, 52% were rated as high EE. But EE was not significantly related to type of trauma, relationship with the patient or severity of psychopathology. Predictions as to the possible associations between EE and outcomes are outlined and the implications of these are discussed. [ABSTRACT FROM AUTHOR]

Despite the proven efficacy of exposure techniques for the treatment of Post-Traumatic Stress Disorder, some obstacles can arise that interfere with successful implementation of exposure-based therapy. In this paper, the theory behind exposure therapy for PTSD is reviewed and basic implementation procedures are detailed. The ways in which three obstacles to treatment (extreme anger, emotional numbing, and overwhelming anxiety) can impede progress in therapy are discussed in terms of theory and case examples. Specific suggestions for circumventing these obstacles are offered, including modifying the exposure techniques and augmenting exposure by using stress inoculation techniques or cognitive therapy. [ABSTRACT FROM AUTHOR]