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AbstractSurvivors of sexual violence often experience short-and long-term mental and physical health conditions due to the victimization. Rape Crisis Centers are community-based advocacy organizations that provide free supportive services to survivors of sexual assault, such as 24-hour crisis hotlines, medical advocacy, individual and group therapeutic services, and victim advocacy services for those with cases within the criminal justice system. However, the efficacy of these services in assisting survivors is not well known, often due to researchers’ lack of access to clients. In this paper, we investigate the experiences of survivors directly from the survivors receiving psychotherapy services from a Rape Crisis Center in an urban jurisdiction in the Midwestern United States. We qualitatively interviewed nine survivors who attended individual and/or group therapy. In-depth analysis showed that four themes emerged regarding their experiences. Two themes pertain to positive outcomes—emotional processing and group therapy dynamics. One theme concerns obstacles. The final theme relates to suggestions for service improvement. The discussion includes summaries of the reflective findings and recommendations for future practice. This research contributes to informing and improving practices and policies to better serve survivors of sexual assault. [ABSTRACT FROM AUTHOR]

Purpose: We examined positive behavioral resources and characteristics that might distinguish resilient personality prototypes among persons with chronic spinal cord injury/disorder (SCID). Positive psychology variables with clear linkages to existing psychological interventions were examined as potential mediators of the resilience–well-being relationship. Research Method and Design: A cross-sectional, self-report study was conducted. Two hundred and ninety-eight consenting members of the Paralyzed Veterans of America (268 male; 236 self-identified as white) provided useable survey data for analysis (including 161 veterans with tetraplegia, 107 with paraplegia, 30 with cauda equina). Cluster analysis of Big Five personality traits identified resilient and nonresilient personality profiles. Tests of mean differences between resilient and nonresilient participants on behavioral resources and characteristics were performed. Path models predicting well-being and health-related quality of life (HRQL) were conducted. Results: One hundred and sixty-three respondents had resilient personality profiles and 135 had nonresilient profiles. Resilient individuals reported significantly more optimal scores on every positive psychology variable, and greater well-being and HRQL than nonresilient respondents. Path models found the relationship of resilience to well-being was explained through its beneficial associations with psychological flexibility, use of personal strengths, meaning in life (MIL), and gratitude. Psychological flexibility also mediated the resilience–HRQL relationship. Cauda equina was significantly associated with higher pain interference and lower HRQL. Conclusions: Higher gratitude, MIL, use of personal strengths, and psychological flexibility appear to characterize resilience and well-being among persons with chronic SCID. Further studies are needed to understand the impact of pain interference on HRQL among individuals with cauda equina. Impact and Implications: The present study documents several positive behavioral resources and characteristics that typify resilience among persons with chronic spinal cord injury/disorder. The results should prompt rehabilitation psychologists to consider further study of the positive psychology variables examined in this paper, and the potential use of the existing interventions associated with each one. [ABSTRACT FROM AUTHOR]

Introduction/Objective: As in the rest of the world, in Latin America there is a high prevalence of interpersonal violence (IV) in childhood and adolescence, which is associated with psychological consequences in the short, medium and long term. At the international level, progress has been made in the recognition of evidence-based psychotherapies, but the situation in Latin America is unknown. The objective of this systematic literature review is to identify which psychotherapy models or modalities have been shown to be effective in Latin America. Methods: A systematic search of five databases was carried out with search terms relating to psychosocial interventions of people exposed to IV during childhood, based in Latin America. Studies regarding Latino populations based in United States were excluded. Results: 14 papers describing 13 studies and one follow-up were identified. Individual and group interventions (mainly cognitive-behavioural and with psychodynamic influence) were included. Although all showed clinically or statistically significant changes in symptoms of post-traumatic stress, anxiety and depression, most were pilot studies with important methodological limitations and a high risk of bias. Conclusions: It is necessary to develop clinical practice in Latin America with more robust research (i.e., controlled and randomised clinical trials) that produce more reliable evidence regarding the effectiveness of psychosocial interventions for IV involving children and adolescents in the Latin American context. [ABSTRACT FROM AUTHOR]

Accelerated resolution therapy (ART) is a psychotherapy for the treatment of prolonged grief disorder (PGD) defined as severe, enduring longing for the lost person. Currently, ART lacks examination of intrapersonal processes, like expectancy, as behavioural mechanisms for action. Therefore, the purpose of this paper was to present the findings on participants' treatment expectations of ART for PGD and then discuss potential hypotheses for future testing. This study was a primary qualitative descriptive analysis of prospectively collected interview data (collected 2017–2019) accrued as part of a randomised, wait‐list controlled clinical trial in bereaved hospice family caregivers in the United States. The sample included 29 former informal caregivers who were at least 1‐year post death of their care recipient. They were primarily female, older (67.4 ± 7.1 years), and a little over half (n = 18) had been married to their care recipient. Thematic analysis resulted in three distinct themes with six sub‐themes: The role of knowledge in expectations (sub‐themes uncertainty, prior knowledge); The role of personality in expectations (sub‐themes openness, positive affect); and Expecting a process (sub‐themes cognitive processes, affective processes) which described the interaction of person and process in shaping expectations of our intervention. An across theme analysis of the specificity of the participants' expectations uncovered that knowledge and personality inform expectations of ART and that individuals who verbalise a process for recovery tend to be very specific in their expectations. Three hypotheses for testing are put forward and implications for practice, research and policy discussed. [ABSTRACT FROM AUTHOR]

Biomarkers may serve as objective measures in complicated grief (CG) potentially capturing responses to stress reduction treatment. This paper reports challenges in obtaining and assessing salivary cortisol and α-amylase (sAA) for a recent randomized clinical trial. Within-session changes in salivary cortisol and sAA for 54 older adults with CG who received Accelerated Resolution Therapy were compared with perceived stress measured by Subjective Units of Distress Scale. Bivariate correlations and multiple regressions examined changes in biomarkers. Protocols, study logs, and audit reports identified challenges. Challenges included obtaining unstimulated passive drool salivary samples and their analyses. Our sample of older females on multiple medications may have resulted in a perfect storm of moderating and intervening variables which affected the stress response. This paper contributes to the discussion on designing clinical trials for older adults which must account for physiologic changes, multimorbidity, and polypharmacy common in this population and makes recommendations moving forward. [ABSTRACT FROM AUTHOR]

As we go to press in a COVID‐19 world, the topic of anxiety is foremost on our minds. While each situation has to be considered in its own context, how to manage different anxieties has common denominators. There is currently a sharp increase in forced migration around the globe so mental health professionals must develop effective skills, like the ability to adapt services to different contexts and cultures, to manage the needs of immigrant people. Problem‐Solving Brief Therapy, as developed at the Mental Research Institute in Palo Alto, is a systemic model of therapy, which aims at promoting change in the complaint the presenting client (the 'talker') cares about. The model's roots in Constructivism foster integrating the clients' beliefs and values into therapy to allow the therapists to adapt to the clients' particular needs. This paper is the analysis of a single case where the therapist worked with an immigrant family because their child suffered from severe anxiety related to the parents' threatened deportation. The paper focuses on premises and strategies that allowed minimising cultural barriers between therapists and family members, thus facilitating a strong therapeutic alliance conducive to improvement. [ABSTRACT FROM AUTHOR]

Objective: Eating disorders (EDs) were once conceptualized as primarily affecting affluent, White women, a misconception that informed research and practice for many years. Abundant evidence now discredits this stereotype, but it is unclear if prevailing "evidence‐based" treatments have been evaluated in samples representative of the diversity of individuals affected by EDs. Our goal was to evaluate the reporting, inclusion, and analysis of sociodemographic variables in ED psychotherapeutic treatment randomized controlled trials (RCTs) in the US through 2020. Methods: We conducted a systematic review of ED psychotherapeutic treatment RCTs in the US and examined the reporting and inclusion of gender identity, age, race/ethnicity, sexual orientation, and socioeconomic status (SES) of enrolled participants, as well as recruitment methods, power analyses, and discussion of limitations and generalizability. Results: Our search yielded 58 studies meeting inclusion criteria dating back to 1985. Reporting was at times incomplete, absent, or centered on the racial/gender majority group. No studies reported gender diverse participants, and men and people of color were underrepresented generally, with differences noted across diagnoses. A minority of papers considered sociodemographic variables in analyses or acknowledged limitations related to sample characteristics. Some progress was made across the decades, with studies increasingly providing full racial and ethnic data, and more men included over time. Although racial and ethnic diversity improved somewhat, progress appeared to stall in the last decade. Discussion: We summarize findings, consider context and challenges for RCT researchers, and offer suggestions for researchers, journal editors, and reviewers on improving representation, reporting, and analytic practices. Public Significance: Randomized controlled trials of eating disorder psychotherapeutic treatment in the US are increasingly reporting full race/ethnicity data, but information on SES is inconsistent and sexual orientation absent. White women still comprise the overwhelming majority of participants, with few men and people of color, and no gender‐diverse individuals. Findings underscore the need to improve reporting and increase representation to ensure evidence‐based treatments are effective across and within diverse groups. [ABSTRACT FROM AUTHOR]

Coronavirus outbreak created diverse challenges for mental health services in general and to psychotherapy in particular. One of the most prominent of these is the move from delivering psychotherapy in face to face sessions to telephone or internet-based platforms. While this is a challenge to all psychotherapies, this paper examines specific considerations that should be taken into account when doing recovery-oriented integrative psychotherapy with persons with schizophrenia. Based on our clinical experiences conducting trials of psychotherapy with people with schizophrenia in Israel and in the United States, we describe several changes that took place as we were providing psychotherapy at the outbreak of the pandemic. These include general changes in the platform of psychotherapy and in the focus of sessions at both process and content levels. These changes represent both barriers and opportunities for the recovery process. Following a description of these changes we discuss and outline adaptations that are needed for sustaining patient's sense of their own agency and of the intersubjective nature of the session. [ABSTRACT FROM AUTHOR]

The complexity of the African American community in the United States continues to evolve. The growing number of professional African Americans who grew up in the postcivil rights era combined with the persistent reminders of inequity paints a complex backdrop for understanding African American relationships. The majority of our knowledge about African American couples disproportionately comes from nonclinical social science fields such as sociology and demography. Unfortunately, the scholarly literature on how to work with African American couples is relatively scant. This paper seeks to add to this limited literature by providing clinicians and scholars with a proposed set of issues to consider when conceptualizing and treating African American couples. In particular, the complexity and nuance needed to work with African American couples are best done by using an integrative model. Thus, this paper will discuss how the Integrative Systemic Therapy (IST) model is particularly well suited for working with African American couples. This paper will summarize the science on African American marriages with a focus on salient factors such as gender, SES, and trust, which will then be translated into clinical practice by utilizing a case example. The case example will be of a middle‐class couple in order to delineate the challenges and the growing heterogeneity of African Americans. The article will conclude with a commentary on the evolving heterogeneity of African Americans, which sheds light on how an integrative perspective is important for disentangling and embracing the growing complexity of African American couples. [ABSTRACT FROM AUTHOR]

This paper summarizes the place of psychotherapy and psychoanalysis in the US health care system. It addresses trends in the field, tensions between biomedical and biopsychosocial models of mental and substance use disorders, and summarizes top-down legislative and bottom-up judicial actions that impact access to psychosocial treatments for mental and substance use disorders. [ABSTRACT FROM AUTHOR]

This paper reviews the use of psychotherapeutic approaches to treat individuals who have committed sex crimes and/or have problematic sexual interests (PSI); including types of psychotherapy used, descriptions of preventive and reintegration programmes, and highlighting specific theoretical controversies. In the second part, experts from Canada, the Czech Republic, Russia, the United Kingdom, and the United States, who participated in an International Consensus Meeting held in Prague (2017), summarize treatment programmes in their countries. The comparison revealed some general findings: each country has variability between its own programmes; most countries have different programmes for people who are in custody and who are in the community; the state-directed treatment programmes are primarily focused on criminal individuals, while non-criminal individuals are treated in preventive programmes and/or in special clinics or are untreated; the presence of PSI in patients is acknowledged in most programmes, although specific programmes exclusively for individuals with PSI rarely exist. Studies on effectiveness are difficult to compare due to methodologic, political, and cultural differences. Further communication between more countries to share knowledge about successful treatments and preventive approaches is needed, especially enhanced international collaboration between researchers and clinicians to verify the effectiveness of current clinical and experimental program, rs. [ABSTRACT FROM AUTHOR]

The opioid epidemic is a national emergency in the United States. To meet the needs of individuals diagnosed with Opioid Use Disorder (OUD) office-based opioid treatment programs (OBOT) are quickly expanding. However, social workers roles in OBOT programs are not clearly described. This paper will emphasize three roles social workers may fulfill in OBOT programs to combat the opioid crisis. [ABSTRACT FROM AUTHOR]

Over the past two decades, research on pediatric bipolar disorder has grown geometrically. The diagnosis of pediatric bipolar disorder was met with enthusiasm, which in healthy doses catalyzed change, and skepticism, which in good measure pushes for rigor. Skepticism led to productive questions about the phenomenology of pediatric bipolar disorder and how best to diagnose and treat it. With regard to prevalence, key questions included whether it was increasing over time, and whether it was limited to the United States. In 2011, we published a meta‐analysis addressing the prevalence questions; results indicated that bipolar disorder manifested at statistically indistinguishable rates in youth community samples across the world. In their recent paper, Parry et al. examine the studies included in the 2011 meta‐analysis using a qualitative approach. Their opinion piece represents a step backwards; every study has shortcomings, but in focusing on a dozen individual studies, Parry et al. fail to take into account the preponderance of evidence – literally thousands of articles across countries, cohorts and methodologies – that support the existence of bipolar disorder in both prepubescent youth and adolescents. This commentary addresses misperceptions regarding the diagnosis of bipolar disorder in youth, particularly with regard to cross‐informant agreement, to present converging data from international sources regarding the onset of bipolar disorder in childhood, and to correct the false claim that pediatric bipolar disorder is controversial. As clinicians and researchers, we have an obligation to do what we can to improve the lives of youth affected by mental illness. Denying the existence of a serious mood disorder will not serve the best interests of young people and will perpetuate the long delays many experience before getting an accurate diagnosis, appropriate treatment, and a fair chance at a good quality of life. Read the Editors' introduction at: doi: 10.1111/camh.12315 Read the core debate at: doi: 10.1111/camh.12231; doi: 10.1111/camh.12243; doi: 10.1111/camh.12306 Read more perspectives in this debate at: doi: 10.1111/camh.12318 doi: 10.1111/camh.12317; doi: 10.1111/camh.12316; doi: 10.1111/camh.12313; doi: 10.1111/camh.12310; doi: 10.1111/camh.12314 [ABSTRACT FROM AUTHOR]

Purpose - The purpose of this paper is threefold: to document the relationship between intellectual disability (ID) and psychopathology; to raise awareness of the ongoing lag in professional training for psychologists in the area of mental health treatment for people with intellectual disabilities; and, to provide recommendations for advancing professional education and, ultimately, adequate mental health treatment availability for people with intellectual disabilities. Design/methodology/approach - The paper reviews the literature on prevalence of mental health problems in people with intellectual disabilities. At the same time, the paper reviews the training of psychologists relative to the burgeoning growth in awareness of the mental health needs of people with intellectual disabilities. Findings - The paper concludes that ID is a significant risk factor for psychopathology. In addition, the paper concludes that the education of psychologists regarding the mental health needs of people with intellectual disabilities is insufficient. The authors document the need for incorporating research and treatment advances related to intellectual disabilities and mental health into to the professional training of psychologists. The paper also describe the potential this training holds for improving both the lives of people with intellectual disabilities and the overall competence of psychologists. Practical implications - This paper provides a literature-based rationale for the need to include education in the mental health needs of people with intellectual disabilities into the general training of mental health professionals. In addition, it provides specific recommendations for how such training can be incorporated into graduate psychology programs. Originality/value - This paper provides mental health professionals with a review of the growth in understanding of the enormous, unmet mental health needs of people intellectual disabilities, and of the critical role of ID in development of mental health problems. Moreover, this paper builds the case for an important revision in the training of psychologists to include competence in understanding and treating mental health problems across the full spectrum of intellectual functioning. [ABSTRACT FROM AUTHOR]

Mentalization-based interventions show promise in improving mental health outcomes for children and parents through increasing a family's reflective functioning, or ability to mentalize. Mentalizing involves the ability to understand behavior in relation to mental states, such as thoughts and feelings, and typically develops within the context of secure attachment relationships. One area not given much consideration when training foster parents is their capacity to mentalize. This study evaluated Family Minds, a newly developed psychoeducational intervention for foster parents, designed to increase their ability to mentalize. The current paper reports on the development and preliminary empirical evaluation of Family Minds in a quasi-experimental study where 102 foster parents received either Family Minds or a typical foster parenting class, which served as a control group. Results indicate that parents who received Family Minds significantly increased their levels of reflective functioning as assessed with the Parental Reflective Functioning Questionnaire and a new Five-Minute Speech Sample procedure coded using the Reflective Functioning Scale, and revealed a tendency to show decreased levels of parenting stress on the Parenting Stress Index, while the control group showed no such improvements. These findings support the hypothesis that a short-term psychoeducational intervention may improve foster parents' ability to mentalize themselves and their children. These skills are very beneficial for foster parents, as they frequently deal with children who come into their home with challenging behaviors, attachment issues, and negative internal working models of relationships. This type of intervention has the potential to lower placement breakdowns and improve the mental health of foster children. [ABSTRACT FROM AUTHOR]

Complex trauma is a significant public health problem in the United States (U.S.), occurring in families with chronic and compounding exposures to traumatic stressors like substance misuse, intimate partner violence (IPV) and child maltreatment (Cook et al., 2017). Yet, few programs exist to treat their intersection, challenging our ability to respond effectively and restore positive trajectories for children and families. In this context, there is a need for innovative approaches to treat these intersecting phenomena. In this conceptual paper, we identify three innovative programs that offer integrative approaches to these intersecting challenges. We analyze common elements among these programs, offering a theoretical foundation for fundamental elements of transformative services. Finally, we consider how the Families First Prevention Act could be leveraged for states to adopt and implement these programs. The goal of this conceptual paper is to advance empirical and practical discussions regarding programmatic and policy options for more effectively responding to substance misuse, and IPV in families, and the associated traumas incurred by maltreated children and their caregivers. • Substance misuse, IPV, and child maltreatment, frequently co-occur. Yet, few programs exist to address their inter-related effects. • This conceptual paper reviews three exemplar integrative programs: Child Development Community Policing, Family-Based Recovery, and Child Parent-Psychotherapy. • We identify key and common elements of these integrative programs. Specifically, we find that: 1 warm handoffs, 2) removing barriers to access, 3) relationship-based practice, 4) a trauma-informed approach, 5) strong case management, 6) providing access to services when families are in crisis, and 7) breaking down silos are important components for integrated approaches. • The federal Family First Prevention Act (FFPSA) could be leveraged to fund innovative, integrative approaches to substance misuse, intimate partner violence, and child maltreatment. • Integrative programs are important for promoting resilience and restoring positive trajectories for children and families. [ABSTRACT FROM AUTHOR]

Background: Mild traumatic brain injuries (mTBI) are the most common of traumatic brain injuries and patients often experience a wide range of symptoms such as headache, fatigue, dizziness, sleep problems and subjective cognitive deficits. Whilemost symptomatic patients recover quickly, a sub-group of ~ 10-20% of patients experience prolonged symptoms. There is currently a lack of evidence-based treatment for these patients. Objective: The objective of the present paper was to conduct a systematic review of the literature on psychotherapeutic interventions specifically for patients with prolonged symptoms (> 3 months after injury) after mTBI. Methods: With a more precise definition of psychotherapy than previous reviews, an extensive literature search was conducted that yielded 2332 hits, of which five were considered to meet the criteria. Only two of the studies were randomized controlled trials. Results and conclusions: Results revealed several methodological limitations in the included studies, leading to the conclusion that it is premature to make any strong recommendations on psychotherapeutic treatment of prolonged symptoms after mTBI. With in-depth methodological analyses of the included studies and comprehensive recommendations for future research, the present review aims to inform clinicians and to encourage scientists to engage in collaborative effort towards increasing the number of methodologically sound clinical trials in the field. [ABSTRACT FROM AUTHOR]

Contemporary person-centered psychotherapy often references empathy as a basic component of the therapeutic alliance and, thus, effective treatment, such that nascent clinicians study this basic skill early in training. However, the psychotherapy literature often presumes a collective agreement about how empathy manifests as a clinical tool, in the process institutionalizing the ideal of omnipresent alignment with a client, applied across populations of patients, regardless of their conditions, ages, and personal and cultural characteristics. Misalignments between clinicians and clients have the potential to bely broadly imagined ethics of empathy (and the notion of collective agreement about what it is) by demonstrating the ways tension, difference, and incongruence promote treatment. Through an autoethnography of a 12-month psychotherapy dyad with an elderly woman committed for treatment at a U.S. psychiatric hospital, we discuss how moments of incongruence between clinician and client expand conceptualizations of empathy in treatment of psychosis. Specifically, in this context, deployment of empathy-as-alignment becomes a fallacy of care, risking the effectiveness of treatment through impossible epistemological assumptions of and counterproductive joining with the client. As such, this transtheoretical discussion presents two types of incongruence in the dyad—developmental and subjective—as a backdrop for expressing empathy. This paper makes space for a theory of empathy as the practice of working in genuine and careful service of the client's psychology through acts of incongruence as much as alignment. • Definition of the construct of empathy lacks consensus in the clinical literature. • Clinicians may struggle struggle to empathize with the life stage and extra-realistic perceptions of elderly clients with psychosis. • Unavoidable elements of incongruence between clinician and client do not need to point to empathic failure. • Use of incongruence through metaphor and radical genuineness may build experiences of empathy and the therapeutic alliance. • Empathy may be delineated as both affective and cognitive affirmation and as shifts between congruence and incongruence. [ABSTRACT FROM AUTHOR]