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Idiographic patient‐reported outcome measures (I‐PROMs) are a growing set of individualized tools for use in routine outcome monitoring (ROM) in psychological therapies. This paper presents a position statement on their conceptualization, use, and analysis, based on contemporary evidence and clinical practice. Four problem‐based, and seven goal‐based, I‐PROMs, with some evidence of psychometric evaluation and use in psychotherapy, were identified. I‐PROMs may be particularly valuable to the evaluation of psychological therapies because of their clinical utility and their alignment with a patient‐centered approach. However, there are several challenges for I‐PROMs: how to generate items in a robust manner, their measurement model, methods for establishing their reliability and validity, and the meaning of an aggregated I‐PROM score. Based on the current state of the literature, we recommend that I‐PROMs are used to complement nomothetic measures. Research recommendations are also made regarding the most appropriate methods for analyzing I‐PROM data. [ABSTRACT FROM AUTHOR]

Background and Objectives: The utilization of Between‐Session Homework (BSH) holds a longstanding tradition in the field of psychotherapy. Significantly, it serves as a pivotal catalyst for change within behavioral and cognitive‐behavioral therapies, and has also garnered endorsement within psychodynamic and humanistic‐experiential therapies. While our current conceptualization of BSH is characterized by assimilation and integration, diversity prevails in how BSH is incorporated into the treatment plan, spanning various therapy stages, thus necessitating a customized therapist‐client interpersonal dynamic. Far from being a panacea, the employment of BSH emerges as a highly sophisticated and intricate clinical methodology, demanding a high degree of therapist proficiency and competence to facilitate client engagement. Methods: In this introductory paper, we present an issue of the Journal of Clinical Psychology: In Session that exemplifies the diverse modalities through which BSH can be integrated into clinical practice across various client demographics and within distinct psychotherapeutic paradigms. We place specific emphasis on the pivotal role of BSH and its interplay with proposed mechanisms of change throughout the course of treatment. Results: Initially, we provide an overarching view of the subject and expound on empirical research substantiating the efficacy of BSH in psychotherapy. Subsequently, we delve into strategies for adeptly integrating and monitoring BSH within clinical practice. Conclusions: Our primary objectives encompass affording readers a more lucid comprehension of (1) the content and nature of homework; (2) the influence of BSH on treatment outcomes; and (3) the ways through which therapists can foster client engagement with BSH. Finally, we introduce the six papers comprising this issue. [ABSTRACT FROM AUTHOR]

Personality disorders (PD) are based not just on maladaptive ideas about self and others, they also are grounded on embodied patterns of behaviors and reactions to interpersonal stressors. There is growing interest in working with the body and through the body so to address automatisms that lead to suffering and dysfunctional social action. In this issue of the Journal of Clinical Psychology: In‐Session the use of art and psychomotor therapies for these patients was explored by seven different clinical perspectives. Patients described presented with different PD and associated symptoms. The arts and psychomotor therapies deployed in personality disorder treatment are: (visual) art therapy, music therapy, drama therapy, dance (movement) therapy, and psychomotor therapy making psychotherapeutic use of the different modalities: art, music, play, role‐play, performance, improvisation, dance, body awareness and movement. Interventions provide kinesthetic, sensory, perceptual, and symbolic opportunities to invite alternative modes of meaning‐making, accessing own needs and wishes, and communicating them to others. In this commentary we summarize some of the different topics covered by the clinical‐based papers, including working mechanisms of arts and psychomotor therapies, the importance of bottom‐up emotion regulation processes, how to treat trauma in the presence of a PD, how to integrate art and psychomotor therapies in a fine‐grained formulation and how to understand the process of change. Although there is a need for more empirical research, we hope this issue makes a solid case that clinicians can effectively include art and psychomotor therapies when treating the full range of PD. [ABSTRACT FROM AUTHOR]

Objective Method Results Conclusions Public Health Significance Statement We aim to uncover the hot topics and development trends in clinical psychology research in the United States.Utilizing bibliometric analysis, we examined clinical psychology papers published in the United States from 2010 to 2022 in the Web of Science database, employing citation analysis, content analysis, author analysis, and journal analysis.Our analysis revealed a significant increase in clinical psychology research, notably catalyzed by the 2019 COVID‐19 pandemic. This surge was particularly evident in studies addressing mental disorders such as PTSD, anxiety, and suicidal behaviors, as well as psychological trauma related to issues like family conflict, elder abuse, and collective trauma. Furthermore, there was a distinct shift towards studying diverse populations, including gender and racial minorities, mothers, and adolescents. Therapeutic approaches, such as mindfulness‐based practices and AI‐assisted technologies, also gained prominence.This study represents the first large‐scale bibliometric analysis in the field of clinical psychology in the United States. Our findings suggest that the COVID‐19 pandemic highlights the importance of studying psychological issues linked to major events. Also, researchers are increasingly focusing on minority groups. This trend, along with the use of new technologies like big data and artificial intelligence, guides future research in clinical psychology.The works in this review suggest that the changing landscape of clinical psychology, especially post‐COVID‐19. The increased research post‐pandemic emphasizes addressing psychological trauma arising from societal issues like family conflicts, elder abuse, and collective trauma. A positive shift towards inclusivity is evident in research, focusing on diverse groups like gender minorities, racial minorities, mothers, and adolescents. Additionally, the amplified focus on mental disorders like PTSD, anxiety, and suicidal behaviors during the pandemic stresses the need for tailored interventions and support systems. Exploring innovative methods such as mindfulness‐based practices and AI‐assisted technologies showcases the field's adaptability in mental health interventions. [ABSTRACT FROM AUTHOR]

This paper describes the development and psychometric evaluation of a brief self‐report measure (BEACON) to inform universal mental health screening in schools. Items assess symptoms and impairment associated with anxiety and attention/hyperactivity problems (grades 4–11) as well as depression and eating difficulties (grades 6–11), with optional items for suicidality and self‐harm (grades 7–11). Initial item examination based on Item Response Theory (IRT) and classical test theory involved 3844 students in grades 4 through 11 (Study 1) and identified 18 items for grades 4–5 and 31 items for grades 6–11 that fulfilled pre‐set criteria. Study 2 extended testing with 10,479 students in grades 4–11 and added an additional four items assessing impairment associated with eating difficulties for older students (grades 6–11) creating a total of 35 items for grades 6–11. All items, for both grade‐level versions, met the pre‐set criteria for IRT and classical test theory analysis supporting their strength in the measurement of the dimensions of concern. The measure showed good reliability (subscale alphas.87 to.95). Validity was also demonstrated against standard symptom measures, school grades, school absenteeism, and help‐seeking. The BEACON appears to be a psychometrically sound measure to use in the first stage of school‐based screening for mental health problems. [ABSTRACT FROM AUTHOR]

Cognitive behavioral therapy (CBT) appears to achieve its effects at least in part by fostering the development of CBT skills. In an effort to leverage CBT skill development, our group developed and tested a skill‐enhanced version of CBT (CBT‐SE) in a recent trial. In this paper, we describe our work with a client who participated in a 12‐week course of CBT‐SE as part of that trial. Although homework is a critical aspect of CBT, the greater emphasis on skill development in CBT‐SE means that homework is even more central. This client's course of treatment illustrates the potential benefits of a strong focus on skill development and the use of specific homework assignments to foster mastery and ongoing use of CBT skills. The client developed CBT skills at a rapid pace early in treatment and exhibited enduring symptom reductions. The experience of this client reinforces the value of a focus on CBT skills and highlights strategies for fostering skill development. Given the evidence in support of the therapeutic value of CBT skills and the well‐established benefits of homework assignment, we encourage use of skill enhancing procedures, including in‐session procedures and assignments that help clients develop and maintain ongoing skill use. [ABSTRACT FROM AUTHOR]

Pathological narcissism is a personality constellation comprising distorted self‐image, maladaptive self‐esteem regulation, and difficulties in intimate relationships. Patients with elevated pathological narcissism may not necessarily meet criteria for narcissistic personality disorder, and may seek treatment for a range of mental health concerns across various clinical settings. An understanding of key principles of control‐mastery theory (CMT) can help clinicians understand the specific goals and challenges of the individual patient with pathological narcissism, and can illuminate ways in which the patient may work in psychotherapy. This paper outlines how patients with pathological narcissism may engage in testing of their pathogenic beliefs, and how therapists can respond in ways that facilitate the patient's sense of safety and foster psychological work. The role of the therapist's attitude is highlighted as a means for countering pathogenic beliefs associated with pathological narcissism. Clinical material from a single case of time‐limited supportive psychotherapy will be used to illustrate these principles and associated therapeutic processes. Insights from CMT regarding pathogenic beliefs and the patient's plan for addressing them can help to explain how therapy works or does not work for patients with pathological narcissism. [ABSTRACT FROM AUTHOR]

In order to effectively treat individuals suffering from Narcissistic Personality Disorder (NPD), it is crucial to establish therapeutic goals and identify tasks to achieve them. However, this is a challenging process with NPD patients because they often struggle to find meaningful goals beyond the pursuit of status. Moreover, in order to change Furthermore, to promote change, they must confront painful emotions such as shame, guilt, or fear, which they habitually try to avoid. Additionally, they face difficulties in forming a positive perception of their therapists and cooperating towards mutually agreed‐upon goals and tasks. As a consequence, NPD patients ask for change but hardly engage themselves in the work necessary to achieve it. Therapists therefore need to pay the uttermost attention to drafting, negotiating and continuously updating a reasonable and realistic therapeutic contract. In this paper we describe the story of a man in his thirties with NPD who was ridden with depression, guilt, envy and anger and did not find ways to pursue the healthy and adaptive behaviors he would need to pursue in order to leave a richer social life. The therapist overcame ruptures in the therapeutic alliance and then involved the patient in a process where they set the steps to follow, making sure the patient was convinced they made sense. After a contract was reached progress became possible. Implications for the role of the therapeutic contract in NPD treatment are discussed. [ABSTRACT FROM AUTHOR]

Treatment of patients with pathological narcissism presents several challenges and there is paucity of published case reports that document meaningful and durable change in patients suffering from this condition. Using descriptive and atheoretical language, this paper presents a treatment of a young man in his transition from young adulthood to middle adulthood while he was negotiating complex residues of his experiences of growing up along with developmental challenges related to work and love. Against the backdrop of these transitions, the patient was working through various aspects of functioning related to pathological narcissism. Initially, given academic pressures and past romantic disappointments, he was confronting issues related to perfectionism, self‐criticism, and avoidance. While he was able to move past some of these dynamics and function academically, later challenges related to becoming an independent adult led to a retreat into an avoidant state of futility and pessimism. Working through painful family dynamics related to not being seen and controlled, along with a deepening attachment in therapy as well as confrontation with realities of his life, led him to take steps toward greater independence. Thereafter, his treatment focused on learning from life experiences such as a newly developed career and romantic life, accepting the complexity of self and others, and tolerating disillusionments. [ABSTRACT FROM AUTHOR]

Background: Complex PTSD is a recent addition to the ICD‐11 diagnostic system. Aims: This case study describes the delivery of Skills Training in Affective and Interpersonal Regulation and Narrative Therapy (SNT), a flexible, multi‐component therapy that addresses the symptoms of complex posttraumatic stress disorder. SNT balances interventions that address current‐day stressors with those that reappraise the meaning of traumatic past events. This paper outlines 16 sessions of SNT with a 55‐year‐old gay man. Discussion: The case analysis describes the ways in which SNT is relevant and effective in addressing the client's mulitple concerns. The skills work helped the client effectively manage ongoing minority stress, discrimination, and micro‐aggressions related to his identity as a gay man. Review and re‐appraisal of his traumatic memories, which focused on the sudden death of his partner from AIDS along with discussion of events from his childhood that shaped his reactions to this loss, allowed the client to create a more integrated sense of self as well as a more compassionate view of himself. Implications regarding the relevance of SNT for sexual and gender minority individuals are discussed. [ABSTRACT FROM AUTHOR]

Objective: Complex post‐traumatic stress disorder (CPTSD) is a classification within the International Classification of Diseases, 11th Revision (ICD‐11) that, besides the DSM‐5 symptom clusters of post‐post‐traumatic stress disorder (PTSD), includes the presence of negative self‐concept, difficulties in regulating emotions and relationship skills. The purpose of the present study was to provide guidance on how to deliver Eye Movement Desensitization and Reprocessing (EMDR) therapy in the context of CPTSD, based on current clinical knowledge and the latest scientific research findings. Method: This paper describes the treatment of a 52‐year‐old woman with CPTSD and borderline personality disorder for which immediate trauma‐focused EMDR therapy was used. Results: First, a description of what EMDR therapy entails and some important treatment strategies that the therapist may employ to assist in trauma‐focused treatment of clients with CPTSD using EMDR therapy are outlined. Conclusion: The treatment results are in line with mounting evidence supporting the notion that EMDR therapy is a safe and potentially effective treatment alternative for individuals with CPTSD or personality problems. [ABSTRACT FROM AUTHOR]

Objectives: The therapeutic alliance (TA) has been shown to be a predictor of psychotherapy treatment success. In the case of psychotherapy with children, there is a dearth of information on TA's role. The aims of the paper are: (1) To estimate the therapist effects on children TA; (2) to investigate if therapists' TA predicts children's TA; (3) to analyze if children's age and sex predict children's TA; (4) to evaluate if the therapist's characteristics predict children's TA. Methods: The sample consisted of 77 children undergoing psychotherapy in Argentina, and the therapists (N = 29) providing services to those children. The assessment tools utilized for the study included the Therapy Alliance Scale for Children and the Personal Style of the Therapist Questionnaire (PST‐Q). Results: Findings indicated that 2% of the children's TA was explained by the therapists (ICC = 0.02), while 17% of the therapists' TA was explained by the therapists (ICC = 0.17). Therapists' TA predicted children's TA. Children's age and sex did not have an effect on their own TA. Moreover, therapists with more experience achieved higher scores of children's TA. Finally, the Operative dimension of the PST had a negative effect on children's TA (i.e., therapists who prefer more spontaneous interventions over structured ones may experience higher levels of therapeutic alliance with child patients). Conclusion: We found a positive effect of the therapist's TA on children's TA, especially in the preference for using more spontaneous intervention techniques. We discuss the implications of the findings on the training of psychotherapists who provide services to children. [ABSTRACT FROM AUTHOR]

The idea that the therapeutic relationship is at the core of psychotherapy is shared by most therapeutic approaches. Also, an increasing variety of therapeutic approaches, consider experiential techniques as central tools to promote effective therapeutic change. Commonly, it is argued that the creation of a positive, empathic, safe, and solid therapeutic alliance should be a prerequisite for administering these techniques. However, recent evidence is beginning to challenge this cautious stance showing that the introduction of experiential work early in therapy can be safe and effective. So, the quality of the therapeutic relationship may either facilitate or hinder the use of experiential techniques, but the use of these techniques may also strengthen or cause ruptures in the therapeutic alliance. So how do we balance the attention to the therapeutic relationship and the use of active, emotionally arousing techniques? In this paper, we present an issue of the Journal of Clinical Psychology: In Session exploring the complex interplay between therapeutic relationship and experiential practices in light of different psychotherapeutic approaches. We do so by first providing an initial overview of the topic. Next, we introduce the five papers of the issue along with some thoughts on how authors from diverse psychotherapeutic orientations contributed to illustrate and reflect on this multifaceted "dance" between therapeutic relationship and techniques. [ABSTRACT FROM AUTHOR]

This document is a reflection by Timothy R. Elliott, the outgoing editor of the Journal of Clinical Psychology (JCLP), on his experiences and observations during his twelve-year tenure. The article discusses the goals of the journal, such as promoting innovative studies and addressing understudied issues in the field. It also highlights the activities and accomplishments of the editorial team, including the number of submissions and rejection rates, special issues published, and frequently cited papers. The document further discusses the clinical efficacy of attentional bias modification procedures and the impact factor of JCLP, which has attracted international authors. Challenges faced during the editor's term include difficulties in finding reviewers for certain topics and the decline in colleagues willing to review manuscripts. The article also addresses research ethics and integrity, emphasizing the importance of open science and transparency, and highlights the challenges faced by professional psychology in the current socio-political climate. [Extracted from the article]

Objective: Retention is challenging in clinical research with pediatric populations. The retention obstacles that are experienced in adult samples are compounded because child samples depend on caregiver support and engagement. The present paper describes retention improvements following protocol adaptations across a pair of cognitive behavioral pilot studies for nightmare sufferers aged 6–17. Methods: Study 1 (N = 20) focused retention efforts on rapport and engagement, flexible scheduling, treatment location choice, and incentives. Study 2 (N = 31) sought to increase retention by improving continuity of care, increasing scheduling flexibility, reducing participant time and effort, and increasing choice and attractiveness of incentives. Results: Only 13 participants (65%) were retained in Study 1; n = 6 (54.5%) treatment and n = 7 (77.78%) waitlist. In contrast, 29 participants (93.5%) were retained in Study 2; n = 15 (93.8%) treatment and n = 14 (93.3%) waitlist. Conclusion: We conclude that asking for and responding to patient feedback to assess all perceived barriers and burdens for participants is essential to ensure that benefits exceed effort. Allowing choices in size and frequency of incentives, as well as improving continuity of care, and reducing session length even while increasing number of sessions, were noted improvements in Study 2. [ABSTRACT FROM AUTHOR]

Objectives: The present review investigates the impact of digital interventions for individuals with features of borderline personality disorder (BPD)/emotional unstable personality disorder (EUPD) as digital interventions show promise as therapeutic tools in underserved groups. BPD/EUPD features are identified as clinically relevant, yet previous reviews on the use of digital interventions fail to include subthreshold symptomatology. Methods: Five online databases were searched for terminology in three categories: BPD/EUPD and related symptoms, mental‐health interventions, and digital technology. Additionally, four relevant journals and two trial registers were searched for additional papers meeting the inclusion criteria. Results: Twelve articles met all inclusion criteria. Meta‐analyses revealed statistically significant differences in symptom measures between intervention and control groups at postintervention and decreases in BPD/EUPD symptomatology and well‐being from pre‐ to postintervention. Service users' engagement, satisfaction, and acceptability of interventions were high. Results support the previous literature on the value of using digital interventions in populations with BPD/EUPD. Conclusion: Overall, it was identified that digital interventions show promise for successful implementation with this population. [ABSTRACT FROM AUTHOR]

Experiential practices are a core component of compassion focused therapy (CFT). Throughout the treatment process, the client's engagement with these practices may become blocked, resulting in a rupture in the therapeutic relationship. In these instances, the interplay between these experiential practices and the therapeutic relationship becomes an essential focus of therapy to repair the rupture, re‐engage the client in the therapeutic process, and proceed with the CFT treatment plan. This paper presents the case of a man diagnosed with social anxiety disorder, with the presence of shame‐based self‐criticism, treated via 12 sessions of CFT. CFT was proceeding well until certain embodiment practices and chair work were introduced, at which point the client refused to continue and became disengaged in the session. The process of repair and re‐engagement will be discussed from the perspective of this interplay between experiential exercises and therapeutic relationships. Implications for CFT practice and clinical recommendations will be provided. [ABSTRACT FROM AUTHOR]

Objective: Group‐analytic psychotherapy is probably the most commonly used psychodynamic group therapy in Europe. This paper describes focused group analytic psychotherapy (FGAP), a new time–limited version of this therapy, based on clinical experience and research. The therapy/suitability of patients: It is relatively structured and individually oriented, and designed for patients with a certain ability to tolerate internal and external stress, without decompensating or developing serious behavioral disturbances (they should have a limited degree of personality pathology). Patients entering FGAP should establish a circumscribed therapy focus ahead of therapy, based on some dysfunctional patterns of interpersonal problems, conflicts, and/or symptoms related to a psychodynamic hypothesis/case formulation. Selection/preparation: The paper describes patient selection and preparation, the evolvement of the group process, and how therapist and other group members interact/intervene. Clinical material/vignettes: Central elements in the evaluation and aspects of the therapy are described and illustrated with an extensive case description and clinical material and vignettes from the group process. [ABSTRACT FROM AUTHOR]

Objective: Shame is a transdiagnostic emotion of strong clinical and research interest. Yet, there is a lack of consensus on the definition and varying methods employed across self‐report measures, potentially affecting our ability to accurately study shame and examine whether clinical interventions to alter shame are effective. This paper offers a systematic review of self‐report measures of generalized shame. Methods: PubMed, PsycInfo, and Web of Science were searched. Studies were included when they were available in English and the primary aim was to evaluate measurement properties of scales or subscales designed to measure generalized shame in adults. Results: Thirty‐six papers examining 19 scales were identified, with measures of trait shame more common than state shame. Construct validity, internal consistency, and structural validity were relative strengths. Development and content validity studies were lacking and suffered from low methodological quality. Conclusions: All measures evaluated needed additional research to meet criteria for recommended use. [ABSTRACT FROM AUTHOR]

The paper aims to show the multilevel and complex cooperation and the inclusion of the psychotherapist leading the psychotherapy in the medical team at the radiotherapy and clinical oncology clinic. We illustrate these interventions with the case of Stan. This 43‐year‐old firefighter was diagnosed with advanced head and neck cancer and pre‐existing mental health problems meeting the criteria of ICD‐10: obsessive‐compulsive disorder, post‐traumatic stress disorder and psychoactive substance abuse. During the treatment, suicidal thoughts and impulses emerged, triggered at the hospital by electronic noises and the feeling of entrapment without a way out. This situation put the patient at high risk and the whole healthcare team needed an urgent effective response. The patient agreed to stay in the secured room, where he was cared for by doctors, nurses, a dietitian, and a psychotherapist. He actively attended daily sessions with noticeable engagement. Psychotherapy sessions focused on alleviating posttraumatic stress disorder and OCD. Mindfulness and breathwork‐based exercises were implemented to increase non‐judgemental self‐awareness and regulate the over‐aroused nervous system. As a result, the patient's mental health has improved and the completion of the cancer treatment was possible. Psychotherapy, good therapeutic alliance, and attentive teamwork effectively managed his mental health and treatment‐related symptoms. [ABSTRACT FROM AUTHOR]

Objectives: Team formulation involves a multidisciplinary team coming together to understand the factors leading to the development and maintenance of a patient's problems and the implications of this for future care planning. Method: This paper presents a case example describing this approach in an acute inpatient setting. Results: "William" was a 59‐year‐old male with longstanding mental health difficulties. During his admission, he presented as verbally abusive, intrusive, and sexually inappropriate. He was also controlling and intimidating toward other patients. Staff were becoming frustrated and hopeless about managing William on the ward leading them to adopt inconsistent approaches in relating to him. A team formulation was developed to understand William's trauma history and how this impacted on his beliefs about himself and other people as well as his way of relating to others. Conclusions: The team formulation helped staff to develop consistent care plans in relation to William's presentation on the ward and more empathy in relation to behaviors that they found challenging. [ABSTRACT FROM AUTHOR]

Objective: To inform measure selection when examining gender differences in suicide risk, this paper evaluates measure performance for a set of gender‐relevant constructs and examines gender differences in mean scores. Methods: A national sample of veterans (n = 968) who had recently attempted suicide (past 6 months) completed measures assessing life experience‐, psychosocial‐, and health‐related constructs. A multigroup latent variable model was used to assess similarity of measurement properties between women and men. Results: Metric and scalar invariance indicated that the latent variables functioned similarly between women and men. Women had higher scores on negative coping, institutional betrayal, and social rejection; men had higher scores on self‐compassion, autonomy, and suicide ideation. Conclusions: Measurement properties and gender differences in mean values support the use of these measures for research on gender differences. Findings also suggest further investigation of social rejection, institutional betrayal, and negative coping among women veterans at risk for suicide. [ABSTRACT FROM AUTHOR]

Aim: This narrative review aimed to analyse the methodologies used by quantitative studies to evaluate their evidence for the association between gender diversity and autism spectrum conditions (ASC) in child and adolescent population samples. Method: A systematic search was conducted for papers published between 2010 and 2020. Results: Fifteen papers met the inclusion criteria; all reported associations between their defined versions of gender diversity and ASC. Gender diversity was characterised as "dysphoria", "variance", and/or "diverse", and was correlated across ASC categories of "symptoms", "traits", or "empathising and systemising styles of thinking". Multiple diagnostic criteria and/or nonspecific, adult administrated measures were used to quantify youth gender experiences and ASCs. Conclusion: Interpretations of the findings are discussed in relation to critical appraisal of methodologies used including data collection and deduction, the characteristics of the sample population, the usage of comparison groups, and the overall quality of statistical reporting amongst others. [ABSTRACT FROM AUTHOR]

Authors included in this issue of the Journal of Clinical Psychology: In‐Session come from diverse theoretical orientations but discuss methods of case conceptualization that share these assumptions: (1) that interpersonal patterns are salient to a good understanding of patient personality and problems and (2) that an individual formulation is helpful in responsively tailoring in‐session processes to meet therapeutic goals. We believe these assumptions resonate with many practitioners working across settings, levels of severity, and theoretical orientations. Each author offers an overview of theory as well as a detailed case description that emphasizes the implications of each formulation for the subsequent process of therapy. A final paper provides commentary across the source papers. The issue is thus evocative not only about clinical practice issues but also of underlying theory. It speaks to the challenges and possibilities of transtheoretical integrated practice and research within our focal domain of common interest, interpersonal relationships. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to examine the links between primary psychopathic traits and driving behavior on the one hand, and driving anger expression on the other hand, through the specific contribution of empathy, impulsiveness, and sensation seeking, in a sample of French driving offenders. Methods: One thousand six hundred and eighty‐six driving offenders completed a paper‐and‐pencil questionnaire during 110 drivers' rehabilitation programs. Results: Primary psychopathic traits were positively associated with violations and aggressive driving anger expression, and negatively associated with prosocial driving behaviors. These associations were partially mediated by empathy, impulsiveness, and sensation seeking. In addition, the negative relation between primary psychopathic traits and adaptive anger expression was fully mediated by these three personal dispositions. Conclusion: Low empathy, high impulsiveness and sensation seeking are important characteristics of driving offenders with high psychopathic traits. Our results provide a better understanding of French driving offenders' risky behaviors and the role of primary psychopathic traits. [ABSTRACT FROM AUTHOR]

The aim of this paper is to report our notes from the field on using movement toward goals at an aggregate level as an inference of service effectiveness. Analysis of routinely collected data from UK youth mental health services was conducted (N = 8,172, age M = 13.8, 67% female, 32% male) to explore the impact of including goal‐based outcome data in combined calculations of standardized measures based on the principles of reliable change ("measurable change"). Due to the broad nature of standardized measures, inferred validity becomes diluted in any team or service level aggregate analysis. To make inferences that are closer to the person's interpretation of their difficulties, we argue that Idiographic Patient Reported Outcome Measures (I‐PROMs) counterbalance these limitations. This is supported by our findings. The measurable change metric is the first step towards enabling national analysis of aggregated I‐PROMs. I‐PROMs, supplemented by standardized measures should be used to consider service evaluation. [ABSTRACT FROM AUTHOR]

The use of exploratory network analysis has increased in psychopathology research over the past decade. A benefit of exploratory network analysis is the wealth of information it can provide; however, a single analysis may generate more inferences than what can be discussed in one manuscript (e.g., centrality indices of each node). This necessitates that authors choose which results to discuss in further detail and which to omit. Without a guide for this process, the likelihood of a biased interpretation is high. We propose that the integration of theory throughout the research process makes the interpretation of exploratory networks more manageable for the researcher and more likely to result in an interpretation that advances science. The goals of this paper are to differentiate between exploratory and confirmatory network analyses, discuss the utility of exploratory work, and provide a practical framework that uses theory as a guide to interpret exploratory network analyses. [ABSTRACT FROM AUTHOR]

Objectives: This paper presents a randomized controlled trial on assimilative integration, which is aimed at integrating elements from other orientations within one approach to enrich its conceptual and practical repertoire. Elements from Emotion‐Focused Therapy (EFT) were integrated into a form of cognitive behavior therapy: Psychological Therapy (PT). In one treatment condition, EFT was added to PT (+EFT) with the intent to enhance therapists' working with emotions. In the other condition, concepts and interventions based on the socialpsychological self‐regulation approach were added to PT (+SR). Our assumption was that the +EFT would lead to greater and deeper change, particularly in the follow‐up assessments. Method: Patients (n = 104) with anxiety, depression, or adjustment disorders were randomized to the two conditions and treated by 38 therapists who self‐selected between the conditions. Primary outcome was symptom severity at 12‐month follow‐up; secondary outcomes included several measures such as interpersonal problems and quality of life. Variables were assessed at baseline, after 8 and 16 sessions, at posttreatment, and at 6‐ and 12‐month follow‐up. Results: Contrary to our hypothesis, no significant between‐group effects were found. Conclusion: The findings first suggest the difficulty of topping an already very effective approach to psychotherapy. Alternative interpretations were that the EFT training, while corresponding to regular practice in AI, was not sufficient to make a difference in outcome, or that while profiting from the enhancement of abilities for working with emotions, this was outbalanced by negative effects of difficulties related to the implementation of the new elements. [ABSTRACT FROM AUTHOR]

Objective: Combat‐exposed veterans risk encountering events that disrupt beliefs. To facilitate reduced discrepancy between prior beliefs and current trauma appraisals, veterans may engage in a process of meaning‐making. Meaning‐making can lead to positive outcomes, such as integrating the traumatic event into one's life narrative or adapting global meaning (meaning made) or elicit distress. Given these potentially different outcomes, this study examined potential correlates of posttraumatic stress symptom (PTSS) severity and meaning made, including relationship attachment dimensions of anxiety and avoidance, and difficulties with emotion regulation, while controlling for combat exposure. Method: Veterans receiving mental health services at a Veterans Affairs (VA) Medical Center and a VA community‐based outpatient clinic (N = 130) completed measures through a paper‐and‐pencil survey. Almost all participants (92%) were male, with a mean age of 55.92 years. Results: In terms of meaning made, lower levels of attachment anxiety and emotional clarity (an aspect of emotion regulation) predicted higher meaning made. In terms of PTSS severity, higher attachment avoidance, attachment anxiety, and difficulties engaging in goal‐directed behavior (an aspect of emotion regulation) significantly predicted higher PTSS severity. Conclusion: Aspects of both attachment style and emotion regulation difficulties affect meaning made and PTSS severity. These constructs may be especially relevant for clinicians working with veterans to help PTSS and support meaning made postcombat. [ABSTRACT FROM AUTHOR]

Objective: Distress tolerance (DT) has been found to be implicated in the development and maintenance of depressive symptomatology and various other significant psychological conditions. As such, it is critical to have measures of DT that are effective and easy to administer. This study aimed to examine the factor structure, psychometric properties, and clinical utility of the Distress Tolerance Scale (DTS) and the short‐form version, the Distress Tolerance Scale Short‐form (DTS‐SF), in a large population of individuals with varying levels of self‐reported depressive symptoms. Method: A total of 959 participants completed an online battery of questionnaires which included an assessment of depressive symptoms as well as the DTS and related measures. Results: Confirmatory factor analyses validated the four‐factor structure of the DTS and the one‐factor structure of the DTS‐SF. Good construct validity and good internal consistency were observed across both the DTS and DTS‐SF. Conclusion: Overall, this paper provides new evidence for the validity, reliability and discriminative ability of the DTS and the brief version of the questionnaire, the DTS‐SF. [ABSTRACT FROM AUTHOR]

Growing awareness that many who are diagnosed with schizophrenia recover has spurred the development of new psychosocial approaches to treatment. These new approaches include forms of individual and group psychotherapy whose focus extends beyond reducing symptoms and improving skills to subjective outcomes related to sense of self. This paper introduces an issue of In Session which presents six case reports which illustrating these approaches in differing international contexts. First, we explore the larger issues of subjective outcomes from schizophrenia. We then discuss each of the papers separately along with implications of these papers as a group for how treatment might promote the recapturing of a sense of self or place in the world. [ABSTRACT FROM AUTHOR]

Background: Loneliness and social avoidance are widespread and serious mental health problems. People experiencing loneliness or social avoidance have difficulties maintaining ordinary life activities and often experience profound suffering. How do we as clinicians deal with or help people out of loneliness and social avoidance? Aims: In this paper, we introduce the issue on loneliness and social avoidance. We do so by first defining loneliness and social avoidance and outlining the impact on mental health issues of these phenomena. Next, we introduce the six papers central to the special issue along with some thoughts on how to understand therapy and treatment of social avoidance. Discussion: We discuss new directions and how to move beyond more conventional therapeutic approaches to these problems. [ABSTRACT FROM AUTHOR]

The relationship between personality and eating disorders has received significant research attention. This review aimed to synthesize research regarding the Five Factor Model (FFM) and disordered eating behaviors, to gain an improved understanding of the relationship between normal‐range personality and subclinical eating disorders. Electronic Databases were used to identify studies published in English that utilized self‐report measures of disordered eating and the FFM. A qualitative synthesis of 45 papers was then conducted. High scores on Neuroticism were associated with increased disordered eating behavior. Different disordered eating behaviors were found to have unique relationships with personality dimensions. Facets within domains varied in direction of correlation with disordered eating behaviors, particularly in the Agreeableness, Contentiousness, and Openness domains. The results indicate that, further research is needed before generalizing treatment approaches for eating disorders for females, males, and gender diverse populations. [ABSTRACT FROM AUTHOR]

Introduction: Early intervention studies for adolescents and early adults are required to explore the acceptability and effectiveness of psychological therapies across the full range of personality disorders (PDs) beyond just borderline PD. The main aim of the current paper was to describe a Metacognitive Interpersonal Therapy group adaptation for adolescents (MIT‐GA) presenting with PDs featuring overcontrol and social inhibition, and in particular Avoidant PD characteristics. Methods: We report findings from a single case of a female adolescent diagnosed with Avoidant PD providing preliminary data on feasibility and the possible effectiveness of MIT‐GA. Results: Evidence of acceptability and meaningful clinical gains are described. Conclusions: Results suggest that MIT‐GA could be a powerful treatment option in patients with generalized social avoidance who do not currently receive gold‐standard psychotherapeutic treatments. This intervention also appears to be effective and cost‐effective in initiating significant clinical changes in profiles of young patients with non‐borderline PD symptoms. [ABSTRACT FROM AUTHOR]

This article presents an adaptation of group schema therapy (GST) developed for patients with severe anxiety. An anonymized case presentation exemplifies the adaptation. GST was originally developed to treat clients with maladaptive personality traits but has been applied to a variety of disorders in recent years. For patients with severe anxiety, who have not responded to other treatments, GST may be a promising approach. The paper presents the GST model, the evidence supporting it, and its adaptation for the treatment of anxiety. The case presentation illustrates the therapeutic process and GST interventions. Finally, the clinical outcome and the implications for implementing GST are discussed. [ABSTRACT FROM AUTHOR]

In the case of psychological treatments, these outcome monitoring tools consist of psychological self-report scales (patient-reported outcome measures, PROMs), which are filled out by the patient usually before each session to capture ongoing therapeutic change. Routine outcome monitoring (ROM) is the regular assessment of patient outcomes to evaluate clinical progress during the course of therapy. Idiographic patient reported outcome measures (I-PROMs) for routine outcome monitoring in psychological therapies: Position paper. [Extracted from the article]

This paper is an analysis of the film Frida, based on accounts of the life of the Mexican artist, Frida Kahlo. Frida may be seen as a tragic hero in the mold of Antigone and Elektra. The paper explores the process by which a self may be created, with special emphasis on the uses of portraiture; it delves into the integration of contraries in the life of the protagonist and offers a psychoanalytic view of the way the self evolves under a variety of conditions. Frida's body has been injured and broken by physical trauma; her mind and spirit have also been influenced by this and other painful events. She fantasizes that she will be cured and made whole by her mentor, lover, husband, and betrayer, Diego Rivera. But Diego's adversary is Death, a personified force to whom Frida has given at least an equal measure of her love. It is inevitable that Death will win in this struggle: Frida, the phoenix, is consumed by fire that is her destruction but also a symbol of her unconquerable passion. [ABSTRACT FROM AUTHOR]

The plan formulation method (PFM) is an empirically validated procedure for identifying a patient's goals for therapy, what is hindering the patient from attaining those goals, and how the patient is likely to work in therapy. In this paper, we employ the PFM to analyze the initial psychotherapy sessions of Geena, a 30‐year‐old outpatient with borderline personality disorder and relational and substance abuse problems. Employing the PFM, we identify a family of pathogenic beliefs (e.g., that she is unlovable and unworthy; that her parents will be hurt if she has satisfying intimate relationships) that Geena sought to disprove in her therapy and explain how she worked with the therapist to do so. We illustrate how the PFM can help the therapist identify what information and what types of interventions will be helpful for a given patient. [ABSTRACT FROM AUTHOR]

Advances in artificial intelligence and machine learning have fueled growing interest in the application of predictive analytics to identify high‐risk suicidal patients. Such application will require the aggregation of large‐scale, sensitive patient data to help inform complex and potentially stigmatizing health care decisions. This paper provides a description of how suicide prediction is uniquely difficult by comparing it to nonmedical (weather and traffic forecasting) and medical predictions (cancer and human immunodeficiency virus risk), followed by clinical and ethical challenges presented within a risk‐benefit conceptual framework. Because the misidentification of suicide risk may be associated with unintended negative consequences, clinicians and policymakers need to carefully weigh the risks and benefits of using suicide predictive analytics across health care populations. Practical recommendations are provided to strengthen the protection of patient rights and enhance the clinical utility of suicide predictive analytics tools. [ABSTRACT FROM AUTHOR]

Intimate partner violence (IPV) is recognized as a worldwide health issue that calls for urgent interventions to prevent the significant physical and mental harm it poses to the individuals involved and to reduce its wider deleterious impacts on society. Despite 40 years of research in the field, incidence rates of IPV have not significantly declined and treatment services for perpetrators of IPV are scarce. Empirical research has been hindered by ideological disputes, and the most commonly used treatment approaches—the feminist‐oriented Duluth approach and cognitive‐behavioral treatments—lack evidence for their efficacy. This introduction to this issue of In Session reviews these ideological controversies and the current state of empirical evidence for the treatment of perpetrators of IPV; and summarizes the five papers, commissioned from different countries in Europe, North America, and Africa, comprising this issue, each of which presents a novel therapeutic intervention for this heterogeneous population [ABSTRACT FROM AUTHOR]

Intimate partner violence (IPV) is responsible for loss of lives and significant psychological, financial, and social costs. Research into therapeutic effectiveness show inconsistent results irrespective of therapeutic orientation. The capacity to understand one's own mental states as subjective and distinct from others is an important factor in the regulation of mental states and physiological arousal associated with the perpetration of IPV. Metacognitive Interpersonal Therapy (MIT) offers an innovative approach in working with male perpetrators of IPV. The current paper outlines 14 sessions of MIT with a 45‐year‐old male perpetrator. A core aspect was helping the client resolve how his view of self and others were subjective experiences that were distinct from relational objectivity. The emergence of healthy self‐narratives was fostered through experiential processes, involving guided imagery, rescripting and body focused interventions. Qualitative outcomes are summarized and implications for the use of MIT in treatment of perpetrators of IPV is discussed. [ABSTRACT FROM AUTHOR]

This commentary on five articles comprising this Journal of Clinical Psychology: In Session issue on therapeutic interventions for perpetrators of intimate partner violence (IPV) brings together relevant issues reflected in these papers concerning the need for tailored treatments for a heterogenous population of individuals with differing characteristics, psychopathology, risk factors and needs. Among the key issues addressed in this commentary are typologies of IPV, the influence of personality disorder and attachment in the predisposition to perpetrating IPV and identifying therapeutic factors common to these interventions. The discussion is contextualised within a field beset by controversy and political ideology which limits the impact of empirical research. [ABSTRACT FROM AUTHOR]

Objective: Although trauma‐focused cognitive‐behavioral therapies (CBTs) for posttraumatic stress disorder (PTSD) have been applied worldwide, the nature of how these Western‐based interventions are applied in diverse settings has varied. This paper systematically reviewed the literature on how trauma‐focused CBTs have been applied and adapted cross‐culturally. Method: A systematic review of studies that discuss the process of cultural adaptation of trauma‐focused CBTs. Results: Seventeen papers were included and varied in the comprehensiveness of the adaptation process. Two studies stated that a theoretical framework was followed. Almost one‐third of the studies did not report whether local stakeholders were involved in the process of application. Fifteen studies examined the efficacy of the adaptations and the results were positive, but the methodology and quality varied. Conclusion: There are inconsistencies in how trauma‐focused CBTs are culturally adapted. A systematic approach to the transportation of such therapies would enable greater investigation into the necessity and efficacy of such adaptations. [ABSTRACT FROM AUTHOR]

This issue of Journal of Clinical Psychology: In Session focuses on the nature and consequences of psychotherapy clients' disclosures, secrets, and dishonesty, with a particular emphasis on the ways in which therapists can best facilitate greater and more honest disclosure. This introduction to this issue reviews the growing theoretical and empirical literature on the frequency, types, motives, and consequences of client and therapist dishonesty (broadly defined); it also reviews the contributions within this issue, noting the welcome focus of the majority of these papers on the nature of client dishonesty in specific disorders (e.g., eating disorders; substance abuse) and/or specific clinical settings (e.g., prisons). Taken together, these papers speak to the ways that therapists may tailor their clinical interventions to match the specific ways that dishonesty manifests in different clinical populations. [ABSTRACT FROM AUTHOR]

This document is an expression of concern regarding an article titled "Interaction of psychosocial and physical risk factors in the causation of mammary cancer, and its prevention through psychological methods of treatment" published in the Journal of Clinical Psychology in 2000. The journal became aware of concerns raised by King's College about 26 papers co-authored by Hans Eysenck and R. Grossarth-Maticek, including this article. King's College found issues with the data and the plausibility of the results. The journal attempted to contact King's College for more information but received no response. Therefore, the journal has decided to issue this expression of concern to inform readers. [Extracted from the article]

This paper describes a 6‐month period of compassion‐focused therapy (CFT) for a client who has a 35‐year history of hearing voices that are threatening, derogatory, and abusive. In this intervention, the client is encouraged to develop compassionate motives toward herself and to her voices, recognizing that her voices may have been functional in the context of difficult early experiences. The client develops a compassionate self‐identity, which becomes the vehicle through which she approaches therapeutic tasks, such as listening and talking to voices, engaging with traumatic childhood pain, and resolving emotional conflicts. The client is an author on this study, so is able to provide valuable first‐hand insights into the experience of working compassionately with her voices, and of experiencing CFT techniques for the first time. [ABSTRACT FROM AUTHOR]

Objective: This paper reviewed the empirical research on inquiry‐based stress reduction (IBSR; also called "The Work"), which has similarities to third‐wave cognitive behavioral approaches such as Acceptance and Commitment Therapy (ACT). Widely used as a self‐help intervention, IBSR has only recently been subjected to empirical research. Method: We reviewed empirical studies (published and unpublished) that examined IBSR. Results: We found 17 empirical studies (15 independent samples) that examined IBSR. Several studies reported positive changes on variables such as stress, anxiety, and well‐being. However, only three studies evaluated IBSR using randomized clinical trials (RCTs). Concerns related to treatment feasibility and cost‐effectiveness of IBSR are noted. Conclusions: There are some promising initial findings on IBSR. However, additional research employing high‐quality research designs is necessary to explore the efficacy and effectiveness of IBSR in various contexts. [ABSTRACT FROM AUTHOR]

Context: Dolphin‐assisted therapy (DAT) is a popular form of animal‐assisted therapy for autism spectrum disorders and other psychological conditions. Objective: In this review, our third, we analyze the most recent DAT studies in terms of construct and internal validity criteria to determine if there is empirical support for DAT. Method: To ensure a systematic review, we searched for peer‐reviewed studies on DAT by submitting relevant search terms to Google Scholar from 2007 to 2020, conducted a further search of all DAT papers in several peer‐reviewed journals, and reviewed reference sections of DAT articles to ensure a thorough review of the literature between 2007 and the present. Results: The DAT literature continues to be marked by several weaknesses in both internal and construct validity that preclude confident inferences regarding the intervention's efficacy. Conclusion: There is still insufficient evidence that DAT has therapeutic value. [ABSTRACT FROM AUTHOR]

Background: In this paper, we outline our approach to dealing with complex social isolation by presenting a network treatment approach named Adaptive Mentalization‐Based Integrative Treatment (AMBIT). Method: We describe the AMBIT approach, what elements it consists of, and we explain how we employed this method in the case of a 17‐year‐old boy referred to our child and adolescent psychiatric clinic, who isolated himself from the world. Results: We emphasize in which ways the specific network approach pertinent to the AMBIT approach was helpful in this complex case. Furthermore, we describe and reveal our insecurities and doubts related to our interventions and the general treatment process and point to why the AMBIT network approach and the interventions were crucial in this case. Discussion: We argue that the boy could not have been helped out of his social isolation within the conventional child and adolescent psychiatric system without engaging and establishing an integrated professional network from many sectors. [ABSTRACT FROM AUTHOR]

This paper provides data on the experiences of 267 patients, all with self‐reported symptoms of depression or anxiety, engaged in an interactive text‐based delivery system for psychotherapy. The paper also offers a case study that illustrates the use of this treatment, indicating ways in which such systems can be useful for patients who may not access or benefit from more traditional therapeutic models. [ABSTRACT FROM AUTHOR]