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This paper argues that the process of modeling in science and the process of encountering and working with a client in clinical psychotherapy overlap. In briefer terms: what makes a good therapist is much like what makes a good scientific modeler. Both modeling and psychotherapy are iterative processes, requiring careful observation, generation and testing of hypotheses. Both processes also face similar epistemic and pragmatic trade-offs. Heuristics and biases can shape both practices, for better and worse. Implications are considered for both training in clinical psychotherapy, and for larger debates concerning evidence-based methods in assessment of mental health care, and categorical v. dimensional approaches to diagnosis. [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]

Case formulation is at the heart of personalised care in psychotherapy. Scientific research into case formulations can provide new insights in the heterogeneity of psychopathology which are relevant for advances in personalised psychopathology research and practice. This mixed-methods study examined the content of 483 fully personalised network-based case formulations in psychotherapy in terms of uniqueness (i.e., frequencies of concepts) and commonality (i.e., the presence of common themes over the different case formulations). In a real-world clinical care setting, patients co-created network-based case formulations with their therapist as part of their routine diagnostic process. These case formulations feature concepts that are relevant to individual patients and their current situation. We assessed how often concepts were used by different patients to quantify uniqueness. We applied a bottom-up thematic analysis to identify patient-relevant themes from the concepts. The case formulations of 483 patients diagnosed with mood and/or anxiety disorders contained a total of 4908 interpretable concepts of which 4272 (87%) were completely unique. Through thematic analysis, we identified seven overarching themes in the concepts: autonomy, connectedness, emotions, self-care, identity, self-efficacy, and bodily sensations. Case formulations were highly unique, thereby illustrating the importance of personalised diagnostics. The unique concepts could be grouped under seven overarching themes which seem to encompass basic human needs. Current advancements in personalised diagnostics and assessment should have a broader scope than symptoms alone, and could use the themes identified here as part of a topic list in the generation of (network-based) case formulations. [ABSTRACT FROM AUTHOR]