J Consult Clin Psychol [JOURNAL]
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200 papers
Long-term effects of the Pregnant Moms' Empowerment Program (PMEP) on intimate partner violence revictimization, maternal mental health, and child internalizing and externalizing problems.
Howell KH, Gilliam HC, Carney JR … +2 more , Maloney CA, Miller-Graff LE
J Consult Clin Psychol · 2025 Sep · PMID 40875361 · Publisher ↗
OBJECTIVES: The present study examined effects of the Pregnant Moms' Empowerment Program (PMEP) 4 years following program completion. It was hypothesized that women who participated in PMEP during pregnancy would experie...
OBJECTIVES: The present study examined effects of the Pregnant Moms' Empowerment Program (PMEP) 4 years following program completion. It was hypothesized that women who participated in PMEP during pregnancy would experience less intimate partner violence revictimization and fewer depressive and posttraumatic stress symptoms as compared to women in the no-treatment control condition. Further, it was expected that the children women were pregnant with when they participated in PMEP, who are now preschool-aged, would exhibit fewer internalizing and externalizing problems as compared to children of women in the control condition. METHOD: Participants were 78 women (56.9% of the original sample) assigned to the PMEP intervention (n = 46) or control condition (n = 32) during pregnancy. Outcomes assessed were intimate partner violence (Revised Conflict Tactics Scales), depressive symptoms (Center for Epidemiologic Studies Depression Scale), posttraumatic stress symptoms (Posttraumatic Stress Disorder Checklist-5), and children's internalizing and externalizing problems (Child Behavior Checklist). RESULTS: Regression models controlling for baseline levels of each dependent variable indicated that 4 years posttreatment, women assigned to the PMEP condition, as compared to women in the control condition, reported significantly lower levels of depressive symptoms. Poisson regression analyses indicated that women who received PMEP reported significantly fewer intimate partner violence experiences than women in the control condition. Children of women who participated in PMEP exhibited significantly fewer externalizing problems than children of women in the control condition. CONCLUSIONS: Findings show that participating in PMEP resulted in benefits not only for women who received the treatment but also for their children 4 years following the intervention. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
Transdiagnostic interventions in prediagnostic youth with elevated distress: A meta-analysis of outcomes.
Radunz M, Johnson C, Dalgleish T … +2 more , Shafran R, Wade TD
J Consult Clin Psychol · 2025 Sep · PMID 40875360 · Publisher ↗
OBJECTIVE: The current systematic review and meta-analysis identified nonpharmacological outpatient interventions with transdiagnostic effects in youth with elevated psychological distress who do not meet the diagnostic...
OBJECTIVE: The current systematic review and meta-analysis identified nonpharmacological outpatient interventions with transdiagnostic effects in youth with elevated psychological distress who do not meet the diagnostic criteria. We examined common elements that may be associated with treatment effects. METHOD: Of the 10,208 studies identified, k = 68 were included involving 10,805 individuals with a Mage of 16.96 years (SD = 1.80; 66.67% female). We examined changes in depression, anxiety, suicidality, disordered eating, and quality of life using random-effects models in the R meta package. RESULTS: Cohen's d effect sizes (95% CIs) were 0.21 [0.11, 0.32] for depression (k = 64), 0.20 [0.11, 0.29] for anxiety (k = 57), and 0.11 [0.01, 0.21] for quality of life (k = 19). Heterogeneity was present (I2 ranging from 6.73 to 16.95%). Due to limited studies for eating (k = 5) and suicidality (k = 4), meta-analyses were not feasible for these outcomes. Moderator analyses indicated that adolescents (vs. children and emerging adults) derived significant benefits. Cognitive behavioral therapy was indicated as an effective transdiagnostic approach for depression and anxiety. The most frequent common elements across cognitive behavioral therapy approaches included cognitive literacy, emotional literacy, psychoeducation, goal setting, and problem solving. CONCLUSIONS: These results provide the first quantitative test of transdiagnostic intervention approaches that can improve mental health in vulnerable, symptomatic youth. Further attention is required to outcomes related to disordered eating and suicidality given their prevalence and serious consequences in youth. Dismantling studies of cognitive behavioral therapy are required to identify effective common elements that can drive better mental health outcomes in youth. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
Dynamic physiology-behavior association patterns in child welfare parents predict response to parenting intervention.
Zhang X, Gatzke-Kopp LM, Skowron EA
J Consult Clin Psychol · 2025 Sep · PMID 40875359 · Full text
OBJECTIVE: This study examined the role of physiology-behavior regulatory functioning in explaining "what works for whom" in parenting intervention. Dynamic associations between parents' physiological reactivity and posi...
OBJECTIVE: This study examined the role of physiology-behavior regulatory functioning in explaining "what works for whom" in parenting intervention. Dynamic associations between parents' physiological reactivity and positive parenting behavior during caregiving interactions were tested as predictors of related intervention response to parent-child interaction therapy. Pre- to postintervention changes in the dynamic associations were also examined. METHOD: Physiological reactivity assessed through interbeat interval and observationally coded parenting behaviors were measured second-by-second during two types of parent-child interaction at pre- and postintervention for 120 child welfare-involved parents (Mage = 32.45, 87.5% mothers) randomized to a parent-child interaction therapy intervention. Response to intervention was examined as (a) treatment engagement (i.e., no early dropout), (b) in-session parenting skills proficiency (meeting the threshold for positive skills without exceeding the threshold for negative parenting behaviors), and (c) postintervention positive parenting skills. RESULTS: Parents who demonstrated dynamic physiology-behavior coupling patterns that restrain positive parenting behaviors during child-led free play were less likely to achieve early parenting skills proficiency and more likely to drop out subsequently from the second phase of parent-child interaction therapy. They also showed fewer positive parenting skills postintervention. No pre- to postchanges were observed in parents' dynamic physiology-behavior associations. CONCLUSIONS: Dynamic physiology-behavior associations manifested in child-led free play predicted disadvantages in parents' early acquisition of skills and persistent engagement in parenting intervention, highlighting the value of physiology in illuminating individual differences in response to intervention. This approach also highlights potential mechanisms underlying treatment nonresponse among child welfare-involved parents, which can aid in the development of tailored intervention strategies. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
A randomized controlled trial testing couple HOPES: An online, self-help couples' intervention for posttraumatic stress disorder.
Fitzpatrick S, Crenshaw AO, Valela R … +17 more , Samonas C, Earle EA, Goss S, Hernandez KM, Bushe J, Varma S, Proctor D, Wagner AC, Goenka K, Luxor O, Collins A, Morland L, Shields N, Roth M, Doss BD, Schumm J, Monson CM
J Consult Clin Psychol · 2025 Aug · PMID 40811121 · Publisher ↗
OBJECTIVE: This article presents a randomized waitlist-controlled trial testing Couple HOPES, a coach-guided, online intervention for couples wherein one member had posttraumatic stress disorder (PTSD) symptoms. Aims inv...
OBJECTIVE: This article presents a randomized waitlist-controlled trial testing Couple HOPES, a coach-guided, online intervention for couples wherein one member had posttraumatic stress disorder (PTSD) symptoms. Aims involved examining whether Couple HOPES resulted in greater improvements in PTSD symptoms, relationship satisfaction, and secondary outcomes compared to a waitlist, whether outcomes were maintained over a 3-month follow-up, and whether outcomes differed if PTSD was COVID-19-related. METHOD: Sixty-seven couples were recruited, where one partner met criteria for likely PTSD and was either a military member, veteran, first responder, health care worker, and/or whose PTSD symptoms were related to COVID. Couples were randomized to receive Couple HOPES immediately or after 8 weeks. Outcomes were measured at the beginning, middle, and end of Couple HOPES/the waiting period, and 1- and 3-months after Couple HOPES. Measures of PTSD and relationship satisfaction were also completed during each of seven modules. RESULTS: Intent-to-treat analyses showed greater improvements in self- and informant-reported PTSD in those receiving Couple HOPES relative to waiting, with large- and medium-effect sizes, respectively. Partners without PTSD symptoms reported greater improvements in relationship satisfaction in Couple HOPES compared to the waitlist with a small effect size, but people with PTSD symptoms did not. Uncontrolled follow-up showed reversion of gains in some outcomes. Whether PTSD was COVID-19-related did not significantly moderate outcomes. CONCLUSIONS: Findings support the efficacy of this low-cost, scalable intervention for improving PTSD, regardless of the means through which it was acquired (COVID-19-related or not). Further testing with larger sample sizes is needed. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
The efficacy of personalization within psychological treatments compared to no or less personalization: A meta-analysis and systematic review.
Harnas SJ, Francken KF, Müller F … +4 more , Nieuwkerk PT, Sprangers MAG, Knoop H, Braamse AMJ
J Consult Clin Psychol · 2025 Aug · PMID 40811120 · Publisher ↗
OBJECTIVE: This meta-analysis and systematic review assessed whether personalization within psychological treatments for mental health problems or persistent somatic symptoms improves treatment outcomes, compared to non-...
OBJECTIVE: This meta-analysis and systematic review assessed whether personalization within psychological treatments for mental health problems or persistent somatic symptoms improves treatment outcomes, compared to non- or less personalized treatments. METHOD: APA PsycInfo, Cochrane Library, MEDLINE, and EMBASE were searched up to January 14, 2024, for randomized controlled trials comparing within-treatment personalization against no or less personalization. Risk of bias was assessed with the Cochrane tool. A meta-analysis was performed using a random-effects model. Additionally, a three-level meta-analysis was conducted, and moderation analyses were performed. A narrative synthesis was included. RESULTS: Sixteen studies were included. Risk of bias was low for two studies and high for three studies, and 11 studies had some concerns. Effect sizes were calculated for the subgroups: symptoms, smoking cessation, and treatment process outcomes. For symptoms, the pooled standardized mean difference was 0.07 (95% CI [-0.06, 0.20], p = .28); for smoking cessation, the pooled odds ratio was 1.12 (95% CI [0.84, 1.51], p = .43); and for treatment process outcomes, the pooled standardized mean difference was 0.29 (95% CI [-0.27, 0.85], p = .31). Treatment format (in person/online), personalization factor (preference/individual profile), or personalized treatment aspect (content/modules) did not moderate the effect of personalization. CONCLUSIONS: Evidence of moderate quality does not convincingly suggest that within-treatment personalization outperforms no or less personalization with respect to treatment outcome. Using evidence-based personalization strategies, future studies should clarify which degree of personalization yields clinically relevant effects for which populations, interventions, and outcomes. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
Curvilinear relations between insight-, cognition-, and skills-oriented technique use and outcome across treatments, or Goldilocks and the three psychotherapies.
McCarthy KS, Solomonov N, Chambless DL … +2 more , Milrod BL, Barber JP
J Consult Clin Psychol · 2025 Aug · PMID 40811119 · Publisher ↗
OBJECTIVE: A "Goldilocks" effect is when "just right" conditions are present for a phenomenon to occur. In psychotherapy research, the Goldilocks effect is when moderate intervention levels (not very low or high) correla...
OBJECTIVE: A "Goldilocks" effect is when "just right" conditions are present for a phenomenon to occur. In psychotherapy research, the Goldilocks effect is when moderate intervention levels (not very low or high) correlate with more improvement than very high or very low levels. Finding curvilinear relations requires the wider range of what a specific intervention can take, which can be seen when examining technique and outcome across different treatments rather than within a single therapy orientation. METHOD: For 151 patients with panic disorder (66% female, 33% racial/ethnic minority) in a randomized comparative trial of panic-focused psychodynamic psychotherapy (B. L. Milrod et al., 1997), panic control therapy (Craske et al., 2000), and applied relaxation training (Schwalberg & Chambless, 2006), observers assessed insight-, cognition-, and skills-focused techniques using the multitheoretical list of therapeutic interventions (McCarthy & Barber, 2009) from Weeks 1, 5, and 9 session recordings. Outcome was assessed at Weeks 1, 5, 9, and termination by the Panic Disorder Severity Scale (Shear et al., 1997). RESULTS: When looking across treatments, very high or low (not moderate) insight-oriented interventions were associated with the most symptom improvement by the subsequent assessment point and at termination. Moderate (not very high or low) skills- and cognition-oriented interventions correlated with more improved outcome at the subsequent assessment and termination. These findings describe when interventions are used in general but not within a specific protocol treatment. CONCLUSIONS: Curvilinear relations between technique and symptom change might more closely depict how interventions relate to outcome than might more conventional linear approaches. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
The role of cardiac-related fear, hypervigilance, and avoidance behavior in exposure-based cognitive behavioral therapy for atrial fibrillation: A mediation analysis based on a randomized controlled trial.
Särnholm J, Axelsson E, Skúladóttir H … +6 more , Bonnert M, Bragesjö M, Rück C, Pedersen SS, Braunschweig F, Ljótsson B
J Consult Clin Psychol · 2025 Aug · PMID 40811118 · Publisher ↗
OBJECTIVE: Atrial fibrillation (AF) is associated with distressing symptoms and diminished quality-of-life (QoL). In a recent randomized controlled trial (RCT), online exposure-based cognitive behavioral therapy (AF-CBT)...
OBJECTIVE: Atrial fibrillation (AF) is associated with distressing symptoms and diminished quality-of-life (QoL). In a recent randomized controlled trial (RCT), online exposure-based cognitive behavioral therapy (AF-CBT) targeting symptoms preoccupation, i.e., cardiac-related fear, hypervigilance, and avoidance behavior, in patients with symptomatic paroxysmal (i.e., intermittent) AF significantly improved AF-specific QoL relative to a control group receiving standardized AF education. This study aims to investigate whether a reduction in symptom preoccupation can explain the treatment effect of AF-CBT on self-rated AF symptoms and AF disability. METHOD: We used data from a recent RCT involving 127 patients diagnosed with paroxysmal AF, randomized to undergo AF-CBT over 10 weeks (n = 65) or to receive AF education (n = 62). Two putative mediators, cardiac-related fear/hypervigilance and avoidance behavior, along with a competing mediator, perceived stress, were measured weekly. Outcome variables included self-rated AF symptoms and AF-related disability. RESULTS: Results from parallel process growth models indicated that the reduction in symptom preoccupation-but not perceived stress-mediated the controlled effect of AF-CBT on both AF symptoms and disability. In cross-lagged panel models, of the within-individual week-by-week change, a reduction in cardiac-related fear predicted subsequent improvement in AF symptoms, while a decrease in avoidance behavior predicted subsequent improvement in AF-related disability. CONCLUSIONS: Our findings suggest that symptom preoccupation plays a significant role in AF symptoms and disability and can be effectively targeted by online AF-CBT. Integrating this understanding into the clinical management of AF holds promise for improving patient outcomes. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
Credibility and expectations: Important factors for understanding clinical response, treatment completion, and dropout in internet-delivered psychological interventions.
Dear BF
J Consult Clin Psychol · 2025 Sep · PMID 40758299 · Publisher ↗
OBJECTIVE: Several large studies have identified perceptions of treatment credibility and treatment outcome expectations as potential moderators of treatment response in internet-delivered psychological treatment. Howeve...
OBJECTIVE: Several large studies have identified perceptions of treatment credibility and treatment outcome expectations as potential moderators of treatment response in internet-delivered psychological treatment. However, no studies have specifically focused on these two constructs and their potential roles in the moderation of treatment-related change, treatment completion, or study dropout. METHOD: Adult samples were derived from four large randomized controlled trials examining internet-delivered treatment for symptoms of depression ( = 445), generalized anxiety ( = 454), social anxiety ( = 486), and panic disorder ( = 292). In these studies, relevant symptom measures were administered at pretreatment and posttreatment, and credibility and expectancy were assessed in Week 2 after participants had had some experience with treatment. RESULTS: Treatment credibility and outcome expectations were relatively high overall, with a majority of participants scoring in the upper ranges. Both variables significantly moderated treatment response across all symptom domains. Specifically, each 1-point increase in either average credibility scores or average expectancy scores were associated with a 5%-8% reduction in symptoms at posttreatment. Higher treatment credibility and outcome expectations were also significantly associated with increased treatment completion and lower rates of study dropout or missingness. CONCLUSIONS: The findings suggest that perceptions of treatment credibility and outcome expectancies are important factors in understanding treatment engagement and response to internet-delivered interventions. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
Results of a positive affect intervention for male couples: Change over time and effects on mental health.
Smith MS, Greenawalt I, Moskowitz JT … +3 more , Addington EL, Mustanski B, Newcomb ME
J Consult Clin Psychol · 2025 Jul · PMID 40587318 · Full text
OBJECTIVE: Positive affect (PA) builds personal resources, buffers the impact of adverse experiences, and improves coping-which contributes to improved mental health. Positive psychological interventions (PPIs) leverage...
OBJECTIVE: Positive affect (PA) builds personal resources, buffers the impact of adverse experiences, and improves coping-which contributes to improved mental health. Positive psychological interventions (PPIs) leverage these health-promotive properties of PA, but it remains unclear whether PPI benefits for mental health (e.g., depression, anxiety) extend to a relationship context. And this is potentially critical among same-sex couples due to their excess burden of stress. METHOD: This article reports efficacy of a PPI for male couples (N = 128 dyads), adapted from an existing efficacious PPI, which was used as a control condition for a randomized controlled trial of a couple-based HIV prevention program (2017-2021). Couples completed five equally spaced assessments over 1 year, and here we examined effects on PA and the impact of changes in PA on mental health. Between baseline and the first follow-up, couples were randomized to (a) a couple-based HIV prevention/relationship enhancement intervention (active condition from the larger randomized controlled trial) or (b) a couple-based PPI called Positive Emotion Orientation for Nurturing Your Relationship. RESULTS: We observed no significant (p < .05) change in PA in either condition across 12-month follow-up. Results from longitudinal actor-partner interdependence models suggested that higher PA corresponded to lower anxiety and depression for individuals and their partners. Baseline depression also moderated response to intervention (i.e., individuals with higher depression at baseline showed less improvement in PA over 12-month follow-up-a suppression of improvement). CONCLUSIONS: Nonsignificant change in PA presents challenges to be resolved in future research regarding the ideal target population and delivery format for Positive Emotion Orientation for Nurturing Your Relationship. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
A randomized controlled trial of an online dialectical behavior therapy skills intervention for war-related distress.
Segal O, Hevron H, Sher H … +2 more , Aderka IM, Weinbach N
J Consult Clin Psychol · 2025 Jul · PMID 40587317 · Publisher ↗
OBJECTIVE: Living in war-afflicted regions involves long-term detrimental consequences for emotional well-being. Given the prevalence of ongoing conflicts worldwide, there is a pressing need to evaluate brief interventio...
OBJECTIVE: Living in war-afflicted regions involves long-term detrimental consequences for emotional well-being. Given the prevalence of ongoing conflicts worldwide, there is a pressing need to evaluate brief interventions that can be disseminated quickly and broadly to improve coping with war-related stress. This study examined the efficacy of an online dialectical behavior therapy (DBT) distress tolerance skills intervention for improving emotional well-being among women experiencing elevated distress amid war. METHOD: The study was conducted during the Israel-Hamas war and recruited 149 women whose first-degree relatives or spouses were deployed. Participants were randomly assigned to one of three conditions: (a) radical acceptance-training in a DBT skill promoting acceptance of reality, (b) relaxation-training in DBT skills fostering body relaxation, and (c) active control-monitoring distressing events without implementing DBT skills. The intervention included an online workshop to learn the skills and three home training sessions over 1 week to practice the skills for coping with personal distressing events. Measures of emotional distress were assessed at baseline, postintervention, 3-week follow-up, and during the home training sessions. RESULTS: During the home training, practicing radical acceptance and relaxation skills led to improvements in negative and positive affect. However, only radical acceptance produced significant pre-to-post intervention reductions in stress, depression, and emotion regulation difficulties, with benefits persisting at follow-up. CONCLUSIONS: A brief online radical acceptance intervention is a cost-effective and accessible tool for coping with acute war-related stress. It may offer rapid emotional support in high-stress situations like war. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
A randomized, controlled trial to evaluate the efficacy of a daily report card intervention to enhance the efficacy of individualized education programs for children with attention-deficit/hyperactivity disorder.
Fabiano GA, Schatz NK, Merrill BM … +14 more , Piscitello J, Hayes TB, Jusko M, Gnagy EM, Greiner AR, Tower D, Boeckel A, Gallo R, Lupas K, Gordon C, Ramos M, Sikov J, Caron S, Pelham WE
J Consult Clin Psychol · 2025 Jul · PMID 40587316 · Publisher ↗
OBJECTIVE: Daily report cards (DRC) are an effective approach for improving behavior in children with attention-deficit/hyperactivity disorder (ADHD). Recently, they have been used to address behavioral goals that are co...
OBJECTIVE: Daily report cards (DRC) are an effective approach for improving behavior in children with attention-deficit/hyperactivity disorder (ADHD). Recently, they have been used to address behavioral goals that are commonly documented in individualized education programs for children with ADHD receiving special education supports. METHOD: The present study evaluated a DRC, established and supported by research study consultants, based on special education (i.e., individualized education program [IEP]) goals and objectives. The sample included 213 students (grades kindergarten to seventh) with ADHD enrolled in a randomized, controlled trial that compared the DRC with school as usual. RESULTS: Results indicated that children with ADHD who had the DRC intervention significantly reduced the frequency of classroom rule violations, and teachers rated reductions in ADHD symptoms and in functional impairment. There were no significant differences between groups for the teacher ratings of academic performance or improvement in meeting special education goals. IEP quality (i.e., alignment between identified needs and goals) was a significant moderator of outcomes, with children who had lower quality IEPs being better supported by the DRC intervention. CONCLUSIONS: Overall, the DRC appears to be a viable approach for positively supporting children with ADHD who are receiving special education supports in schools, particularly for improving behavior in the classroom. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
Testing adaptations to contingency management for alcohol use disorders: A randomized controlled trial.
McDonell MG, Parent S, Jett JD … +11 more , Keshtkar M, Palmer K, Beck R, Tyutyunnyk D, Williams M, Weeks DL, Chaytor NS, McPherson S, Murphy SM, Ries RK, Roll JM
J Consult Clin Psychol · 2025 Aug · PMID 40569730 · Full text
OBJECTIVE: To determine if adults with an alcohol use disorder (AUD), who had a preintervention urine ethyl glucuronide (uEtG) level predictive of nonresponse to contingency management (CM), would respond to two interven...
OBJECTIVE: To determine if adults with an alcohol use disorder (AUD), who had a preintervention urine ethyl glucuronide (uEtG) level predictive of nonresponse to contingency management (CM), would respond to two intervention modifications (https://clinicaltrials.gov/ ID: NCT03481049). METHOD: One hundred fifty-eight adults (53.2% female) with AUD, serious mental illness, and a mean uEtG ≥ 350 ng/mL over a 4-week induction period were randomized to (a) usual CM (uEtG-negative [<150 ng/mL] samples reinforced with $1,686); (b) high magnitude CM (uEtG-negative samples reinforced with $2,983); or (c) shaping CM (reduced drinking [uEtG < 500 ng/mL] samples reinforced for 4 weeks, then uEtG-negative samples reinforced for 12 weeks with $1,686). The primary outcome was uEtG-negative samples during induction and Weeks 5-16 of CM. The relationship between outcomes and uEtG-defined heavy drinking (≥ 500 ng/mL) immediately prior to randomization was assessed. RESULTS: CM conditions did not differ in uEtG-negative samples during the intervention period, Wald, χ²(2) = 1.96, = .46. Participants were 4.2 times (95% CI [3.02, 5.92], < .01) more likely to submit a uEtG-negative sample during CM, relative to induction. Those with a heavy drinking uEtG result immediately before randomization were less likely to submit uEtG-negative samples during CM, Wald, χ²(1) = 15.33, < .01. CONCLUSIONS: CM modifications were not associated with lower levels of alcohol use. Participants engaged in less alcohol use during CM, relative to induction. Two patterns of response to CM were observed based on uEtG-defined heavy drinking immediately prior to CM. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
Interrelationships of symptomatic and relational distress: Improvements in interpersonal problems predict subsequent improvement in depressive symptoms during open-ended psychotherapy for adults with depression.
Høstmælingen A, Nissen-Lie HA, Monsen JT … +1 more , Solbakken OA
J Consult Clin Psychol · 2025 Jun · PMID 40388151 · Publisher ↗
OBJECTIVE: Depressed patients often experience interpersonal distress. Understanding how interpersonal distress and depressive symptoms are associated may have implications for understanding the etiology and maintenance...
OBJECTIVE: Depressed patients often experience interpersonal distress. Understanding how interpersonal distress and depressive symptoms are associated may have implications for understanding the etiology and maintenance of depression, as well as for treatment. In this naturalistic psychotherapy study, we explored whether change in depressive symptoms predicted subsequent change in interpersonal distress or vice versa. METHOD: Depressive symptoms (depression scale of the Symptom Check List-90-Revised) and interpersonal problems (Inventory of Interpersonal Problems-64) were assessed on nine occasions, including before, during, and after treatment and at 1 and 2.5 years follow-up in a sample of 178 depressed patients receiving open-ended psychotherapy. We used latent curve modeling with structured residuals to assess possible reciprocal relations between interpersonal problems and depression, controlling for personality disorder. RESULTS: The findings showed that interpersonal distress had a slower rate of change compared to depressive symptoms, but improvements in interpersonal distress predicted subsequent improvement in depressive symptoms during psychotherapy, and this effect was stable over time. Patients with comorbid personality disorder had higher initial levels of both depression and interpersonal distress, but there were no differences in rates of change for any of the outcomes. CONCLUSION: Our results indicate that improvements in interpersonal problems may play an important role in alleviating depressive symptoms during psychotherapy. We propose that reduction of interpersonal distress is associated with increased interpersonal flexibility, which may lead to more positive responses from others, thereby contributing to a reduction in depressive symptoms. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
Exploring the matching effect: The association between preference accommodation, the working alliance, and outcome in psychotherapy.
Jacobsen CF, Falkenström F, Karstoft KI … +5 more , Igra L, Lunn S, Nielsen J, Lauritzen L, Poulsen S
J Consult Clin Psychol · 2025 Jun · PMID 40388150 · Publisher ↗
OBJECTIVE: This study investigated two proposed change mechanisms in preference accommodation, thought to improve psychotherapy outcomes: a direct effect of a match between clients' initial preferences and their subseque...
OBJECTIVE: This study investigated two proposed change mechanisms in preference accommodation, thought to improve psychotherapy outcomes: a direct effect of a match between clients' initial preferences and their subsequent experiences of the therapy activities, or a mediated "matching effect" operating through the working alliance. Furthermore, the study explored whether the effect of a preference-experience (mis)match depended on the phase of therapy or type of therapy activity. METHOD: Three hundred sixty-six adults (Mage = 43.2, 75% female) were seen by 50 therapists in individual psychotherapy. Cross-lagged associations between latent preference-activity discrepancies (measured by the Preference and Experience Questionnaire), working alliance (measured by the Session Alliance Inventory), and affective symptoms (measured by the Symptom Checklist-11) were analyzed using dynamic panel modeling adjusted for between-person differences. RESULTS: Generally, the clients' initial preference levels exceeded the amount of therapy activities they experienced receiving. Deviations from this general discrepancy, so that the amount of activities increased in the direction of the client's preference levels, were significantly associated with stronger alliance ratings for all activity types and across most sessions. However, no fully mediated sequence between a change in preference-experience-discrepancy, the alliance, and symptoms was found. Moreover, the direct associations between preference-experience-discrepancy and subsequent symptom change were inconsistent and indicated differences between distinct activity types and phases of therapy. CONCLUSIONS: Both direct effects and alliance effects in preference accommodation were found, but the study provides particular support for matching effects impacting the working alliance and highlights the potential of preference work in alliance development. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
The effect of mindfulness interventions on couple relationship satisfaction: A systematic review and meta-analysis.
Voldstad A, Zeas-Sigüenza A, Skolzkov A … +3 more , Walthaug M, Montero-Marín J, Kuyken W
J Consult Clin Psychol · 2025 Jun · PMID 40388149 · Publisher ↗
OBJECTIVE: Mindfulness interventions (MIs) train nonjudgmental attention to present-moment experience and aim to improve mental health and well-being. The evidence for their effect on interpersonal relationships is promi...
OBJECTIVE: Mindfulness interventions (MIs) train nonjudgmental attention to present-moment experience and aim to improve mental health and well-being. The evidence for their effect on interpersonal relationships is promising but uncertain. This study examines the effect of MIs on couple relationship satisfaction (RS). METHOD: Randomized controlled trials of MIs including RS were selected based on systematic searches in Web of Science, PubMed, APA PsycInfo, Embase, Cochrane Central, ProQuest, and Google Scholar. We applied three-level meta-analysis with robust variance estimation to pool effects and multimodel approaches to explore moderators. RESULTS: We calculated 90 effect sizes (k) nested within 28 studies (K) including 6,097 participants in a couple relationship. MIs had a significant medium effect on RS with high heterogeneity (g = 0.60, 95% confidence interval [0.16, 1.04], I2 = 97 [95, 99]). The effect on RS was influenced by extreme outliers (e.g., g up to 7.48). Removing outliers resulted in a significant small effect with low heterogeneity (g = 0.21 [0.11, 0.31], I2 = 25 [0, 67], k = 85, K = 26). Effects were moderated by intervention length, baseline satisfaction, and risk of bias. There were significant effects for both clinical and community samples. The certainty of the evidence is very low due to inconsistency, imprecision, risk of bias, and suspicion of publication bias. Generalization is limited by insufficient reporting. CONCLUSIONS: This meta-analysis indicates that MIs have a consistent small effect on RS, but the quality of evidence points to the need for program theory and rigorous methodology. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
Efficacy of cognitive behavioral therapies with a trauma focus for posttraumatic stress disorder: An individual participant data meta-analysis.
Wright SL, Karyotaki E, Sijbrandij M … +40 more , Cuijpers P, Bisson JI, Papola D, Witteveen AB, Back SE, Bichescu-Burian D, Capezzani L, Cloitre M, Devilly GJ, Elbert T, Mello MF, Ford JD, Grasso D, Gray R, Haller M, Hunt N, Kleber RJ, König J, Kullack C, Laugharne J, Liebman R, Lee CW, Lely J, Markowitz JC, Monson C, Nijdam MJ, Norman S, Olff M, Orang TM, Ostacoli L, Paunovic N, Petkova E, Rosner R, Schauer M, Schmitz JM, Schnyder U, Smith B, Vujanovic AA, Zang Y, Seedat S
J Consult Clin Psychol · 2025 Jun · PMID 40388148 · Publisher ↗
OBJECTIVE: This individual participant data meta-analysis aimed to investigate the effectiveness of cognitive behavioral therapy with a trauma focus (CBT-TF) for posttraumatic stress disorder (PTSD). Furthermore, we exam...
OBJECTIVE: This individual participant data meta-analysis aimed to investigate the effectiveness of cognitive behavioral therapy with a trauma focus (CBT-TF) for posttraumatic stress disorder (PTSD). Furthermore, we examined the effect of moderators on PTSD symptom severity. METHOD: This study included randomized controlled trials comparing CBT-TF to an inactive or active comparison group for adults with PTSD. The primary and secondary outcomes were PTSD symptom severity and remission, respectively. Moderators included sociodemographic and clinical variables. RESULTS: Twelve studies compared CBT-TF with inactive (n = 625) and 11 with active comparison conditions (n = 706). The one-stage individual participant data meta-analysis found that CBT-TF was more effective than inactive comparison conditions (β = -0.78; OR = 2.34) and not significantly different from active comparison conditions (β = 0.02; OR = 0.53) in reducing PTSD symptom severity and achieving PTSD remission, respectively. When comparing CBT-TF with inactive treatments, moderator analysis found that divorced participants had greater PTSD symptoms postintervention following CBT-TF than participants who were single, cohabitating, or married receiving CBT-TF, both in the completer (β = 0.93) and full-sample (β = 0.59) analyses. For the active treatment comparison, moderator analysis found that participants taking psychotropic medication had lower PTSD symptoms following CBT-TF than those not taking psychotropic medication in the completer analysis (β = -0.39). CONCLUSION: Based on our moderator analyses, further research is needed to understand the effect of psychotropic medication on the CBT-TF intervention process. Moreover, divorced participants with PTSD receiving CBT-TF might benefit from enhanced support. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
Beyond total scores: Enhancing psychotherapy outcome prediction with item-level scores.
Pena Loray JS, Hehlmann MI, Gomez Penedo JM … +2 more , Schöttke H, Rubel JA
J Consult Clin Psychol · 2025 Jul · PMID 40372873 · Publisher ↗
OBJECTIVE: This study aims at improving dropout and treatment nonresponse prevention by optimizing the performance of models for their prediction through the integration of item-level data. METHOD: Routine data from 1,27...
OBJECTIVE: This study aims at improving dropout and treatment nonresponse prevention by optimizing the performance of models for their prediction through the integration of item-level data. METHOD: Routine data from 1,277 patients ( = 36.95, = 13.64; 64.77% female) treated at Osnabrück University was used to train and evaluate 20 machine-learning algorithms and five ensemble models. Measures included sociodemographic information, Outcome Questionnaire-30, Questionnaire for the Evaluation of Psychotherapeutic Progress, Questionnaire on Emotional Well-Being, Symptom Checklist-90-R, and the Inventory of Interpersonal Problems-32. Prediction models were trained with nested cross-validation and validated in a holdout sample. SHapley Additive exPlanations values were extracted for the best resulting model. RESULTS: Item-level models achieved the highest performance for both dropout (F1-Score = 0.87, Brier score = 0.0529, balanced accuracy = 0.88) and treatment nonresponse (F1-Score = 0.60, Brier score = 0.1646, balanced accuracy = 0.72) prediction. Items reflecting cognitive and bodily dimensions, respectively, emerged as key predictors. CONCLUSION: This study demonstrates the clinical value of using item-level data to enhance predictive modeling for dropout and treatment nonresponse and the potential to provide actionable insights for clinical practice. Integrating such models into clinical feedback systems could help identify at-risk patients and reduce dropout and nonresponse rates. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
Considerations in selecting comparison conditions in psychotherapy trials: Recommendations for future research.
Young JF, Wilfley DE, Tanofsky-Kraff M … +1 more , Mufson L
J Consult Clin Psychol · 2025 May · PMID 40354274 · Publisher ↗
OBJECTIVE: In this commentary, we outline conceptual and methodological concerns we have with a recent randomized trial of two group-delivered transdiagnostic eating disorder treatments (Stice et al., 2023), particularly...
OBJECTIVE: In this commentary, we outline conceptual and methodological concerns we have with a recent randomized trial of two group-delivered transdiagnostic eating disorder treatments (Stice et al., 2023), particularly regarding the description, implementation, and labeling of the comparison condition. METHOD: We discuss the selection of a control condition in comparative psychotherapy trials; the distinction between adaptations and other types of intervention modifications; the need for processes to ensure that an intervention is developmentally and diagnostically appropriate; and the provision of detailed descriptions of interventions in articles and supplementary materials, as well as making manuals publicly available, to ensure that reviewers and readers can understand the interventions delivered and can accurately interpret the results. RESULTS: We highlight the potential downstream implications of mislabeling an intervention and conclude that the comparison condition in Stice et al.'s (2023) article should be reclassified to avoid misinterpretation. CONCLUSIONS: There are published frameworks and guidelines available that promote more detail, precision, and transparency about interventions being tested in clinical trials. We believe it is time for journals to implement these guidelines to ensure that reviewers and readers can fully understand what interventions were tested to draw informed conclusions from the study, replicate research findings, and reliably deliver these interventions in clinical practice. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
Building toward a text-based intervention for parents of suicidal adolescents seeking emergency department care: A pilot randomized controlled trial.
Czyz E, Nahum-Shani I, Ewell Foster C … +8 more , Micol V, Jiang A, Al-Dajani N, Arango A, Walton M, Hong V, Ahamed SI, King C
J Consult Clin Psychol · 2025 May · PMID 40354273 · Full text
OBJECTIVE: The growing demand for emergency department (ED) care for suicidal ideation and attempts in adolescents calls for effective interventions preventing post-ED recurrence of suicidal crises. Parents are tasked wi...
OBJECTIVE: The growing demand for emergency department (ED) care for suicidal ideation and attempts in adolescents calls for effective interventions preventing post-ED recurrence of suicidal crises. Parents are tasked with implementing postdischarge suicide prevention recommendations, often with little support. To address this need, this study examined a parent-facing texting intervention targeting parental engagement in suicide prevention activities to lower youth suicide risk after discharge. METHOD: A pilot randomized controlled trial was conducted with 120 parents (83.3% mothers) and their adolescents (ages 13-17, 65.8% female, 75.0% White) presenting to an ED with suicide risk concerns. Parents were randomized to a control group or a 6-week intervention providing parents with daily adolescent-centered text messages encouraging post-ED parental engagement in recommended suicide prevention activities with or without added parent-centered texts intended to support parents' own well-being. Proposed mechanisms (parental self-efficacy, engagement in suicide prevention activities) were assessed at 2, 6, and 12 weeks. This trial is registered with https://clinicaltrials.gov (NCT05058664). RESULTS: The text-based intervention was feasible and acceptable. In exploratory analyses, relative to control, the text-based intervention was associated with greater parental engagement in suicide prevention activities postintervention at 6 (d = 0.48, p = .027) and 12 weeks (d = 0.53, p = .019) and lower youth suicide attempts at 12 weeks (hazard ratio = 0.23, CI [0.06, 0.96], p = .044), regardless of whether parents received additional parent-centered texts. CONCLUSIONS: Warranting further study in a fully powered trial, findings suggest this parent-facing texting intervention intended to promote youth safety was acceptable and may offer a promising strategy to lower post-ED youth suicide risk. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
Cognitive restructuring before exposure therapy or behavioral experiments? How the timing of expectancy violation and magnitude of expectancy change influence exposure therapy outcomes.
Johnco CJ, Norberg M, Wuthrich VM … +1 more , Rapee RM
J Consult Clin Psychol · 2025 May · PMID 40354272 · Publisher ↗
OBJECTIVE: Inhibitory learning models emphasize the central role of threat expectancy violation during exposure therapy. However, exposure is often implemented alongside cognitive restructuring, which reduces threat expe...
OBJECTIVE: Inhibitory learning models emphasize the central role of threat expectancy violation during exposure therapy. However, exposure is often implemented alongside cognitive restructuring, which reduces threat expectancies before exposure, reducing the potential for expectancy violation. This study examined whether the timing of expectancy violation (before/during exposure) and magnitude of expectancy change impact the efficacy of exposure therapy. METHOD: A total of 249 adults (range 18-59 years old, M = 21.19, SD = 6.89) with elevated public speaking anxiety completed an intensive exposure session. Participants were randomly allocated to receive exposure based on (a) behavioral experiments (BE; i.e., maximizing expectancy violation and emphasizing prediction error following exposure); (b) cognitive restructuring before exposure (CR + EXP; i.e., threat expectancies reduced before exposure, thus reducing expectancy violation during exposure tasks); or (c) exposure without explicit processing of threat expectancies or expectancy violation. Change in symptoms was assessed pre-post exposure session and at 1-week follow-up. RESULTS: The BE and CR + EXP groups showed superior anxiety reduction (primary outcome) and threat expectancy change (secondary outcome) compared to exposure without explicit processing of threat expectancies or expectancy violation. There was a nonsignificant small effect size difference in anxiety reduction favoring BE over CR + EXP. There was greater expectancy change in the BE group compared to the CR + EXP group and shorter treatment duration. Greater threat expectancy change during exposure tasks was associated with greater anxiety reduction. CONCLUSIONS: Threat expectancy change facilitates anxiety reduction during exposure therapy, and there may be modest advantages to challenging threat expectancies after exposure (BE) compared to before exposure (CR + EXP). (PsycInfo Database Record (c) 2025 APA, all rights reserved).
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