J Consult Clin Psychol [JOURNAL]
Sun
200 papers
In search of lost time: Discrete- versus continuous-time models of working alliance and symptom severity.
Wester RA, Koch T, Münch F … +3 more , Driver C, Lutz W, Rubel J
J Consult Clin Psychol · 2025 Jan · PMID 39786804 · Publisher ↗
OBJECTIVE: The therapeutic alliance is one of the most stable predictors of symptom burden over the course of therapy. So far, this effect has only been examined on the basis of sessions. Continuous-time models (CTM) all...
OBJECTIVE: The therapeutic alliance is one of the most stable predictors of symptom burden over the course of therapy. So far, this effect has only been examined on the basis of sessions. Continuous-time models (CTM) allow this relationship to be modeled as a continuous process in which the actual time interval between measurements is considered. The aim of the present study was to compare the fit of discrete-time models (DTM) of the alliance-symptom relationship with CTM using different time variables (sessions vs. actual time interval). METHOD: Data from 1,413 patients at a university psychotherapy outpatient clinic were analyzed. The alliance and symptom burden were assessed each session with the Bernese Session Report and the Hopkins Symptom Checklist-Short-Form, respectively. Different DTM and CTM were estimated using the R-package ctsem and compared in their fit via the Akaike information criterion. RESULTS: CTMs with session as the time unit fitted the data best. Significant negative within-person effects of alliance and symptom burden were found. These effects showed a significant positive correlation, implying that individuals with a stronger effect of the alliance on symptom severity also showed a stronger effect of symptom severity on the alliance. CONCLUSIONS: When modeling the relationship of symptom severity and alliance, it seems to be of more importance to capture the fact that a session occurred than to capture the exact time intervals between sessions. Future studies should examine this finding for other psychotherapeutic factors. Interpersonal factors might explain the positive association of the reciprocal alliance-symptom effects. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
Sudden gains in the treatment of children and adolescents with prolonged grief.
Lechner-Meichsner F, Spuij M, Boelen PA
J Consult Clin Psychol · 2025 Jan · PMID 39786803 · Publisher ↗
OBJECTIVE: Sudden gains describe large and stable reductions in symptoms between two consecutive treatment sessions and have not yet been investigated in prolonged grief disorder (PGD), a new disorder in the 11th edition...
OBJECTIVE: Sudden gains describe large and stable reductions in symptoms between two consecutive treatment sessions and have not yet been investigated in prolonged grief disorder (PGD), a new disorder in the 11th edition of the and text revision of the fifth edition of the characterized by separation distress and accompanying symptoms beyond 6 months of bereavement. The study aimed to examine the occurrence of sudden gains and their relation to treatment outcome and content during cognitive behavioral therapy (CBT) and supportive counseling for children and adolescents with PGD symptoms. METHOD: We used data from 118 patients (50% female; age: = 12.93, = 2.81) who were randomized to receive either nine individual sessions of CBT or nondirective supportive counseling. Session-by-session PGD symptoms were assessed using the Grief Checklist. We identified sudden gains using the original criteria by Tang and DeRubeis (1999) and compared treatment outcomes between sudden gainers and nonsudden gainers using linear mixed models. RESULTS: Nine patients (7.63%) experienced a total of 10 sudden gains. Most sudden gains occurred during CBT. We found no differences between sudden gainers and nonsudden gainers regarding PGD symptoms, posttraumatic stress, and depressive symptoms, but problem behaviors declined toward the follow-up assessments in sudden gainers. CONCLUSIONS: Sudden gains seem to be a rare event with limited clinical relevance in the treatment of PGD symptoms in children and adolescents. Results imply future research into predictors of sudden gains and other forms of symptom change during PGD treatment. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
Mediators of a randomized controlled trial of a preventive intervention for youth of parents with depressive disorders.
Ciriegio AE, Pine AE, Cole DA … +3 more , McKee LG, Forehand R, Compas BE
J Consult Clin Psychol · 2025 Jan · PMID 39786802 · Full text
OBJECTIVE: The present study assessed two theory-driven mediators of the effects of a family group cognitive-behavioral (FGCB) preventive intervention for youth of parents with a history of major depressive disorder (MDD...
OBJECTIVE: The present study assessed two theory-driven mediators of the effects of a family group cognitive-behavioral (FGCB) preventive intervention for youth of parents with a history of major depressive disorder (MDD) or dysthymia on long-term youth psychopathology symptoms and diagnoses. METHOD: Sample included 180 parents ( = 41.9, 89% female, 82% White, non-Hispanic) and one of their children/adolescents ages 9-15 years ( = 11.4, 49% female, 74% White, non-Hispanic). Changes in the hypothesized mediators, observations of positive parenting (Iowa Family Interaction Rating Scales) and youth secondary control coping (SCC) skills (Responses to Stress Questionnaire), were assessed at 6 months. Changes in youth psychopathology symptoms were assessed on the Child Behavior Checklist and Youth Self-Report at 18- and 24-month follow-ups and MDD diagnoses with the Kiddie Schedule for Affective Disorders and Schizophrenia at 12 and 24 months. RESULTS: Changes in youth SCC skills (e.g., acceptance, reappraisal) after the intervention mediated the effects of the FGCB program on changes in youth internalizing and externalizing symptoms at 18- and 24-month follow-ups. Effects for changes in positive parenting behaviors as a mediator were more limited. SCC skills were further shown to mediate the effects of the FGCB intervention on MDD diagnoses from 12 to 24 months. CONCLUSIONS: This study provides clear and strong evidence that changes in youth SCC skills mediated the long-term effects of preventive intervention for families of depressed parents. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
Efficacy of facilitative interpersonal and relational skills training for teletherapy: A randomized controlled trial.
Lin T, Anderson T, Antebi-Lerman E … +2 more , Bate J, Aafjes-van Doorn K
J Consult Clin Psychol · 2025 Feb · PMID 39760736 · Publisher ↗
OBJECTIVE: Therapists report a lack of confidence and competence in teletherapy compared to in-person therapy. Training focusing on teletherapy skills is scarce. This study reports on (a) the development of a training wo...
OBJECTIVE: Therapists report a lack of confidence and competence in teletherapy compared to in-person therapy. Training focusing on teletherapy skills is scarce. This study reports on (a) the development of a training workshop for facilitative interpersonal skills (FIS) in teletherapy (tele-FIRST) and (b) a randomized controlled trial assessing the efficacy of tele-FIRST. Tele-FIRST is a 2-hr online synchronous training workshop that incorporates didactics, deliberate practice, simulation of teletherapy challenges, modeling, and discussion. METHOD: A set of tele-FIS stimulus clips that depict four types of teletherapy challenges (e.g., emotional disconnection, distraction) was used to evaluate and train therapists' teletherapy skills. A total of 182 licensed therapists and trainees were randomized into either the tele-FIRST or a waitlist group. Of these, 153 participants completed baseline assessment and were included in the final analyses (tele-FIRST: = 82; waitlist: = 71). At baseline, posttraining, and follow-up, participants were assessed on their observer-rated FIS for teletherapy, self-reported FIS, teletherapy skills, acceptance of teletherapy, and self-efficacy. RESULTS: Therapists demonstrated increased teletherapy skills following the tele-FIRST workshop. After controlling for baseline scores, the tele-FIRST group demonstrated significantly higher observer-rated tele-FIS (η² = .134), self-reported FIS (η² = .106), teletherapy skills (η² = .037), acceptance of teletherapy technology (η² = .082), and self-efficacy (η² = .036) compared to the waitlist group at posttraining. CONCLUSION: The tele-FIRST demonstrated significant short-term effects on enhancing therapists' teletherapy skills as rated by both independent observers and therapists themselves. Tele-FIRST may improve the quality of teletherapy, though more research is needed to investigate its long-term effects. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
Evaluating hypothetical prevention strategies for internalizing symptoms in the general population and at-risk children.
Dall'Aglio L, Labrecque JA, Schuurmans I … +8 more , Zhang Y, Creasey N, Wilson M, Kennedy CJ, Muetzel RL, Smoller JW, Tiemeier H, Choi KW
J Consult Clin Psychol · 2025 Apr · PMID 39760735 · Publisher ↗
OBJECTIVE: Specific modifiable factors (e.g., screen time [ST], sleep duration, physical activity, or social connections) are targets for reducing depression risk in adults. However, research in adolescents lacks causal...
OBJECTIVE: Specific modifiable factors (e.g., screen time [ST], sleep duration, physical activity, or social connections) are targets for reducing depression risk in adults. However, research in adolescents lacks causal inference implementations, as prevention trials are costly and often prohibitive. Emulating randomized trials with observational data enables inference regarding hypothetical interventions on modifiable factors that reduce depression risk, in general and at-risk populations. METHOD: Data from the Adolescent Brain Cognitive Development ( = 8,699) and the Generation R ( = 3,739) studies were leveraged for modifiable factors (age 10) and internalizing symptoms (age 12-14). We (a) tested prospective associations of each modifiable factor with internalizing symptoms under target trial emulation (TTE) and (b) used G-formula to estimate the potential effects on internalizing symptoms if hypothetical interventions were implemented. Analyses were conducted in the full sample (universal prevention setting) and at-risk youth (selective and indicated prevention setting). RESULTS: First, under TTE, only ST associated with internalizing symptoms. Second, in the universal prevention setting, adhering to more stringent ST guidelines (0-1 hr) decreased internalizing symptoms by 0.10-0.16 s while following more lenient guidelines (3-4 hr) increased them by 0.07-0.09 s, compared to existing guidelines (2 hr). Such changes were greater in the indicated (subclinical symptom) prevention settings and robust to residual confounding. Restricting physical activity reduced internalizing risk in the indicated setting, but findings were not robust. CONCLUSIONS: With a causally informed strategy, we demonstrated the potential effects of numerous hypothetical interventions on modifiable factors for depression risk reduction, across multiple preventive settings. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
Individual risk of not responding to psychotherapy in Latin America: Bringing data-informed precision care to underresourced clinical settings.
Gómez Penedo JM, Errázuriz P, Coyne AE … +1 more , Flückiger C
J Consult Clin Psychol · 2024 Dec · PMID 39715426 · Publisher ↗
OBJECTIVE: Machine learning has a great potential for prospectively forecasting individual patient response to mental health care (MHC), thereby enabling treatment personalization. However, previous efforts have been lim...
OBJECTIVE: Machine learning has a great potential for prospectively forecasting individual patient response to mental health care (MHC), thereby enabling treatment personalization. However, previous efforts have been limited to populations living in predominantly higher income, developed countries. This study aimed to extend the reach of precision MHC systems by developing and testing a feasible and readily implementable algorithm for identifying patients at risk of nonresponse to routinely delivered psychotherapy in Chile, a developing country in Latin America. METHOD: Data were derived from a community-based, randomized trial that tested the effects of progress feedback on naturalistically delivered psychotherapy outcome. Patients were 547 adults who were consecutively admitted to an outpatient clinic in Santiago, Chile. Treatment response was defined using norms for reliable improvement on the Outcome Questionnaire-30. Based on 10 sociodemographic and seven clinical predictors, we trained elastic net and random forest algorithms on a randomly selected training set (70%; n = 384). The best performing algorithm was tested on a hold-out sample (30%; n = 163). RESULTS: Reliable improvement was achieved in 42% of the cases. A random forest algorithm demonstrated moderate performance in the hold-out sample (area under the curve = .74, Brier score = .21), correctly identifying 73% of the patients who did not respond. CONCLUSION: This study developed a predictive algorithm that demonstrated moderate accuracy in identifying patients at risk of nonresponse to naturalistic psychotherapy in Chile, using routinely assessed and easy-to-collect sociodemographic and clinical information. Using such tools may represent one step toward reducing the multilayered outcome disparities faced by individuals receiving MHC in socioeconomically disadvantaged contexts. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
Effects of a responsive parenting intervention on Black mothers' depressive symptoms postpartum: Secondary analysis of a randomized clinical trial.
Adesogan O, Beach SRH, Carter SE … +2 more , Metzger IW, Lavner JA
J Consult Clin Psychol · 2024 Dec · PMID 39715425 · Full text
OBJECTIVE: This study examined whether a responsive parenting (RP) intervention for first-time Black mothers had secondary benefits for their mental health by reducing their postpartum depressive symptoms. METHOD: In tot...
OBJECTIVE: This study examined whether a responsive parenting (RP) intervention for first-time Black mothers had secondary benefits for their mental health by reducing their postpartum depressive symptoms. METHOD: In total, 212 first-time Black mothers participated in the Sleep Strong African American Families randomized control trial. Mothers were randomized to the RP condition or a safety control condition at 1-week postpartum. Participants reported their depressive symptoms at 1-, 8-, and 16-week postpartum. Data were analyzed using linear regression and moderation analyses. RESULTS: There was not a significant main effect of the intervention condition on mothers' depressive symptoms at 8- or 16-week postpartum. However, at 8-week postpartum, the main effect of the condition was significantly moderated by mothers' depressive symptoms at baseline: Mothers in the RP condition reported significantly lower levels of 8-week depressive symptoms than mothers in the safety control condition if they initially had clinically significant depressive symptoms but did not differ from controls if they did not initially have clinically significant depressive symptoms. This interaction effect was not significant at 16-week postpartum. Effects remained consistent, controlling for demographic variables, which did not significantly moderate condition effects at 8- or 16-week postpartum. CONCLUSION: Participation in the Sleep Strong African American Families responsive parenting intervention led to a more rapid reduction in depressive symptoms among first-time Black mothers with clinically significant depressive symptoms at baseline relative to the control condition. Findings suggest that family-focused responsive parenting interventions may serve as forms of "constructed resilience" that promote positive mental health early in the postpartum period. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
The power of friends in reducing sexual assault risk in college women: A preliminary test of dyad-based motivational intervention approach.
Read JP, Livingston JA, Shaw RJ … +7 more , Wiseblatt AF, Jenzer T, DiPaolo LR, Mastroleo NR, Katz J, Testa M, Colder CR
J Consult Clin Psychol · 2024 Dec · PMID 39715424 · Publisher ↗
OBJECTIVE: Sexual assault (SA) is unfortunately common in U.S. college campuses. Friends are central to the social context of college women, and thus to the context of SA, and thus may play a key role in SA prevention. T...
OBJECTIVE: Sexual assault (SA) is unfortunately common in U.S. college campuses. Friends are central to the social context of college women, and thus to the context of SA, and thus may play a key role in SA prevention. The objective of the present study was to provide a preliminary test of a novel friend-based motivational intervention (FMI) that encourages and prepares friends to work together to reduce SA risk. METHOD: In a pilot trial, 51 friend dyads (N = 102) were randomized to either FMI or waitlist control (WLC) conditions and then followed over 3 months. Participant perceptions of the intervention and intervention-associated outcomes (engagement in friend-based assault protective behaviors [FAPB], readiness to change, barriers, sexual assault occurrences) were examined. RESULTS: Those in the FMI reported greater readiness to engage in efforts to protect their friend against SA and reported higher rates of FAPB across time points relative to the WLC. Though not statistically significant, women in the FMI also reported half as many incidences of SA at the 3-month follow-up. We did not observe decreases in perceived barriers to intervening that were targeted with the FMI. Participant feedback on their experiences with the FMI was positive; women reported that FMI was empowering, personally relevant, and useful. CONCLUSIONS: Findings point to the promise of this dyad-based motivational intervention that capitalizes on the natural resource of women's friendships to decrease risk for sexual assault. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
The benefits of mindfulness training for momentary mindfulness and emotion regulation: A randomized controlled trial for adolescents exposed to chronic stressors.
Miller-Chagnon RL, Shomaker LB, Prince MA … +7 more , Krause JT, Rzonca A, Haddock SA, Zimmerman TS, Lavender JM, Sibinga E, Lucas-Thompson RG
J Consult Clin Psychol · 2024 Dec · PMID 39715423 · Full text
OBJECTIVE: The goal of this study was to test if a mindfulness-based intervention (MBI) compared to an active control ameliorates the impacts of life stressors on momentary mindfulness and emotion regulation difficulties...
OBJECTIVE: The goal of this study was to test if a mindfulness-based intervention (MBI) compared to an active control ameliorates the impacts of life stressors on momentary mindfulness and emotion regulation difficulties among adolescents exposed to chronic stressors. METHOD: Adolescents exposed to chronic stressors (N = 81, Mage = 13.75 years; 56% boys; 24% Hispanic/Latino, 57% White) were randomized to receive MBI within the context of a community-based mentoring program (MBI + mentoring) or mentoring-alone. Participants completed ecological momentary assessments (EMAs) three times each day for 7 days at three intervals/bursts (preintervention, midintervention, and postintervention), contributing to a total of 3,178 EMA reports. EMA assessed momentary exposure to life stressors, mindfulness (vs. mindlessness), and emotion regulation difficulties. RESULTS: Linear mixed-effects models revealed that the interaction between intervention arm (MBI + mentoring vs. mentoring-alone) and burst was significantly associated with the random slopes of life stressor exposure predicting mindful attention (b = -.05, SE = .01, p < .001), mindful nonjudgment (b = -.03, SE = .01, p < .001), and emotion regulation difficulties (b = -.04, SE = .01, p < .001). Estimated marginal means revealed that MBI + mentoring, compared to mentoring-alone, produced small but significant attenuation in the association of life stressors with mindful attention, mindful nonjudgment, and emotion regulation difficulties at postintervention. CONCLUSION: Mindfulness training may buffer adolescents exposed to chronic stressors against the negative impacts of life stressors on mindfulness and emotion regulation in daily life. Going forward, it will be important to investigate these relationships in the context of mental/physical health outcomes and to include longer periods of follow-up to determine the sustainable benefits of MBI for adolescent health. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
"Informed" consent? Ethical considerations for clinicians using therapy-matching platforms.
Delawalla CN, Lorenzo-Luaces L
J Consult Clin Psychol · 2024 Dec · PMID 39715422 · Publisher ↗
Mental health care in the United States is prohibitively difficult to access. Barriers of entry include a shortage of providers, high cost of services, insufficient insurance coverage, and layers of bureaucracy. This pro...
Mental health care in the United States is prohibitively difficult to access. Barriers of entry include a shortage of providers, high cost of services, insufficient insurance coverage, and layers of bureaucracy. This problem of low supply and high demand created a unique environment for capitalist problem solvers to enter the therapeutic market, via "therapy-matching platforms." Several ethically related Federal Trade Commission (FTC) complaints and independent investigations into these platforms highlight that the forward progress is not without growing pains. This commentary focuses on ensuring proper informed consent when providing services on therapy-matching platforms (e.g., BetterHelp, TalkSpace). (PsycInfo Database Record (c) 2024 APA, all rights reserved).
Effects on family functioning and the home environment of a family-based preventive intervention for children of parents with severe mental illness: A randomized controlled trial.
Gjøde ICT, Müller AD, Hjorthøj C … +10 more , Hemager N, Ingversen S, Moszkowicz M, Christensen SH, Mikkelsen LJ, Nielsen SS, Melau M, Forman J, Nordentoft M, Thorup AAE
J Consult Clin Psychol · 2025 Apr · PMID 39666517 · Publisher ↗
OBJECTIVE: Children of parents with severe mental illness are at increased risk of mental illness throughout their lifespan due to complex gene-environment interactions. Preventive interventions supporting parents and ch...
OBJECTIVE: Children of parents with severe mental illness are at increased risk of mental illness throughout their lifespan due to complex gene-environment interactions. Preventive interventions supporting parents and children are warranted. Compared with usual treatment, we tested the effectiveness of a multidisciplinary family-based preventive intervention, VIA Family. METHOD: We did a parallel randomized controlled superiority trial in Copenhagen, Denmark. A total of 95 families, of 95 parents with either schizophrenia spectrum disorder ( = 12 [12.6%]), bipolar disorder ( = 25 [26.3%]), or recurrent major depressive disorder ( = 58 [61.1%]), participated. A total of 179 coparents and 113 children (6-12 years) participated. Assessments took place at baseline and after 18 months of intervention. We estimated the effects on family functioning with the McMaster Family Assessment Device and on levels of stimulation and support in the home environment with the Home Observation Measurement of the Environment. RESULTS: Effects on family functioning did not differ between the two groups: parents with severe mental illness (0.11; 95% CI [-0.10, 0.31]), = .296, and coparents (-0.07; 95% CI [-0.27, 0.13]), = .482. Assessor-rated levels of stimulation and support in the home environment improved in VIA Family, but not significantly compared with usual treatment (: 1.79; 95% CI [-0.37, 3.95], = .104). Sensitivity analyses confirmed our main findings. CONCLUSIONS: Effects on family functioning and the home environment did not differ between VIA Family and usual treatment. We cannot rule out a clinically relevant effect of VIA Family on levels of stimulation and support in the home environment. Long-term follow-up will investigate potential preventive effects. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
A randomized controlled trial of an online mindfulness program for adolescents at risk for internalizing problems.
Garber J, Chavira DA, Adam EK … +8 more , Craske MG, McMahon T, Williams A, Abitante G, Lanser I, Pashtunyar DS, Chen S, Zinbarg R
J Consult Clin Psychol · 2025 Apr · PMID 39621373 · Full text
OBJECTIVE: The purpose of this randomized controlled trial was to test the effects of an online, coached mindfulness intervention on momentary negative affect (mNA) for youth with high levels of trait negative affectivit...
OBJECTIVE: The purpose of this randomized controlled trial was to test the effects of an online, coached mindfulness intervention on momentary negative affect (mNA) for youth with high levels of trait negative affectivity. METHOD: Participants were 111 youth ages 12 to 17 years old ( = 14.17, = 1.60). Youth self-identified as 68% female, 29% male, and 4.5% gender diverse; 54.55% identified as White; 31.82 reported being Hispanic/Latinx. Participants were selected for having high levels of trait negative affect and were randomized to receive either the mindfulness program or no intervention. We used ecological momentary assessment to measure stress and emotions and to derive measures of mNA comprised of stressor-independent and stressor-reactive negative affect. The ecological momentary assessment protocol involved participants completing a short survey/diary entry on Qualtrics four times per day for 5 days. Internalizing symptoms were assessed with the Patient Health Questionnaire-8, Generalized Anxiety Disorder-7, and the Screen for Child Anxiety Related Disorders. RESULTS: The mindfulness intervention resulted in a significant reduction in stressor-reactive negative affect ( = 2.001, = 96, = .048; Cohen's = .40), but not stressor-independent mNA or overall mNA. Additionally, reductions in stressor-reactive negative affect significantly correlated with changes in internalizing symptomatology (standardized β = .26, = .032). CONCLUSIONS: These results indicate that among youth with high levels of trait negative affectivity, a relatively affordable and accessible digital mindfulness program significantly reduced stressor-reactive negative affect. The absence of an effect on stressor-independent or overall average mNA suggests some specificity of the effects of mindfulness to stressor-reactive negative affect in an at-risk sample of adolescents. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
"Caminando y socializando con Happy Older Latinos are Active (HOLA)": Results of a randomized clinical trial to promote health and prevent depression and anxiety in older Latinos.
Jimenez DE, Ross EJ, Weinstein ER … +4 more , Martinez Garza D, Signorile JF, Perdomo-Johnson D, Martinez C
J Consult Clin Psychol · 2025 Apr · PMID 39621372 · Full text
OBJECTIVE: This study sought to evaluate the feasibility, acceptability, and preliminary efficacy of the Happy Older Latinos are Active (HOLA) health promotion intervention in a group of older Latinos who were at risk fo...
OBJECTIVE: This study sought to evaluate the feasibility, acceptability, and preliminary efficacy of the Happy Older Latinos are Active (HOLA) health promotion intervention in a group of older Latinos who were at risk for developing major depressive disorder or generalized anxiety disorder. METHOD: Sixty older Latinos age 60+ with subthreshold depression or anxiety were randomized to receive either HOLA (n = 30) or enhanced psychoeducation through control ( = 30). The primary outcomes of interest were feasibility, acceptability, and reduction in depression and anxiety symptom severity. Outcome measures were administered at baseline and at the end of the intervention. RESULTS: Within a year, the enrollment target was met with < 5% of eligible participants refusing randomization. The randomization scheme produced equal numbers of participants randomized to each condition. Four participants (6.7%; HOLA = 1; control = 3) were lost to follow-up, 69% of the HOLA sessions were attended, and participants reported high satisfaction with the intervention. Finally, compared with control, a significant proportion of participants in HOLA experienced a clinically significant reduction in their anxiety symptoms (60% vs. 26.7%). CONCLUSIONS: Findings highlight the feasibility, acceptability, and significant impact the HOLA intervention can have in reducing psychological distress because it is responsive, respectful, and specific to the needs of older Latinos. Furthermore, using a community health worker to deliver a health promotion intervention to prevent common mental disorders in older Latinos is an innovative approach for reducing disease burden in a population living with high disparities in accessing and engaging in mental health services. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
Response to commentary by Mattos et al. (2024).
Crotty K, Gartlehner G, Viswanathan M
J Consult Clin Psychol · 2024 Nov · PMID 39621371 · Publisher ↗
Replies to comments made by Mattos et al. (see record 2025-49982-003) on the original article (see record 2024-19816-001). Mattos et al. critiqued our assessments of the certainty of evidence as being overly permissive a...
Replies to comments made by Mattos et al. (see record 2025-49982-003) on the original article (see record 2024-19816-001). Mattos et al. critiqued our assessments of the certainty of evidence as being overly permissive and not adhering to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) Working Group's guidelines. GRADE has become an international standard to describe the level of confidence that investigators have in estimates of effects. Like the risk of bias evaluations, determining the certainty of evidence involves subjective judgment. The true value of GRADE is not in yielding a definitive evidence certainty rating but in its emphasis on transparency. While we acknowledge and respect the differing viewpoints of Mattos et al. regarding our ratings, we caution against the rigid and formulaic use of the GRADE methodology. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
Letter to the editor: Methodological flaws on the conduct and reporting in "Psychotherapies for the treatment of borderline personality disorder: A systematic review".
Mattos BP, Pascher E, Catelan RF … +1 more , Eckert I
J Consult Clin Psychol · 2024 Nov · PMID 39621370 · Publisher ↗
This brief commentary critically examines the study "Psychotherapies for the Treatment of Borderline Personality Disorder: A Systematic Review" by Crotty et al. (2023) It highlights several methodological and reporting c...
This brief commentary critically examines the study "Psychotherapies for the Treatment of Borderline Personality Disorder: A Systematic Review" by Crotty et al. (2023) It highlights several methodological and reporting concerns that impact the study's credibility and conclusions. Key issues include the retrospective registration of the study protocol, discrepancies in authorship and protocol content, lack of clarity in inclusion and exclusion criteria, and limitations in geographical scope without clear justification. Furthermore, the letter discusses inconsistencies in the risk of bias and quality of evidence assessments, particularly in the application of the Grading of Recommendations Assessment, Development, and Evaluation system. These methodological shortcomings question the study's findings, contrasting with other comprehensive reviews in the field. The critique emphasizes the importance of methodological rigor and transparency in systematic reviews, especially those influencing clinical practice and policy decisions in mental health care. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
Examining racial and ethnic differences in youth psychotherapy treatment engagement and outcomes.
Johansen K, Saran I, Cho E … +2 more , Weisz JR, Price MA
J Consult Clin Psychol · 2024 Nov · PMID 39621369 · Full text
OBJECTIVE: Research has identified racial/ethnic disparities in mental health treatment engagement, and there have been recent calls to examine effects of mental health treatment engagement on clinical outcomes among you...
OBJECTIVE: Research has identified racial/ethnic disparities in mental health treatment engagement, and there have been recent calls to examine effects of mental health treatment engagement on clinical outcomes among youth of color. This study aimed to examine racial/ethnic differences in (a) behavioral and attitudinal engagement, (b) treatment effectiveness, and (c) the associations between engagement and treatment effectiveness. METHOD: = 200 youth (ages 7-15; 33% White, 28% Black, 25% Hispanic/Latinx, and 14% multiracial; 52% male) and their = 200 parents participated in a randomized controlled trial testing the effectiveness of a transdiagnostic psychotherapy for common youth emotional and behavioral problems. Youth and parents reported internalizing and externalizing symptoms and treatment engagement (e.g., behavioral and attitudinal). Multilevel regression models examined variations in youth symptom trajectories by racial/ethnic group. RESULTS: While all racial/ethnic groups showed comparable attitudinal engagement scores, Black and Latinx youth attended significantly fewer sessions than White and multiracial youth (8-9 vs. 13). However, youth in all racial/ethnic groups showed significant and similar improvements in treatment outcomes. CONCLUSIONS: Black and Latinx youth attended fewer sessions than White youth, but their clinical outcomes were similar to those of White youth. Future research should examine the meaning and implications of session attendance in relation to outcomes in youth of color. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
Cognitive behavioral digital therapeutic effects on distress and quality of life in patients with cancer: National randomized controlled trial.
Taub CJ, Zion SR, Ream M … +10 more , Ramiller A, Heathcote LC, Eich G, Mendelsohn M, Birckbichler J, Ganz PA, Cella D, Penedo FJ, Antoni M, Shumay DM
J Consult Clin Psychol · 2024 Nov · PMID 39621368 · Publisher ↗
OBJECTIVE: Cancer-specific psychological interventions like cognitive behavioral stress management (CBSM) demonstrate distress (e.g., anxiety/depression) and quality of life (QoL) benefits. Digital formats can expand acc...
OBJECTIVE: Cancer-specific psychological interventions like cognitive behavioral stress management (CBSM) demonstrate distress (e.g., anxiety/depression) and quality of life (QoL) benefits. Digital formats can expand access. METHOD: Patients (80.6% female; 76.5% White; 25-80 years) with Stage I-III cancer and elevated anxiety within 6 months of treatment (surgery/chemotherapy/radiation/immunotherapy) receipt were randomized 1:1 to a 10-module CBSM or health education control digital app and completed questionnaires at Weeks 0, 4, 8, 12. Primary outcomes of greater group-level anxiety (PROMIS-A) and depression symptom (PROMIS-D) reductions for CBSM were met and published; this secondary report evaluates individual-level response results for these outcomes and outcomes beyond anxiety and depression. Chi-square tests compared responder proportions using PROMIS-A/PROMIS-D symptom categories and two levels (≥5/≥7.5) of T-score point reductions. Changes across conditions over time for stress (Perceived Stress Scale), cancer-specific distress (Impact of Event Scale-Intrusions), and QoL (Functional Assessment of Cancer Therapy-General) were analyzed using repeated measures linear mixed-effects modeling (N = 449). Patient Global Impression of Change-Well-being was also examined. RESULTS: At Week 12, a greater proportion of CBSM (vs. control) participants reported normal-to-mild (vs. moderate-to-severe) PROMIS-A and PROMIS-D, and a greater proportion of CBSM participants at Week 8 or 12 had a ≥7.5 T-score reduction in PROMIS-A and a ≥5 T-score reduction in PROMIS-D (ps < .05). CBSM participants (vs. control) showed significantly greater reductions in Perceived Stress Scale and Impact of Event Scale-Intrusions and increases in Patient Global Impression of Change-Well-being and Functional Assessment of Cancer Therapy emotional and physical well-being (ps < .05), but not functional or social/family well-being. CONCLUSION: Digitized CBSM benefits distress and QoL. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
Change processes associated with functional improvement in a web-based version of Skills Training in Affective and Interpersonal Regulation (webSTAIR) for trauma-exposed veterans.
Macia KS, Carlson EB, Blonigen DM … +2 more , Lindsay J, Cloitre M
J Consult Clin Psychol · 2024 Oct · PMID 39480289 · Publisher ↗
OBJECTIVE: In spite of the evidence that both symptom reduction and functional improvement are important for supporting recovery from trauma, psychotherapy process research has largely focused on mechanisms of symptom re...
OBJECTIVE: In spite of the evidence that both symptom reduction and functional improvement are important for supporting recovery from trauma, psychotherapy process research has largely focused on mechanisms of symptom reduction. A better understanding of how change occurs in treatments that emphasize functional improvement rather than trauma processing is critical for optimizing effective, patient-centered care. METHOD: This study involved secondary analysis of data collected in three multisite trials of a 10-module web-based version of Skills Training in Affective and Interpersonal Regulation, a skills-focused transdiagnostic intervention. The sample included 314 trauma-exposed veterans (38% male; 64% non-Hispanic White) who screened positive for elevated symptoms of posttraumatic stress disorder and/or depression. Latent change score modeling examined prospective relationships between changes from pre-to-mid and mid-to-post treatment in four potential mechanisms (emotion regulation, interpersonal problems, posttraumatic stress disorder symptoms, and depression symptoms) and the association of these changes with overall functional improvement (at posttreatment and follow-up). RESULTS: Emotion regulation change during the first half of treatment predicted interpersonal and symptom improvements during the second half of treatment, but not vice versa. Changes in each potential mechanism were uniquely associated with functional improvement and together statistically accounted for 78% additional variance in functional improvement beyond what was associated with baseline functioning and covariates. CONCLUSIONS: Results support emotion regulation as an early mechanism of transdiagnostic therapeutic change in web-based version of Skills Training in Affective and Interpersonal Regulation and highlight the relevance of all four potential mechanisms to functional improvement. The study contributes to an understanding of how change occurs in skills-focused interventions for trauma-exposed individuals. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
School-based organizational skills training for students in grades 3-5: A cluster randomized trial.
Nissley-Tsiopinis J, Power TJ, Fleming PF … +12 more , Tremont KL, Poznanski B, Ryan S, Cacia J, Egan T, Montalbano C, Holdaway A, Patel A, Gallagher R, Abikoff H, Localio AR, Mautone JA
J Consult Clin Psychol · 2024 Oct · PMID 39480288 · Publisher ↗
OBJECTIVE: Research has demonstrated the effectiveness of interventions to reduce organizational skills deficits and homework problems, including the clinic-based Organizational Skills Training (OST-C) program (Abikoff e...
OBJECTIVE: Research has demonstrated the effectiveness of interventions to reduce organizational skills deficits and homework problems, including the clinic-based Organizational Skills Training (OST-C) program (Abikoff et al., 2013). In this study, OST-C was adapted for schools as a small-group (Tier 2) intervention delivered by school partners (OST-T2). METHOD: The study was conducted in 22 schools serving students from diverse backgrounds. Students (n = 186; 122 male) in Grades 3-5, ages 8-12 (M = 9.7 years; SD = 0.88) with organizational skills deficits referred by teachers were enrolled. Schools were randomly assigned to OST-T2 or treatment as usual with waitlist. OST-T2 consisted of sixteen 35-min child sessions, two caregivers, and two teacher consultations. Outcomes were evaluated with longitudinal mixed effects modeling at posttreatment, 5-month and 12-month follow-up using caregiver and teacher reports of organizational skills, homework, and academic performance. RESULTS: OST-T2 resulted in reductions in organizational skills deficits on caregiver and teacher report (p < .001) at posttreatment and 5-month follow-up (effect sizes [ES], Cohen's d = 0.96, 1.20). Findings also revealed a reduction in caregiver-reported homework problems at posttreatment and 5-month follow-up (p < .001, ES = 0.60, 0.72), and an improvement in teacher-rated homework at posttreatment (p = .007, ES = 0.64). Effects were attenuated at 12-month follow-up. The effects of OST-T2 on academic measures were not significant. CONCLUSIONS: Findings provide evidence for the immediate and short-term effectiveness of OST-T2 delivered by school professionals. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
Data-informed psychological therapy, measurement-based care, and precision mental health.
Lutz W, Vehlen A, Schwartz B
J Consult Clin Psychol · 2024 Oct · PMID 39480287 · Publisher ↗
Measurement-based care, that is, incorporating data-informed decision support for therapists into psychological therapy, has undergone significant advancements over the past 2 decades. Technological innovations such as c...
Measurement-based care, that is, incorporating data-informed decision support for therapists into psychological therapy, has undergone significant advancements over the past 2 decades. Technological innovations such as computerized data assessment and feedback tools have facilitated its widespread adoption across various settings. For instance, clinicians can utilize psychometric data to personalize therapeutic approaches, strategies, or modules and track a patient's response to therapy in real time (e.g., Lutz, Schwartz, & Delgadillo, 2022). Furthermore, new algorithm-based clinical support tools used within measurement-based care can optimize treatment for such patients at risk for treatment failure. Consequently, measurement-based care is evolving into a data-informed and precision psychological therapy concept that can be viewed as a low-intensity transtheoretical adjunct to evidence-based treatments. It can be integrated at multiple care points into clinical practice regardless of the clinical modality, manual, or program used in a given health care system. Therefore, it emerges as an important component of clinical competence, practice, and training, akin to continuous monitoring of physical health indicators (e.g., insulin, fever, or blood pressure). In this viewpoint article, we summarize the core concepts of data-informed psychological therapy that customizes individual psychological interventions to meet specific patient needs. We also explore implications and future steps to integrate this approach into clinical practice . (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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