J Consult Clin Psychol [JOURNAL]
Sun
200 papers
Effect of third-wave cognitive behavioral therapy in adults with acquired brain injury: A systematic review and meta-analysis of randomized controlled trials.
Rask Buskbjerg C, Munk A, Zachariae R … +3 more , Hedegaard Klausen S, Amidi A, Wu LM
J Consult Clin Psychol · 2026 May · PMID 42241065 · Publisher ↗
OBJECTIVE: Third-wave cognitive behavioral therapies may be beneficial for relieving psychological symptoms in adults with acquired brain injury, but no comprehensive overview and pooled estimate of their effects exist....
OBJECTIVE: Third-wave cognitive behavioral therapies may be beneficial for relieving psychological symptoms in adults with acquired brain injury, but no comprehensive overview and pooled estimate of their effects exist. We conducted a systematic review and meta-analysis of randomized controlled trials to address this gap. METHOD: Three databases (Pubmed, APA PsycInfo, and the Cochrane Library) were searched. Included studies were quality-assessed and frequentist and Bayesian analytical strategies were employed for data synthesis and interpretation. Effects were evaluated for outcomes reported in ≥7 studies, and potential moderating influences of study characteristics were explored when available in ≥10 studies. RESULTS: Twenty-eight randomized controlled trials (N = 1,869) were included. Statistically significant effects at postintervention were observed for depression (K = 20, Hedges's g = 0.49, 95% CI [0.17, 0.81]), anxiety (K = 13, g = 0.48, 95% CI [0.01, 0.95]), mindfulness skills (K = 7, g = 0.33, 95% CI [0.12, 0.54]), and health-related quality of life (QoL; K = 11, g = 0.62, 95% CI [0.21, 1.03]). At follow-up, effects were significant for depression (K = 12, g = 0.42, 95% CI [0.12, 0.72]), psychological flexibility (K = 4, g = 0.47, 95% CI [0.13, 0.81]), and stress (K = 3, g = 0.39, 95% CI [0.02, 0.77]). The observed effects were generally smaller after adjusting for outliers (±2 SDs; g = 0.23-0.29). After adjusting for outliers, Bayesian meta-analysis provided strong to very strong support (Bayes factors values: 16-90) for effects on depression at posttreatment and follow-up and QoL at posttreatment. The only moderator analysis reaching statistical significance was for study quality, with higher values being associated with smaller effects on anxiety and QoL. CONCLUSION: Third-wave cognitive behavioral therapies are likely to be beneficial for relieving psychological symptoms in adults with acquired brain injury, particularly depression and QoL. However, more research is needed to establish robust evidence for their efficacy and clinical relevance. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
Effectiveness of stepped counseling on depression in distressed family caregivers of older adults: A randomized pragmatic trial (ReDiCare).
Töpfer NF, Pfeiffer K, Wrede N … +2 more , Büchele G, Wilz G
J Consult Clin Psychol · 2026 May · PMID 42241064 · Publisher ↗
OBJECTIVE: The high prevalence of depressive symptoms among family caregivers of older adults dependent on care highlights the need for interventions for reducing depression. Stepped-care approaches of evidence-based int...
OBJECTIVE: The high prevalence of depressive symptoms among family caregivers of older adults dependent on care highlights the need for interventions for reducing depression. Stepped-care approaches of evidence-based interventions have not yet been evaluated in routine settings despite their potential to tailor interventions to the specific risk and need profiles of caregivers in a resource-efficient way. The objective of the study was to evaluate the effectiveness of a stepped counseling approach on depressive symptoms in distressed family caregivers in a randomized pragmatic trial. METHOD: 437 family caregivers of older adults (≥60 years) were randomly assigned to the intervention (n = 224) or a control group receiving routine care (CG; n = 213). The stepped counseling approach combined a low-threshold short problem-solving intervention (Intervention 1) with an optional subsequent telephone-based cognitive behavioral therapy intervention (Intervention 2). The primary outcome of depressive symptoms was compared between the groups at 3 months (T1, after intervention 1), 9 months (T2, after optional Intervention 2), and 15 months (T3, 6-month follow-up) using analyses of covariance. RESULTS: Intention-to-treat analyses showed that the intervention significantly reduced depressive symptoms at T1 (d = -0.24), T2 (d = -0.28), and T3 (d = -0.26) compared to CG. CONCLUSIONS: The stepped counseling intervention had a small positive effect on depressive symptoms in a sample of caregivers with below-average socioeconomic status in one of the very few translational studies. The effectiveness of the intervention was likely reduced due to challenges posed by the COVID-19 pandemic. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
Dysfunctional attitudes in cognitive-behavioral therapy and antidepressant pharmacotherapy for adult depression: A systematic review and meta-analysis of individual participant data.
Don FJ, Boschloo L, Wienicke FJ … +14 more , Weitz ES, Hollon SD, Cohen ZD, Segal ZV, Kennedy SH, DeRubeis RJ, Bagby RM, Quilty LC, Simons AD, Twisk JWR, Cristea IA, Furukawa TA, Cuijpers P, Driessen E
J Consult Clin Psychol · 2026 May · PMID 42241063 · Publisher ↗
OBJECTIVES: Dysfunctional attitudes (DA) constitute a vulnerability factor for depression that might be most effectively targeted with cognitive-behavioral therapy (CBT), but evidence is inconclusive. This individual par...
OBJECTIVES: Dysfunctional attitudes (DA) constitute a vulnerability factor for depression that might be most effectively targeted with cognitive-behavioral therapy (CBT), but evidence is inconclusive. This individual participant data meta-analysis examined DA change during CBT and antidepressant medication, potential pathways of change by exploring how DA were related to depressive symptoms at posttreatment, and whether baseline DA moderated CBT versus antidepressants' efficacy on depression outcomes. METHOD: We conducted systematic literature searches up to May 1, 2024. We included randomized comparisons of CBT and antidepressants in the acute-phase treatment of adult depression, assessing the Dysfunctional Attitude Scale at baseline and posttreatment. Individual participant data were requested and analyzed with mixed-effects models and network estimation techniques. RESULTS: Five studies totaling 734 participants met inclusion criteria. DA decreased significantly after CBT and antidepressants, with no significant difference between treatments. Regardless of treatment, posttreatment DA were positively associated with posttreatment depressive symptomatology, particularly with guilt and suicidal thoughts. Baseline DA moderated the efficacy of CBT versus antidepressants on observer-rated outcomes, with CBT more effective for participants with higher DA and antidepressants more effective for those with lower DA, but this was not replicated across individual studies nor with self-reported outcomes. CONCLUSIONS: Change in DA and its associations with changes in depressive symptomatology do not appear specific to CBT. We found inconsistent evidence for the notion that CBT is more efficacious than antidepressants for individuals with high levels of DA. Repeated DA assessment during treatment would allow for more nuanced analysis in future studies. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
Complete delivery matters: Multilevel complier average causal effect analysis of universal mental health curricula in two randomized controlled trials in U.K. schools.
Knowles C, Thornton E, Panayiotou M … +10 more , Hayes D, Thompson A, Deighton J, Santos J, Mason C, Ashworth E, Mansfield R, March A, Stallard P, Humphrey N
J Consult Clin Psychol · 2026 May · PMID 42241062 · Publisher ↗
OBJECTIVE: Complete implementation is assumed in intention-to-treat analyses of universal, school-based mental health literacy curricula, but implementation data routinely reveal program delivery is often incomplete (or...
OBJECTIVE: Complete implementation is assumed in intention-to-treat analyses of universal, school-based mental health literacy curricula, but implementation data routinely reveal program delivery is often incomplete (or in extreme cases, no implementation occurs). Complier average causal effect estimation can rigorously determine whether this makes a difference to intervention outcomes. METHOD: We used multilevel complier average causal effect estimation to establish if intervention compliance modified treatment effects for universal, school-based mental health literacy interventions delivered in two large U.K. cluster randomized controlled trials (Interventions in Schools for Promoting Mental Wellbeing: Research in Education; Approaches for Wellbeing and Mental Health Literacy: Research in Education): Strategies for Safety and Wellbeing (k = 64 primary schools, N = 3,397 pupils, 91% compliers; k = 29 secondary schools, N = 3,692 pupils, 87% compliers), Mental Health and High School Curriculum Guide (k = 84 secondary schools, N = 4,879 pupils, 71% compliers; complete vs. incomplete delivery: effects on help-seeking intentions); and Youth Aware of Mental Health (k = 87 secondary schools, N = 5,408 pupils, 51% compliers; complete delivery vs. no delivery: effects on emotional difficulties). RESULTS: A compliance effect was observed for Youth Aware of Mental Health (d = -0.97), Mental Health and High School Curriculum Guide (d = 0.17), and Strategies for Safety and Wellbeing when implemented in secondary schools (d = 0.24) but not primary schools. CONCLUSION: This study provides important evidence that universal school-based mental health literacy curricula can serve as potentially efficacious programs to reduce emotional difficulties and enhance help-seeking behavior but that effects in secondary schools are largely contingent on, or amplified by, complete session delivery. To maximize impact, research must prioritize development of effective strategies and systems of support to overcome commonly identified barriers to implementation. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
Investigating craving as an indicator of early response to buprenorphine treatment among adults with opioid use disorder.
Votaw VR, London Z, Bailey AJ … +2 more , Weiss RD, McHugh RK
J Consult Clin Psychol · 2026 May · PMID 42241061 · Full text
OBJECTIVE: Reduction of craving is a key mechanism of buprenorphine treatment for opioid use disorder but has not been examined as an indicator of early response versus nonresponse. We aimed to (a) identify cut points fo...
OBJECTIVE: Reduction of craving is a key mechanism of buprenorphine treatment for opioid use disorder but has not been examined as an indicator of early response versus nonresponse. We aimed to (a) identify cut points for craving in the first week of buprenorphine treatment that best predicted later sustained opioid use and (b) examine associations between early nonresponse based on craving and opioid-related, retention, and psychosocial outcomes. METHOD: Data were from two buprenorphine trials (N = 562; M = 34 years; 38% female). Craving was rated on a 0-10 visual analog scale in each of the first 4 weeks. Area under the receiver operating characteristic curve was used to identify optimal craving cut points predicting sustained opioid use during Weeks 5-12. Associations between craving-based early nonresponse and opioid-free weeks, buprenorphine retention, and psychosocial outcomes were examined using regression models. RESULTS: Sustained opioid use was optimally predicted by craving ≥2 in Week 1 (sensitivity = 0.700; specificity = 0.513, positive predictive value = 0.398, negative predictive value = 0.788). Participants above this threshold had 2.53 times greater odds 95% CI = [1.69, 3.81] of sustained opioid use. Craving-based nonresponse was also associated with fewer opioid-free weeks and poorer end-of-treatment depression and quality of life outcomes. CONCLUSIONS: Even mild craving early in buprenorphine treatment may signal an increased risk of poor outcomes, thus identifying those who could benefit from monitoring and low-effort interventions to manage craving. However, future work is needed to optimize the prediction of poor buprenorphine outcomes, potentially using models integrating both craving and opioid use in the first weeks of treatment. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
Mental health benchmarks in the United States: An unheeded call to action.
Linkh DJ, Lancaster SL
J Consult Clin Psychol · 2026 May · PMID 42241060 · Publisher ↗
Despite longstanding calls for standardized benchmarks in U.S. outpatient mental health care, none are widely adopted, limiting the ability to evaluate outcomes, compare providers, and advance measurement-based care (MBC...
Despite longstanding calls for standardized benchmarks in U.S. outpatient mental health care, none are widely adopted, limiting the ability to evaluate outcomes, compare providers, and advance measurement-based care (MBC). Benchmarks-defined as expected outcome distributions adjusted for diagnosis, severity, and treatment dose-would make care quality observable and actionable. Their absence reflects systemic barriers, including fragmented leadership, misaligned incentives, and limited adoption of routine outcomes monitoring, rather than technical constraints. This gap obscures variability in outcomes, weakens quality improvement efforts, and hinders enforcement of mental health parity. Drawing on field experience and international comparisons, this paper argues that benchmarking must be treated as public infrastructure, supported by federal leadership, aligned incentives, and safe data-sharing frameworks. Establishing national benchmarks is essential to improving transparency, accountability, and equity in outpatient mental health care. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
Randomized controlled trial of job crafting as a digital health intervention for occupational burnout in psychological therapists.
Delgadillo J, Laker V, Simmonds-Buckley M … +14 more , Davis B, Furlong-Silva J, Keeble S, Davis O, Southgate A, Royal P, Lucock M, Booth G, Ludbrook J, McDonagh M, Webb C, Tyson-Adams H, Moon J, Thwaites R
J Consult Clin Psychol · 2026 Apr · PMID 42080863 · Publisher ↗
OBJECTIVE: Occupational burnout is common in the mental health care workforce, with negative consequences for professionals and patients. This study aimed to evaluate the efficacy of a digital health intervention to alle...
OBJECTIVE: Occupational burnout is common in the mental health care workforce, with negative consequences for professionals and patients. This study aimed to evaluate the efficacy of a digital health intervention to alleviate burnout in psychological therapists. METHOD: This randomized controlled trial recruited 135 therapists working across 17 psychological services in England. The intervention involved six online group webinars based on principles of job crafting. Half of the participants accessed the intervention immediately (Group 1), and half were assigned to a waitlist control group (Group 2). After 6 weeks, Group 2 started the intervention. Participants completed measures of burnout (primary outcome), well-being, and job satisfaction at four time points (baseline, 6, 12, 36 weeks). Outcomes were compared between groups using mixed-effects models controlling for baseline severity and clustering by service. RESULTS: Differences between groups were statistically significant after 6 weeks, favoring job crafting versus waitlist control in burnout (d = 0.43, p < .001), well-being (d = -0.39, p = .023), and job satisfaction (d = -0.28, p = .006) measures. However, the magnitude of improvements relative to baseline levels declined over a 36-week period. CONCLUSION: A brief job crafting intervention led to short-term improvements in occupational health indicators. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
Treating maternal mental health problems with an app-based program: A randomized control trial of the Building Emotional Awareness and Mental Health (BEAM) program, for mothers of young children.
Roos LE, Mackinnon AL, Xie EB … +14 more , Simpson KM, Rioux C, Reynolds KA, Giuliano RJ, Harrington J, Protudjer JLP, Sauer-Zavala S, Giesbrecht GF, Lebel C, Watts D, Belows M, Penner-Goeke L, Freeman M, Tomfohr-Madsen L
J Consult Clin Psychol · 2026 Apr · PMID 42080862 · Publisher ↗
OBJECTIVES: Exposure to maternal mental illness in the first 3 years of life is associated with poor child outcomes. Many mothers experience mental health problems and few have access to evidence-based treatments. Mobile...
OBJECTIVES: Exposure to maternal mental illness in the first 3 years of life is associated with poor child outcomes. Many mothers experience mental health problems and few have access to evidence-based treatments. Mobile health treatments show promise for mood and anxiety disorders but rarely include parenting strategies. This study evaluated the efficacy of Building Emotional Awareness and Mental Health (BEAM), a 10-week app-based therapist-guided program, which responds to maternal mental health and parenting needs. METHOD: A two-arm, Phase III randomized controlled trial was conducted to evaluate the BEAM intervention compared to unrestricted services-as-usual. Participants completed self-report measures at eligibility, prior to randomization, and immediately following the intervention. The sample included 140 mothers with children aged 18-36 months, who self-reported moderate-to-severe symptoms of depression and/or anxiety. RESULTS: Participants in both groups experienced significant decreases in depression over time with no significant difference between groups. However, BEAM outperformed the unrestricted services-as-usual condition in reducing anxiety symptoms. Among participants with higher levels of anxiety and depression symptoms at screening, those assigned to BEAM experienced greater reductions in anxiety, anger, and dysfunctional parenting interactions as well as lower harsh parenting composite scores compared to unrestricted services-as-usual. CONCLUSION: BEAM is a highly scalable intervention that has the potential to rapidly reach underserved groups in need of mental health and parenting support. Next steps include improving the user interface and exploring engagement and implementation of the program within existing health and social service systems for long-term improvements in family health and well-being. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
Who benefits from a digital intervention for appearance concerns? A randomized controlled trial of a large mixed-gender sample.
Patel TA, Cougle JR
J Consult Clin Psychol · 2026 Apr · PMID 42080861 · Full text
OBJECTIVE: Individuals with excessive appearance concerns commonly engage in appearance-related safety behaviors (ARSBs), or behaviors aimed at managing or avoiding negative evaluation of one's physical appearance. Targe...
OBJECTIVE: Individuals with excessive appearance concerns commonly engage in appearance-related safety behaviors (ARSBs), or behaviors aimed at managing or avoiding negative evaluation of one's physical appearance. Targeting these behaviors can lead to reductions in appearance concerns and related symptoms. However, prior studies have only examined these effects among women scoring above a specific cutoff, excluding men and individuals with lower levels of these concerns. The present study further evaluated the efficacy of this brief ARSB intervention and examined who benefits from this intervention. METHOD: Adults (N = 400) interested in treatment for appearance concerns were recruited across the United States and randomized to a 1-month smartphone-based intervention targeting ARSBs or a four-session relaxation video control. RESULTS: Baseline appearance concerns moderated condition effects such that, among those with elevated concerns, ARSB fading led to lower appearance concerns than control at post, while conditions did not differ among those with low concerns. Probing the moderated effect using the Johnson-Neyman technique indicated ARSB fading led to significantly lower appearance concerns at post among those scoring in the upper two thirds in appearance concerns (SMD = 0.39). ARSB fading also led to lower body dissatisfaction (SMD = 0.15-0.19) at post and follow-up, and among those high in appearance concerns, ARSB fading led to lower bulimic symptoms at post (SMD = 0.34). No demographic factor moderated the effects of treatment, indicating comparable efficacy between men and women. CONCLUSIONS: These findings further support the efficacy of ARSB fading and provide novel evidence for individuals who are likely to benefit from this intervention. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
Strengthening self-continuity to reduce depressive symptoms and derailment: A multiphasic mixed-methods randomized controlled trial.
Davis CJ, Levinbook EJ, Spearman SR … +2 more , Lyman C, Burrow AL
J Consult Clin Psychol · 2026 Apr · PMID 42080860 · Publisher ↗
OBJECTIVE: Emerging adulthood is a critical period for identity formation and heightened vulnerability to depression. Given that disruptions in identity continuity and coherence-captured by the construct derailment-are l...
OBJECTIVE: Emerging adulthood is a critical period for identity formation and heightened vulnerability to depression. Given that disruptions in identity continuity and coherence-captured by the construct derailment-are linked to elevated depressive symptoms, strengthening temporal-identity processes may offer a path for symptom relief. We tested a narrative journaling intervention targeting self-continuity to reduce depressive symptoms among emerging adults. METHOD: In Phase 1, we examined baseline associations among derailment, self-continuity, and depressive symptoms in a community sample (N = 242). In Phase 2, eligible participants (N = 112) were randomized to a derailment-focused intervention or neutral reflective journaling control condition, with outcomes assessed during the intervention and at 2 week and 2 month postintervention. In Phase 3, we conducted an exploratory thematic analysis of responses within the experimental condition. RESULTS: Relative to controls, participants in the experimental condition reported lower derailment, higher self-continuity, and lower depressive symptoms, with group differences maintained at 2 month postintervention. An autoregressive cross-lagged path analysis yielded a pattern consistent with an indirect association between intervention assignment and both downstream depressive symptoms and derailment through early gains in self-continuity. Exploratory thematic analyses indicated that participants reporting larger symptom decreases described narratives characterized by reflective self-evaluation, whereas those reporting minimal changes more often described fragmented narratives and ruminative brooding. CONCLUSION: Findings provide evidence that a derailment-focused journaling intervention may reduce depressive symptoms and derailment. Early gains in self-continuity represent a plausible candidate process and a target for future mechanistic tests. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
Alliance in internet-based interventions: A systematic review and correlation multilevel meta-analysis.
Flückiger C, Schweizer AM, Boehme MS … +3 more , Goméz Penedo JM, Berger T, Wampold BE
J Consult Clin Psychol · 2026 Apr · PMID 42080859 · Publisher ↗
OBJECTIVE: Internet-based interventions (IBIs) offer scalable, low-threshold treatment options for mental health care. The therapeutic alliance is a key collaborative quality in psychological therapy, yet its role and st...
OBJECTIVE: Internet-based interventions (IBIs) offer scalable, low-threshold treatment options for mental health care. The therapeutic alliance is a key collaborative quality in psychological therapy, yet its role and structure in IBIs remain debated. METHOD: This correlational meta-analysis synthesizes the overall alliance-outcome association (k = 82 effect sizes nested in s = 40 independent samples; n = 2,864 participants) and its variability across the Working Alliance Inventory subscales using meta-analytic multilevel models. RESULTS: The overall association was small to moderate (r = .21) confirming the relevance of alliance in digital contexts. Subscale-specific analyses showed that task (r = .25) and goal (r = .19) were more predictive of treatment outcomes than bond (r = .12), highlighting a shift toward cognitive-collaborative components in IBIs. Even exploratory in nature, none of the examined moderators (diagnosis, alliance rater, face-to-face contact, therapeutic approach, publication year, and country) systematically influenced the effect size. CONCLUSIONS: The results confirm the robustness of the prediction of the alliance on outcomes observed in the general literature and at the same time point to the particular qualities of using IBIs. Future work is needed to adapt the conceptualization and assessment of alliance in IBI. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
Efficacy of a blended counseling intervention (I-PREGNO) on mental well-being of vulnerable mothers postpartum: Findings from a cluster randomized controlled trial.
Vogel L, Seizer L, Boehlke E … +12 more , Deliens T, Färber T, Henning C, Liel C, Lux U, Opitz A, Schoemann N, Seiferth C, Van Poppel MN, Versele V, Wolstein J, Löchner J
J Consult Clin Psychol · 2026 Mar · PMID 41926194 · Publisher ↗
OBJECTIVE: Parents face numerous changes and challenges during the postpartum period, increasing their risk of mental health issues. Parents with psychosocial burdens are particularly vulnerable to develop mental health...
OBJECTIVE: Parents face numerous changes and challenges during the postpartum period, increasing their risk of mental health issues. Parents with psychosocial burdens are particularly vulnerable to develop mental health issues and are in need of targeted intervention programs. This article presents analyses of secondary outcomes of a cluster randomized controlled trial examining the efficacy of the intervention "I-PREGNO" in psychosocially burdened mothers during the postpartum period. I-PREGNO represents a 12-week mobile application-based blended counseling aiming to enhance transdiagnostic psychological mechanisms and health behavior during the postpartum period. METHOD: A two-arm parallel cluster randomized controlled trial was conducted in Germany with N = 108 psychosocially burdened mothers of children aged 0-12 months, recruited via a national early childhood intervention program. Assessments included baseline assessment (T0), postintervention assessment 12 weeks after baseline (T1), and one follow-up assessment 6 months after baseline (T2). Mixed-model repeated measures analyses were used to examine differences in well-being between the intervention group and the control group (treatment as usual), measured by scores on the Parenting Stress Index and the Edinburgh Postnatal Depression Scale. RESULTS: No significant differences between the groups at T1 and T2 were observed on Parenting Stress Index and the Edinburgh Postnatal Depression Scale. Post hoc tests revealed that mothers in the intervention group who started the intervention within the first 5 months postpartum had significantly reduced Parenting Stress Index scores at T1. CONCLUSION: While exploratory analyses indicated that I-PREGNO may have potential in reducing parenting stress shortly after childbirth, it may not be sufficient for the prevention of postpartum depressive symptoms. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
Interventions for autistic adults: A meta-analysis.
Smith IC, Holmes LG, White SW
J Consult Clin Psychol · 2026 Mar · PMID 41926193 · Publisher ↗
OBJECTIVE: The vast majority of autistic adults experience challenges related to co-occurring mental health problems, social cognition, postsecondary education or competitive employment, and other concerns. Services to a...
OBJECTIVE: The vast majority of autistic adults experience challenges related to co-occurring mental health problems, social cognition, postsecondary education or competitive employment, and other concerns. Services to address these challenges have been identified as a priority for research. This review and meta-analysis were undertaken to determine the clinical impact of interventions for a wide range of concerns for autistic adults. METHOD: We conducted a preregistered systematic review and meta-analysis of interventions targeting social cognition, mental health, and academic- and transition-related outcomes for autistic adults. Randomized controlled trials and quasi-experimental studies were eligible for inclusion, while single-case and pre-post designs were excluded. We extracted data on participant and intervention characteristics, primary outcome data in 10 domains (e.g., mental health, social cognition), and risk of bias. RESULTS: Thirty-five studies were included (N = 1,631 total participants). Random-effects meta-analyses using robust variance estimation revealed significant small to moderate pooled effect sizes for mental health (k = 16, g = .35, 95% CI [0.19, 0.51], I2 = 18.13%), social cognition (k = 16, g = .45, 95% CI [0.17, 0.74], I2 = 67.77%), and quality of life (k = 8, g = .64, 95% CI [0.14, 1.15], I2 = 80.48%). Meta-analyses of behavioral, cognitive, adaptive, and employment outcomes were nonsignificant. CONCLUSION: Interventions for autistic adults show promise, often producing small-to-moderate positive outcomes as compared to treatment as usual or waitlist controls. Effects largely align with those seen in the child and adolescent autism literature, despite considerable heterogeneity. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
Legal outcomes of task-shifting contingency management for youth substance use to rural probation officers: Secondary results from a randomized clinical trial.
Sheidow AJ, Drazdowski TK, Chapman JE … +1 more , McCart MR
J Consult Clin Psychol · 2026 Mar · PMID 41926192 · Full text
OBJECTIVE: Youth substance use disorder is a significant problem in rural communities, yet treatment access is negligible. Task-shifting evidence-based treatments to juvenile probation officers (JPOs) may help, but could...
OBJECTIVE: Youth substance use disorder is a significant problem in rural communities, yet treatment access is negligible. Task-shifting evidence-based treatments to juvenile probation officers (JPOs) may help, but could increase surveillance and thus be iatrogenic for legal outcomes. Task-shifting contingency management (CM) to JPOs was examined for increased youth legal system consequences. METHOD: Data were from a randomized clinical trial that randomized 32 JPOs in Idaho to probation as usual (PAU) or family-based CM integrated into probation. Then, 160 youth with substance use disorder on probation were randomized to JPOs delivering PAU or JPO-delivered CM. Legal system records (charges and detentions) spanning 18 months before and after randomization were obtained for each youth from the state database. RESULTS: For CM and PAU groups, respectively, 32.6% versus 51.4% had at least one charge postrandomization, 22.1% versus 20.3% had at least one detention, and median charge count was 0.0 (interquartile range, 0.0-1.0) versus 1.0 (interquartile range, 0.0-2.0). Intent-to-treat generalized linear mixed effects models nested youth within JPOs. Groups did not differ on charge count (event rates = 1.12; 95% CI [0.29, 4.36]) or likelihood of detention (OR = 1.54; 95% CI [0.65, 3.65]). However, CM youth had a significantly lower likelihood of receiving a charge (OR = 0.42; 95% CI [0.21, 0.83]), with a predicted probability of 31% (95% CI [21%, 42%]) versus 52% for PAU (95% CI [40%, 63%]). CONCLUSIONS: Youth legal system consequences do not worsen when JPOs deliver CM. The likelihood of a new charge actually decreases when JPOs deliver CM. Task-shifting CM for youth substance use to JPOs could increase treatment access in rural communities. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
Comparing dropout from cognitive processing therapy versus prolonged exposure: Results from a randomized clinical trial.
Harper KL, Crow TM, Thompson-Hollands J … +6 more , Kearns JC, Mattern AC, Collazo EN, Arenson MB, Marx BP, Schnurr PP
J Consult Clin Psychol · 2026 Mar · PMID 41926191 · Full text
OBJECTIVE: Dropout from evidence-based psychotherapies for posttraumatic stress disorder (PTSD; e.g., cognitive processing therapy [CPT] and prolonged exposure [PE]) remains a problem, with rates around 38%-51% in routin...
OBJECTIVE: Dropout from evidence-based psychotherapies for posttraumatic stress disorder (PTSD; e.g., cognitive processing therapy [CPT] and prolonged exposure [PE]) remains a problem, with rates around 38%-51% in routine care settings. Research is needed to characterize predictors and timing of dropout to inform intervention efforts. Using data from the largest randomized controlled trial of CPT and PE to date, we examined the timing and predictors of dropout, including sociodemographic and psychosocial variables. METHOD: Participants (N = 916; average age = 45.2; 79.9% male; 64.4% White) were U.S. veterans with PTSD who were randomized to receive PE (n = 455) or CPT (n = 461). Participants completed measures to assess demographic characteristics, PTSD symptoms, depression symptoms, quality of life, substance use, and treatment expectations and preferences. Dropout was defined as completing less than 12 sessions or completing fewer sessions than required based on the study protocol for early responders. RESULTS: Dropout was significantly higher in PE (52.31%) than in CPT (45.77%). Survival analyses indicated better retention in CPT over time and suggested that this group difference became significant starting after Session 3. Slower reduction in PTSD symptom severity was related to dropout in CPT, but not in PE. Regression models showed that veterans who were younger, Black, and service-connected for PTSD were more likely to drop out. CONCLUSIONS: Few pretreatment predictors were associated with dropout, indicating the need for additional research, such as using more intensive, longitudinal methods with time-varying predictors during treatment, to elucidate reasons for dropout from these first-line trauma psychotherapies. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
Randomized controlled trial of smartphone-based interpretation bias intervention for anxiety and depression.
Silverman AL, Kovarsky Rotta G, Shin D … +2 more , Ferguson I, Beard C
J Consult Clin Psychol · 2026 Mar · PMID 41926190 · Full text
OBJECTIVE: HabitWorks (HW) is a personalized, transdiagnostic, smartphone-based interpretation bias intervention for depression and anxiety that has demonstrated feasibility and acceptability in prior pilot studies. This...
OBJECTIVE: HabitWorks (HW) is a personalized, transdiagnostic, smartphone-based interpretation bias intervention for depression and anxiety that has demonstrated feasibility and acceptability in prior pilot studies. This preregistered randomized controlled trial (https://doi.org/10.17605/OSF.IO/EJ89T; Silverman, Kovarsky Rotta, et al., 2025) tested the effectiveness of HW compared with a symptom tracking (ST) control condition. METHOD: A nonclinical community sample of U.S. adults with at least mild anxiety and depression symptoms (N = 340; Mage = 33.04 years, 57.4% women, 60.6% White, 14.7% Black, 11.2% Asian, 10.9% Multiracial, 22.1% Hispanic/Latine) were randomly assigned to complete three weekly interpretation bias exercises and once weekly depression and anxiety symptom surveys (HW) or three weekly depression and anxiety symptom surveys (ST) for 4 weeks. RESULTS: A priori benchmarks for retention, adherence, and satisfaction were achieved: 77.8% of HW participants were still using the app in Week 4, 43.7% achieved perfect adherence, and app usability and acceptability were rated positively. As hypothesized, HW was superior to ST at improving negative and benign interpretation biases (Word-Sentence Association Paradigm) and functional impairment (Work and Social Adjustment Scale); and HW (vs. ST) participants reported significantly greater global improvement (Clinical Global Impressions Scale-Improvement Self-Report) and subjective engagement (Twente Engagement with eHealth Technologies Scale) at postintervention. Unexpectedly, while depression and anxiety symptoms (Patient Health Questionnaire-8 and Generalized Anxiety Disorder Scale-7) improved significantly, these changes were not unique to HW. CONCLUSIONS: HW is an engaging and scalable intervention that may be effective for improving overall severity and functioning. Further validation of effectiveness for specific symptom domains is needed. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
Examining theoretical mediators in a culturally adapted, community health worker-led intervention for depression and anxiety.
Eddington KM, Supple AJ, Poindexter C … +3 more , Markle S, Livas G, Alegría M
J Consult Clin Psychol · 2026 Feb · PMID 41712341 · Publisher ↗
OBJECTIVE: Emerging research suggests that mental health interventions led by community health workers (CHW) are effective and increase access to services for minoritized groups. However, the question of how these interv...
OBJECTIVE: Emerging research suggests that mental health interventions led by community health workers (CHW) are effective and increase access to services for minoritized groups. However, the question of how these interventions work has rarely been tested. In this secondary analysis of data from a randomized clinical trial of a CHW-led intervention that included training in mindfulness and encouraged active engagement and self-efficacy in managing mental health care, we aimed to examine several mediators of change based on theoretical mechanisms of action. METHOD: A sample of 1,044 racially and ethnically diverse adults (mean age 42.6; 83.8% female-identifying) with moderate to severe depression or anxiety symptoms were randomly assigned to the Strong Minds, Strong Communities psychoeducational intervention or an enhanced control condition. Models tested the direct effects of the intervention on outcomes (depression, anxiety, and functional impairment) as well as the indirect effects of proposed mediators (mindfulness, patient activation, self-efficacy, and working alliance). RESULTS: Multiple mediator models showed consistent, significant indirect effects of mindfulness across all outcomes, suggesting partial mediation. Patient activation was a significant partial mediator for depression only. Results for the working alliance were consistently nonsignificant. Exploratory analyses examined moderation by racial/ethnic group (Latinx, Asian, non-Latinx Black, and non-Latinx White), finding no significant effects. CONCLUSION: These findings suggest that structured, short-term CHW-led interventions are operating through similar therapeutic processes as those observed in studies using licensed professionals. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
Cost-effectiveness of transdiagnostic group cognitive behavioral therapy for emotional disorders in primary care: An analysis of the PsicAP clinical trial.
Ruiz-Rodríguez P, Muñoz-Navarro R, Esteller-Collado G … +7 more , Moretti L, Carpallo-González M, Prieto-Vila M, González-Blanch C, Moriana JA, Medrano LA, Cano-Vindel A
J Consult Clin Psychol · 2026 Feb · PMID 41712340 · Publisher ↗
UNLABELLED: Objective/s: Transdiagnostic cognitive behavioral therapy has proven to be an effective treatment for emotional disorders. However, the cost-effectiveness of group Transdiagnostic cognitive behavioral therapy...
UNLABELLED: Objective/s: Transdiagnostic cognitive behavioral therapy has proven to be an effective treatment for emotional disorders. However, the cost-effectiveness of group Transdiagnostic cognitive behavioral therapy remains unknown. Given the growing demand for psychological care in primary care in the context of limited resources, an economic evaluation of transdiagnostic group cognitive behavioral therapy (TD-GCBT) would provide valuable data for treatment decision making. AIMS: To conduct an economic evaluation of the PsicAP treatment protocol. METHOD: The PsicAP-Costs was a multicenter, randomized controlled trial of 429 patients with a suspected diagnosis of anxiety, depression, and/or somatoform disorders. Participants were randomized to treatment as usual (TAU [control group] or TD-GCBT plus TAU [experimental group]). Treatment consisted of seven sessions of TD-GCBT delivered over a 12-14 week period. RESULTS: The primary efficacy outcomes were significantly better in the TD-GCBT + TAU group, with small to large effect sizes for the reduction of depression, anxiety, and somatization symptoms. The economic evaluation yielded a mean incremental effectiveness of .06 quality-adjusted life years with a mean incremental cost of 263€. This resulted in an incremental cost-effectiveness ratio of 4,759€ per quality-adjusted life year. CONCLUSIONS: The integration of TD-GCBT into TAU represents a cost-effective therapeutic approach. The incremental cost-effectiveness ratio of 4,759€ per quality-adjusted life years is well below the willingness-to-pay threshold accepted in Spain, which ranges from 20,000€ to 25,000€. At this threshold, the probability that the intervention is cost-effective is high, ranging from 86% to 89%. Therefore, the implementation of TD-GCBT in PC may represent a cost-effective option for improving the quality of care for emotional disorders. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
Therapist effects in internet-delivered cognitive behavior therapy for anxiety and depression.
Feliciano IFG, Staples L, Scott A … +4 more , Jones MP, Hadjistavropoulos H, Titov N, Dear BF
J Consult Clin Psychol · 2026 Feb · PMID 41712339 · Publisher ↗
OBJECTIVE: Several clinical studies have found that therapists differ in their client outcomes, supporting the notion of "therapist effects" in psychotherapy. However, only a handful of studies have investigated therapis...
OBJECTIVE: Several clinical studies have found that therapists differ in their client outcomes, supporting the notion of "therapist effects" in psychotherapy. However, only a handful of studies have investigated therapist effects in internet-delivered cognitive behavior therapy. This study aimed to examine therapist effects in internet-delivered cognitive behavior therapy treatment of anxiety and depression in routine care. METHOD: Data of 8,145 clients who were treated by 44 therapists were examined. Generalized linear mixed models were performed to identify the presence of therapist effects and the amount of variance attributable to therapists across several outcomes: (a) change in symptoms over time, (b) the occurrence of clinically significant change, (c) treatment completion, and (d) client satisfaction. RESULTS: Significant therapist effects were observed across all outcomes, indicating that there were differences between therapists in each outcome domain. However, the therapist effects appear relatively modest overall, with therapists explaining 1.5% and 1.4% of variance in change over time in anxiety and depression, respectively, 0.6% and 0.7% of the variance in the occurrence of clinical change in anxiety and depression, respectively, 2.3% of treatment completion, and 1.4% of client satisfaction. CONCLUSIONS: The findings suggest that there are differences among therapists across a range of outcomes. However, these differences account for a modest proportion of the overall variation in client outcomes. Future research is needed to replicate these findings across different contexts before firm conclusions are drawn. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
A randomized controlled trial of injunctive norms feedback with and without motivational interviewing to reduce alcohol use and negative consequences among college students.
Neighbors C, Rodriguez LM, Rinker DV … +8 more , Young CM, DiBello AM, Swanson A, Krieger H, Tomkins M, Cronce JM, Knee CR, Lewis MA
J Consult Clin Psychol · 2026 Feb · PMID 41712338 · Publisher ↗
OBJECTIVE: Personalized normative feedback interventions targeting perceived descriptive norms (perceptions of how much or how often other people drink) have repeatedly been shown to reduce problem drinking among young a...
OBJECTIVE: Personalized normative feedback interventions targeting perceived descriptive norms (perceptions of how much or how often other people drink) have repeatedly been shown to reduce problem drinking among young adults. Less work has targeted perceived injunctive norms (perceptions of others' approval of drinking), possibly due to the potential for reactance to feedback, which communicates that others disapprove of intervention recipients' drinking. Motivational interviewing (MI) is a nonjudgmental clinical approach that diffuses reactance by emphasizing empathy and autonomy. This study evaluated the efficacy of in-person computer-delivered injunctive personalized normative feedback (IPNF) and facilitator-delivered IPNF with MI (IPNF + MI) in reducing alcohol consumption (past month drinking, typical weekly drinking, and maximum drinks consumed on one occasion) and two indices of alcohol-related consequences. METHOD: Participants included 605 heavy-drinking college students from two large universities who were randomized to receive either IPNF, IPNF + MI, or attention control feedback. Participants completed 3- and 6-month follow-up surveys. RESULTS: Findings revealed no significant reductions in alcohol outcomes for IPNF relative to control. Results showed significant reductions for IPNF + MI relative to control in drinks per week and both indices of alcohol-related consequences. The effect of IPNF + MI was significantly stronger than IPNF for one index of consequences. There were no between-condition effects for peak drinks consumed or past month drinking after correcting for multiple comparisons. Mediation results revealed indirect effects of both IPNF conditions versus control through reductions in injunctive norms on all outcomes. CONCLUSIONS: Results provide modest evidence for injunctive norms-based feedback as an intervention strategy for heavy-drinking students only when MI-delivered. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe