Psychotherapy Research

Psychotherapy Research

Published by Taylor & Francis

Online ISSN: 1468-4381

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Print ISSN: 1050-3307

Journal websiteAuthor guidelines

Top-read articles

137 reads in the past 30 days

Secret-keeping in therapy by clients who are sexually attracted to children

October 2023

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1,904 Reads

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6 Citations

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Ian V. Mcphail

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Objective This study investigated the reasons why pedohebephilic clients disclose their sexual attraction to children in therapy and the experiences associated with this decision among English-speaking samples. Method: The pre-registered online survey combined (1) quantitative correlational data of self-reported improvement, alliance, therapist reaction to disclosure, and the belief that mandatory reporting laws were in place, and (2) qualitative data about reasons for disclosure or no disclosure as well as perceived consequences. The sample consisted of pedohebephilic people who have been clients in therapy and have disclosed (n = 96) or not disclosed (n = 40). Results: While the disclosure and no disclosure groups did not differ in improvement or beliefs about mandatory reporting, those who had disclosed reported a stronger alliance. Clients who did not perceive the therapist’s reaction as supportive reported less improvement than the no disclosure group. Thematic analysis of qualitative data identified three themes concerning motives for disclosing or not disclosing and a fourth regarding differential impacts of disclosure. Discussion: This study indicates that disclosing pedohebephilia does not in and of itself lead to improvement but is contingent on a therapist’s reaction.

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74 reads in the past 30 days

Development of the Cultural Humility Scale—Short Form (CHS-SF)

December 2024

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142 Reads

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1 Citation

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Jesse Owen

Objective: The purpose of the present study was to develop a brief version of the Cultural Humility Scale (CHS; Hook et al., 2013) to reduce participant burden in clinical settings. Method: In Study 1 (n = 247), we used confirmatory factor analyses (CFA) and two-factor item response theory (IRT) models to create the Cultural Humility Scale – Short Form (CHS-SF). In Study 2 (n = 272), we performed cross-validation of the CHS-SF. We also examined construct validity using the Cross-Cultural Counseling Inventory-Revised (CCCI-R; LaFromboise et al., 1991) and the Working Alliance Inventory (WAI; Tracey & Kokotovic, 1989). Results: The CHS-SF has two 3-item subscales (positive/negative cultural humility). The CFA for the CHS-SF showed excellent model fit, and all coefficients demonstrated good-to-excellent reliability for the whole scale. The factor structure was replicated with a unique sample, and we also found evidence of measurement invariance by gender and race/ethnicity. The CHS-SF again showed adequate estimates of reliability. The CHS-SF was positively correlated with both the CCCI-R and WAI. Conclusion: The CHS-SF offers an efficient tool for measuring therapists' cultural humility based on client perceptions during treatment. Like the original CHS, it is well-suited for routine care and training environments. Implications for practice and research, limitations, and directions for future inquiry are discussed.

Aims and scope


Psychotherapy Research seeks to enhance the development, scientific quality, and social relevance of psychotherapy education, policy, and practice.

  • Psychotherapy Research seeks to enhance the development, scientific quality, and social relevance of psychotherapy research and to foster the use of research findings in practice, education, and policy formulation.
  • Psychotherapy Research is the official journal of the Society for Psychotherapy Research.
  • A pan-discipline, pan-theoretical publication, its scope covers all aspects of psychotherapy research from process to outcomes; service evaluation and training.
  • Access to all the online content of the journal from 1991 is available free to all members of SPR.
  • The journal publishes original research on all aspects of psychotherapy, including its outcomes, its processes, education of practitioners, and delivery of services.
  • It publishes: original empirical research papers, theoretical and methodological research papers, review articles.
  • The journal is committed to promoting international communication by addressing an international and …

For a full list of the subject areas this journal covers, please visit the journal website.

Recent articles


Predicting working alliance in psychotherapy: A multi-modal machine learning approach
  • Article

February 2025

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31 Reads

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2 Citations

Objective.Session-by-session tracking of the working alliance enables clinicians to detect alliance deterioration and intervene accordingly, which has shown to improve treatment outcome, and reduce dropout. Despite this, regular use of alliance self-report measures has failed to gain widespread implementation. We aimed to develop an automated alliance prediction using behavioral features obtained from video-recorded therapy sessions. Method: A naturalistic dataset of session recordings with patient-ratings of working alliance was available for 252 in-person and teletherapy sessions from 47 patients treated by 10 clinicians. Text and audio-based features were extracted from all 252 sessions. Additional video-based feature extraction was possible for a subsample of 80 sessions. We developed a modeling pipeline for audio and text and for audio, text and video to train machine learning regression models that fuse multimodal features. Results: Best results were achieved with a Gradient Boosting architecture, when using audio, text, and video features extracted from the patient (ICC = 0.66, Pearson r = 0.70, MAE = 0.33). Conclusion: Automated alliance prediction from video-recorded therapy sessions is feasible with high accuracy. A datadriven multimodal approach to feature extraction and selection enables powerful models, outperforming previous work.



Figure 1. Illustration of experimental intervention and number of participants
Figure 3. Fiona's weekly ODSIS scores and pre-and post-therapy scores on BDI and WSAS.
Figure 4. Celina's weekly ODSIS scores and pre-and post-therapy scores on BDI and WSAS.
Figure 5. Casper's weekly ODSIS scores and pre-and post-therapy scores on BDI and WSAS * . Note. * In Casper's case, the pNOT criteria were slightly adjusted, making room for AOI even though the ODSIS score dropped 1 point.
Personalization of structured group psychotherapy through add-on interventions: A potential for active engagement
  • Article
  • Full-text available

February 2025

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12 Reads

Objective: Routine Outcome Monitoring (ROM) in group psychotherapy has shown varied results, as personalizing therapy for multiple patients is challenging. This study explored the impact of ROM and individual Add-On Interventions (AOIs) for patients with depression who were not progressing during Group Cognitive Behavioral Therapy (GCBT). We followed the research question, "How can individual AOIs contribute to patients' therapy courses?". Method: We interviewed patients and therapists involved in GCBT with ROM and individual AOIs prompted by Not-On-Track alerts. Thematic analysis was used to generate themes related to participants' experiences. Three cases were selected to illustrate the structure of the themes. Results: The main theme, "AOIs: Potential for active engagement," was constituted by seven subthemes concerning the influence of ROM, therapeutic collaboration, shared decision-making, allowing for person-tailored interventions, and the dynamic between group and individual sessions. The potential for active engagement was nurtured through flexible awareness, as patients shifted between a first-person perspective and an external perspective on their therapy process. Conclusion: Individual AOIs, prompted by patient feedback, could create opportunities for reflection and engagement. However, the impact was shaped by the therapeutic relationships, the shared decision-making process, and the extent to which the AOIs offered complementary approaches to group psychotherapy. Clinical or Methodological Significance of this Article: This study introduces a new way of integrating ROM into group psychotherapy by applying individual AOIs for patients who are not improving as expected. The findings provide a foundation for the future development of more flexible and responsive ROM systems in group psychotherapy, offering a personalized treatment path that can enhance engagement for patients at risk of non-response.





Figure 2. Number of papers using empirical data collected with CORE measures over the years (N = 491).
Mapping the growth of the CORE system tools in psychotherapy research from 1998 to 2021: Learning from historical evidence

February 2025

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32 Reads

Background: The Clinical Outcomes in Routine Evaluation (CORE) system was launched in 1998 intended to support the development of practice-based evidence and to reduce the research/practice gap. Since then, CORE instruments have been widely used. Aims: To map the utilization of the CORE system as reflected in peer-reviewed literature. Methods: We followed the guidelines for conducting a scoping review. Results: We identified 721 papers from 1998 to 2021 citing the CORE system, with 636 of them referencing its use in clinical settings. There has been a marked increase in use of the system over that period. All CORE instruments were used at least once, spanning 39 countries and 24 languages. Papers had a broad spectrum of objectives and populations across diagnoses and settings, aligning with the authors’ planned versatility for the CORE system. Conclusions: In the light of the findings, we present a guide to enhance the reporting of work utilizing the CORE system. This could be applied to all practice-based evidence data collection, CORE or otherwise.



Development and validation of countertransference feeling and behavior awareness measures in an Italian and American clinician sample

January 2025

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32 Reads

Objective: Countertransference (CT) has been shown to interfere with therapy goals, and its management is crucial to desired treatment outcomes. As a first step, a clinician’s awareness of their covert and overt CT reactions is critical to successfully managing CT. Research on CT awareness is scarce, however, mainly because of difficulties in empirically investigating and measuring this construct. In this study, we sought to develop and validate two instruments: one to measure CT feelings and one to measure CT behaviors. Method: We developed the Countertransference Feelings Awareness Measure and the Countertransference Behavior Awareness Measure, both composed of 12 items comprising 3 dimensions: dominant, hostile and distant. A sample of 245 Italian and 110 American clinicians participated in the research. Confirmatory factor analysis was conducted to verify the factor structure of the measures. Reliability and invariance analyses were conducted for both measures and both samples. Results: Factorial structure, reliability, and configural invariance across nationalities of both measures were confirmed. Conclusion: These tools should prove useful for future research, supervision, theoretical advances, and clinical application, allowing a deeper understanding of how clinicians’ awareness of different elements of their CT experience impacts the outcome of therapy.








Development of the Cultural Humility Scale—Short Form (CHS-SF)

December 2024

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142 Reads

·

1 Citation

Objective: The purpose of the present study was to develop a brief version of the Cultural Humility Scale (CHS; Hook et al., 2013) to reduce participant burden in clinical settings. Method: In Study 1 (n = 247), we used confirmatory factor analyses (CFA) and two-factor item response theory (IRT) models to create the Cultural Humility Scale – Short Form (CHS-SF). In Study 2 (n = 272), we performed cross-validation of the CHS-SF. We also examined construct validity using the Cross-Cultural Counseling Inventory-Revised (CCCI-R; LaFromboise et al., 1991) and the Working Alliance Inventory (WAI; Tracey & Kokotovic, 1989). Results: The CHS-SF has two 3-item subscales (positive/negative cultural humility). The CFA for the CHS-SF showed excellent model fit, and all coefficients demonstrated good-to-excellent reliability for the whole scale. The factor structure was replicated with a unique sample, and we also found evidence of measurement invariance by gender and race/ethnicity. The CHS-SF again showed adequate estimates of reliability. The CHS-SF was positively correlated with both the CCCI-R and WAI. Conclusion: The CHS-SF offers an efficient tool for measuring therapists' cultural humility based on client perceptions during treatment. Like the original CHS, it is well-suited for routine care and training environments. Implications for practice and research, limitations, and directions for future inquiry are discussed.


Affect integration, metacognitions, and early maladaptive schemas as predictors of outcome in cognitive and metacognitive therapies for social anxiety disorder

December 2024

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100 Reads

Objective: Few reliable patient characteristics have emerged as significant predictors of outcomes for Social Anxiety Disorder (SAD). This study aimed to explore whether affect integration, metacognitions, and maladaptive schemas could serve as predictors of therapeutic outcomes for patients with SAD. Relationships between these psychological constructs and baseline SAD symptomatology were also examined. Methods: Eighty-eight patients across three sites participated in Cognitive Behavioral Therapy (CBT) or Metacognitive Therapy (MCT) for SAD in inpatient or outpatient clinics. Measures of predictors and SAD symptomatology were repeatedly assessed. Statistical analyses included longitudinal, multilevel modelling. Results: Difficulties with affect integration, metacognitions and early maladaptive schemas clearly related to higher levels of SAD symptoms at baseline but were not generally predictive of changes in SAD symptoms during therapy. However, examining sub-domains revealed that difficulties with the integration of jealousy and tenderness, and the maladaptive schema of defectiveness/shame, predicted poorer outcomes. In contrast, initial difficulties with the integration of sadness, a greater lack of cognitive confidence, and the maladaptive schema of dependence/incompetence were associated with greater symptom improvement. Conclusion: Identifying issues of affect integration and core self-other beliefs prior to therapy may enhance patient selection and allow for a more individualized treatment. Clinical significance statement: General difficulties with affect integration, metacognitions, and early maladaptive schemas are key features of SAD severity but do not appear to hinder symptom improvement for patients undergoing cognitive or metacognitive therapy. However, poor affect integration of jealousy and tenderness, along with the maladaptive schema of defectiveness/shame, may limit therapeutic progress.








A first look at diversity gaps in psychotherapy research publications and representation

November 2024

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134 Reads

Abstract Objective There is a pervasive underrepresentation of researchers and clinicians from diverse backgrounds in psychology. This is the first study to focus on diversity gaps in Psychotherapy Research. We examine a gap in the representation of research from low-income countries and summarize barriers and solutions to increase diversity in the field. Method We examined trends in submission, acceptance, and rejection rates of all submissions (n = 7183) from 75 countries, representing eight geographical regions to Psychotherapy Research, between 28 April 2005 and 22 June 2023. Results Most submissions were from Europe and North America, with the fewest from Africa and Asia/Northeast Asia. High-income countries had significantly more submissions than low-income countries, with gaps increasing over time. North America and Europe had the highest acceptance rates and Africa and Asia/Southeast Asia had the lowest rates. Conclusion Psychotherapy Research is one of the most internationally representative journals in the field. Yet, we found underrepresentation of non-western countries. There is a need to increase the representation of research participants and researchers from non-western countries through direct initiatives and investments in research and researchers from underrepresented backgrounds.



Journal metrics


2.6 (2023)

Journal Impact Factor™


37%

Acceptance rate


7.8 (2023)

CiteScore™


12 days

Submission to first decision


1.853 (2023)

SNIP


1.477 (2023)

SJR

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