A randomized controlled trial of targeted vs. General direct-to-consumer marketing to address psychotherapy attitudes and stigma in military service members and Veterans.

Many military service members and Veterans who experience a psychological need do not seek psychotherapy, which may be due to negative attitudes and stigma toward mental health services. In this study, we investigated the effectiveness of a general vs. military-specific direct-to-consumer psychotherapy marketing video to address psychotherapy attitudes in a nationwide sample of military service members and Veterans ( = 262).

Preventing dropout in spiritually integrated psychotherapies: What are the effective methods of attending to clients' spirituality?

The purpose of this study was to examine associations between clinicians' use of varying types of spiritual interventions in the first session of spiritually integrated psychotherapies (SIPs) and clients' likelihood of returning for a second session. In total, 154 practitioners of SIPs from 33 settings in a practice-research network reported on their implementation of different methods for addressing clients' religion/spirituality on an after-session summary checklist. Roughly 80% or more of the clinicians implemented at least one spiritual intervention in the first session; on average, clinicians used 3.

Adherence to Online Interventions for Family Caregivers of People With Dementia: A Meta-Analysis and Systematic Review.

Objective: Online interventions hold promise in supporting the well-being of family caregivers and enhancing the quality of care they provide for individuals with long-term or chronic conditions. However, dropout rates from support programs among specific groups of caregivers, such as caregivers of people with dementia, pose a challenge. Focused reviews are needed to provide more accurate insights and estimates in this specific research area.

No client left behind: A meta-analysis of premature termination from psychotherapy in U.S. service members and veterans.

Dropout has been identified as a significant problem among military populations seeking psychotherapy (Goetter et al., 2015; Hoge et al., 2014), yet an overall estimate of its exact prevalence and predictors does not exist.

Effort and effort discounting as predictors of seeking psychotherapy among individuals with depression.

Objectives: Many individuals who experience depression do not seek psychotherapy, and past research has had limited success in predicting help-seeking in this population. Accounting for behavioral characteristics of depression that affect help-seeking decisions, such as effort discounting (devaluation of rewards as a function of effort), may address this gap.

Methods: Individuals with moderate-severe depression symptoms who were not in psychotherapy (N = 253) reported their depression symptom severity and the amount of effort they anticipated seeking psychotherapy would require; they also completed a behavioral measure of effort discounting.

A meta-analysis of the effects of role induction in psychotherapy.

Role induction is a pantheoretical method that can be used in the initial phase of psychotherapy to prepare patients for treatment. The purpose of this meta-analysis was to examine the effects of role induction on treatment dropout, and immediate, mid-, and posttreatment outcomes for adult individual psychotherapy patients. A total of 17 studies were identified that met all inclusion criteria.

Patient perspectives on working with preferences in psychotherapy: A consensual qualitative research study.

Objective: Assessing and accommodating patient preferences is integral to evidence-based practice. This qualitative study sought to explore patient perspectives and experiences of preference work in psychotherapy.

Methods: Participants were 13 UK-based patients who had completed up to 24 sessions of a collaborative-integrative psychotherapy.

Stigma and Intentions to Seek Psychotherapy Among Primary Care Providers During the COVID-19 Pandemic: A Mediational Analysis.

Background: Medical personnel have reported increases in psychological distress and depression during the COVID-19 pandemic. Additionally, many providers, including primary care providers (PCPs), face significant stigma related to personal mental healthcare. However, the process by which stigma affects help-seeking among PCPs is unclear.

A Behavioral Economic Model of Help-Seeking for Depression.

Findings from the clinical psychology literature indicate that many who experience depression do not seek treatment when needed. This may be due to help-seeking models and interventions failing to account for the behavioral characteristics of depression that affect decision making (e.g.

Religious microaggressions in psychotherapy: A mixed methods examination of client perspectives.

Ethical guidelines state that psychologists should consider clients' religion in their practice. However, some clients have reported negative experiences regarding clinicians' treatment of religion in psychotherapy. These experiences may constitute microaggressions, which have been negatively associated with the working alliance and treatment outcomes among clients with various identities (e.

Client preference accommodation for religious/spiritual integration and psychotherapy outcomes in naturalistic practice settings.

The purpose of this practice-research network study was to examine client preferences for religious/spiritual (R/S) integration and test whether preference accommodation in this area is linked to positive treatment outcomes (i.e., less dropout and greater client change).

Nonstigmatizing and Precise Terminology to Describe Processes and Outcomes in Addiction Medicine.

Scholarly journals and professional organizations in addiction medicine have recently discussed the importance of adopting nonstigmatizing and precise terminology. The present commentary expands that ongoing discussion to terms related to treatment processes and outcomes. Four implicit assumptions of stigmatizing and imprecise terms related to treatment processes and outcomes are overviewed, and research evidence against these assumptions is presented.

Client and therapist agreement in moment-to-moment helpfulness ratings in psychotherapy: A microprocess approach.

Method: Clients (n = 16; M  = 32.88 years; 81% female) and their therapists (n = 10; 80% female) from a training clinic provided moment-to-moment ratings while reviewing a video recording of a recent session. West and Kenny's Truth-and-Bias (T&B) model was used to examine agreement in ratings.

Shared decision-making in mental and behavioural health interventions.

Elements of shared decision-making (ie, collaboration, patient preferences, and working alliance) have long been discussed and studied in the field of clinical psychology; however, research indicates that shared decision-making is not typically used in clinical practice. Instead, clinicians often rely on a paternalistic approach. In this article, we provide a narrative review of the existing research supporting shared decision-making for mental and behavioural health concerns, we discuss several barriers that impede its use in actual clinical practice, and we provide recommendations for increasing shared decision-making when working with patients.

Developing a collaborative relationship with clients during the initial sessions of psychotherapy.

Establishing a collaborative therapeutic relationship is an important research-supported goal for the initial sessions of psychotherapy. Fostering a collaborative relationship can occur through strategies such as recognizing the client's expertise in treatment, involving the client in the treatment decision-making process, and discussing the possibility of therapist mistakes. In this article, we present theoretical and research support for establishing a collaborative relationship.

The impact of accommodating client preference in psychotherapy: A meta-analysis.

Client preferences in psychotherapy reflect specific conditions and activities that clients desire in their treatment, with increasing evidence pointing to preference accommodation as facilitating psychotherapy outcomes. This updated meta-analysis establishes the magnitude of the effect of client preference accommodation in psychotherapy. Based on data from 53 studies and over 16,000 clients, preference accommodation was associated with fewer treatment dropouts (OR = 1.

Improving psychotherapy effectiveness by addressing the problem of premature termination: Introduction to a special section.

Premature termination appears to be a consistent problem in psychotherapy, showing up across client, treatment, and therapist types. As psychotherapy researchers and practitioners, it is important that we gain a better understanding of this negative psychotherapy event and identify methods for reducing its occurrence. This article introduces a special section on premature termination in psychotherapy.

A meta-analysis of nonsystematic responding in delay and probability reward discounting.

Delay discounting (DD) and probability discounting (PD) are behavioral measures of choice that index sensitivity to delayed and probabilistic outcomes, which are associated with a range of negative health-related outcomes. Patterns of discounting tend to be predictable, where preferences for immediate (vs. delayed) and certain (vs.

Inclusion and exclusion strategies for conducting meta-analyses.

Some of the most important decisions that a researcher will make when conducting a meta-analysis are decisions about the search strategies and inclusion/exclusion criteria. Decisions regarding inclusion/exclusion criteria serve to define the scope of a meta-analysis and search strategy decisions can have a large impact on how well the results of a meta-analysis actually represent the existing body of literature. In this article, we provide descriptions and recommendations for performing searches and making inclusion/exclusion decisions.

Understanding the client's perspective of helpful and hindering events in psychotherapy sessions: A micro-process approach.

The purpose of this study was to bridge the methodologies of significant events and micro-process research to gain a better understanding of clients' perceptions of helpful and hindering events in psychotherapy. A total of 16 clients were asked to review a recent psychotherapy session and, while watching, complete a moment-by-moment rating of helpful/hindrance using a dial rating system. They were also asked to describe the most helpful and hindering segments that were rated as such.

The client as the expert in psychotherapy: What clinicians and researchers can learn about treatment processes and outcomes from psychotherapy clients.

Clients are frequently recognized as perhaps having the largest impact on the eventual success or failure of treatment; however, researchers and clinicians alike often give inadequate attention to clients' perspectives on psychotherapy processes and outcomes. Researchers who do examine client variables in psychotherapy often conduct research about the client rather than from the client. The purpose of this article is to introduce a special issue focused on the client's perspective in psychotherapy.

Do all therapists do that when saying goodbye? A study of commonalities in termination behaviors.

This study aimed to identify core termination behaviors of psychotherapists across theoretical orientations in a successful course of treatment. Sixty-five experts from diverse theoretical traditions reported the frequency with which they used 80 tasks in a planned, mutually agreed termination of individual psychotherapy. Fifty-one items reached a positive consensus, 27 items did not obtain consensus, and 2 items were consensually employed infrequently.