Multimodal analysis of temporal affective variability within treatment for depression.

Objective: Affective flexibility, the capacity to respond to life's varying environmental changes in a dynamic and adaptive manner, is considered a central aspect of psychological health in many psychotherapeutic approaches. The present study examined whether affective two-dimensional (i.e.

Clients' and therapists' parasympathetic interpersonal and intrapersonal regulation dynamics during psychotherapy for depression.

Objective: The literature on affective regulation in psychotherapy has traditionally relied on explicit client self-report measures. However, both clients' and therapists' affect fluctuate moment-to-moment during a session, highlighting the need for more implicit and continuous indices to better understand these dynamics. This study examined parasympathetic interpersonal and intrapersonal regulation dynamics between therapists and clients with Major Depressive Disorder during Supportive-Expressive Therapy.

Practice-Oriented Research: An Introduction to New Developments and Future Directions.

Aimed at understanding and improving psychological therapies as they are conducted in clinical routine, practice-oriented research (POR) is now a well-established approach to the scientific foundations of mental health care services. Resting on the accumulation of a wide range of practice-based evidence related to treatment outcome and process, as well as factors associated with the participants of psychotherapy and its context, POR is ripe for new developments - regarding what to investigate and how to investigate it. This paper is the introduction of a series devoted to recent advances and future directions of POR as their pertained to routine outcome monitoring, technologies and artificial intelligence, the integration of constructs and methods from program evaluation and implementation science, and the investigation of populations with limited financial resources across various regions of the world.

Transdiagnostic effects of therapist self-disclosure on diverse emotional experiences of clients with emotional disorders and schizophrenia.

Objective: Despite the clinical significance of emotional diversity, also known as emodiversity, there has been limited investigation into the therapeutic interventions that influence this construct. In the current study we examined the association between immediate therapist self-disclosure (TSD) and emodiversity among two diagnostic groups who tend to experience emotional difficulties: people with schizophrenia and people with emotional disorders (i.e.

Leveraging natural language processing to study emotional coherence in psychotherapy.

The association between emotional experience and expression, known as emotional coherence, is considered important for individual functioning. Recent advances in natural language processing (NLP) make it possible to automatically recognize verbally expressed emotions in psychotherapy dialogues and to explore emotional coherence with larger samples and finer granularity than previously. The present study used state-of-the-art emotion recognition models to automatically label clients' emotions at the utterance level, employed these labeled data to examine the coherence between verbally expressed emotions and self-reported emotions, and examined the associations between emotional coherence and clients' improvement in functioning throughout treatment.

Is empathic accuracy enough? The role of therapists' interventions in the associations between empathic accuracy and session outcome.

Therapists' ability to accurately assess their clients' emotions is a critical clinical skill across various therapeutic approaches. However, little is understood about the contexts that facilitate or interfere with the effects of this accuracy on therapeutic outcomes. This study investigated the relationship between therapists' empathic accuracy (EA) concerning their clients' emotions and session outcomes, and whether this relationship is moderated by the therapists' use of different intervention types.

A Clinical Leadership Lens on Implementing Progress Feedback in Three Countries: Development of a Multidimensional Qualitative Coding Scheme.

Background: Progress feedback, also known as measurement-based care (MBC), is the routine collection of patient-reported measures to monitor treatment progress and inform clinical decision-making. Although a key ingredient to improving mental health care, sustained use of progress feedback is poor. Integration into everyday workflow is challenging, impacted by a complex interrelated set of factors across patient, clinician, organizational, and health system levels.

Leveraging Novel Technologies and Artificial Intelligence to Advance Practice-Oriented Research.

Mental health services are experiencing notable transformations as innovative technologies and artificial intelligence (AI) are increasingly utilized in a growing number of studies and services.These cutting-edge technologies carry the promise of substantial improvements in the field of mental health. Nevertheless, questions emerge about the alignment of novel technologies and AI systems with human needs, especially in the context of vulnerable populations receiving mental healthcare.

Facing Change: Using Automated Facial Expression Analysis to Examine Emotional Flexibility in the Treatment of Depression.

Objective: Depression involves deficits in emotional flexibility. To date, the varied and dynamic nature of emotional processes during therapy has mostly been measured at discrete time intervals using clients' subjective reports. Because emotions tend to fluctuate and change from moment to moment, the understanding of emotional processes in the treatment of depression depends to a great extent on the existence of sensitive, continuous, and objectively codified measures of emotional expression.

The effect of Oxytocin administration on patient-therapist alliance congruence: Results from a randomized controlled trial.

Objectives: The effects of oxytocin (OT) administration on psychotherapeutic processes have thus far been elusive. This study explored the effect of OT administration on patient-therapist congruence of the working alliance.

Method: Inpatients with mental disorders (= 87) participating in a randomized controlled trial received OT (= 44) or placebo (= 43) intranasally twice a day, for four weeks.

A dyadic session-by-session assessment of therapeutic alliance and short-term outcome among clients with schizophrenia in comparison with clients with emotional disorders.

Objective: Although the clinical significance of the therapeutic alliance (TA) is well documented, the literature regarding the establishment of TA and the relation between client-therapist agreement on it to short-term outcome among various diagnostic groups-and specifically among clients diagnosed with serious mental illness (SMI)-is sparse. The aim of the present study was to examine the effect of client diagnosis on the abovementioned TA characteristics.

Method: Dyadic analyses of session-by-session (SBS) data were used to compare clients diagnosed with schizophrenia and clients diagnosed with emotional disorders (based on a clinical interview) in their TA characteristics.

Clients' emotional experience as a dynamic context for client-therapist physiological synchrony.

Objective: Client-therapist physiological synchrony has recently attracted significant empirical attention. Recent theoretical accounts propose that physiological linkages should not be considered a stable dyadic virtue but rather a dynamic process that depends on the situational context in which they transpire. The present study adopted a "momentary" (vs.

Facilitating dyadic synchrony in psychotherapy sessions: Systematic review and meta-analysis.

This paper highlights the facilitation of dyadic synchrony as a core psychotherapist skill that occurs at the non-verbal level and underlies many other therapeutic methods. We define dyadic synchrony, differentiate it from similar constructs, and provide an excerpt illustrating dyadic synchrony in a psychotherapy session. We then present a systematic review of 17 studies that have examined the associations between dyadic synchrony and psychotherapy outcomes.

Examining the associations between difficulties in emotion regulation and symptomatic outcome measures among individuals with different mental disorders.

Background: Difficulties in emotion regulation (ER) abilities have been found to play a central role in different psychiatric disorders. However, researchers rarely compare ER across different diagnostic groups. In the current study, we examined ER and its relation to functional and symptomatic outcome among three distinct diagnostic groups: people with schizophrenia (SCZ), people with emotional disorders (EDs; i.

Client-therapist temporal congruence in perceiving immediate therapist self-disclosure and its association with treatment outcome.

Immediate therapist self-disclosure (Im-TSD) can be a powerful intervention. When engaged in judiciously, it can provide clients with a unique opportunity to explore their interpersonal relationship in real time. Relational theories suggest that for Im-TSD to be effective, both client and therapist must have temporally congruent perceptions of its occurrence.

Oxytocin reactivity to the therapeutic encounter as a biomarker of change in the treatment of depression.

Depression affects millions worldwide, thus underscoring the urgent need to optimize health care practices. To better understand the processes involved in psychotherapy gains, studies have emphasized the need to complement subjective reports with objective measures, in particular biological markers. Oxytocin (OT) has been proposed as a potential biomarker in the treatment of depression given its involvement in depression-related psychological and physiological functions and the formation of close relationships.

Intrapersonal and interpersonal vocal affect dynamics during psychotherapy.

Objective: The present study implements an automatic method of assessing arousal in vocal data as well as dynamic system models to explore intrapersonal and interpersonal affect dynamics within psychotherapy and to determine whether these dynamics are associated with treatment outcomes.

Method: The data of 21,133 mean vocal arousal observations were extracted from 279 therapy sessions in a sample of 30 clients treated by 24 therapists. Before and after each session, clients self-reported their well-being level, using the Outcome Rating Scale.

Using topic models to identify clients' functioning levels and alliance ruptures in psychotherapy.

Computerized natural language processing techniques can analyze psychotherapy sessions as texts, thus generating information about the therapy process and outcome and supporting the scaling-up of psychotherapy research. We used topic modeling to identify topics discussed in psychotherapy sessions and explored (a) which topics best identified clients' functioning and alliance ruptures and (b) whether changes in these topics were associated with changes in outcome. Transcripts of 873 sessions from 58 clients treated by 52 therapists were analyzed.

When to disclose and to whom? examining within- and between-client moderators of therapist self disclosure-outcome associations in psychodynamic psychotherapy.

While previous studies have indicated that therapists' self-disclosure (TSD) can have curative effects, the contextual variables that may moderate the link between TSD and treatment outcome have not been sufficiently explored. Using session-by-session psychotherapy data, we examined the extent to which within-client distress and between-clients emotion regulation difficulties moderated the associations between TSD and session outcomes. The sample comprised 68 clients treated according to the principles of psychodynamic psychotherapy by 47 therapists in a university clinic.

Beyond symptom reduction: Development and validation of the Complementary Measure of Psychotherapy Outcome (COMPO).

Most measures of psychotherapy outcome focus on symptomatic change. However, clients often report other changes through therapy, such as increased self-acceptance. This study reports on the development and validation of the Complementary Measure of Psychotherapy Outcome (COMPO) that assesses different areas of psychological functioning deemed important by clients and therapists.

The reciprocal relationship between alliance and early treatment symptoms: A two-stage individual participant data meta-analysis.

Objective: Even though the early alliance has been shown to robustly predict posttreatment outcomes, the question whether alliance leads to symptom reduction or symptom reduction leads to a better alliance remains unresolved. To better understand the relation between alliance and symptoms early in therapy, we meta-analyzed the lagged session-by-session within-patient effects of alliance and symptoms from Sessions 1 to 7.

Method: We applied a 2-stage individual participant data meta-analytic approach.

A meta-analysis of client-therapist perspectives on the therapeutic alliance: Examining the moderating role of type of measurement and diagnosis.

Background: Clients and therapists often have different perspectives on their therapeutic alliance (TA), affecting the process and outcome of therapy. The aim of the present meta-analysis was to assess the mean differences between clients' and therapists' estimations of TA among clients with severe disturbances, while focusing on two potential moderators: client diagnosis and alliance instrument.

Method: We conducted a systematic literature search of studies examining both client perspective and therapist perspective on TA in psychotherapy among people with schizophrenia spectrum disorders, personality disorders, and substance misuse disorders.