Parsing the existential isolation-outcome association into its within- and between-patient components in naturalistic psychotherapy.

Complementing the oft-studied construct of isolation, research has increasingly focused on existential isolation (EI), or the subjective feeling of separateness in one's experience. In the clinical realm, several studies have demonstrated that higher EI is associated with more severe mental health problems at a single cross-section of time. Moreover, one study showed that higher pretreatment EI predicted worse psychotherapy outcomes.

Does Practice Make Perfect? The Effects of an Eight-Week Manualized Deliberate Practice Course With Peer Feedback on Patient-Rated Working Alliance in Adults: A Pilot Randomized Controlled Trial.

Background: Deliberate Practice (DP), which underscores the importance of expert mentorship, personalized learning objectives, feedback, and repetition, has been suggested as a method to enhance the effectiveness of therapists.

Method: The study tested the efficacy of an eight-week, structured, group-based online course, enriched with peer feedback, for 37 Cognitive Behavioral Therapists. The goal was to assess whether this intervention could boost the quality of therapist-patient alliances, as compared to a control group.

Responding to Key Process Markers as a Focus of Psychotherapy Training and Practice.

Historically, evidence-based psychotherapy training has favored the standardized application of discrete treatment packages, with key outcomes being the therapist's adherence to and competent delivery of theory-prescribed ingredients. However, this model often fails to align with the priorities and values of clinicians, and research casts doubt on the notion that a therapist's faithful application of treatment protocols is a valid index of clinical expertise. Considering this, training and practice models that emphasize evidence-based clinician flexibility and patient-centered tailoring of interventions are receiving increased attention.

Therapist-Level Moderators of Patient-Therapist Match Effectiveness in Community Psychotherapy.

Based on patient-reported outcomes data analyzed at the provider level, there is evidence that psychotherapists can possess effectiveness strengths and weaknesses when treating patients with different presenting concerns. These within-therapist differences hold promise for personalizing care by prospectively matching patients to therapists' historical effectiveness strengths. In a double-masked randomized controlled trial (RCT; NCT02990000), such matching outperformed pragmatically determined usual case assignment-which leaves personalized, measurement-based matching to chance-in naturalistic outpatient psychotherapy (Constantino et al.

A refreshing and necessary start: Commentary on Westra and Di Bartolomeo (2024).

Westra and Di Bartolomeo (2024) make a compelling case for integrating "process acuity" skills into routine clinical training. The authors have done the field a service by articulating the need for novel and process-science-informed psychotherapy training and practice. This brief commentary echoes the authors' observations about the status quo of clinical training and expands upon what else will need to be considered to fully realize the goals of their proposal.