Consensus on the perceived presence of transtheoretical principles of change in routine psychotherapy practice: A survey of clinicians and researchers.

Goldfried (1982) hypothesized that there are five transtheoretical principles of change that guide routine psychotherapy practice. This survey investigated if there is consensus on the perceived presence of these principles in the approaches of a professionally diverse pool of psychotherapy clinicians and researchers. One thousand nine hundred ninety-eight participants, aged 21-85 years ( = 50.

Revived call for consensus in the future of psychotherapy.

The emblem of success in psychotherapy research and practice has long been innovation. Although such ingenuity is commendable, it has nonetheless perpetuated fragmentation across the field. At least four decades ago, it was suggested that achieving consensus on what constitutes psychotherapy's theoretical, empirical, and practical 'core' might allow the discipline to evolve beyond its siloed state, as is reflective of mature science.

The gap between science and practice: A conversation.

The authors, friends, colleagues, and collaborators for almost 60 years engage in an informal discussion concerning the gap between science and practice. They identify some sources of the problem, some manifestations of it, and point the way to some possible solutions. The articles in this special section, because of their use of data collected in a naturalistic setting and the prominent role of clinicians, are viewed as one of many promising directions for the reconciliation of the activity of researchers and the needs of clinicians.

Obtaining consensus in psychotherapy: What holds us back?

Although the field of psychotherapy has been in existence for well over a century, it nonetheless continues to be preparadigmatic, lacking a consensus or scientific core. Instead, it is characterized by a large and increasing number of different schools of thought. In addition to the varying ways in which psychotherapy has been conceptualized, there also exists a long-standing gap between psychotherapy research and how it is conducted in actual clinical practice.

Clinical Consensus Strategies to Repair Ruptures in the Therapeutic Alliance.

Objective: The alliance been recognized as an essential common factor and robust predictor of outcome. The present study sought to further our knowledge of the alliance and to promote the integration of research and practice by assessing consensus among peer-nominated expert therapists of varying theoretical orientations on the effectiveness of clinical strategies to repair alliance ruptures.

Method: This study drew on the behavioral-analytic model (Goldfried & D'Zurilla, 1969) and the methodology of the (Frances, Docherty, & Kahn 1997).

Clinical Feedback About Empirically Supported Treatments for Obsessive-Compulsive Disorder.

Previous evidence for the treatment of obsessive-compulsive disorder (OCD) has been derived principally from randomized controlled trials. As such, evidence about the treatment of OCD has unilaterally flowed from researchers to clinicians. Despite often having decades of experience treating OCD, clinicians' feedback on their clinical observations in using these treatments has not been solicited.

A Professional Journey Through Life.

In response to the request to write about those changes that have occurred in my professional outlook and practice that have come with age, I have recounted some of the experiences I have had that seem to have contributed to these changes. There are a couple of important themes that have run through my professional experiences as a therapist, supervisor, teacher, and researcher. One of the themes has to do with my psychotherapy orientation.

Research on psychotherapy integration: building on the past, looking to the future.

Integration has become an important and influential movement within psychotherapy practice, reflected by the fact that many treatment providers now identify as integrative. However, integration has not had as great an influence on psychotherapy research. The goal of this paper is to highlight the growing body of research on psychotherapy integration, and to identify future directions for research that may strengthen the integration movement as well as the field of psychotherapy as a whole.

Implications of RDoC for the research and practice of psychotherapy.

The field of psychotherapy is at an important juncture. Recent changes in the field include (a) the skeptical reception of the fifth edition of the Diagnostic and Statistical Manual and (b) NIMH's prioritization of an alternative classification system to guide translational and intervention research. Moreover, (c) the field continues to be held accountable to governmental agencies and third-party payers to demonstrate its empirical basis.

Clinical experiences in using cognitive-behavior therapy to treat panic disorder.

Although there is a growing body of research to support the use of psychological treatments for specific disorders, there has been no way for practitioners to provide feedback to researchers on the barriers they encounter in implementing these treatments in their day-to-day clinical work. In order to provide practitioners a means to give researchers information about their clinical experience, the Society of Clinical Psychology and the Division of Psychotherapy of the American Psychological Association collaborated on an initiative to build a two-way bridge between practice and research. A questionnaire was developed on the therapist, patient, and contextual variables that undermine the effective use of CBT in reducing the symptoms of panic disorder, a clinical problem that occurs frequently in clinical practice and has an extensive research base.

Clinical experiences in conducting cognitive-behavioral therapy for social phobia.

Several authors have identified a disconnect between psychotherapy research, including research on cognitive behavioral therapy (CBT), and real-world psychotherapy practice. This disconnect has several negative consequences, potentially including less-than-optimal practice standards as well as a lack of input from practicing psychotherapists on how research can be improved and made more relevant in their day-to-day clinical work. As part of an ongoing effort to engage practicing psychotherapists in a feedback loop with psychotherapy researchers, this study reports the results of a survey of CBT therapists who have used CBT in the treatment of social phobia (SP).

Clinical experiences in conducting empirically supported treatments for generalized anxiety disorder.

Knowledge of the efficacy of cognitive-behavioral therapy (CBT) for generalized anxiety disorder (GAD) predominantly derives from randomized controlled trials (RCTs). However, there may be unique or complex issues encountered in practice, but not necessarily in the context of a controlled clinical trial. Therefore, launching a systematic dialogue between researcher and practicing clinician can be instrumental in augmenting evidence-based therapies through identification of variables that promote and interfere with clinical effectiveness.

On the dissemination of clinical experiences in using empirically supported treatments.

This article addresses the long-standing gap that has existed between psychotherapy research and practice and the efforts that have been made to bridge it. It also introduces one such effort, which has consisted of 3 clinical surveys on the experiences of practitioners in using empirically supported treatments for panic disorder, social anxiety, and OCD. In contrast to attempts to close the gap by disseminating research findings to the clinician, the clinical surveys are intended to allow for practitioners to disseminate their clinical experiences to the researcher-and also to other clinicians.

Evidence-based treatment and cognitive-affective-relational-behavior-therapy.

In conceptualizing CBT as an approach to treatment that is closely linked to basic empirical principles of human behavior, it is possible to incorporate evidence-based contributions from different theoretical orientations. This is illustrated by how CBT can be open to a variety of interventions that are not typically associated with CBT, but which nonetheless have empirical support. This article describes the following clinical interventions, together with their theoretical rationale and empirical support: (a) Having a therapeutic focus on what is occurring within the session itself, (b) Becoming aware of one's negative reactions toward the patient and transforming them into a more compassionate stance, and (c) Using procedures for enhancing emotional arousal in changing a patient's cognitive-affective distortions.

What should we expect from psychotherapy?

In addressing the very general question of what we should expect from psychotherapy, this article begins by discussing what constitutes relevant evidence on which to base the efficacy and effectiveness of psychotherapy. In this context, an important distinction is made between empirically supported treatments and evidence-based practice. Although there is evidence that psychotherapy does indeed work, there are also findings that there are times when our patients are harmed by our interventions.

What should we expect from psychotherapy?

In addressing the very general question of what we should expect from psychotherapy, this article begins by discussing what constitutes relevant evidence on which to base the efficacy and effectiveness of psychotherapy. In this context, an important distinction is made between empirically supported treatments and evidence-based practice. Although there is evidence that psychotherapy does indeed work, there are also findings that there are times when our patients are harmed by our interventions.

The relationship between experiences of discrimination and mental health among lesbians and gay men: An examination of internalized homonegativity and rejection sensitivity as potential mechanisms.

Objective: The current study used path analysis to examine potential mechanisms through which experiences of discrimination influence depressive and social anxiety symptoms.

Method: The sample included 218 lesbians and 249 gay men (total N = 467) who participated in an online survey about minority stress and mental health. The proposed model included 2 potential mediators-internalized homonegativity and rejection sensitivity-as well as a culturally relevant antecedent to experiences of discrimination-childhood gender nonconformity.

A translational model of research-practice integration.

We propose a four-level, recursive Research-Practice Integration framework as a heuristic to (a) integrate and reflect on the articles in this Special Section as contributing to a bidirectional bridge between research and practice, and (b) consider additional opportunities to address the research-practice gap. Level 1 addresses Treatment Validation studies and includes an article by Lochman and colleagues concerning the programmatic adaptation, implementation, and dissemination of the empirically supported Coping Power treatment program for youth aggression. Level 2 translation, Training in Evidence-Based Practice, includes a paper by Hershenberg, Drabick, and Vivian, which focuses on the critical role that predoctoral training plays in bridging the research-practice gap.

Bridging the gap between clinical research and clinical practice: introduction to the special section.

This Special Section, developed by the American Psychology Association's Division 12 (Clinical) 2011 Committee on Science and Practice, highlights different ideas to help bridge the gap between clinical research and clinical practice, and notes recent innovations that help make research-practice integration feasible. The articles consider how to break down the barriers to enhance researcher-practitioner dialogue, as well as how to make ongoing outcome assessment feasible for clinicians. Moreover, the articles address how to promote training in evidence-based practice, and how to translate efficacy research into clinical practice and clinical insight into empirical study to better establish a two-way bridge between research and practice.

Clinical consensus strategies for interpersonal problems between young adults and their parents.

Objective: Research that identifies areas of agreement among expert therapists can complement findings from clinical trials by highlighting common practices as well as innovations. The present study accessed consensus among expert therapists on the effectiveness of clinical strategies for treating young adults experiencing interpersonal problems with their parents.

Method: This study drew on the behavioral-analytic model (Goldfried & D'Zurilla, 1969) and the methodology of the Expert Consensus Guideline Series (Frances, Kahn, Carpenter, Ross, & Docherty, 1996).

Expressive writing for gay-related stress: psychosocial benefits and mechanisms underlying improvement.

Objective: This study tested the effectiveness of an expressive writing intervention for gay men on outcomes related to psychosocial functioning.

Method: Seventy-seven gay male college students (mean age = 20.19 years, SD = 1.

Training implications of harmful effects of psychological treatments.

The goal of this article is to delineate training implications regarding harmful effects associated with psychotherapy. The authors strongly recommend that trainees be made aware of (and encouraged to examine carefully) the potentially harmful treatments that have been recently identified (Lilienfeld, 2007). Consistent with a broad perspective on evidence-based practice, it is also argued that additional guidelines for the prevention and repair of harmful impacts can be derived from psychotherapy research on process (technique and relationship) and participant (client and therapist) variables.