Client characteristics and early working alliance development: A person-centered research approach.

Objective: Certain client characteristics are associated with early working alliance difficulties in psychotherapy. However, there is limited quantitative evidence on whether combinations of these characteristics (e.g.

Psychotherapy dose, clinical outcome, and academic withdrawal at university counseling centers.

Academic withdrawal from colleges and universities is a common occurrence, particularly among students with mental health concerns. Receiving a successful course of psychotherapy may reduce students' risk of academic withdrawal, but outcomes in university counseling centers (UCCs) could be hindered by strategies used to meet high service demands with limited resources, such as offering a low number or frequency of sessions. The present study examined associations among psychotherapy dose, clinical outcome, and academic withdrawal among students ( = 16,197) in short-term individual psychotherapy at 85 UCCs in the United States.

Therapeutic alliance and clinical outcomes in teletherapy and in-person psychotherapy: A noninferiority study during the COVID-19 pandemic.

The current study aimed to inform the varied and limited research on clinical variables in the context of teletherapy. Questions remain about the comparative quality of therapeutic alliance and clinical outcome in the context of teletherapy compared to in-person treatment. We utilized a cohort design and a noninferiority statistical approach to study a large, matched sample of clients who reported therapeutic alliance as well as psychological distress before every session as part of routine clinical practice at a university counseling center.

Reconstructing dropout: Building from multiple definitions, therapist effects, and center effects.

The literature regarding dropout from psychotherapy has suffered from issues of diverse operationalization of the construct. Some have called for a more uniform definition to aid in generalization across research; this study aimed to assess the viability of such a definition by examining the rate of occurrence for three distinct definitions simultaneously. In addition, therapist and center level variances are explored to further understand the differences between definitions.

Client-Therapist Convergence on Sleep Difficulty and its Impact on Treatment Outcomes.

While agreement between clients and their clinicians on therapy goals has frequently been investigated as a process-level variable (i.e., working alliance), dyadic convergence on presenting concerns is also important for initial case formulation.

The dose-effect and good enough level models of change for specific psychological concerns.

Objective: Most research on the dose-effect (DE) and good-enough level (GEL) models of change has used general outcome measures. The purpose of this study was to determine if predictions from these models generalize to specific presenting concerns and outcome measures.

Method: A large sample of treatment-seeking college students (N = 64,319) who attended different numbers of therapy sessions and completed the College Counseling Assessment of Psychological Symptoms-34 (CCAPS-34, Locke et al.

Group therapy for mood disorders: A meta-analysis.

The addition of group psychotherapy as a specialty by the APA in 2018 creates a need for rigorous empirical reviews of group treatments for specific disorders. We conducted a meta-analysis of randomized controlled trials (RCTs) that tested the effect of group psychotherapy for mood disorders, including depression and bipolar disorder, at posttreatment and follow-up time-points, as well as rates of recovery and attrition. Major databases were searched for RCTs of group treatment for depression and bipolar disorder published from 1990 to 2018, which identified 42 studies across both disorders.

Predicting future courses of psychotherapy within a grouped LASSO framework.

There is a paucity of studies examining the experience of clients who undergo multiple courses of psychotherapy. Conducted within a large practice research network, this study demonstrated that returning therapy clients comprise a considerable portion of the clinical population in university counseling settings, and identified variables associated with return to therapy. Utilizing data spanning 2013 to 2017, statistical variable selection for predicting return to therapy was conducted via grouped least absolute shrinkage and selection operator (grouped LASSO) applied to logistic regression.

Dynamic changes in generalized anxiety and depression during counseling.

Comorbidity of generalized anxiety and depression is common in clinical populations. Understanding how change in generalized anxiety and depression are related during counseling may help improve treatment. College student data ( = 51,922) from university and college counseling centers across the United States were used to examine relationships between change in generalized anxiety and depression across 12 counseling sessions using bivariate dual change score models.

Health disparities between genderqueer, transgender, and cisgender individuals: An extension of minority stress theory.

Interpersonal, social, and structural stressors have been identified as key elements that explain health disparities between transgender and cisgender individuals. However, most of this research has focused on binary transgender individuals or has not differentiated between binary and nonbinary individuals; little research has examined the experiences of minority stress or health of those identifying outside the gender binary. Guided by intersectionality and drawing on a sample of 3,568 college students from the Center for Collegiate Mental Health's 2012-2016 database-of whom 892 identified outside the gender binary-we conducted analyses of demographic and outcome measures administered in participants' 1st counseling appointment, examining differences between cisgender, transgender, and genderqueer individuals.

Developing a therapeutic relationship monitoring system for group treatment.

The use of outcome monitoring systems to identify clients that are at-risk for treatment failure has now become part of daily clinical practice, shown in >25 empirical studies to improve client outcomes. These promising findings have led to outcome monitoring systems being recognized as evidence-based. Feedback systems based on client perception of therapeutic processes are recent additions to the monitoring literature, and the research suggests that these too lead to improved outcomes.

Are we in crisis? National mental health and treatment trends in college counseling centers.

The current state of college student mental health is frequently labeled a "crisis," as the demand for services and severity of symptomatology have appeared to increase in recent decades. Nationally representative findings are presented from the Center for Collegiate Mental Health, a practice research network based in the United States, composed of more than 340 university and college counseling centers, in an effort to illuminate trends in symptom severity and patterns in treatment utilization for the campus treatment seeking population. Clinical data collected over 5 academic years (2010-2015) showed small but significantly increasing trends for self-reported distress in generalized anxiety, depression, social anxiety, family distress, and academic distress, with the largest effect sizes observed for generalized anxiety, depression, and social anxiety.

Therapist effects on dropout from a college counseling center practice research network.

Dropout has been a pervasive and costly problem in psychotherapy, particularly for college counseling centers. The present study examined potential predictors of dropout using a large data set (N = 10,147 clients, 481 therapists) that was gathered through a college counseling center practice research network as a replication and extension of recent findings regarding therapist effects on dropout. The final model resulted in a dropout rate of 15.

Outcome differences between individual and group formats when identical and nonidentical treatments, patients, and doses are compared: A 25-year meta-analytic perspective.

There are mixed findings regarding the differential efficacy of the group and individual format. One explanation of these mixed findings is that nearly all-recent meta-analyses use between-study effect sizes to test format equivalence introducing uncontrolled differences in patients, treatments, and outcome measures. Only 3 meta-analyses were located from the past 20 years that directly tested format differences in the same study using within-study effect sizes; mixed findings were reported with a primary limitation being the small number of studies.