Dyadic, longitudinal associations among outcome expectation and alliance, and their indirect effects on patient outcome.

Research indicates that patient outcome expectation (OE) correlates with improvement, and that this association may be mediated by better patient-therapist alliances. However, despite OE and alliance being dyadic and dynamic constructs, most research on these direct and indirect associations has assessed these variables from only one dyad member's perspective and at single time points. Addressing these gaps, we used a longitudinal actor-partner interdependence model to first examine OE-alliance associations.

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.

Treatment refusal and premature termination in psychotherapy, pharmacotherapy, and their combination: A meta-analysis of head-to-head comparisons.

The purpose of this meta-analysis was to examine rates of treatment refusal and premature termination for pharmacotherapy alone, psychotherapy alone, pharmacotherapy plus psychotherapy, and psychotherapy plus pill placebo treatments. A systematic review of the literature resulted in 186 comparative trials that included a report of treatment refusal and/or premature termination for at least 2 of the 4 treatment conditions. The data from these studies were pooled using a random-effects analysis.

The rebirth of psychosocial importance in a drug-filled world.

In the United States, the public is heavily lobbied to accept medications as the main answer for dealing with mental maladies like depression. However, examination of the empirical evidence reveals that even when drugs are the primary treatments, findings of benefit are often more dependent on psychosocial, interpersonal factors than commonly believed. This article highlights the reemerging worth of psychotherapeutic relationships in quelling emotional discomfort.

Change in patients' interpersonal impacts as a mediator of the alliance-outcome association in treatment for chronic depression.

Objective: Theories posit that chronically depressed individuals have hostile and submissive interpersonal styles that undermine their interpersonal effectiveness and contribute to the cause and maintenance of their depression. Recent findings support this theory and demonstrate that chronically depressed patients' interpersonal impacts on their therapist become more adaptive (i.e.

Clinician interventions and participant characteristics that foster adaptive patient expectations for psychotherapy and psychotherapeutic change.

Patients' expectations about the efficacy and nature of psychotherapy have long been considered important common treatment factors, and the empirical literature has largely supported this perspective. In this practice-oriented review, we examine the research on the association between patients' psychotherapy expectations and both adaptive treatment processes and outcomes. We also examine the research on specific psychotherapist interventions and patient and psychotherapist characteristics that influence the development of positive expectations for psychotherapy and psychotherapeutic change.

Premature discontinuation in adult psychotherapy: a meta-analysis.

Objective: Premature discontinuation from therapy is a widespread problem that impedes the delivery of otherwise effective psychological interventions. The most recent comprehensive review found an average dropout rate of 47% across 125 studies (Wierzbicki & Pekarik, 1993); however, given a number of changes in the field over the past 2 decades, an updated meta-analysis is needed to examine the current phenomenon of therapy dropout.

Method: A series of meta-analyses and meta-regressions were conducted in order to identify the rate at which treatment dropout occurs and predictors of its occurrence.

Learning psychotherapy in the digital age.

There is substantial literature documenting the process factors that lead to effective psychotherapy. Similarly, there is now a wealth of data attesting to the effectiveness of several psychotherapy brands. Little is known about the elements that facilitate learning how to be an effective clinician.

The accuracy of psychiatric medication advertisements in medical journals.

Psychiatric medications are frequently advertised in medical journals, yet no study has addressed the veracity of claims made in these advertisements. The present study examined the accuracy of 69 medical journal advertisements for psychiatric medications and the availability of sources cited in these advertisements. Just over half of claims made in advertisements (50.

Are patient expectations still relevant for psychotherapy process and outcome?

Patient expectations have been regarded as a variable affecting the course of psychotherapy for more than 50 years. Yet, even though expectations are often considered a factor common to most psychotherapy systems, their importance may be undervalued. This paper places the expectancy issue in a historical context, discusses the varied definitions of expectancy, and reviews the extant expectancy research literature.

Endogenous opiates and the placebo effect: a meta-analytic review.

Objective: A meta-analysis was performed to investigate the ability of placebo administration to reduce self-report of pain and to examine whether placebo-induced pain reduction might have physiological and psychological underpinnings.

Method: Forty-five effect sizes and 1183 participants from 12 studies were meta-analyzed for the effects of placebo and the opioid antagonist, naloxone, on self-report of pain.

Results: Analyses showed that placebo administration was associated with a decrease in self-report of pain, and a hidden or blind injection of naloxone reversed placebo-induced analgesia.

Advances in the assessment of object relations in the 1990s.

In this paper, we review the empirical publications from the 1990s on the assessment of object relations (OR). Twelve different measures are referenced. Major findings of studies, conclusions, and evaluations of each measure are provided.