Journal of Contemporary Psychotherapy

Harris, Catherine E.; Wupperman, Peggilee

doi: 10.1007/s10879-025-09696-4pmid: N/A

Mindfulness and Modification Therapy (MMT) has been shown to significantly reduce multiple dysregulated behaviors, including alcohol/drug use and aggression, in women with histories of trauma. However, no studies have explored the effects of MMT on Posttraumatic Stress Disorder (PTSD) symptoms. The current pilot study compared a 20-week, mindfulness-focused, integrated therapy (MMT) versus treatment as usual (TAU; a cognitive behavioral-oriented intervention in a clinic specializing in PTSD treatment) in decreasing PTSD symptoms among women self-referred for problematic substance use and anger issues. The sample (N = 20) included women who completed measures at baseline and treatment completion (20 weeks later). Wilcoxon signed-ranked tests were used to evaluate changes in PTSD symptoms for MMT (n = 12) vs. TAU (n = 8). MMT showed significant and large decreases in total PTSD symptoms, as well as decreases in PTSD symptom clusters (reexperiencing, avoidance/numbing, hyperarousal), with medium and large effect sizes. Despite very low power, ANOVA results showed a trend toward significance in the effect of group (MMT vs. TAU, p =.06), suggesting that symptom reductions in MMT may be larger than those in TAU. Though extremely preliminary, findings suggest that MMT may be an appropriate first-stage treatment for behavior dysregulation among individuals with co-occurring dysregulated behaviors and PTSD symptoms. Further research is warranted.

Kramer, Ueli; Timulak, Ladislav

doi: 10.1007/s10879-025-09709-2pmid: N/A

The current synthesis elaborates the principles of working with emotion in psychotherapy with personality disorders. We start with arguing that personality disorders are actually emotional disorders – in addition to interaction problems –, where the roots of the clinical presentations are to be found in the client’s emotional system. We then put forward a theory of change in clients with personality disorders, by using a multi-level conception of emotional change. Specifically, we define five clusters of emotional experiences that are of primary concern in clients with personality disorders. We elaborate on the role of the therapeutic relationship in the context of working with emotions with personality disorders. The main part of the paper lays out three specific treatment goals and ten emotion-focused therapeutic skills and methods to address in psychotherapy for personality disorders. Finally, our synthesis ends with specific clinical adaptations of an emotion-focused therapy for clients with personality disorders.

Agudelo-Hernández, Felipe; Vélez-Botero, Helena; González-De los Ríos, Juan Sebastián; Jimenez-López, Eliana; Osorio-Valencia, Danna; Ospina-Carmona, Santiago

doi: 10.1007/s10879-025-09697-3pmid: N/A

An increase in suicidal behavior has been reported in the Americas. Some interventions have demonstrated efficacy in reducing recurrence of suicidal behavior, but there are gaps in accessing these services. The present study aimed to analyze variables associated with psychosocial recovery in relation to the type of treatment prescribed following a suicide attempt. A descriptive, cross-sectional, population-based study was conducted using stratified random sampling to include 622 participants. In addition to a basic sociodemographic data, participants were asked about Connor-Davidson Resilience Scale, UCLA Loneliness Scale, Patient Health Questionnaire-9, Subjective Well-Being Scale, Alberta Continuity of Services Scale for Mental Health. Family psychotherapy exhibited the highest number of significant correlations (p < .001) with psychological well-being variables. Regarding psychiatric consultations, significant differences were found only in access to health services (p < .001) and treatment continuity (p = .002). No significant differences were found in subjective well-being, resilience, depression, or days since the last crisis among different psychiatric care groups. Following a suicide attempt, the most frequently prescribed treatments were psychotropic medications, followed by psychotherapy, and to a lesser extent, support communities. The critical role of adherence to individual psychotherapy and continuity of care in improving psychosocial recovery indicators. It also exposes the underutilization of group and community psychosocial interventions.

Grzesiuk, Lidia; Szymańska, Agnieszka; Dobrenko, Kamila

doi: 10.1007/s10879-025-09699-1pmid: N/A

The study examined links between patient characteristics, therapy experiences, and outcomes. A catamnestic survey was sent to 1210 former patients of the Academic Psychotherapy Center; 276 responded (55% women, 45% men, mostly under 30). Data were analyzed using structural equation modeling, k-means clustering, and neural network modeling. Results showed that expectations mediated between patient traits and outcomes, while the therapeutic relationship mediated between interventions and both immediate and delayed effectiveness. Cluster analysis identified two patient groups with distinct experiences and results. Neural networks indicated moderate outcome predictability. Findings emphasize psychotherapy’s complexity and the key role of expectations and therapeutic relationships.

Holmes, Samantha C.; Johnson, Nicole L.; Dalessandro, Kylie M.; Smith, Megan V.

doi: 10.1007/s10879-025-09701-wpmid: N/A

Low-income women experience depression at disproportionately high rates and may have difficulty accessing treatment due to a multitude of barriers. Previous studies have demonstrated that providing depression treatment to populations of low-income women can be effective in treating depression. However, low-income women are at higher risk for trauma exposure and PTSD which may negatively impact treatment outcomes. The current study tested whether an on-site 90-min 8-session cognitive behavioral therapy (CBT) group for women living in public housing is differentially impactful based on trauma exposure (number and interpersonal) and PTSD (diagnosis and symptoms). A predominantly Black non-Hispanic sample of women living in public housing or receiving housing subsidies (N = 154) with symptoms indicative of Major Depressive Disorder enrolled in CBT groups delivered on-site. Participants completed assessments at baseline, each session, treatment completion, and 6-month and 12-month post-treatment. Path analysis was conducted and results demonstrated that neither baseline trauma exposure (number or interpersonal) nor PTSD (diagnosis or symptoms) demonstrated a significant impact on treatment attendance. On average, regardless of trauma exposure and PTSD, participants attended approximately 5 of the 8 sessions. Similarly, a latent growth curve analysis did not demonstrate a significant effect of baseline trauma exposure (number or interpersonal) or PTSD (diagnosis or symptoms) on the reduction in depressive symptoms over time. However, across participants, significant reductions in depressive symptoms were identified – participants, on average, experienced a 13 points reduction in symptoms across the follow-up period. This CBT group appears beneficial for this population regardless of trauma exposure and PTSD.

Munir, Mubeena; Dawood, Saima; Rehman, Neelofar

doi: 10.1007/s10879-025-09708-3pmid: N/A

Body dysmorphic disorder (BDD) is a persistent psychological disorder that is unlikely to be remitted without proper treatment. The present systematic review aims to evaluate the effectiveness of cognitive behavior therapy (CBT) for BDD in both face-to-face and online formats. Online databases such as PubMed, ScienceDirect, Web of Science, Cochrane Library, ProQuest, and PsycINFO were searched for RCTs on BDD published between 2011 and 2025. After screening, eight RCTs were included. All studies used CBT as an active treatment and demonstrated moderate to large effects on BDD symptoms. Both digital and face-to-face CBT both showed significant improvements. A random-effects meta-analysis across the included studies revealed a large pooled effect of CBT in reducing BDD symptoms (SMD= -0.93, 95% CI [-1.17, -0.69], I2 = 33%). The potential risk of bias was also evaluated. Overall, the systematic review suggested that CBT is an effective treatment for reducing the symptoms of BDD across both face-to-face and online formats. It highlighted the potential of online therapy format as an accessible alternative treatment option.

Silva, Sara; Magalhães, Nuno; Salgado, João; Cunha, Carla

doi: 10.1007/s10879-025-09695-5pmid: N/A

Depression was already a leading cause of disability worldwide before the COVID-19 pandemic. In 2020, global estimates suggested 3153 cases of major depressive disorder per 100,000 people, deepening the gap between treatment demand and available resources. Blended therapy, which combines face-to-face sessions with online Cognitive Behavioral Therapy (CBT) modules, may help address this gap by shortening treatment while maintaining effectiveness. This study examines symptom change and the client’s perspective on therapeutic progress during blended CBT for depression. Using a single-case study, we analyzed a case of a client treated in primary care. Symptoms of depression, anxiety, and general mental health were monitored throughout therapy and at follow-up, while perceived changes were assessed using the Change Interview. Results showed a clinically significant reduction in depressive symptoms (PHQ-9: from 16 to 6) and anxiety symptoms (GAD-7: from 14 to 5), with improvements maintained at follow-ups (16, 26 and 52 weeks). The client attributed these changes to the blended therapy process, reporting that online modules complemented face-to-face sessions and supported continued progress during the pandemic. This study contributes to the growing evidence on blended CBT by highlighting how clients experience change and by demonstrating its potential utility in resource-limited contexts.

Maliqi, Rineta; Uka, Fitim; Uka, Erestinë; Musliu, Arian; Sopjani, Vanesa; Zharku, Lum; Bajrami, Adela; Statovci, Albina; Rexha, Fjolla; Baliu, Lira; Tovërlani, Loreta

doi: 10.1007/s10879-025-09707-4

Alferes, Filipa; Lárez, Estefânia; Simões de Almeida, Raquel

doi: 10.1007/s10879-025-09705-6pmid: N/A

This scoping review aims to identify technological modalities for remote Dialectical Behavior Therapy (DBT) delivery for Borderline Personality Disorder (BPD), assess their effectiveness and engagement, examine associated advantages and challenges, and offer insights for future research and clinical practice. A literature search was performed across PubMed, Web of Science, EBSCO, B-ON, and IEEE Xplore, including studies from the last 10 years. Fourteen studies with diverse methodological designs met the inclusion criteria for analysis. Digital DBT emerged as a promising intervention, demonstrating positive efficacy and engagement, suggesting it as a viable alternative to conventional therapy. Common modalities include videoconferencing and mobile applications. Challenges identified include technical issues, potential impact on the therapeutic relationship, and data security concerns requiring attention for clinical feasibility. Digital DBT offers a promising, cost-effective alternative to traditional therapy. While initial evidence supports its effectiveness and engagement, further research, particularly randomized clinical trials, is crucial to evaluate long-term outcomes and optimize implementation.

Bakkeli, Isak; Sandvoll, Ragna Louise; Thimm, Jens C.; Stänicke, Erik; Lillevoll, Kjersti

doi: 10.1007/s10879-025-09700-xpmid: N/A

A growing body of research has found contradictions between self-report symptom inventories and other information sources when evaluating psychotherapy outcomes - a phenomenon described as a paradoxical outcome. Previous studies have highlighted the need to identify patterns of this phenomenon. This article addresses this by conducting a systematic review and meta-synthesis of 12 case studies. Using Thematic Synthesis, two analyses were performed: one identifying manifestations of paradoxical outcome, and one examining researchers’ interpretations. Three meta-themes described the phenomenon: (1) false improvement, (2) false worsening, and (3) invisible change. Across studies, variations in the therapeutic alliance were consistently linked to paradoxical outcome patterns. A fourth meta-theme − (4) the inclusion of uncaptured aspects of psychotherapeutic outcome - highlighted researchers’ interpretations, suggesting that paradoxical outcomes often reflect aspects of therapeutic change not captured by standard symptom inventories. The findings emphasize the need to move beyond linear views of symptom trajectories, to triangulate multiple sources of information, and to interpret symptom changes within the context of patients’ lived situations. The study is registered in PROSPERO (CRD42024535341).