Journal of Consulting and Clinical Psychology

doi: 10.1037/ccp0000969pmid: 40758299

Objective: Several large studies have identified perceptions of treatment credibility and treatment outcome expectations as potential moderators of treatment response in internet-delivered psychological treatment. However, no studies have specifically focused on these two constructs and their potential roles in the moderation of treatment-related change, treatment completion, or study dropout. Method: Adult samples were derived from four large randomized controlled trials examining internet-delivered treatment for symptoms of depression (n = 445), generalized anxiety (n = 454), social anxiety (n = 486), and panic disorder (n = 292). In these studies, relevant symptom measures were administered at pretreatment and posttreatment, and credibility and expectancy were assessed in Week 2 after participants had had some experience with treatment. Results: Treatment credibility and outcome expectations were relatively high overall, with a majority of participants scoring in the upper ranges. Both variables significantly moderated treatment response across all symptom domains. Specifically, each 1-point increase in either average credibility scores or average expectancy scores were associated with a 5%–8% reduction in symptoms at posttreatment. Higher treatment credibility and outcome expectations were also significantly associated with increased treatment completion and lower rates of study dropout or missingness. Conclusions: The findings suggest that perceptions of treatment credibility and outcome expectancies are important factors in understanding treatment engagement and response to internet-delivered interventions.

doi: 10.1037/ccp0000966pmid: 40875359

Objective: This study examined the role of physiology–behavior regulatory functioning in explaining “what works for whom” in parenting intervention. Dynamic associations between parents’ physiological reactivity and positive parenting behavior during caregiving interactions were tested as predictors of related intervention response to parent–child interaction therapy. Pre- to postintervention changes in the dynamic associations were also examined. Method: Physiological reactivity assessed through interbeat interval and observationally coded parenting behaviors were measured second-by-second during two types of parent–child interaction at pre- and postintervention for 120 child welfare-involved parents (Mage = 32.45, 87.5% mothers) randomized to a parent–child interaction therapy intervention. Response to intervention was examined as (a) treatment engagement (i.e., no early dropout), (b) in-session parenting skills proficiency (meeting the threshold for positive skills without exceeding the threshold for negative parenting behaviors), and (c) postintervention positive parenting skills. Results: Parents who demonstrated dynamic physiology–behavior coupling patterns that restrain positive parenting behaviors during child-led free play were less likely to achieve early parenting skills proficiency and more likely to drop out subsequently from the second phase of parent–child interaction therapy. They also showed fewer positive parenting skills postintervention. No pre- to postchanges were observed in parents’ dynamic physiology–behavior associations. Conclusions: Dynamic physiology–behavior associations manifested in child-led free play predicted disadvantages in parents’ early acquisition of skills and persistent engagement in parenting intervention, highlighting the value of physiology in illuminating individual differences in response to intervention. This approach also highlights potential mechanisms underlying treatment nonresponse among child welfare-involved parents, which can aid in the development of tailored intervention strategies.

doi: 10.1037/ccp0000968pmid: 40875360

Objective: The current systematic review and meta-analysis identified nonpharmacological outpatient interventions with transdiagnostic effects in youth with elevated psychological distress who do not meet the diagnostic criteria. We examined common elements that may be associated with treatment effects. Method: Of the 10,208 studies identified, k = 68 were included involving 10,805 individuals with a Mage of 16.96 years (SD = 1.80; 66.67% female). We examined changes in depression, anxiety, suicidality, disordered eating, and quality of life using random-effects models in the R meta package. Results: Cohen’s d effect sizes (95% CIs) were 0.21 [0.11, 0.32] for depression (k = 64), 0.20 [0.11, 0.29] for anxiety (k = 57), and 0.11 [0.01, 0.21] for quality of life (k = 19). Heterogeneity was present (I2 ranging from 6.73 to 16.95%). Due to limited studies for eating (k = 5) and suicidality (k = 4), meta-analyses were not feasible for these outcomes. Moderator analyses indicated that adolescents (vs. children and emerging adults) derived significant benefits. Cognitive behavioral therapy was indicated as an effective transdiagnostic approach for depression and anxiety. The most frequent common elements across cognitive behavioral therapy approaches included cognitive literacy, emotional literacy, psychoeducation, goal setting, and problem solving. Conclusions: These results provide the first quantitative test of transdiagnostic intervention approaches that can improve mental health in vulnerable, symptomatic youth. Further attention is required to outcomes related to disordered eating and suicidality given their prevalence and serious consequences in youth. Dismantling studies of cognitive behavioral therapy are required to identify effective common elements that can drive better mental health outcomes in youth.

doi: 10.1037/ccp0000976pmid: 40875361

Objectives: The present study examined effects of the Pregnant Moms’ Empowerment Program (PMEP) 4 years following program completion. It was hypothesized that women who participated in PMEP during pregnancy would experience less intimate partner violence revictimization and fewer depressive and posttraumatic stress symptoms as compared to women in the no-treatment control condition. Further, it was expected that the children women were pregnant with when they participated in PMEP, who are now preschool-aged, would exhibit fewer internalizing and externalizing problems as compared to children of women in the control condition. Method: Participants were 78 women (56.9% of the original sample) assigned to the PMEP intervention (n = 46) or control condition (n = 32) during pregnancy. Outcomes assessed were intimate partner violence (Revised Conflict Tactics Scales), depressive symptoms (Center for Epidemiologic Studies Depression Scale), posttraumatic stress symptoms (Posttraumatic Stress Disorder Checklist–5), and children’s internalizing and externalizing problems (Child Behavior Checklist). Results: Regression models controlling for baseline levels of each dependent variable indicated that 4 years posttreatment, women assigned to the PMEP condition, as compared to women in the control condition, reported significantly lower levels of depressive symptoms. Poisson regression analyses indicated that women who received PMEP reported significantly fewer intimate partner violence experiences than women in the control condition. Children of women who participated in PMEP exhibited significantly fewer externalizing problems than children of women in the control condition. Conclusions: Findings show that participating in PMEP resulted in benefits not only for women who received the treatment but also for their children 4 years following the intervention.