While Mindfulness-Based Interventions (MBIs) have been shown to be effective for a range of patient populations and outcomes, a question remains as to the role of common therapeutic factors, as opposed to the specific effects of mindfulness practice, in contributing to patient improvements. This project used a mixed-method design to investigate the contribution of specific (mindfulness practice-related) and common (instructor and group related) therapeutic factors to client improvements within an MBI. Participants with mild-severe depression (N= 104; (...) 73% female,Mage = 40.28) participated in an 8-week MBI. Specific therapeutic factors (formal out-of-class meditation minutes and informal mindfulness practice frequency) and social common factors (instructor and group ratings) were entered into multilevel growth curve models to predict changes in depression, anxiety, stress, and mindfulness at six timepoints from baseline to 3-month follow-up. Qualitative interviews with participants provided rich descriptions of how instructor and group related factors played a role in therapeutic trajectories. Findings indicated that instructor ratings predicted changes in depression and stress, group ratings predicted changes in stress and self-reported mindfulness, and formal meditation predicted changes in anxiety and stress, while informal mindfulness practice did not predict client improvements. Social common factors were stronger predictors of improvements in depression, stress, and self-reported mindfulness than specific mindfulness practice-related factors. Qualitative data supported the importance of relationships with instructor and group members, involving bonding, expressing feelings, and instilling hope. Our findings dispel the myth that MBI outcomes are exclusively the result of mindfulness meditation practice, and suggest that social common factors may account for much of the effects of these interventions. Further research on meditation should take into consideration the effects of social context and other common therapeutic factors. (shrink)

Conversation analytic research has advanced understanding of the psychotherapeutic process by understanding how psychotherapy is organised over time in and through interaction between clients and therapists. This study progresses knowledge in this area by examining how psychological accounts of experience are progressively developed across a range of helping relationships. Data include: (1) approximately 30 h of psychotherapy sessions involving trainee therapists; (2) approximately 15 h of psychotherapy demonstration sessions involving expert therapists; and (3) approximately 30 h of everyday conversations (...) involving close friends or family members. This article reports an analysis of techniques that are used to bring together two experiences that were discussed separately, to proffer a candidate connection between them. This proffering of candidate connections was recurrently used in psychotherapy. If confirmed by a client, a proffered connection could be used to develop a psychological account of a client’s experiences, which could then warrant some psychological intervention. In contrast, the proffering of connections was observed in only one of the everyday conversations included in the current study, where it was used to develop psychological accounts of experience. This shows that although proffering candidate connections is an everyday interactional practice, it appears to be used with greater frequency in psychotherapy, to advance its specific institutional aims. (shrink)

Several authors have recently argued that psychotherapy, as it is commonly practiced, is deceptive and undermines patients’ ability to give informed consent to treatment. This ‘deception’ claim is based on the findings that some, and possibly most, of the ameliorative effects in psychotherapeutic interventions are mediated by therapeutic common factors shared by successful treatments, rather than because of theory-specific techniques. These findings have led to claims that psychotherapy is, at least partly, likely a placebo, and that practitioners of (...) psychotherapy have a duty to ‘go open’ to patients about the role of common factors in therapy ; to not ‘go open’ is supposed to unjustly restrict patients’ autonomy. This paper makes two related arguments against the ‘go open’ claim. While therapies ought to provide patients with sufficient information to make informed treatment decisions, informed consent does not require that practitioners ‘go open’ about therapeutic common factors in psychotherapy, and clarity about the mechanisms of change in psychotherapy shows us that the common-factors findings are consistent with, rather than undermining of, the truth of many theory-specific forms of psychotherapy; psychotherapy, as it is commonly practiced, is not deceptive and is not a placebo. The call to ‘go open’ should be resisted and may have serious detrimental effects on patients via the dissemination of a false view about how therapy works. (shrink)

The second edition of The Great Psychotherapy Debate has been updated and revised to include a history of healing practices, medicine, and psychotherapy, an expanded theoretical presentation of the contextual model, an examination of therapist effects, and a thorough review of the research on common factors such as the alliance, expectations, and empathy.

The Great Psychotherapy Debate: Models, Methods, and Findings comprehensively reviews the research on psychotherapy to dispute the commonly held view that the benefits of psychotherapy are derived from the specific ingredients contained in a given treatment (medical model). The author reviews the literature related to the absolute efficacy of psychotherapy, the relative efficacy of various treatments, the specificity of ingredients contained in established therapies, effects due to common factors, such as the working alliance, adherence and allegiance to the (...) therapeutic protocol, and effects that are produced by different therapists. In each case, the evidence convincingly corroborates the contextual model and disconfirms the prevailing medical model. (shrink)

Psychotherapy is effective. Since the 1970’s, meta-analyses, and meta-analyses of meta-analyses, have consistently shown a significant effect size for psychotherapeutic interventions when compared to no treatment or placebo treatments. This effectiveness is normally taken as a sign of the scientific legitimization of clinical psychotherapy. A significant problem, however, is that most psychotherapies appear to be equally effective. This poses a problem for specific psychotherapies: they may work, but likely not for the reasons that ground their theoretical explanations for (...) their effectiveness. A prominent explanation for the findings of common efficacy in psychotherapy is to postulate that all successful therapies work by altering maladaptive meanings and providing patients with new, more adaptive meanings. This paper argues that the ‘meaning view’ of psychological change is likely mistaken; psychological problems are not normally problems of meaning nor are they directly ameliorated by changes in meaning. This paper then outlines a skill-based explanation for the findings of the common efficacy of psychotherapy. (shrink)

Compared with mainstream medicine and complementary and alternative therapies, the practice of psychotherapy has enjoyed a relative pass when it comes to ethical evaluation. Therefore, contributions to the, although slowly growing, body of literature on psychotherapy ethics are to be welcomed. In his paper ‘Psychotherapy, placebos, and informed consent’, Garson Leder takes issue with what he calls the ‘go open’ project in psychotherapy ethics—the idea that the so-called ‘common factors’ in therapy should be disclosed to prospective patients. Although (...) Leder does not give a detailed list, the common factors include therapist characteristics, patient characteristics, and the working alliance. He argues that the project advocating disclosure of these factors is flawed on two grounds: that information about common factors is not necessary for informed consent; and clarity about specific mechanisms of change in therapy is consistent with ‘many theory-specific forms of psychotherapy’. There are multiple serious problems with Leder’s critique of the recent literature, including how he represents the contours of the debate, which I list, and address in this response. (shrink)

In the present contribution, we argue that all health care professionals and particularly psychotherapists should provide a plausible rationale for their treatment including an etiological model and a model of unique and common change mechanisms. The provision of a plausible rationale has two goals: (1) meet the ethical challenge of informed consent, and (2) to improve treatment outcome by fostering the meaning response. In the course of the ethical and a legal obligation of psychotherapists to obtain patients’ informed consent (...) before initiating psychotherapy, patients have the right to receive maximally comprehensive information for providing their consent, which - among other information about the treatment (such as general psychotherapeutic approach, setting, and procedures) – should include a plausible treatment rationale. A useful concept in conceptualizing and communicating a treatment rationale as part of the informed consent procedure is Moerman’s general notion of the meaning response as the physiological or psychological effects of meaning in the course and treatment of an illness. The more compelling the rational explanation of the targeted treatment effects, the stronger the meaning response is expected to be. As the mechanisms of change in psychotherapy are known to be quite abstract and considered common to all approaches to a large extent, it seems especially important to provide a convincing treatment rationale to strengthen trust in the therapist and potentially foster positive expectations of process and outcome. To that extent, strengthening a patient`s meaning response to information provided at the beginning of psychotherapy may be central to activating common therapeutic factors. (shrink)

In ‘Psychotherapy, Placebos and Informed Consent’, I argued that the minimal standard for informed consent in psychotherapy requires that ‘patients understand that there is currently no consensus about the mechanisms of change in psychotherapy, and that the therapy on offer…is based on disputed theoretical foundations’, and that the dissemination of this information is compatible with the delivery of many theory-specific forms of psychotherapy (including cognitive behavioural therapy [CBT]). I also argued that the minimal requirements for informed consent do not include (...) information about the role of therapeutic common factors in healing (e.g., expectancy effects and therapist effects); practitioners may discuss the common factors with patients, but they are not part of the ‘core set’ of information necessary to obtain informed consent. In a recent reply, Charlotte Blease criticises these two arguments by claiming they are not supported by empirical findings about the therapeutic common factors. Blease’s response is based on serious misunderstandings of both CBT and what the common factor findings actually find. Nevertheless, addressing the reasons for these misunderstandings is instructive and gives us an opportunity to clarify what, exactly, needs to be explained to patients in order to obtain informed consent for psychotherapy. (shrink)

During psychotherapy, patient and therapist tend to spontaneously synchronize their vocal pitch, bodily movements, and even their physiological processes. In the present article, we consider how this pervasive phenomenon may shed new light on the therapeutic relationship– or alliance– and its role within psychotherapy. We first review clinical research on the alliance and the multidisciplinary area of interpersonal synchrony. We then integrate both literatures in the Interpersonal Synchrony (In-Sync) model of psychotherapy. According to the model, the alliance is grounded in (...) the coupling of patient and therapist’s brains. Because brains do not interact directly, movement synchrony may help to establish inter-brain coupling. Inter-brain coupling may provide patient and therapist with access to another’s internal states, which facilitates common understanding and emotional sharing. Over time, these interpersonal exchanges may improve patients’ emotion-regulatory capacities and related therapeutic outcomes. We discuss the empirical assessment of interpersonal synchrony and review preliminary research on synchrony in psychotherapy. Finally, we summarize our main conclusions and consider the broader implications of viewing psychotherapy as the product of two interacting brains. (shrink)

With its focus on evidence, psychology has grown into a mature, professional, and scientifically supported practice over the last decades. In general, psychotherapy and psychological counselling have shown to be more efficacious than waiting it out and a staggering 350 specific treatments have been scientifically supported as effective. Although, evidencebased treatments seem to work equally well, not all people benefit from evidence-based treatments, and it often remains unclear why. This raised the field-wide concern of what works for whom and sparked (...) a wealth of research on specific ingredients, common factors, process factors, and intra- and... (shrink)

The present narrative review seeks to unravel where we are now, and where we need to go to delineate the active ingredients in psychotherapy delivered by conversational agents (e.g., chatbots). While psychotherapy delivered by conversational agents has shown promising effectiveness for depression, anxiety, and psychological distress across several randomized controlled trials, little emphasis has been placed on the therapeutic processes in these interventions. The theoretical framework of this narrative review is grounded in prominent perspectives on the active ingredients in (...) psychotherapy. Based on search terms derived from various theoretical perspectives, we conducted a systematic literature search of four scientific databases and identified 17 studies. Across the selected studies, three themes emerged: relationship variables, emotional venting, and cognitive factors. While methodological issues compromise the epistemic value of this evidence base, core questions also remain to be answered. Such questions include, but are not limited to, whether humans can form affectionate bonds to inanimate beings and whether these kind of mental health treatments should be understood as psychotherapy or something else. Researchers should therefore be cautious when applying theories of psychotherapy in the realm of conversational agents. We conclude the paper by introducing recommendations for future research, which we hope will help instigate methodologically sound studies in this field. (shrink)

Positive Psychology Interventions as an Opportunity in Arab Countries to Promoting Well-being AbstractIn this perspective paper, we emphasize the importance of further research on culturally-sensitive positive psychology interventions in the Arab region. We argue that these interventions are needed in the region because they not only reduce mental health problems but also promote well-being and flourishing. To achieve this, we shed light on the cultural elements of the Arab region and how the concept of well-being differs from that of Western (...) culture. We review the research conducted in Arabia, briefly evaluate the quality of this research and list some adapted measurements. We furthermore propose guidelines and recommendations for future evidence-based positive psychology interventions research to align with the national culture in various sectors and community samples that contribute to the development of well-being in the Arab world.Introduction Extensive research on Positive Psychology Interventions (PPIs) - defined as activities focus on promoting positive feelings, thoughts, or behaviour (Sin & Lyubomirsky, 2009) - has shown their effectiveness in well-being and mental illness (e.g., Chakhssi et al., 2018; Hendriks et al., 2020). A recent review of 347 studies showed that PPIs have a significant effect on promoting quality of life and well-being and reducing anxiety and depression (Carr et al., 2020). However, the issue is that most of these studies (82%) remain narrow in focus only on Western Educated Industrialised Rich Democratic (WEIRD) countries (Hendriks et al., 2019). Therefore, they may not be effective for other countries such as the Arab countries where there are various cultural differences. This highlights the key role that culture can play in enhancing PPIs engagement, acceptability, and eventually, effectiveness (Hendriks & Graafsma, 2019). Recently, the field of PP in the Arab region has begun to grow (Basurrah et al., 2021; Rao et al., 2015). However, studies conducted in these countries are scant and of poor methodological quality. We have found humble quantity and quality of empirical studies. Yet, Arab countries, home to 5% of the world’s population, have a burden of mental health problems above global levels (GBD 2015 Eastern Mediterranean Region Mental Health Collaborators, 2018). Prevalent stigma, war and conflict were some of the contributors (Maalouf et al., 2019). Thus, to properly address this cultural stigma against mental health problems, PPIs could provide an additional role alongside traditional psychology approaches (e.g., Cognitive Behavioural therapy - CBT). Further, in light of the political conditions that some Arab countries are going through and the negative effects that they cause, it has become necessary to use the method of prevention that is the focus of PP and not only of treatment as a strategy for applications and practice. It has been noted that the mental health care system in the Arab region focuses highly on illnesses treatment and neglects the significant role that PP plays in enhancing human potential and well-being. We - here in Arabia –are becoming more influenced by many global issues particularly the COVID-19 pandemic and their impact on mental health and well-being (e. g. prevalence of stress, anxiety, depression among the general population during the pandemic (Salari et al., 2020). In response, Waters et al. (2021) have recently presented how positive psychological factors can play a significant role in buffering mental illness, enhancing mental health throughout the pandemic, and building positive processes and capacities that can help to promote future mental health.Here in this perspective paper, we highlight the cultural aspects of Arab countries. Specifically, we present previous PPIs research conducted in Arabia and briefly evaluate the quality of this research. Importantly, we discuss the need of developing an indigenous and culturally sensitive PP among the Arab region (Lambert et al., 2015).Arab Culture “Arab World,” which comprises 5% of the world’s population, refers to the Arab countries in the Middle East and North Africa. Despite the increasing pace and progress of different businesses in many Arab countries, individual communities are still limited in certain prominent economic places. Arab people rather gather in collective communities. They generally share the same Arabic Islamic culture, speak the same language, and descend from the same Arab families when going back in history no matter what nationality they have nowadays. Yet, very many changes came to communities before borders were drawn between countries and after. For instance, geography, topography, demography, and socio-economic status affect peoples’ nature of jobs and lifestyles. For example, Arabs in the east, west, or the middle have similar tongues; however, almost every Arab country has its accent. Therefore, people need to go back to the formal Arabic language ‘Fus-ha’ or learn more about different Arabic dialects when communicating cross-countries. According to Hofstede’s model (2011) based on the individualism-collectivism dimension, the Arab countries (Eastern society) have been classified as a collectivist culture, where their identity and decisions are influenced by social systems. In contrast, the United States (Western society) has been classified as an individualist culture focusing on individual decisions. Although there are degrees of individualism among Arabs in certain countries, they still share collective common characteristics. Here, we explore the meaning of collectivistic conceptions of the self, emotions, values, and religion in Arab countries and how they differ from those in individual Western cultures. The Self Since the field of PP focuses on the development of self, it is vital to recognize that self-concept varies across cultures. Individualism generally emphasises the self-directed and autonomous individual (Realo et al., 2002). People in individualist countries focus primarily on their personal characteristics (e.g., motives, abilities) to build their self-concept. On the other hand, collectivism refers to several social structures that highly value the groups to which people belong, such as family and tribe (Realo, 2003). People in collectivist countries such as the Arab countries focus primarily on their relationships with others to build their self-concept (Markus & Kitayama, 1991). Hence, research from Arab countries should focus on the core elements of collectivism when implementing PPIs to make a significant, meaningful impact. For example, people from a collective culture may experience a greater enhancement in well-being when practising interventions that are more prosocial and group-oriented such as compassion, performing acts of kindness, writing a gratitude letter, and using character strengths in everyday context including social context, compared with self-oriented interventions such as identifying character strengths. Emotions, value, and Religion Research shows that Western culture emphasises the goal of maximizing positive emotions, while Eastern culture emphasises embracing and balancing positive and negative emotions (Leu et al., 2011). To illustrate, culture plays an important role in influencing perceptions of happiness. People in individualist countries value happiness highly. In contrast, people from the collective countries value low arousal positive emotions (Leu et al., 2011) and exhibit a fear of happiness (Joshanloo & Weijers, 2014; Joshanloo, 2013). Hence, the influence of positive emotions plays a limited role in the mental health of Eastern society. Speaking of Value, for an Arab, the family is the centre of honour and the most important social unit. This loyalty has an impact on every part of an Arab’s life. Arabs honour their families and highly value their friendships. Therefore, future research could shed more light on group-oriented interventions (e.g., kindness) that focus more on the relationship with family, friends, and community. When it comes to religion, Arab society has a rich culture in values and believes that place a high emphasis on spirituality. Religion is the most important and distinctive aspect of Arab culture. Arab countries vary in terms of religion, with Islam being the predominant religion in most of them. Well-being (Hedonic and Eudaimonic) It is necessary here to clarify what is meant by hedonic and eudaimonic definitions of well-being. While the term ‘Hedonic’ is based on the pursuit of maximum levels of pleasure (feeling good), the term ‘Eudaimonic’, on the other hand, is based on meaning and the development of virtues (functioning well; Keyes & Annas, 2009). Research indicates that cultures are not equally supportive of hedonic and eudaimonic aspects (Joshanloo & Jarden, 2016). In comparison to collectivism, hedonism appears to be more congruent with individualism (Joshanloo, 2014). Pleasure and positive emotions are considered a way to pursue happiness in Western culture, while this method is not highly favoured in Eastern cultures (Lee et al., 2013); Because they consider suffering and negative emotions as contributing factors to spiritual development. Therefore, the eastern perspective is more in line with a eudaimonistic view which emphasises virtues, meaning, and feeling of belongingness. However, although we believe that both approaches can be found to a certain level in both cultures, the differences suggest that there are different routes to happiness. Positive Psychology in the Arab region Positive psychology - "the scientific study of what makes life most worth living" (Seligman & Csikszentmihalyi, 2000) - is one of the newest branches of psychology. It focuses on three main pillars: (1) positive subjective experiences (such as happiness and love); (2) positive individual characters (such as gratitude and compassion); and (3) positive institutions (for the application of positive principles within institutions and organizations; Seligman & Csikszentmiha lyi, 2000). Some of the main topics of interest in positive psychology include character strengths, gratitude, hope, happiness, mindfulness, optimism, positive thinking, and resilience. Within the applications of this science, various domains of well-being (such as happiness, engagement, positive emotions, and meaning) can be enhanced by practising positive psychology interventions (Sin & Lyubomirsky, 2009). Interestingly, these interventions have also produced benefits beyond well-being, such as reduced mental health issues (Chakhssi et al., 2018; Hendriks et al., 2020).Nowadays, PP is increasingly noticed in the Arab world (Lambert & Pasha-Zaidi, 2019; Rao et al., 2015). In recent years, there has been a great effort to explore the PP field across Arab countries. Several initiatives have emerged aimed at promoting well-being and flourishing. For example, the Middle East Journal of Positive Psychology published its first volume in 2015. On the International Day of Happiness in 2017, United Arab Emirates University launched its Emirates Center for Happiness Research. Meanwhile, Effat University in Saudi Arabia started the first Positive Psychology and Well-being Research Lab, the first symposium, and the first PP course. In 2019, Louise Lambert and Nausheen Pasha-Zaidi published the first regional text entitled “Positive Psychology in the Middle East/North Africa.” There are other efforts spent in the region as well; such as the work conducted in Egypt. Ibrahim Younus established the Arab Association for Positive Psychology https://www.psycholearn.com/en/associative.php which provides several courses on PP and also published a book entitled “The Power of Positive Psychology” (Younus, 2017). Despite this development, nothing can compare to the quantity and even quality of research in other countries. In light of our observations, the few PP studies may be attributed to the lack of awareness of the constructive approach and prevention compared to problem-solving. An Arab dentist once said: “people do not come to me until they are badly in pain.” In any case, many studies have taken place in Arab countries in the last decade, more of which are descriptive and less of which experimental. For example, Abdel-Khalek (2010) found positive correlations between quality of life, subjective well-being, and religiosity among students in Kuwait. Abdel-Khalek (2016) developed “the Arabic Scale of Religiosity,” which significantly correlated with PP variables among students in Algeria, Kuwait, and Egypt. Recently, empirical studies on PPIs have arisen in Arab-Islamic countries. More attention has been focused on promoting well-being and alleviating the high burden of mental health problems in the region (GBD 2015 Eastern Mediterranean Region Mental Health Collaborators, 2018). For instance, several studies examined the effectiveness of mindfulness among university students (e.g., Al-Ghalib & Slim, 2018; Awad, 2019; Thomas et al., 2016), parents of children with autism (Rayan & Ahmed, 2016) and addicted adults (Al-Rashidi, 2018). Such an intervention has positive effects. Participants who practised mindfulness reported reduction in stress and depression as well as improvement in well-being and resilience. Moreover, the results of a recent pilot study found positive impacts on enhancing emotional regulations and reducing stress among Arab teachers (Berkovich-Ohana et al., 2020). Some studies have also begun to examine various interventions targeting character strengths (Basurrah et al., 2020; Chérif et al., 2020), self-compassion (Elaiwah, 2017), positive thinking (Mohammed et al., 2014; Hadad, 2014), and hope (Zaki, 2016). Interestingly, a new finding considering the fear of happiness among people from collective countries has been examined. Lambert et al. (2019) provided evidence that a 14-week PPIs programme has an impact on reducing the fear and fragility of happiness beliefs among university students in the United Arab Emirates.Since Arab countries place great emphasis on spirituality, several authors have considered the aspect of religion when implementing PPIs. For instance, an empirical study by Al-Seheel and Noor (2016) found that expressing gratitude towards God “Allah” increases the happiness of the Muslim more than the usual gratitude intervention. Additionally, Al-Ghalib and Salim (2018) examined a religiously sensitive mindfulness-training programme with university students and found a positive effect on life satisfaction and a slight reduction in stress, depression, and anxiety. Hence, the role of religion is vital to make the interventions more relevant to Arab culture where people can connect Islamic philosophy with PP theories and practices. These studies reviewed here provide further support for the need for culturally sensitive interventions among the Arab population. More recently, the first systematic review of PPIs in Arab countries was conducted by Basurrah et al. (2021; the protocol has been published in BMJ Open and the final manuscript has been submitted for publication). Reviewing a total of 39 studies, the most commonly studied interventions were mindfulness, positive thinking, and resilience. Only a handful of studies examined gratitude, character strengths, forgiveness, self-compassion, savouring, or finding flow. Further analysis revealed that most studies from Arab countries have several methodological limitations. This included a lack of protocol guidelines, few well-designed randomized controlled trials (RCTs), blinding issues, small sample sizes, lack of active control groups, and lack of research into certain populations (e.g., teachers, employees, and people in distress in refugee camps). Discussion PP was founded on an individualistic framework (Christopher & Hickinbottom, 2008). To ensure that PPIs are culturally meaningful, this paper includes some cultural elements of the Arab region that should be considered to serve the needs of the Arab population. In the Arab world, some people may believe that PP is solely about happiness and being positive. If so, it is important to educate the public about the findings of rigorous studies evaluating PPIs such as gratitude, hope or flow on health, well-being and performance. To explain the value and effectiveness of these evidence-based approaches, examples might include studies linking gratitude with benefits for people with heart disease (Cousin et al., 2021), or how PPIs can promote quality of life in cancer patients (Casellas-Grau et al., 2014). There is some evidence about PPIs being effective in improving well-being in the Arab region, but research in this region is still in its infancy and little information is available regarding PPIs and the experience of Arabs participating in such interventions. Hence, there is still much more to investigate in this regard. Future research should empirically examine the effectiveness of various unstudied interventions such as savouring, gratitude, self-compassion, character strengths or finding flow. A combination of quantitative and qualitative approaches is required to provide an in-depth understanding of Arabs’ experience and impressions of PPIs and how and why they work. This may provide useful information to inform the appropriate design of PPIs to suit Arab culture and needs. Furthermore, while some research on PPIs has been carried out in the region, most of these studies have been of poor quality that suffered from small sample sizes, confounding factors, and a high degree of bias. To overcome these issues, future research should improve research quality, including protocol guidelines and well-designed RCTs. In particular, research should include randomization, allocation, blinding, power analysis to determine adequate sample size, active control groups to reduce bias, and follow-up periods of at least 12 months.Among the most popular resources that future PP practitioners may refer to are the International Positive Psychology Association (IPPA) and the International Positive Education Network (IPEN). Also, we recommend the Middle East Journal of Positive Psychology and the first regional book (Lambert & Pasha-Zaidi, 2019). To develop and/or adapt a multi-component PPIs, we would recommend referring to Character Strengths (Peterson & Seligman, 2004), the theory of well-being (PERMA Model: Positive Emotion, Engagement, Relationships, Meaning, and Accomplishment; Seligman, 2011), and the Five Ways to Well-being: Connect, Be Active, Take Notice, Keep Learning, and Give (Aked et al., 2008). Finally, single-component PPIs are based on theories like Broaden-And-Build (Fredrickson, 2004), Hope (Snyder et al., 2002), and Self-Determination (Deci & Ryan, 2012) can be also considered. Two other concepts that would be usefully applied are ‘Savouring’ (Bryant & Veroff, 2007) and Phillip Zimbardo’s Time Perspective (Stolarski et al., 2015). For instance, savouring has a positive temporal orientation to reminiscing the good memories from the past, enjoying the hedonic present moments, and willing proactively to make a better future. Now, what is even maybe more interesting for Muslims is “Transcendent Future” where all intentions, words and actions are devoted to that life after death. In addition, there is a model already prepared for the clinical purpose called Positive Psychotherapy (PPT). Tayyab Rashid and Martin Seligman published a PPT manual for clinicians in 2018. And for cross-cultural applications, including Muslim Arab culture, Rashid and Al-Haj Baddar (2019) have written a paper presenting PPT and its efficacy. PPT overview in detail shows sessions, themes, skills, practice, and cultural considerations where a mixture of PPIs based on PERMA, Strengths, and other PP concepts can be found. Regarding PP measurements, it is highly recommended to generate indigenous tools based on cultural backgrounds reviewed here in the article. An example of this is a tool for measuring Muslim well-being by including domains beyond what is found in Western literature. So far, in the Arab region, several attempts have been made to adapt PP tools. For example, Marei Salama-Younes (2018) validated the Arabic versions of different measures of well-being (e.g., satisfaction with life scale, the subjective vitality scale). Other validated scales as well include the self-compassion scale (Alabdulaziz et al., 2020), and the passion scale (Salama-Younes & Hashim, 2018). Conclusion This paper has discussed the cultural aspects of Arab countries and the need of developing culturally sensitive PPIs. The past decade has seen an increase in mental health problems in the Arab region. Stigma and lack of awareness have been always there. Among the issues are also wars, conflicts, and displacement in many Arab countries such as Iraq, Lebanon, and Palestine (Hassan et al., 2016). These indicate an urgent need to prevent mental illness and promote well-being. Indeed, we highlighted the importance of integrating culture with PPIs, following the guidelines for the cultural adaptation of PPIs (Hendriks & Graafsma, 2019) and the ethical guidelines for PP practice (Jarden et al., 2020). Another significant contribution of this paper is to highlight the importance of improving the quality of research conducted in Arab countries. In brief, this paper has several practical implications. It is an open invitation for researchers, policymakers, and practitioners alike to be more exposed to PP; as well as to better conceptualising and adapting interventions and measurement tools to the local culture in different sectors to maximize their effectiveness. And as we consider it as an invitation for us too, here we are starting a PPIs practice guide in Arabic language and for Arab practitioners. The insights gained from this paper may be useful for placing well-being on top of priorities for achieving individual, organizational, and optimal national functioning in different sectors. There is also a need to change the stigma or negative beliefs about seeking health for psychological support, which is an issue for countries in the Middle East (Baess, 2018). (shrink)

This exciting volume brings together leading figures across existential psychology in a clear-sighted guide to its current practice and therapeutic possibilities. Its accessible yet scholarly presentation dispels common myths about existential psychotherapy while demonstrating core methods and innovative techniques as compatible with the range of clinicians' theoretical orientations and practical approaches. Chapters review the evidence for its therapeutic value, and provide updates on education, training, and research efforts in the field, both in the US and abroad. Throughout, existential (...) psychotherapy emerges as a vital, flexible, and empirically sound modality in keeping with the current-and future-promotion of psychological well-being. Highlights of the coverage include: Emotion, relationship, and meaning as core existential practice: evidence-based foundations. · Meaning-centered psychotherapy: a Socratic clinical practice. Experience processing as an aspect of existential psychotherapy: life enhancement methodology. Structural Existential Analysis (SEA): a phenomenological method for therapeutic work. Experiencing change: an existential perspective. Creating the World Congress for existential therapy. Clarifying and Furthering Existential Psychotherapy will spark discussion and debate among students, therapists, researchers, and practitioners in existential psychology, existential psychotherapy, and allied fields as well as the interested public. It makes a suitable text for graduate courses in existential therapy, psychological theories, and related subjects. (shrink)

Psychotherapy with the use of psychedelic substances, including psilocybin, lysergic acid diethylamide (LSD), ketamine, and 3,4-methylenedioxymethamphetamine (MDMA), has demonstrated promise in treatment of post-traumatic stress disorder (PTSD), anxiety, addiction, and treatment-resistant depression. Psychedelic-assisted psychotherapy (PP) represents a unique psychopharmacological model that leverages the profound effects of the psychedelic experience. That experience is characterized by strong dependency on two key factors: participant mindset and the therapeutic environment. As such, therapeutic models that utilize psychedelics reflect the need for careful design that (...) promotes an open, flexible, trusting mindset and a supportive setting. To meet this need, the PP model is increasingly supplemented by auxiliary methods, including meditation, relaxation, visualization or spiritual practices. We suggest virtual reality (VR) as a full-spectrum tool able to capitalize on and catalyze the innately therapeutic aspects of the psychedelic experience, such as detachment from familiar reality, alteration of self-experience, augmentation of sensory perception and induction of mystical-type experiences. This is facilitated by VR’s evidenced capacity to: aid relaxation and reduce anxiety; buffer from external stimuli; promote a mindful presence; train the mind to achieve altered states of consciousness (ASC); evoke mystical states; enhance therapeutic alliance and encourage self-efficacy. While these unique VR features appear promising, VR’s potential role in PP remains speculative due to lack of empirical evidence on the combined use of VR and PP. Given the increased commercial interest in this synergy there is an urgent need to evaluate this approach. We suggest specific VR models and their role within PP protocols to inspire future direction in scientific research, and provide a list of potential disadvantages, side effects and limitations that need to be carefully considered. These include sensory overstimulation, cyber-sickness, triggering memories of past traumatic events as well as distracting from the inner experience or strongly influencing its contents. A balanced, evidence-based approach may provide continuity across all phases of treatment, support transition into and out of an ASC, deepen acute ASC experiences including mystical states and enrich the psychotherapeutic process of integration. We conclude that the potential application of VR in modulating psychedelic-assisted psychotherapy demands further exploration and an evidence-based approach to both design and implementation. (shrink)

Objective: To determine the usefulness of Q methodology to locate and describe shared subjective influences on clinical decision making among participant physicians using hypothetical cases containing common ethical issues. Design: Qualitative study using by-person factor analysis of subjective Q sort data matrix. Setting: University medical center. Participants: Convenience sample of internal medicine attending physicians and house staff (n = 35) at one midwestern academic health sciences center. Interventions: Presented with four hypothetical cases involving urgent decision making near the end (...) of life, participants selected one of three specific clinical actions offered for each case. Immediately afterward and while considering their decision, each respondent sorted twenty-five subjective self-referent items in terms of the influence of each statement on their decision-making process. By-person factor analysis, where participants are defined as variates, yielded information about the attitudinal background the physicians brought to their consideration of each hypothetical case. We performed a second-order factor analysis on all of the subjective viewpoints to determine if a smaller core of shared attitudes existed across some or all of the four case vignettes. Factor scores for each item and post-sort comments from interviews conducted individually with each respondent guided the interpretation of ethical perspective used by these respondents in making clinical decisions about the cases. Measurements and Main Results: Second-order factor analysis on seventeen viewpoints used by physicians in the four hypothetical urgent decision cases revealed three moderately correlated (r 2 < 40%) subjective core attitudinal guides used broadly among all the cases and among sixteen of the seventeen original factors. Across all the cases, our participants were guided in general by: (1) patient-focused beneficence, (2) a patient- and surrogate-focused perspective that includes risk avoidance, and (3) best interest of the patient guided by ethical values. Economic impact on the physician, expediency in resolution of the situation, and the expense of medical treatment were not found to be influential determinants in this study. Conclusions: Q sorting and by-person factor analysis are useful qualitative methodological tools to study the complex structure of subjective attitudes that influence physicians in making medical decisions. This study revealed the subjective viewpoints used by our physician participants as they made ethically challenging treatment decisions. The three second-order factors identified here are grounded in current bioethical values as well as the personal traits of physicians. The participants' decision methods appear to resemble casuistry more than principle-based decision making. Generalizability of results will require further studies. (shrink)

Previous research has investigated factors that contribute to the development of different risk-taking behaviors, such as can occur on lab-based behavioral risky decision making tasks. On several of the most common tasks, participants must develop an adequate understanding of the relative risks and benefits associated with each decision in order to learn to decide advantageously. However, contextual factors can affect the decision making process and one’s ability to weigh the risks and benefits of a decision. The present (...) study investigates the extent to which music may be an additional contextual factor that can disrupt decision making and other executive functions. Across four studies we examine whether having music playing passively in the background or having participants actively listen to music affects performance on measures of risky decision making, working memory, processing speed, and problem solving. Participants reported greater distraction for rock music than classical music in the passive listening studies but did not report any differences in distraction across conditions in the active listening studies. Despite this self-reported increased level of distraction, few significant differences were found in task performance across groups and across studies. The Angling Risk Task was sensitive to differences in risk by condition, with music leading to greater risk-taking in a passive listening study, but less risk-taking in an active listening study, compared to no music. The extent to which music serves as a contextual factor disrupting performance on measures of risky decision making and other executive functions may depend in part on whether individuals are actively versus passively listening to the music. (shrink)

Since the emergence of psychology, its relation with religion has been inconsistent. Their different sources and methodologies but common aims made them close or distanced. Today these disciplines acknowledged and learned to benefit from each other. The affect of religion/spirituality on human’s lives raised the attention of psychology and required the integration of these into psychotherapy. In order to approach the psychology-religion relation via the traces of religion within psychotherapy the paper deals with the necessity, the knowledge needed, the (...) principles when integrating religious/spiritual principles and practices into psychotherapy; finally the religious traces in psychotherapy. The paper comprises few Turkish examples together with the huge body of theoretical and practical examples on the topic. These theories and practices should be important examples for Turkey. By addressing the religious traces in psychotherapy the aim of the paper is to show that the cliff between psychology and religion is in fact not that deep.SummaryIt can be argued that psychology and religion have common interests relating the well-being of individuals. There is a huge body of research that emphasizes the implementation and necessity of cultural, religious, spiritual principles in professional psychology. The proprium of these models is to integrate the client’s religious/spiritual sources into therapy. Especially religious clients benefit from therapies that define their treatment goals around their religious views. However, it must be considered that if the disorder has a biological dimension and/or is severe psychopathologic pure religious interventions will not be sufficient. This paper traces the religious/spiritual principles within psychotherapies and shows that the cliff between religion and psychology is not that deep.At different places in the world therapy is done according to western standards. However, determining mental health or disorders according to western criteria might be problematic. In societies in which religious/spiritual life is an essential part of culture, religion plays a crucial role in people’s perception of disease and treatment. In mental health, spirituality is an important and primary source for coping. Empirical studies reveal the positive outcomes of religious practices such as personal prayer, repentance, meditation, and dhikir on mental and physical health. In light of this data it becomes clear that psychotherapies should be revised socio-culturally and culturally sensitive psychotherapies that cover belief and religious practices should be developed. Another need for the integration of religion, belief, and spirituality with psychotherapy is the significant effect of these experiences on individual’s lives. With regard to the broad impact of religion, psychological interventions solely might not be sufficient to fulfill human psychological needs. As studies show, religious clients expect religious practices in treatment as well as a therapist who is open and respectful to religious principles, ready to talk about own religious beliefs, willing to integrate religious matters into therapy. To fulfill these expectations therapists, need to be trained and educated in religious/spiritual matters. Additionally, the therapist must acknowledge and be conscious about her/his own worldview, religious commitment, and spiritual life. However, the therapist needs not to be religious him/herself or share the same religion as the client. It is sufficient that the therapist is open and receptive to the client’s beliefs so that these can be used as effective sources in therapy. Spiritual psychotherapy considers spirituality as one of the main sources of clients. Thus, it might be critical when the therapist has poor knowledge about religion when the client considers it as significant. This source might be helpful for the client in coping with his/her problems and limitations. Having knowledge about the client’s religion and culture might also be important to acknowledge his/her perceptions and beliefs. Because individuals’ understanding of disease, their beliefs about reasons for mental disorders, their expectations from the health system are important factors in seeking help and choosing therapy.Therapists who decide to integrate spiritual/religious principles into psychotherapy have to adhere to some ethical principles. The source and the degree of the psychological disorder are important, too. Even though the efficacy of religious rituals and spiritual interventions are extensive in each case it has to be investigated whether religiosity/spirituality is part of the problem or the solution. Certain aspects will guide the therapist in deciding whether to integrate religiosity/spirituality into the therapy process or not. Additionally, he/she has to gather information about the client’s religious/spiritual life (spiritual anamneses) in order to choose the most appropriate religious method and intervention. Today psychotherapy deals with coping, questions about the meaning, purpose, and way of life. Actually, these are issues with which religious traditions has dealt and proposed solutions for thousands of years ago. For example, ethical principles for mental health professionals correspond to those of religious teachings. The attitudes and the type of relationship recommended by the client-centered approach are also commended by religious teachings for all human relations. Beginning with the 1960’s an increasing interest in Buddhist teachings is observable among psychotherapists. Mental exercises (especially meditation) cause transformations in the self-perception and lead to enduring changes in consciousness. Religions such as Islam, Judaism, and Buddhism recommend meditation technics like contemplation, dhikr, and yoga. Confession in the Catholic Church has similarities with psychotherapeutic catharsis. Many cultures own one kind of forgiveness rituals of confessions. As studies report people benefit from these rituals. Forgiveness is a multifaceted issue with psychological and spiritual dimensions and involves cognitive, emotional, relational, and spiritual processes. Research indicates the religious and psychological functions of forgiveness. Many subjects such as personal prayer, hope, empathy, love, and tolerance are common issues of both, psychotherapy and religion/spirituality. Different psychotherapeutic approaches and especially positive psychology integrate these values that are valued by religion/spirituality into their theories and practices.In conclusion, the cliff between psychology and religion/spirituality is not that deep at it seems at first sight. They have many subjects in common. Individuals turn to religion and spirituality in times of crises. This makes it inevitable to include religion and spirituality into the therapeutic process. Because religions provide ways of coping, hope, and meaning in difficult times. This fact is recognized and accepted abroad and lead to the religious/spiritual psychotherapy movement, which will hopefully an inspiration for Turkish psychology as well. (shrink)

This edited volume comprehensively examines the critical ethical challenges that arise in the practice of counselling and psychotherapy. It translates philosophical positions and professional ethical guidelines in a way that can be applied to practice. The various chapters focus on specific ethical issues that emerge in working with a range of different client groups; for example, children, couples and families. While some ethical imperatives are common across the board, others could be more closely associated with certain client groups. (...) Practitioners might experience uncertainty in working with vulnerable client groups; for example, lesbian/gay/transgender/intersex (LGBT) clients, or persons who report intimate partner violence. Several chapters raise questions, provide information and additional resources to enhance ethically informed practice. Chapter contributions also highlight the ethical dilemmas that might be unique to certain contexts; for example, private practice, schools and consultation-liaison settings. This volume also addresses contemporary and relatively less understood playing fields like 'digital ethics' related to therapist-client interface in the internet space and the navigation of ethical dilemmas in the newly emerging field of employee assistance programmes which address mental health needs in the corporate sector. Written by experienced practitioners of psychotherapy, and culturally contextualized, this is a valuable resource for academics and practitioners interested in psychotherapy and counselling. (shrink)

In recent decades the relationship between psychoanalysis and psychotherapy has been a focal point for debate about the distinctiveness of analysis as a particular kind of therapeutic enterprise. In _Interpretation and Interaction_, Jerome Oremland invokes the interventions of "interpretation" and "interaction," rooted in the values of understanding and amelioration, respectively, as a conceptual basis for reappraising these important issues. In place of the commonly accepted triadic division among psychoanalysis, exploratory psychotherapy, and supportive psychotherapy, he proposes a new triad: psychoanalysis, psychoanalytically-oriented (...) psychotherapy, and interactive psychotherapy. Anchoring his classification in what he terms the "orientation of the therapy" rather than the "orientation of the therapist," Oremland submits that analysis and psychoanalytically-oriented psychotherapy strive systematically to _interpret_ the therapeutic interaction as expressed in the transference. Interactive psychotherapy, on the other hand, uses the transference selectively to ameliorate psychic stress. _Interpretation and Interaction_ is enriched by a concluding chapter from Merton Gill, a preeminent authority on the therapeutic process. Gill's critical appreciation of Oremland's proposals amounts to an illuminating refinement of his own position on the relationship between psychoanalysis and psychotherapy. Scholarly in conception, thoughtful in tone, and pragmatic in yield, _Interpretation and Interaction_ is a clarifying addition to the psychoanalytic theory of psychotherapy. It will have the practical consequence, in Gill's words, of "aiding clinicians in retaining their analytic identities and their analytic orientation across the spectrum of their therapeutic work.". (shrink)

Time series analysis is a technique to describe the structure and forecast values of a particular variable based on a series of sequential observations. While commonly used in finance and engineering to understand structural changes across time, its applicability to humanistic processes like discourse is less clear. This article demonstrates the feasibility and complementary use of TSA with a case study of metaphor use in psychotherapy sessions. A conceptual sketch of how TSA components relate to discourse components is followed (...) by a step-by-step analysis of two therapist–client dyads. Each dyad is shown to be adequately described by a different model, and the key characteristics of the models are interpreted alongside prior qualitative analysis of the dyads, shedding new light on their structural properties and attendant implications. Limitations of the present analysis and future research directions are briefly discussed. (shrink)

On page 1 of his classic text, Millsap states, “Measurement invariance is built on the notion that a measuring device should function the same way across varied conditions, so long as those varied conditions are irrelevant [emphasis added] to the attribute being measured.” By construction, measurement invariance techniques require not only detecting varied conditions but also ruling out that these conditions inform our understanding of measured domains. In fact, measurement invariance techniques possess great utility when theory and research inform (...) their application to specific, varied conditions that, if not detected, introduce measurement biases, and, thus, depress measurement validity. Yet, we see emerging bodies of work where scholars have “put the cart before the horse” when it comes to measurement invariance, and they apply these techniques to varied conditions that, in fact, may reflect domain-relevant information. These bodies of work highlight a larger problem in measurement that likely cuts across many areas of scholarship. In one such area, youth mental health, researchers commonly encounter a set of conditions that nullify the use of measurement invariance, namely discrepancies between survey reports completed by multiple informants, such as parents, teachers, and youth themselves. In this paper, we provide an overview of conceptual, methodological, and measurement factors that should prevent researchers from applying measurement invariance techniques to detect informant discrepancies. Along the way, we cite evidence from the last 15 years indicating that informant discrepancies reflect domain-relevant information. We also apply this evidence to recent uses of measurement invariance techniques in youth mental health. Based on prior evidence, we highlight the implications of applying these techniques to multi-informant data, when the informant discrepancies observed within these data might reflect domain-relevant information. We close by calling for a moratorium on applying measurement invariance techniques to detect informant discrepancies in youth mental health assessments. In doing so, we describe how the state of the science would need to fundamentally “flip” to justify applying these techniques to detect informant discrepancies in this area of work. (shrink)

Cultural interactions have been at the forefront of political strife in recent years as authoritarian regimes have come to power across the globe. This warrants investigation by social science researchers in the fields of social psychology, political psychology, and cognitive psychology. This study drew upon those three fields to explore the relationships between political orientation and (1) authoritarian traits, (2) attitudes towards intergroup relations and cross-cultural interactions (CCI), and (3) identity factors, largely through the lens of Social Identity (...) Theory. Participants comprised 2,582 undergraduates at a public university in the U.S. The Diverse Learning Environments survey assessed views on social identity, intergroup relations, political and religious ideology, and social and political issues. Correlational analysis and ANOVA were conducted to determine relationships between variables and differences between groups. Results indicated that the more strongly respondents rated their political orientation as conservative, the more authoritarian traits they tended to report, the less likely they were to engage in CCI, and the more likely they were to hold negative views of those from different backgrounds than themselves. The more respondents rated their political orientation as liberal, the more open they were to diversity and more likely they were to engage in CCI. Identity factors appeared to be more important to conservatives than to liberals in that strength of political ideology was related to common identity characteristics for conservatives but not for liberals. (shrink)

Digital images taken by mobile phones are the most frequent class of images created today. Due to their omnipresence and the many ways they are encountered, they require a specific focus in research. However, to date, there is no systematic compilation of the various factors that may determine our evaluations of such images, and thus no explanation of how users select and identify relatively “better” or “worse” photos. Here, we propose a theoretical taxonomy of factors influencing the aesthetic (...) appeal of mobile phone photographs. Beyond addressing relatively basic/universal image characteristics, perhaps more related to fast perceptual processing of an image, we also consider factors involved in the slower re-appraisal or deepened aesthetic appreciation of an image. We span this taxonomy across specific types of picture genres commonly taken—portraits of other people, selfies, scenes and food. We also discuss the variety of goals, uses, and contextual aspects of users of mobile phone photography. As a working hypothesis, we propose that two main decisions are often made with mobile phone photographs: Users assess images at a first glance—by swiping through a stack of images—focusing on visual aspects that might be decisive to classify them from “low quality” to “acceptable” to, in rare cases, “an exceptionally beautiful picture.” Users make more deliberate decisions regarding one’s “favorite” picture or the desire to preserve or share a picture with others, which are presumably tied to aspects such as content, framing, but also culture or personality, which have largely been overlooked in empirical research on perception of photographs. In sum, the present review provides an overview of current focal areas and gaps in research and offers a working foundation for upcoming research on the perception of mobile phone photographs as well as future developments in the fields of image recording and sharing technology. (shrink)

Moral distress has been widely reviewed across many care contexts and among a range of disciplines. Interest in this area has produced a plethora of studies, commentary and critique. An overview of the literature around moral distress reveals a commonality about factors contributing to moral distress, the attendant outcomes of this distress and a core set of interventions recommended to address these. Interventions at both personal and organizational levels have been proposed. The relevance of this overview resides in (...) the implications moral distress has on the nurse and the nursing workforce: particularly in regard to quality of care, diminished workplace satisfaction and physical health of staff and increased problems with staff retention. (shrink)

There is robust scientific evidence from meta-analyses in psychotherapy research that common factors such as the alliance between patients and therapists, empathy, goal consensus/collaboration, positive regard/affirmation and genuineness have a much greater effect on the overall psychotherapy outcome than the so-called specific factors like particular treatment methods or ingredients of therapy.1 The current evidence base also suggests that the effects of telepsychiatric treatment are comparable with those of face-to-face treatment, not only regarding clinical outcome parameters but also (...) with respect to patient satisfaction, acceptance and adherence—all common factors of psychotherapy.2 According to a comprehensive review of the main ethical arguments for and against different forms of online psychotherapy, the online setting provides several weighty advantages: for example, increased access, availability, flexibility, convenience, satisfaction, acceptance and increased demand.3 Among the arguments against online psychotherapy, privacy, confidentiality and data security issues, emergency issues, as well as communication issues have been mentioned.3 Frittgen and Haltaufderheide 4 are concerned that telepsychiatry could ‘impact ethically relevant aspects of the therapeutic relationship’. They conclude that ‘there is evidence for ethically relevant changes of the therapeutic relationship in video-based telepsychiatric consultations’,4 particularly pertaining to ‘respect for autonomy, lucidity, fidelity, justice and humanity towards each other’.4 Indeed, video-based consultations as technically mediated communication ‘do not only transmit but transform what can be perceived, …. (shrink)

Consider a scenario where, at the start of an appointment with a therapist, she explains to you that ‘the success of the therapy will depend on your own positive expectations, the respect and esteem that you have for me as a qualified health professional, the warm tone and empathic approach that I adopt towards you, and the trust that you place in me, during the course of treatment’. You might find this transparency about the therapeutic process to be refreshingly honest. (...) You might, however, be surprised if this openness turned out to be an ethical obligation that she owed you. Yet, for some commentators, this ‘open’ approach to psychotherapy – where there is openness about the common factors that can explain the efficacy of the therapy –is required by ethical standards of informed consent and respect for patient autonomy. In this edition of the Journal of Medical Ethics, Garson Leder formulates two responses to this type of ‘open therapy claim’: that ‘….informed consent does not require the practitioners ‘go open’ about the therapeutic common factors in psychotherapy, and clarity about the mechanism of change shows us …. (shrink)

Psychotherapy is commonly described as a “talking cure,” a treatment method that operates through linguistic action and interaction. The operative specifics of therapeutic language use, however, are insufficiently understood, mainly due to a multitude of disparate approaches that advance different notions of what “talking” means and what “cure” implies in the respective context. Accordingly, a clarification of the basic theoretical structure of “talking cure models,” i.e., models that describe therapeutic processes with a focus on language use, is a desideratum of (...) language-oriented psychotherapy research. Against this background the present paper suggests a theoretical framework of analysis which distinguishes four basic components of “talking cure models”: (1) a foundational theory (which suggests how linguistic activity can affect and transform human experience), (2) an experiential problem state (which defines the problem or pathology of the patient), (3) a curative linguistic activity (which defines linguistic activities that are supposed to effectuate a curative transformation of the experiential problem state), and (4) a change mechanism (which defines the processes and effects involved in such transformations). The purpose of the framework is to establish a terminological foundation that allows for systematically reconstructing basic properties and operative mechanisms of “talking cure models.” To demonstrate the applicability and utility of the framework, five distinct “talking cure models” which spell out the details of curative “talking” processes in terms of (1) catharsis, (2) symbolization, (3) narrative, (4) metaphor, and (5) neurocognitive inhibition are introduced and discussed in terms of the framework components. In summary, we hope that our framework will prove useful for the objective of clarifying the theoretical underpinnings of language-oriented psychotherapy research and help to establish a more comprehensive understanding of how curative language use contributes to the process of ther-apeutic change. (shrink)

Background Relatively little information is available regarding the level of acceptance of evolution and knowledge about evolution in different educational settings in Europe. The aim of the present study is to fill this gap and provide a comprehensive overview of the current state of research regarding evolutionary knowledge and acceptance of students and teachers across Europe, based on a systematic literature review. -/- Results We identified 56 papers for the period 2010–2020, presenting results for 29 European countries. Both knowledge (...) and acceptance of evolution were assessed in 17 studies. Out of 13 instruments most commonly used in the literature, five have been used in the European context so far: ACORNS, CINS, I-SEA, KEE and MATE. Thirty-one other instruments were identified of which 16 were used in studies on knowledge and 15 in studies on acceptance. The extent of knowledge was hard to compare even within groups of the same education level due to the application of different instruments and assessment of different key concepts. Our results illustrate the persistence of misconceptions through all education levels. Comparing acceptance among different education levels and countries revealed a high diversity. However, a lack of evolution in curricula tended to be associated with rejection of evolution in some countries. European studies that investigated both acceptance of evolution and knowledge about evolution varied highly concerning the existence and strength of the relationship between these factors. However, some trends are visible, such as an increase of strength of the relationship the higher the education level. -/- Conclusions The present review highlights the lack of a standardized assessment of evolutionary knowledge and acceptance of evolution across Europe and, therefore, of reasonably comparable data. Moreover, the review revealed that only about one-third of all studies on acceptance and/or knowledge about evolution provided evidence for local validity and reliability. We suggest the use of assessment categories for both knowledge and acceptance instruments to allow for interpretation and comparison of sum scores among different sample groups. This, along with prospective comparative research based on similar samples, paves the way for future research aimed at overcoming current biases and inconsistencies in results. (shrink)

Self-regulation in early childhood is an important predictor of success across a variety of indicators in life, including health, well-being, and earnings. Although conceptually self-regulation has been defined as multifaceted, previous research has not investigated whether there is conceptual and empirical overlap between the factors that comprise self-regulation or if they are distinct. In this study, using a bifactor model, we tested the shared and unique variance among self-regulation constructs and prediction to pre-academic and social-emotional skills. The sample (...) included 932 preschool children, their parents, and their teachers in the United States. Children’s self-regulation was assessed using measures of executive function, behavioral self-regulation, and emotion regulation. The bifactor model demonstrated a common overarching self-regulation factor, as well as distinct executive function and emotion regulation factors. The common overarching self-regulation factor and executive function predicted children’s pre-academic and social-emotional skills. The emotion regulation factor predicted children’s social-emotional skills. Identifying the shared and unique aspects of self-regulation may have important implications for supporting children’s regulatory skills as well as their success in school. (shrink)

Reading is a complex cognitive task with the ultimate goal of comprehending the written input. For longer, connected text, readers generate a mental representation that serves as its basis. Due to limited cognitive resources, common models of discourse representation assume distinct processing levels, each relying on different processing mechanisms. However, only little research addresses distinct representational levels when text comprehension is assessed, analyzed or modelled. Moreover, current studies that tried to relate process measures of reading to comprehension did not (...) consider comprehension as a multi-faceted, but rather a uni-dimensional construct, usually assessed with one-shot items. Thus, the first aim of this paper is to use confirmatory factor analysis to test whether comprehension can be modelled as a uni-or multi-dimensional concept. The second aim is to investigate how well widely used one-shot items can be used to capture comprehension. 400 participants read one of three short stories of comparable length, linguistic characteristics, and complexity. Based on the evaluation of three independent raters per story, 16 wh-questions and 60 yes/no-statements were compiled in order to retrieve information at micro and inference level, and 16 main contents were extracted to capture information at the macro level in participants’ summaries. Still, only a fraction of these items showed satisfactory psychometric properties and factor loadings – a blatant result considering the common practice for item selection. For CFA, two models were set up that address text comprehension as either a one-dimensional construct, or a three-dimensional construct reflecting the three distinct representational levels. Across stories and item types, model fit was consistently better for the three-factor model providing evidence for a multi-dimensional construct of text comprehension. Our results provide concrete guidance for the preparation of comprehension measurements in studies investigating the reading process. (shrink)

ObjectivesDuring their lifetimes, a majority of musicians experience playing-related musculoskeletal disorders. PRMD prevalence is tied to instrument choice, yet most studies examine heterogeneous groups of musicians, leaving some high-risk groups such as oboists understudied. This paper aims to ascertain the prevalence and nature of PRMDs in oboists, determine relevant risk factors, and evaluate the efficacy of treatment methods in preventing and remedying injuries in oboe players.MethodsA 10-question online questionnaire on PRMDs and their treatments was completed by 223 oboists. PRMDs (...) were compared across gender, weekly playing hours, career level, age, and years of playing experience.ResultsOf all respondents, 74.9% reported having had at least one PRMD in their lifetime. A majority of these injuries were of moderate to extreme severity. Females reported significantly more severe injuries than males. No significant effects of career level, age, or years of playing experience were observed. We found significant non-linear relationships between weekly playing hours and PRMD prevalence and severity. Injuries were most commonly on the right side of the body, with the right thumb, wrist, hand, and forearm being most affected in frequency and severity. Of those injuries for which recovery information was provided, only 26.1% of injuries were “completely recovered.” The perceived effectiveness of a few treatments tended to be ranked more highly than others.ConclusionThe oboists in this study experienced high rates of PRMD, particularly in the right upper extremities. Females and those playing 7-9 and 16-18 h per week reported a significantly higher severity of injuries than other groups. (shrink)

Aims: The experience of a compromised sense of ‘self’, termed ego-dissolution, is a key feature of the psychedelic experience and acute psychosis. This study aimed to validate the Ego-Dissolution Inventory (EDI), a new 8-item self-report scale designed to measure ego-dissolution. Additionally, we aimed to investigate the specificity of the relationship between psychedelics and ego-dissolution. Method: Sixteen items relating to altered ego-consciousness were included in an internet questionnaire; 8 relating to the experience of ego-dissolution (comprising the EDI), and 8 relating to (...) the antithetical experience of increased self-assuredness. Items were rated using a visual analogue scale. Participants answered the questionnaire for experiences with classical psychedelic drugs, cocaine or alcohol. They also answered the 7 questions from the Mystical Experiences Questionnaire (MEQ) relating to the experience of unity with one’s surroundings. Results: 691 participants completed the questionnaire, providing data for 1828 drug experiences (1043 psychedelics. 377 cocaine. 408 alcohol). Exploratory factor analysis demonstrated that the 8 EDI items loaded exclusively onto a single common factor, which was orthogonal to a second factor comprised of the items relating to increased self-assuredness (rho= -.110), demonstrating discriminant validity. The EDI correlated strongly with our measure of unitive experience (rho =.735), demonstrating convergent validity. EDI internal consistency was excellent (Cronbach’s alpha 0.93). Three analyses confirmed the specificity of ego-dissolution for experiences occasioned by psychedelic drugs. Firstly, EDI score correlated with drug-dose for psychedelic drugs (rho=.371), but not for cocaine (rho=.115) or alcohol (rho=-0.055). Secondly, the linear regression line relating the subjective intensity of the experience to EDI was significantly steeper for psychedelics (unstandardized B coefficient= 0.701) compared with cocaine (0.135) or alcohol (0.144). Finally, a binary support vector machine classifier identified experiences occasioned by psychedelic drugs vs. cocaine or alcohol with over 85% accuracy using ratings of ego-dissolution and ego-inflation alone. Conclusions: Our results demonstrate the psychometric structure, internal consistency and construct validity of the EDI. Moreover, we demonstrate the close relationship between ego-dissolution and the psychedelic experience. The EDI will facilitate the study of the neuronal correlates of ego-dissolution, which is relevant for psychedelic-assisted psychotherapy and our understanding of psychosis. (shrink)

Michael Martin aims to affirm a certain pattern of first-person thinking by advocating disjunctivism, a theory of perceptual experience which combines naive realism with the epistemic conception of hallucination. In this paper I argue that we can affirm the pattern of thinking in question without the epistemic conception of hallucination. The first part of my paper explains the link that Martin draws between the first-person thinking and the epistemic conception of hallucination. The second part of my paper explains how we (...) can achieve Martin’s ambition without Martin’s theory. One resource that I enlist for this purpose is a naive-realist friendly conception of first-person access to experience. The metaphysical theory that I enlist is a form of naive realism that endorses an intentionalist or representationalist “common-factor” approach to veridical and hallucinatory experience. The third part of my paper briefly develops this theory. (shrink)

Psychedelics are experiencing a renaissance in clinical research. In recent years, an increasing number of studies on psychedelic-assisted treatment have been conducted. So far, the results are promising, suggesting that this new (or rather, rediscovered) form of therapy has great potential. One particular reason for that appears to be the synergistic combination of the pharmacological and psychotherapeutic interventions in psychedelic-assisted treatment. But how exactly do these two interventions complement each other? This paper provides the first account of the interaction between (...) pharmacological and psychological effects in psychedelic-assisted treatment. Building on the relaxed beliefs under psychedelics (REBUS) hypothesis of Carhart-Harris and Friston and the contextual model of Wampold, it argues that psychedelics amplify the common factors and thereby the remedial effects of psychotherapy. More precisely, psychedelics are assumed to attenuate the precision of high-level predictions, making them more revisable by bottom-up input. Psychotherapy constitutes an important source of such input. At best, it signalizes a safe and supportive environment (cf. setting) and induces remedial expectations (cf. set). During treatment, these signals should become incorporated when high-level predictions are revised: a process that is hypothesized to occur as a matter of course in psychotherapy but to get reinforced and accelerated under psychedelics. Ultimately, these revisions should lead to a relief of symptoms. (shrink)

Since the inception of the psychology of personality, psychologists have been trying to account for regularities in behavior. The preferred construct has been the personality trait as an inner disposition that directs conduct and which is common to all people. Although found lacking during the 1970s, the search for sources of direction from within has been resurrected in the form of the five-factor theory. According to this approach there are five underling structural factors common to all people (...) and independent of cultural influences—an asocial, ahistorical, biologically based conception. Examination of the theory finds it to be dealing with traits of temperament rather than personality and judges it insufficient on that basis. Rather than conceiving of personality as fixed and universal, it is argued that personality is an adaptation worked out in the cultural and historical context of the individual life. It is further contended that a reconsideration of the personality theory of Gordon Allport will provide a better basis for understanding personality and personality traits specifically. 2012 APA, all rights reserved). (shrink)

There are numerous approaches to psychotherapy with distinct underlying theories. Yet, it is unlikely that any of these is conclusive because they broadly yield similar therapeutic effects. A different approach attempts to derive the common factors from the specific treatments and proposes that these common factors primarily promote therapeutic effects. But although generally promising, these common factors have not been integrated into a more fundamental explanatory framework that also considers the effectiveness of specific (...) class='Hi'>factors. Therefore, an integrative model of psychotherapeutic interventions is still missing. The aim of this paper is to help fill that gap by applying the theory of predictive processing to interventions from various psychotherapeutic approaches, including cognitive behavioural therapy, client-centred therapy, and psychoanalysis. The analysis results in the predictive processing model of psychotherapeutic interventions (3PI model for short). The new model reveals that psychotherapy comprises two main functions: to provide a safe and positive environment to which the patient can adapt, and to facilitate the process of updating a dysfunctional generative model. Further, it shows that common factors primarily promote the first function, while specific factors mainly support the second function, offering a new perspective to the debate on common and the specific factors. (shrink)

It is commonly assumed across the language sciences that some semantic participant information is lexically encoded in the representation of verbs and some is not. In this paper, we propose that semantic obligatoriness and verb class specificity are criteria which influence whether semantic information is lexically encoded. We present a comprehensive survey of the English verbal lexicon, a sentence continuation study, and an on-line sentence processing study which confirm that both factors play a role in the lexical encoding (...) of participant information. (shrink)

Factors such as subsistence turnover, warfare, or interaction between different groups can be major sources of cultural change in human populations. Global demographic shifts such as the transition to agriculture during the Neolithic and more recently the urbanization and globalization of the twentieth century have been major catalysts for cultural change. Here, we test whether cultural traits such as patri/matrilocality and postmarital migration persist in the face of social upheaval and gene flow during the past 150 years in postcolonial (...) South Africa. The recent history of South Africa has seen major demographic shifts that resulted in the displacement and forced sedentism of indigenous Khoekhoe and San populations. During the expansion of the colonial frontier, the Khoe-San admixed with European colonists and enslaved individuals from West/Central Africa, Indonesia, and South Asia, introducing novel cultural norms. We conducted demographic interviews among Nama and Cederberg communities representing nearly 3,000 individuals across three generations. Despite the history of colonial expansion, and the subsequent incorporation of Khoe-San and Khoe-San-descendant communities into a colonial society with strong patrilocal norms, patrilocality is the least common postmarital residence pattern in our study populations today. Our results suggest that more recent forces of integration into the market economy are likely the primary drivers of change in the cultural traits examined in our study. Birthplace had a strong effect on an individual’s odds of migration, distance moved, and postmarital residence form. These effects are at least partially explained by the population size of the birthplace. Our results suggest that market factors local to birthplaces are important drivers of residence decisions, although the frequency of matrilocal residence and a geographic and temporal cline in migration and residence patterns also indicate the persistence of some historic Khoe-San cultural traits in contemporary groups. (shrink)

Many studies find reflective thinking predicts less belief in God or less religiosity — so-called analytic atheism. However, the most widely used tests of reflection confound reflection with ancillary abilities such as numeracy, some studies do not detect analytic atheism in every country, experimentally encouraging reflection makes some non-believers more open to believing in God, and one of the most common sources of online research participants seems to produce lower data quality. So analytic atheism may be less than universal (...) or partially explained by confounding factors. To test this, we developed better measures, controlled for more confounds, and employed more recruitment methods. All four studies detected signs of analytic atheism above and beyond confounds (N > 70,000 people from five of six continental regions). We also discovered analytic apostasy: the better a person performed on reflection tests, the greater their odds of losing their religion since childhood — even when controlling for confounds. Analytic apostasy even seemed to explain analytic atheism: apostates were more reflective than others and analytic atheism was undetected after excluding apostates. Religious conversion was rare and unrelated to reflection, suggesting reflection’s relationships to conversion and deconversion are asymmetric. Detected relationships were usually small, indicating reflective thinking is a reliable albeit marginal predictor of apostasy. (shrink)

This paper explores an empirical puzzle, namely, how inter-organizational relationships can be sustained between organizations that draw upon distinctive—and potentially conflicting—institutional logics under conditions of power asymmetry. This research analyses cases of these relationships and suggests some key conditions underlying them. Examining relationships between ‘Fair Trade’ organizations and corporate retailers, a series of contingent factors behind the dynamic persistence of such relationships are proposed, namely: the presence of pre-existing ‘hybrid logics’; the use of boundary-spanning discourses; joint tolerance of conflict; (...) and co-creation of common rules. These four elements are supported by a fifth mediating factor, i.e. the presence and use of a Fair Trade certification system in the collaboration. The latter appears as a central vehicle facilitating cross-logic relationships—it can be seen as a ‘boundary object’ embodying a series of narratives and discourses that are open to multiple interpretations corresponding to the dominant institutional logics of each partner organization. (shrink)

Working speed as a latent variable reflects a respondent’s efficiency to apply a specific skill, or a piece of knowledge to solve a problem. In this study, the common assumption of many response time models is relaxed in which respondents work with a constant speed across all test items. It is more likely that respondents work with different speed levels across items, in specific when these items measure different dimensions of ability in a multidimensional test. Multiple speed (...) factors are used to model the speed process by allowing speed to vary across different domains of ability. A joint model for multidimensional abilities and multifactor speed is proposed. Real response time data are analyzed with an exploratory factor analysis as an example to uncover the complex structure of working speed. The feasibility of the proposed model is examined using simulation data. An empirical example with responses and response times is presented to illustrate the proposed model’s applicability and rationality. (shrink)

Within a perspective that views groups as communities of practice and sites of construction of knowledge, learning, and identity, this article aims to explore the contribution that participation in different groups over the course of one’s life provides to the development of the professional practices of psychotherapist trainees enrolled in the C.O.I.R.A.G. school, an Italian graduate program in group psychotherapy. Through qualitative analyses of 10 semi-structured interviews, our study empirically shows that by participating in groups, the trainees not only learn (...) the practices of that group but also develop a sort of meta-learning which takes place across groups. The results highlight that: Transversality, duration, and informality are found to be the group properties with the highest formative value; and Learning practices across different groups have common characteristics: are organized around complex topics of group life, began in early group experiences, are in continuous evolution, are associated with a critical event, and a negative affect. At the same time, it seems that these critical events are exactly what triggered and sustained the learning practices. Data from the interviews also showed how professional identities are constructed as the outcome of learning in different communities of practice. The study outlines how the experience made in different groups is elaborated in and through meaningful self-narratives, highlighting them as a fundamentally collective and culturally shaped sense-making process. Overall, these results contribute to a better understanding of learning processes as situated and jointly constructed through multiple group participations over time. Furthermore, they contribute to highlighting the role of self-narratives as a primary way through which trainees shape their identity as self-reflexive professionals who are competent in reading group dynamics. Directions for future research and suggestions for psychotherapist training paths are outlined in the conclusions. (shrink)

Common objects comprise living and non-living things people interact with in their daily-lives. Images depicting common objects are extensively used in different fields of research and intervention, such as linguistics, psychology, and education. Nevertheless, their adequate use requires the consideration of several factors, and careful validation procedures. The current study presents a systematic review of the available published norms for images of common objects. A systematic search using PRISMA guidelines indicated that despite their extensive use, the (...) production of norms for such stimuli with adult populations is quite limited, particularly for more ecological images, such as photos. Among the several dimensions in which the items were assessed, the most commonly referred in our sample were familiarity, visual complexity and name agreement, illustrating some consistency across the reported dimensions while also indicating the limited examination of other potentially relevant dimensions for image processing. The lack of normative studies simultaneously examining affective, perceptive and semantic dimensions was also documented. The number of such normative studies has been increasing in the last years and published in relevant peer-reviewed journals. Moreover, their datasets and norms have been complying with current open science practices. Nevertheless, they are still scarcely cited and replicated in different linguistic and cultural contexts. The current study brings important theoretical contributions by characterizing images of common objects stimuli and their culturally-based norms while highlighting several important features that are likely to be relevant for future stimuli selection and evaluative procedures. The systematic scrutiny of these normative studies is likely to stimulate the production of new, robust and contextually-relevant normative datasets and to provide tools for enhancing the quality of future research and intervention. (shrink)

The increasing digitalization in the field of psychological and educational testing opens up new opportunities to innovate assessments in many respects (e.g., new item formats, flexible test assembly, efficient data handling). In particular, computerized adaptive testing provides the opportunity to make tests more individualized and more efficient. The newly developed continuous calibration strategy (CCS) from Fink, Born, Spoden, and Frey (2018) makes it possible to construct computerized adaptive tests in application areas where separate calibration studies are not feasible. Due to (...) the goal of reporting on a common metric across test cycles, the equating is crucial for the CCS. The quality of the equating depends on the common items selected and the scale transformation method applied. Given the novelty of the CCS, the aim of the study was to evaluate different equating setups in the CCS and to derive practical recommendations. The impact of different equating setups on the precision of item parameter estimates and on the quality of the equating was examined in a Monte Carlo simulation, based on a fully crossed design with the factors common item difficulty distribution (bimodal, normal, uniform), scale transformation method (mean/mean, mean/sigma, Haebara, Stocking-Lord), and sample size per test cycle (50, 100, 300). The quality of the equating was operationalized by three criteria (proportion of feasible equatings, proportion of drifted items, and error of transformation constants). The precision of the item parameter estimates increased with increasing sample size per test cycle, but no substantial difference was found with respect to the common item difficulty distribution and the scale transformation method. With regard to the feasibility of the equatings, no differences were found for the different scale transformation methods. However, when using the moment methods (mean/mean, mean/sigma), quite extrem levels of error for the transformation constants A and B occurred. Among the characteristic curve method the performance of the Stocking-Lord method was slightly better than for the Haebara method. Thus, while no clear recommendation can be made with regard to the common item difficulty distribution, the characteristic curve methods turned out to be the most favorable scale transformation methods within the CCS. (shrink)

The Maslach Burnout Inventory-General Survey: validation across different occupational groups in Poland This paper concerns the psychometric evaluation of the Polish version of a self-report questionnaire to measure burnout. Although the Maslach Burnout Inventory is the most commonly employed measure of burnout, researchers have been troubled by some of its psychometric limitations. The aim of this study is to examine the MBI-GS factor structure in three occupational groups, and to evaluate its reliability. In evaluating factorial validity, we carried out (...) an explanatory analysis and a number of confirmatory analyses. An additional aim was to explore the relationships between biographic characteristics and burnout. The results of the confirmatory analyses show us that all three models fit the data almost acceptably, both in the total sample and in the separate occupational groups, and that the fit of the three-factor solution appears to be somewhat better than that of the one- and two-factor solutions. When the initial model failed to fit the data well, we had to eliminate two items with weak reliability. The results then confirmed the factorial validity of the MBI-GS—as expected, the MBI-GS consists of three scales that are moderately correlate. (shrink)

Introduction: Consultation methods differ between medical practitioners depending on the individual setting. However, the central tenet to the doctor–patient relationship is the issue of confidentiality. This prospective survey highlights patient attitudes towards consultation methods in the setting of an ophthalmic outpatient department. Method: Questionnaires were completed by 100 consecutive patients, who had been seen by an ophthalmologist in a single room, which had a joint doctor–patient consultation occurring simultaneously. Results: Each question of all 100 questionnaires was completed. 58% of patients (...) were not concerned about sharing a consultation room with another patient or doctor. However, this did not equate to the 49% of patients who were indifferent to discussing issues in the joint consultation room. The most common factor was the general issue of confidentiality. Discussion: Ensuring total patient confidentiality may be deemed more necessary for certain medical specialties than for others, as seen in the practice of separate medical records in genitourinary medicine, for instance. However, with regard to patient consultations, the same level of confidentiality should be afforded across all specialties, and such factors should be borne in mind when planning outpatient clinics. (shrink)

The National Longitudinal Study of Adolescent Health data were used to test predictions from life history theory. We hypothesized that (1) in young adulthood an emerging life history strategy would exist as a common factor underlying many life history traits (e.g., health, relationship stability, economic success), (2) both environmental harshness and unpredictability would account for unique variance in expression of adolescent and young adult life history strategies, and (3) adolescent life history traits would predict young adult life history strategy. (...) These predictions were supported. The current findings suggest that the environmental parameters of harshness and unpredictability have concurrent effects on life history development in adolescence, as well as longitudinal effects into young adulthood. In addition, life history traits appear to be stable across developmental time from adolescence into young adulthood. (shrink)