To Use or Not to Use: Exploring Therapists' Experiences with Pre-Treatment EMA-Based Personalized Feedback in the TheraNet Project.

BACKGROUND: Using idiographic network models in psychotherapy has been a growing area of interest. However, little is known about the perceived clinical utility of network models. The present study aims to explore therapists' experiences with network model-based feedback within the context of the TheraNet Project. METHODS: In total, 18 therapists who had received network-based feedback for at least 1 patient at least 2 months prior were invited to retrospective focus groups. The focus group questions related to how participation in the study influenced the therapeutic relationship, how the networks were used, and what might improve their clinical utility. The transcribed focus groups were analyzed descriptively using qualitative content analysis. RESULTS: Most therapists mentioned using the feedback to support their existingtheir case concept, while fewer therapists discussed the feedback directly with the patients. Several barriers to using the feedback were discussed, as well as various suggestions for how to make it more clinically useful. Many therapists reported skepticism with regards to research in the outpatient training center in general, though they were also all pleasantly surprised by being involved, having their opinions heard, and showing a readiness to adapt research to their needs/abilities. CONCLUSIONS: This study highlights the gap between researchers' and therapists' perceptions about what useful feedback should look like. The TheraNet therapists' interest in adapting the feedback and building more informative feedback systems signals a general openness to the implementation of clinically relevant research. We provide suggestions for future implementations of network-based feedback systems in the outpatient clinical training center setting.

[Therapists' Perspectives on Changes in the Therapeutic Relationship after Switching from in-Person to Online Video Therapy Due to Corona: A Qualitative Analysis]. / Veränderung der therapeutischen Beziehung in Folge eines coronabedingten Wechsel von Präsenz- zu Videotherapiesitzungen: Eine qualitative Analyse von Therapeut*inneninterviews.

OBJECTIVE: The aim of this study was to investigate the extent to which the therapeutic relationship changed as a result of the COVID-19-related switch from face-to-face to video therapy. METHOD: Twenty-one psychotherapists, who had changed the setting of therapy from face-to-face to video therapy were interviewed. The interviews were then transcribed, coded and superordinate themes were created in the context of a qualitative analysis. RESULTS: More than half of the therapists reported that the therapeutic relationship with their patients remained stable. In addition, the majority of therapists described uncertainties in dealing with and responding to non-verbal signals, as well as maintaining an appropriate distance to their patients. Overall, both an improvement and a deterioration of the therapeutic relationship was reported. DISCUSSION: The stability of the therapeutic relationship was mainly attributed to the therapists' previous face-to-face contact with their patients. The uncertainties expressed could be interpreted as risk factors for the therapeutic relationship. Although the sample represented only a small portion of working therapists, the findings from this study represent an important milestone in understanding how psychotherapy has changed as a result of the COVID-19 pandemic. CONCLUSION: The therapeutic relationship remained stable despite the change from face-to-face to video therapy.

Savouring and psychological well-being in family dyads coping with cancer: An actor-partner interdependence model.

Previous studies have investigated interdependence of the associations between predictors and negative psychological outcomes in dyads of cancer patients and family caregivers. This study examined the dyadic effects of perceived capability of savouring the moment on psychological well-being. A total of 152 dyads of cancer patients and caregivers reported their perceived capability of savouring the moment (Savoring Beliefs Inventory), state positive affect (Chinese Affect Scale) and life satisfaction (Satisfaction With Life Scale) within 6 months following diagnosis. Actor-Partner Interdependence Model (APIM) demonstrated that patients' and caregivers' savouring the moment was positively associated with their own positive affect and life satisfaction (actor effects: ßs = 0.309-0.603, 95% CIs = 0.171-0.502, 0.446-0.703, ps < 0.001). Patients' savouring the moment was positively associated with caregivers' positive affect (ß = 0.158, 95% CI = 0.018, 0.299, p = 0.028), whereas caregivers' savouring the moment was positively associated with patients' life satisfaction (ß = 0.158, 95% CI = 0.026, 0.289, p = 0.020). Partner effects between caregivers' savouring the moment and patients' positive affect and between patients' savouring the moment and caregivers' life satisfaction were not significant. The findings suggest the role of savouring in psychological well-being within patient-caregiver dyads, highlighting the importance of investigating positive psychological pathways in their joint adaptation.

Treatment credibility as a mechanism of change in cognitive behavioral therapy: Effects on depression and anxiety.

OBJECTIVE: This study aimed to provide evidence for treatment credibility (TC) as a potential mechanism of change in cognitive behavioral therapy (CBT). Therefore, it focused on within-person effects that are free of the influence of stable characteristics and thus allow to exclude certain alternative explanations for the association under study. METHOD: The sample included 1,423 patients receiving outpatient CBT, who presented a wide variety of psychiatric diagnoses (mostly affective and anxiety disorders). TC, depression, and anxiety were measured every fifth session from Session 5 to 25 using the Credibility Expectancy Questionnaire (CEQ), the Patient Health Questionnaire-9 (PHQ-9), and the General Anxiety Disorder-7 (GAD-7), respectively. Symptom severity was assessed every session using the Hopkins Symptom Checklist-11. Within- and between-person effects of TC, depression, and anxiety were analyzed using the latent curve model with structured residuals (LCM-SRs). In exploratory analyses, within-person effects of TC on next-session symptom severity were assessed using a modification of the LCM-SR. RESULTS: LCM-SRs exhibited excellent fit in main analyses. There were significant negative correlations of both intercepts and slopes (between-person level) of CEQ and PHQ-9 as well GAD-7. No significant cross-lagged effects (within-person level) were found over the five-session interval. However, session-wise analyses revealed significant cross-lagged effects of CEQ on Hopkins Symptom Checklist-11. CONCLUSIONS: This study is the first to find significant within-person effects of TC in session-wise analyses. This lends preliminary support to the notion of TC as a mechanism of change. The lack of significant findings at the five-session interval is discussed considering the specific design used in this study. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Exploring the complex interrelation between depressive symptoms, risk, and protective factors: A comprehensive network approach.

BACKGROUND: Depressive symptoms seem to be interrelated in a complex and self-reinforcing way. To gain a better understanding of this complexity, the inclusion of theoretically relevant constructs (such as risk and protective factors) offers a comprehensive view into the complex mechanisms underlying depression. METHODS: Cross-sectional data from individuals diagnosed with a major depressive disorder (N = 986) and healthy controls (N = 1049) were analyzed. Participants self-reported their depressive symptoms, as well as several risk factors and protective factors. Regularized partial correlation networks were estimated for each group and compared using a network comparison test. RESULTS: Symptoms of depression were more strongly connected in the network of depressed patients than in healthy controls. Among the risk factors, perceived stress, the experience of negative life events, emotional neglect, and emotional abuse were the most centrally embedded in both networks. However, the centrality of risk factors did not significantly differ between the two groups. Among the protective factors, social support, personal competence, and acceptance were the most central in both networks, where the latter was significantly more strongly associated with the symptom of self-hate in depressed patients. CONCLUSION: The network analysis revealed that key symptoms of depression were more strongly connected for depressed patients than for healthy controls, and that risk and protective factors play an important role, particularly perceived stress in both groups and an accepting attitude for depressed patients. However, the purpose of this study is hypothesis generating and assisting in the potential selection of non-symptom nodes for future research.

Development and validation of the Inventory of Depression and Anxiety Symptoms-II-German version.

The expanded version of the Inventory of Depression and Anxiety Symptoms (IDAS-II) is a 99-item self-report measure containing 18 nonoverlapping dimensional scales assessing symptoms of depression, anxiety, and mania. The aim of this study was to develop and validate a German adaptation of the IDAS-II. Participants from a community sample (N = 1,054) completed the IDAS-II (German version). In addition, part of the sample (N = 550) completed a series of additional measures of depression (Patient Health Questionnaire-9, WHO-Five Well-Being Index, Symptom Checklist-90 Revised-Short Version) and anxiety disorders (Generalized Anxiety Disorder Scale-7, Fear of Negative Evaluation Scale-5, Dimensional Obsessive-Compulsive Scale, The International Trauma Questionnaire). We conducted item-level confirmatory factor analyses (CFA) separately for the 15 nonsaturated IDAS-II scales, which confirmed unidimensionality. McDonald's ω indicated good internal consistency (ω > .8) of all symptom scales except Euphoria (ω = .751) and Ordering (ω = .728). A CFA of the IDAS-II scales, based on exploratory results by Watson et al. (2012), confirmed a three-factor model of "Distress," "Obsessions/Fear," and "Positive Mood." Correlational analyses with additional symptom measures supported the convergent and discriminant validity of the IDAS-II scales. The IDAS-II (German version) allows for a reliable assessment of the severity of depression, anxiety, and bipolar symptoms and is one of the first clinical measures for German-speaking samples that is consistent with the Hierarchical Taxonomy of Psychopathology (HiTOP). (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Addressing the Mental Health Challenges of Refugees-A Regional Network-Based Approach in Middle Hesse Germany.

Refugees constitute a vulnerable group with an increased risk of developing trauma-related disorders. From a clinician's integrative perspective, navigating the detrimental impact of the social, economic, structural, and political factors on the mental health of refugees is a daily experience. Therefore, a collective effort must be made to reduce health inequities. The authors developed a treatment concept which provides broader care structures within a scientific practitioner's approach. The resulting "Trauma Network" addresses the structural challenges for refugees in Middle Hesse. Accompanying research provided a sound basis for further discussions with policy-makers to improve the situation for refugees in the short- and long-term.

A Systematic Review of Momentary Assessment Designs for Mood and Anxiety Symptoms.

Background: Altering components of ecological momentary assessment (EMA) measures to better suit the purposes of individual studies is a common and oftentimes necessary step. Though the inherent flexibility in EMA has its benefits, no resource exists to provide an overview of the variability in how convergent constructs and symptoms have been assessed in the past. The present study fills that gap by examining EMA measurement design for mood and anxiety symptomatology. Methods: Various search engines were used to identify 234 relevant studies. Items administered, data collection schedules (i.e., beeps per day), response scales (i.e., Likert), data collection platforms (i.e., apps), and psychometric properties (i.e., reliability) were extracted. Results: Study designs varied greatly in all aspects across the identified papers. Over 4,600 extracted items were qualitatively analyzed, resulting in the identification of 12 themes. The most EMA items focused on affect, with categories such as "happiness" and "tension" appearing most frequently. We provide all of our data extraction in the format of an open-source database. Limitations: Despite our best attempts to include as much of the relevant literature as possible, this review and the accompanying database are not exhaustive, but can easily be built upon to include other, newer studies. Conclusions: The fact that the affect theme featured both positive and negative emotional constructs highlights the dichotomous focus on valence and affect within the literature surrounding anxious and depressive symptomatology. We hope that our database will act as a helpful design decision-making resource for researchers studying this kind of symptomatology in the future. Systematic Review Registration: PROSPERO (CRD42019139409).