Effects and experiences of idiographic patient-reported outcome measures for feedback in psychotherapy: A systematic review and secondary analysis of the empirical literature.

Objective: There is a growing interest in idiographic patient-reported outcome measures (I-PROMs) for routine outcome monitoring (ROM) and clinical feedback (CF) in psychotherapy, but to our knowledge, no systematic reviews of the empirical literature. Method: We conducted a systematic literature search for empirical papers investigating effects and experiences of I-PROMs for ROM/CF and found a total of 13 papers. There was only one experimental controlled effectiveness study. Results: We formulated a narrative summary of the data set as a whole. We conducted a secondary analysis of nine papers containing qualitative data on stakeholder experiences with I-PROMs and found three superordinate themes and eight subthemes, summarized as "I-PROMs can facilitate self-reflection for patients, assist in identifying and tracking therapeutic topics, and make patients more committed to therapy by giving them a greater sense of responsibility and empowerment. Formulating goals and problems can be difficult, and lack of progress can be demotivating. Time in therapy is precious and must be spent wisely. Effective use of I-PROMs is facilitated by flexibility and therapists' use of clinical skills." Conclusion: We discuss the limitations of the study and provide recommendations for future research and clinical practice.

The Patient-Perceived Helpfulness of Measures Scale: Development and Validation of a Scale to Assess the Helpfulness of Using Measures in Psychological Treatment.

In response to the increase in Routine Outcome Monitoring and Clinical Feedback, the Patient-Perceived Helpfulness of Measures Scale (ppHMS) was developed to assess the helpfulness-as perceived by patients-of using measures in psychological treatment. Study 1: The construct of patient-perceived helpfulness of measures was explored using thematic analysis with 15 patients. Six helpful and three unhelpful themes were identified and informed item development. Study 2: 28 items were formulated and rated by experts. Ten items were taken forward for psychometric shortening in a sample of 76 patients. Confirmatory factor analysis (CFA) led to an adequately fitting six-item model with excellent internal consistency, and convergence with the Delighted-Terrible single item of product satisfaction and a single item of measure helpfulness. Study 3: In a stratified online sample of 514 U.K. psychotherapy patients, a five-item model constituted the best fit. The final ppHMS had excellent internal consistency (McDonald's ω = .90), convergent validity with psychotherapy satisfaction (r = .5; p < .001), divergence from social desirability (r = .1), and metric and scalar invariance across measures. Study 4: Analyses were replicated and confirmed in a stratified U.S. sample (n = 602). The ppHMS is a reliable and valid scale that can be used to assess and compare patients' perceptions of the helpfulness of different measures as part of their psychological treatment.

The Cooper-Norcross Inventory of Preferences: Measurement invariance across & international datasets and languages.

OBJECTIVE: The Cooper-Norcross Inventory of Preferences (C-NIP) is a brief, multidimensional measure of clients' therapy preferences. This study aimed to examine the factor structure and measurement invariance of the C-NIP. METHOD: Fifteen datasets (N = 10,088 observations) representing the C-NIP in nine language versions were obtained from authors of psychometric studies. Confirmatory factor analysis and exploratory structural equation modeling were used to analyze the data. RESULTS: None of the proposed models adequately fit the data. Therefore, a new model was developed that sufficiently fit most of the C-NIP version 1.1 datasets. The new model was invariant up to the strict and means levels across genders, ages, and psychotherapy experience but only up to the metric level across translations. CONCLUSIONS: The C-NIP can be used to compare men and women, people of diverse ages, and people with some vs. no experience with psychotherapy. Lower reliabilities of the C-NIP scales are a limitation.

Extended validation of the Relational Depth Frequency Scale: Retest reliability, divergent validity, criterion validity with psychotherapy satisfaction, and measurement invariance in UK- and US-stratified samples.

BACKGROUND: The Relational Depth Frequency Scale (RDFS) assesses moments of profound connection in psychotherapy, associated with therapeutic benefit. To date, the RDFS has not been tested for its retest reliability, divergent and criterion validity, and measurement invariance, nor has it been tested in stratified samples of psychotherapy patients. METHODS: Two stratified online samples of United Kingdom (n = 514) and United States (n = 402) psychotherapy patients filled out the RDFS, the Brief Social Desirability Scale (BSDS); and the Satisfaction with Therapy and Therapist Scale-revised (STTS-R). Two subsamples of patients (United Kingdom: n = 50 and United States: n = 203) filled out the RDFS again after 1 month. RESULTS: Reliability for the six-item RDFS were excellent in United Kingdom and United States samples (Cronbach's α = 0.91 and 0.92; retest r = 0.73 and r = 0.76). Divergent (r = 0.10 and r = 0.12) and criterion validity (r = 0.69; and r = 0.70) were good. Full scalar invariance was established across countries, genders, and time. CONCLUSION: This contributes important evidence to the validity of the RDFS. Future research should assess predictive validity against psychotherapy outcomes and replicate these analyses in diverse samples.

Cancer patients' experiences of moments of relational depth during psychological therapy: a qualitative study.

OBJECTIVE: Research into psychological interventions for cancer patients has focused on the effectiveness of different treatment methods. Investigating common factors across treatments, such as qualities within the therapeutic relationship, has been neglected. This study explores cancer patients' experiences of moments of profound contact and engagement with their therapist, including any perceived impact. METHODS: Semi-structured interviews were conducted with ten cancer patients. Eight participants reported having experienced moments of relational depth. Their transcripts were analyzed using thematic analysis. FINDINGS: Five themes were identified: "Being physically and psychically vulnerable," "Being rescued from the waves," "Experiencing the calm after the storm," "More than a feeling," and "The therapist as 'a stranger and not a stranger'." CONCLUSION: Both novice and experienced practitioners should be aware of the potential power of moments of relational depth for cancer patients: to normalize patients' increased vulnerability and emotionality, and to manage breaks and endings with relational sensitivity.

Validation of the Cooper-Norcross Inventory of Preferences (C-NIP) in Chinese lay clients and mental health professionals: Factor structure, measurement invariance, and scale differences.

The Cooper-Norcross Inventory of Preferences (C-NIP) is one of the most widely used measures of psychotherapy preferences. However, its psychometric properties have not been examined in non-Western samples. Research on disparities between the preferences of mental health professionals and their clients is also limited. We evaluated the C-NIP's psychometric properties and measurement invariance in Chinese lay clients and mental health professionals and evaluated the latent mean differences between clients' and professionals' scores on the C-NIP's four scales (preference for therapist vs. client directiveness, emotional intensity vs. emotional reserve, past vs. present orientation, and warm support vs. focused challenge). This cross-sectional investigation involved 301 lay clients and 856 mental health professionals who completed the Chinese version of the C-NIP. Confirmatory factor analysis (CFA) and exploratory structural equation modeling (ESEM) were used to examine the factor structure of the C-NIP. ESEM provided stronger evidence than CFA for the four-factor model in both samples. The four scales had adequate internal consistency in both the lay clients (αs = .68-.89) and the mental health professionals (αs = .70-.80). Partial scalar invariance was established across these two populations. Chinese mental health professionals preferred less therapist directiveness, past orientation, and warm support-but more emotional intensity-than Chinese lay clients (ds = 0.25-0.90). Culture-specific cutoff values (norms) to identify strong therapy preferences were established. This study supports the application of the C-NIP to non-Western populations and suggests that discrepancies between the preferences of lay clients and mental health professionals are a cross-cultural phenomenon. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Patient perspectives on working with preferences in psychotherapy: A consensual qualitative research study.

OBJECTIVE: Assessing and accommodating patient preferences is integral to evidence-based practice. This qualitative study sought to explore patient perspectives and experiences of preference work in psychotherapy. METHODS: Participants were 13 UK-based patients who had completed up to 24 sessions of a collaborative-integrative psychotherapy. Ten participants identified as female and three as male. Interviews were conducted at endpoint and analyzed using a team-based, consensual qualitative research approach. RESULTS: Three superordinate domains were developed: Preferences Themselves, Process of Working with Preferences in Psychotherapy, and Effect of Preference Work (or its Absence). Patients typically wanted leadership, challenge, and input from their psychotherapist, and an affirming style. Patients attributed the origin of their preferences to personal history, characteristics, or circumstances; the present psychotherapy; or past episodes of psychotherapy. Some preferences changed over time. Preference work was described as having positive effects on the therapeutic relationship and patients' intrapersonal worlds; however, variantly, non-accommodation of preferences was also experienced as beneficial. CONCLUSION: Our findings provide in-depth answers to a range of novel questions on preference work-potential mechanisms by which preference work impacts outcomes, factors that may facilitate preference work, and origins of preferences-as well as nuancing previously-established quantitative findings. Implications for clinical training and practice are discussed.

Test-retest stability, convergent validity, and sensitivity to change for the Goal-Based Outcome tool for adolescents: Analysis of data from a randomized controlled trial.

OBJECTIVE(S): To examine the psychometric properties of the idiographic Goal-Based Outcome (GBO) tool for young people: test-retest stability, convergent validity, and sensitivity to an intervention. METHODS: This measure validation study used data from a randomized controlled trial of school-based humanistic counseling. We used multilevel analyses to assess test-retest stability, convergent validity of the GBO tool against nomothetic measures of mental wellbeing, and sensitivity to an intervention. RESULTS: The GBO tool showed acceptable stability over a 6-24 week period; moderate convergent validity with nomothetic measures of mental well-being, self-esteem, and depression; and greater sensitivity to an intervention than a measure of psychological distress. CONCLUSIONS: The GBO tool shows evidence of having acceptable psychometric properties and is suitable for monitoring change on individual goals. It may also have the capacity to function as a population-level indicator of outcomes in conjunction with the use of other measures of mental health and wellbeing.

Idiographic patient reported outcome measures (I-PROMs) for routine outcome monitoring in psychological therapies: Position paper.

Idiographic patient-reported outcome measures (I-PROMs) are a growing set of individualized tools for use in routine outcome monitoring (ROM) in psychological therapies. This paper presents a position statement on their conceptualization, use, and analysis, based on contemporary evidence and clinical practice. Four problem-based, and seven goal-based, I-PROMs, with some evidence of psychometric evaluation and use in psychotherapy, were identified. I-PROMs may be particularly valuable to the evaluation of psychological therapies because of their clinical utility and their alignment with a patient-centered approach. However, there are several challenges for I-PROMs: how to generate items in a robust manner, their measurement model, methods for establishing their reliability and validity, and the meaning of an aggregated I-PROM score. Based on the current state of the literature, we recommend that I-PROMs are used to complement nomothetic measures. Research recommendations are also made regarding the most appropriate methods for analyzing I-PROM data.

Goals Form: Reliability, validity, and clinical utility of an idiographic goal-focused measure for routine outcome monitoring in psychotherapy.

OBJECTIVE: This study aimed to assess the reliability, validity, and clinical utility of an idiographic, goal-focused patient-reported outcome measure: The Goals Form. METHODS: Data were analyzed from 88 participants, across three samples, who had participated in collaborative-integrative psychotherapy at university-based clinics in the UK. The samples were approximately 70% female with mean age of 30 years old. RESULTS: The psychometric properties of the Goals Form were generally good. Noncompletion of individual items was low, temporal stability tended to be at target levels, and mean change scores showed moderate to good convergent validity against measures of psychological distress. The measure appeared sensitive to change in psychotherapy and was experienced by most patients as helpful. CONCLUSIONS: The Goals Form shows acceptable psychometric and clinical properties for routine outcome monitoring in psychotherapy.

Relational depth from the perspective of the psychotherapy dyad: Psychometric properties of the Relational Depth Frequency Scale.

Objective: The Relational Depth Frequency Scale (RDFS) is a 6-item measure to assess the impact of relational depth experiences on psychotherapeutic outcomes. To date, the RDFS has only been validated in online samples of clinical and non-clinical individuals. This study aimed to examine the psychometric properties of the RDFS in clinical dyads of clients and psychotherapists.Method: A total of 86 psychotherapy dyads-86 psychotherapists (18 male, 68 female, mean age = 44.34) and 86 clients (17 male, 69 female, mean age = 34.22)-completed the RDFS, and the Scale to Assess the Psychotherapeutic Relationship (STAR), mid-psychotherapy.Results: CFA showed acceptable fit statistics for a one-factor model. The partial measurement invariance across both partners of the psychotherapeutic dyad was positively verified. The RDFS had good internal consistency for psychotherapists and clients (α = .90 and .81, respectively). Actor-partner interdependence model confirmed moderate to high levels of convergent validity against the STAR. Relational depth in both partners was predicted by their own perceptions of the quality of the psychotherapeutic relationship. Psychotherapist frequency of relational depth was also related to client perceptions of the psychotherapeutic relationship.Conclusion: The RDFS is a promising tool measuring relational depth both from psychotherapist and client perspectives.

Utilization of coal fly ash waste for effective recapture of phosphorus from waters.

Reutilization of the waste by-products from industrial and agricultural activities is crucially important towards attainment of environmental sustainability and the 'circular economy'. In this study, we have developed and evaluated a sustainably-sourced adsorbent from coal fly ash, which was modified by a small amount of lanthanum (La-FA), for the recapture of phosphorous (P) from both synthetic and real natural waters. The prepared La-FA adsorbent possessed typical characteristic diffraction peaks similar to zeolite type Na-P1, and the BET surface area of La-FA was measured to be 10.9 times higher than that of the original FA. Investigation of P adsorption capability indicated that the maximum adsorption (10.8 mg P g-1) was 6.14 times higher than that (1.8 mg P g-1) of the original fly ash material. The ζ potentials measurement and P K-edge X-ray Absorption Near Edge Structure (XANES) spectra demonstrated that P was bonded on La-FA surfaces via an adsorption mechanism. After applying the proposed adsorbent to real lake water with La/P molar ratios in the range from 0.5:1 to 3:1, the La-FA adsorbent showed the highest phosphate removal ability with a La/P molar ratio 1:1, and the P adsorption was similar to that performance with the synthetic solution. Moreover, the La-FA absorbent produced a negligible effect on the concentrations of total dissolved nitrogen (TDN), NH4+-N and NO3--N in water. This study thus provides a potential material for effective P recapture and details of its operation.

A Pluralistic Perspective on Research in Psychotherapy: Harnessing Passion, Difference and Dialogue to Promote Justice and Relevance.

The adoption of a pluralistic perspective on research design, processes of data collection and analysis and dissemination of findings, has the potential to enable psychotherapy research to make a more effective contribution to building a just society. A review of the key features of the concept of pluralism is followed by a historical analysis of the ways in which research in counselling, psychotherapy and related disciplines has moved in the direction of a pluralistic position around knowledge creation. Core principles of a pluralistic approach to research are identified and explored in the context of a critical case study of contemporary research into psychotherapy for depression, examples of pluralistically oriented research practices, and analysis of a pluralistic conceptualisation of the nature of evidence. Implications of a pluralistic perspective for research training and practice are discussed. Pluralistic inquiry that emphasises dialogue, collaboration, epistemic justice and the co-existence of multiple truths, creates opportunities for individuals, families and communities from a wide range of backgrounds to co-produce knowledge in ways that support their capacities for active citizenship and involvement in open democratic decision-making. To fulfil these possibilities, it is necessary for psychotherapy research to be oriented towards social goals that are sufficiently relevant to both researchers and co-participants to harness their passion and work together for a common good.

Reducing arsenic toxicity using the interfacial oxygen nanobubble technology for sediment remediation.

The arsenic (As)-bearing eutrophic waters may suffer from the dual conditions of harmful algal blooms and release of As, driven by algal-induced hypoxia/anoxia. Here, we investigate the use of interfacial oxygen (O2) nanobubble technology to combat the hypoxia and control As exposure in simulated mesocosm experiments. It was observed that remediation of algal-induced hypoxia at the sediment-water interfaces (SWI) by application of O2 nanobubbles reduced the level of dissolved As from 23.2 µg L-1 to <10 µg L-1 and stimulated the conversion of As(III) to the less toxic As(V) (65-75%) and methylated As (10-15%) species. More than half of the oxidation and all the methylation of As(III) resulted from the manipulation by O2 nanobubbles of microbes responsible for As(III) oxidation and methylation. Hydroxyl radicals were generated during the oxidation of reductive substances at the SWI in darkness, and should be dominant contributors to As(III) abiotic oxidation. X-ray absorption near-edge structure (XANES) spectroscopic analysis demonstrated that surface sediments changed from being sources to acting as sinks of As, due to the formation of Fe-(hydr)oxide. Overall, this study suggests that interfacial O2 nanobubble technology could be a potential method for remediation of sediment As pollution through the manipulation of O2-related microbial and geochemical reactions.

Effects of elevated sulfate in eutrophic waters on the internal phosphate release under oxic conditions across the sediment-water interface.

Eutrophication in freshwater environments may be enhanced by the elevation of sulfate in waters, through the release of internal phosphorus (P) from anoxic sediments. However, the influence of increasing but modest sulfate concentrations (less than 3000 µM) on P release under oxic conditions across the sediment-water interface (SWI) in eutrophic freshwater is poorly understood. In this study, the profiles of P, iron (Fe), sulfur (S) and physicochemical parameters were measured in a simulated lacustrine system with varying concentrations of sulfate (970-2600 µM) in overlying water. The results indicated that elevated concentrations of sulfate increased the soluble reactive P in overlying waters under oxic conditions across the SWI. A 100 µM increase of sulfate was found to induce a 0.128 mgm-2d-1 increase of P flux from surface sediments into overlying waters under oxic conditions. Higher sulfate concentrations in the overlying waters increased the concentrations of labile S(-II) in the deep sediments, due to sulfate penetration and subsequent reduction to S(-II). We also found the fluxes of labile Fe (10.34 to 18.33 mgm-2d-1) and P (2.70 to 1.33 mgm-2d-1) from deep to surface sediment were both positive and greater than the corresponding fluxes (Fe, 2.2 to 3.51 and P, 2.6 to 0.39 mgm-2d-1, respectively) from surface sediment to the overlying water, suggesting that reduction of P-bearing Fe(III)(oxyhydr)oxides in deep anoxic sediment acted as a major source of internal P release. In addition, the upward flux of Fe(II) was significantly lower under higher sulfate conditions, indicating that the Fe(II) flux could be mitigated by formation of Fe(II) sulfides in the deep sediment. Under these conditions, less Fe(II) from deep sediments could be re-oxidized and combine with P in the surface, oxic sediment, thereby reducing the retention capacity for P and leading to higher release of internal P to the water column.

The impact of a needs-based model of care on accessibility and quality of care within children's mental health services: A qualitative investigation of the UK i-THRIVE Programme.

BACKGROUND: The i-THRIVE Programme is a needs-based model of care, based on the THRIVE Framework, that is being implemented across the United Kingdom with the aim of improving outcomes for children and young people's mental health and wellbeing. This study aimed to investigate the impact that this programme has on accessibility and quality of care, as viewed by key stakeholders. METHODS: Interviews with professionals and service users were conducted during the implementation of the THRIVE Framework in four sites of one mental health and community service provider. RESULTS: Three themes are identified: 'impact of needs-based groupings on referral', 'impact of collaborative and interagency approach' and 'impact of i-THRIVE on clinical practice'. Findings suggest that accessibility was seen to be promoted through the integration of a needs-based approach, flexible re-referral, signposting and information sharing, the use of goal-orientated interventions and collaboration over risk and treatment endings. Shared decision making was perceived to improve the experience of care for young people, as was interagency working. Goal-focused interventions and upfront discussion of treatment endings were seen to help clinicians manage expectations and discharge but could also compromise effectiveness and engagement. Obstacles to impact were resistance to interagency working and a shortage of resources across the system. CONCLUSIONS: i-THRIVE is a promising approach with the potential to facilitate the accessibility and quality of mental health care. However, a tension exists between enhancing accessibility and quality of care, which points towards the importance of outcome and satisfaction monitoring. Obstacles to impact point to the importance of a whole-system approach supported by sufficient resources across the locality.

Humanistic counselling plus pastoral care as usual versus pastoral care as usual for the treatment of psychological distress in adolescents in UK state schools (ETHOS): a randomised controlled trial.

BACKGROUND: About one in seven adolescents have a mental health disorder in England, UK. School counselling is one of the most common means of trying to address such a problem. We aimed to determine the effectiveness and cost-effectiveness of school-based humanistic counselling (SBHC) for the treatment of psychological distress in young people in England, UK. METHODS: We did a two-arm, individually randomised trial in 18 secondary state-funded schools across the Greater London area of the UK. Participants were randomly assigned (1:1) using a centrally secure randomisation procedure with random permuted blocks to either SBHC plus schools' pastoral care as usual (PCAU), or PCAU alone. Participants were pupils aged 13-16 years who had moderate-to-severe levels of emotional symptoms (measured by a score of ≥5 on the Strengths and Difficulties Questionnaire Emotional Symptoms scale) and were assessed as competent to consent to participate in the trial. Participants, providers, and assessors (who initially assessed and enrolled participants) were not masked but testers (who measured outcomes) were masked to treatment allocation. The primary outcome was psychological distress at 12 weeks (Young Person's Clinical Outcomes in Routine Evaluation measure [YP-CORE]; range 0-40), analysed on an intention-to-treat basis (with missing data imputed). Costs were assessed at 24 weeks (Client Service Receipt Inventory and service logs). The trial was registered with ISRCTN, number ISRCTN10460622. FINDINGS: 329 participants were recruited between Sept 29, 2016, and Feb 8, 2018, with 167 (51%) randomly assigned to SBHC plus PCAU and 162 (49%) to PCAU. 315 (96%) of 329 participants provided data at 12 weeks and scores were imputed for 14 participants (4%). At baseline, the mean YP-CORE scores were 20·86 (SD 6·38) for the SBHC plus PCAU group and 20·98 (6·41) for the PCAU group. Mean YP-CORE scores at 12 weeks were 16·41 (SD 7·59) for the SBHC plus PCAU group and 18·34 (7·84) for the PCAU group (difference 1·87, 95% CI 0·37-3·36; p=0·015), with a small effect size (0·25, 0·03-0·47). Overall costs at 24 weeks were £995·20 (SD 769·86) per pupil for the SBHC plus PCAU group and £612·89 (1224·56) for the PCAU group (unadjusted difference £382·31, 95% CI £148·18-616·44; p=0·0015). The probability of SBHC being more cost-effective reached 80% at a willingness to pay of £390 for a 1-point improvement on the YP-CORE. Five serious adverse events occurred for four participants in the SBHC plus PCAU group, all involving suicidal intent. Two serious adverse events occurred for two participants in the PCAU group, one involving suicidal intent. INTERPRETATION: The addition of SBHC to PCAU leads to small reductions in psychological distress, but at an additional economic cost. SBHC is a viable treatment option but there is a need for equally rigorous evaluation of alternative interventions. FUNDING: This work was supported by the Economic and Social Research Council (grant reference ES/M011933/1).

Mitigating antibiotic pollution using cyanobacteria: Removal efficiency, pathways and metabolism.

The occurrence of pharmaceuticals and personal care products (PPCPs) in wastewater poses huge environmental threats, even at trace concentrations, and novel approaches are urged due to the inefficiencies of conventional wastewater treatment plants, especially when processing contaminants at high concentrations. Meanwhile, another widespread problem in the aquatic domain is the occurrence of harmful algal blooms (HABs) which cause serious damage to the ecosystem, but have rarely been investigated for possible valorization. This study investigated the possibilities, mechanisms, and effects of toxin release of using a harmful cyanobacterial species, Microcystis aeruginosa (M. aeruginosa), in order to remove the widely used drug, tetracycline, at high concentration. The results were compared with the performance obtained by the use of the hitherto generally-selected chlorophyte alga Chlorella pyrenoidosa (C. pyrenoidosa) for tetracycline concentrations of 10-100 mg L-1. M. aeruginosa exhibited a much more effective and rapid tetracycline removal (over 98.0% removal in 2 days) than did C. pyrenoidosa (36.7%-93.9% in 2 days). A comprehensive kinetic investigation into probable removal pathways indicated that, theoretically, bio-remediation dominated the process by M. aeruginosa (71.6%), while only accounting for 20.5% by C. pyrenoidosa. Both microalgae promoted the hydrolysis of tetracycline under conditions of increased pH and inhibited abiotic photolytic reactions by the shading effect to the water column, when compared with control experiments. Although identical degradation by-products were identified from treatments by both microalgal species, distinct by-products were also confirmed, unique to each treatment. Moreover, the growth of M. aeruginosa biomass exhibited strong tolerance to tetracycline exposure and released significantly lower levels of microcystin-LR, compared with the control systems. This study supports the possibility of reusing HABs species for the effective remediation of antibiotics at high concentrations. We have further suggested possible mechanisms for remediation and demonstrated control of toxin release.

Molecular-level investigations of effective biogenic phosphorus adsorption by a lanthanum/aluminum-hydroxide composite.

Biogenic phosphorus (P), such as organic P and inorganic pyrophosphates, could substantially contribute towards eutrophication in aquatic systems by internal loading of P from sediment through P species transformation. Previous eutrophication management studies mainly focus on the removal of orthophosphate (Ortho-P), however, an effective approach for biogenic P control from water sources, prior to incorporation in sediment, is still lacking. In this study, a lanthanum/aluminum-hydroxide (LAH) composite was demonstrated to provide both superior removal of Ortho-P and biogenic P, employing myo-inositol hexakisphosphate (IHP) and pyrophosphate (Pyro-P) as model compounds. The maximum IHP and Pyro-P adsorption capacities by LAH attained 36.4 and 21.8 mg P g-1, respectively. In order to understand the mechanisms of adsorption, zeta potential, 31P solid-state nuclear magnetic resonance (NMR) spectroscopy and P K-edge X-ray absorption near edge structure (XANES) techniques were used to characterize the LAH after adsorption. The results supported the hypothesis that the interaction between LAH and P species was through surface adsorption, by the formation of inner-sphere complexes. Linear combination fitting results of XANES data indicated that IHP and Pyro-P preferentially bonded with La-hydroxide in LAH. This study elucidates the adsorption properties and binding mechanisms of IHP and Pyro-P on lanthanum-bearing compounds at the molecular level, indicating that LAH is a promising material for the control of eutrophication.