Functional magnetic resonance imaging (fMRI) was used to examine functional brain activity in two demographically matched depressed women following their participation in a Behavioral Activation Treatment for Depression (BATD; Hopko & Lejuez, 2007) or Pragmatic Psychodynamic Psychotherapy (PPP; Summers & Barber, 2010). A reward responsiveness pleasurable music listening scanner paradigm was employed during brain scanning to assess reward responsivity prior to and following treatment. Both women responded positively to treatment, evidenced reductions in depression, and exhibited changes in their blood oxygenation level dependence (BOLD) response as measured by fMRI following treatment. BOLD response changes were not observed in either patient in subcortical regions implicated in reward responsiveness following treatment. However, BOLD response changes were observed for both patients in regions of the dorsolateral and medial orbital prefrontal cortex and subgenual cingulate following treatment, with each treatment affecting these areas. These findings support the notion that when BATD and PPP are implemented effectively they are associated with functional brain changes in areas implicated in the pathophysiology of depression.

The current study explored the relationship between client’s history of childhood abuse and psychotherapy outcome, specifically, depressive symptoms, interpersonal problems, dysfunctional attitudes, self-esteem and attachment. The study also explored the relationship between client’s history of childhood abuse and current introject style, as well as the relationship between client introject style and psychotherapy outcome. The current study consisted of a sample of 60 clients and was drawn from an archival database of clients who were diagnosed with Major Depressive Disorder and received 16 weeks of psychotherapy treatment (Watson, Gordon, Stermac, Kalogerakos & Steckley (2003). Client’s history of childhood abuse was determined using the Traumatic Stress Inventory (TSI short-form; McCann & Pearlman, 1992). Introject styles were established using the Structural Analysis of Social Behaviour (SASB; Benjamin, 1974), an observer rated process measure. The middle 15 minutes of an early (session 3) and late session (session 15) were rated using the SASB. Results indicated that women who experienced childhood abuse showed a reduction in levels of their self-accepting introject style in session 15 compared to session 3 while women without childhood abuse showed increased levels of the self-accepting introject style in session 15 compared to session 3. Results also indicated that clients with managing and cultivating of self introject styles as measured at session 3 showed improvements in dysfunctional attitudes, interpersonal problems and self-esteem by the end of 16-weeks of psychotherapy. Having a history of childhood abuse was not related to any of the outcome measures; clients, regardless of history of childhood abuse improved over time. Results did show history of childhood abuse to be related to perceptions of early childhood attachment experiences; specifically, clients with histories of childhood abuse showed higher scores overall for perceptions of experiences with caregivers as rejecting and angry. Finally, results indicated that clients with a history of childhood abuse have a significantly greater number of depressive episodes on average than clients without a history of childhood abuse. Implications for future research and clinical work are discussed.

The current study explored the relationship between client’s history of childhood abuse and psychotherapy outcome, specifically, depressive symptoms, interpersonal problems, dysfunctional attitudes, self-esteem and attachment. The study also explored the relationship between client’s history of childhood abuse and current introject style, as well as the relationship between client introject style and psychotherapy outcome. The current study consisted of a sample of 60 clients and was drawn from an archival database of clients who were diagnosed with Major Depressive Disorder and received 16 weeks of psychotherapy treatment (Watson, Gordon, Stermac, Kalogerakos & Steckley (2003). Client’s history of childhood abuse was determined using the Traumatic Stress Inventory (TSI short-form; McCann & Pearlman, 1992). Introject styles were established using the Structural Analysis of Social Behaviour (SASB; Benjamin, 1974), an observer rated process measure. The middle 15 minutes of an early (session 3) and late session (session 15) were rated using the SASB. Results indicated that women who experienced childhood abuse showed a reduction in levels of their self-accepting introject style in session 15 compared to session 3 while women without childhood abuse showed increased levels of the self-accepting introject style in session 15 compared to session 3. Results also indicated that clients with managing and cultivating of self introject styles as measured at session 3 showed improvements in dysfunctional attitudes, interpersonal problems and self-esteem by the end of 16-weeks of psychotherapy. Having a history of childhood abuse was not related to any of the outcome measures; clients, regardless of history of childhood abuse improved over time. Results did show history of childhood abuse to be related to perceptions of early childhood attachment experiences; specifically, clients with histories of childhood abuse showed higher scores overall for perceptions of experiences with caregivers as rejecting and angry. Finally, results indicated that clients with a history of childhood abuse have a significantly greater number of depressive episodes on average than clients without a history of childhood abuse. Implications for future research and clinical work are discussed.

The present study examined the emotional responses of 112 dyads of same-sex friends in early and middle childhood as they competed against each other on 3 identical games, enabling each child in the pair to experience 3 outcome conditions: winning, losing, and tying. Emotional reactions were videotaped and rated for degree of enjoyment and discomfort. In addition, following the 3 games, children were individually interviewed and asked to report their levels of happiness regarding winning, losing, and tying. The social context of a dyad is more closely associated with female social interaction which tends to be egalitarian. It was hypothesized that boys' well-documented greater comfort with competition relative to girls would be attenuated in the context of a dyad. Results indicated that boys showed more comfort and enjoyment throughout the competitive process than did girls. However, both boys and girls showed equal levels of comfort and enjoyment for the win and tie outcomes, indicating boys, like girls, were also concerned with doing the same as their friend. A developmental difference was also seen as the children in middle childhood reported less happiness than the kindergarten children when they experienced the win outcome. The results are discussed in terms of the necessity of considering the social context in which competition occurs when investigating gender differences in competition.

The purpose of this project was to summarize psychotherapy outcomes for eating disorders using meta-analysis. Psychotherapy was defined as any psychosocial treatment including face-to-face therapy, self-help, and Internet approaches. All primary studies, meeting inclusion/exclusion criteria from 1980 to 2010, were included. Results suggested that individuals treated with active treatments demonstrate better outcomes than those in control conditions (d= 0.33, p <.01, 95% CI [0.19-0.46]). CBT was the most often occurring treatment in the primary studies and a small effect, favoring CBT, was found when the treatment was compared to all other active treatments (d = 0.16, p = .02, 95% CI [0.03-0.28]). Internet and self-help approaches continue to show promise with Internet treatments demonstrating superior outcomes to control conditions (d = 0.54, p <.01, 95% CI [0.19-0.90]). More research is needed to determine whether these approaches can suffice as stand-alone treatments or if they are best used in addition to already well-established approaches (i.e., individual CBT). The meta-analysis also explored whether treatment type, outcome measure, diagnosis, attrition, and diagnostic severity moderate treatment effect. Finally, the meta-analysis updated and improved upon previous meta-analyses by focusing on randomized controlled trials, including all diagnoses of eating disorder, only combining effect sizes from similar conditions, including all possible studies that meet inclusion criteria, computing and comparing effect sizes for outcome measures beyond those considered primary to eating disorder treatment, and also addressing outcomes for all brands of psychotherapy including traditional talk therapy, self-help, and Internet approaches.

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Given the high rates of premature termination in training clinics, research aimed at understanding client attrition is urgently needed. Recent investigations in this area have implicated expectations of psychotherapy as a strong predictor of premature termination; however, this phenomenon has only been studied from the perspective of client expectations to date. There is reason to believe clinician expectations for the duration and effectiveness of psychotherapy may further impact the likelihood of their clients terminating prematurely. This study sought to address this gap in the literature by examining the association of clinicians' expectations to clients' psychotherapy outcomes and termination status in a training clinic setting. Clinicians were found to hold significantly higher expectations for client improvement than would be expected, and these high expectations were found to be positively correlated with clinically significant change in clients. Implications for improving client retention and treatment outcome in training clinics are discussed.

Given the alarmingly high rates of premature termination in training clinics, research aimed at understanding the course of change and treatment outcomes in training clinics deserves considerable attention. Additionally, more research is needed to understand the effectiveness of psychotherapy training and whether more training is actually associated with better client outcomes. Thus, this study sought to investigate whether clinicians' level of training and experience were related to a variety of clients' outcomes (e.g., well-being, symptom reduction, and life functioning) based on the phase model of psychotherapy. Unfortunately, confirmatory factor analysis of the OQ45.2 did not support the three-factor conceptual model paralleling the phase model. Rather, a two-factor model of best fit was identified. Neither clinicians' level of clinical training nor therapeutic orientation were found to be related to client improvements. However, this finding may have been attenuated by limited variance in client outcomes. Implications for clinical training and future outcome research methodologies are discussed.

The Clinical Support Tools (CST) was developed to help therapists organize and target potential problems that might account for negative outcomes in psychotherapy. The core of CST feedback is The Assessment for Signal Clients (ASC). The purpose of this study was to describe and identify patterns of problems that typically characterize off-track cases. A cluster analysis of 107 off-track clients revealed three client types: those whose problems were characterized by alliance and motivational difficulties; those characterized by social support and life event difficulties; and those whose problems had an indistinguishable pattern. Loglinear modeling showed that if patients had less therapeutic alliance problems they were also less likely to have motivational problems. Findings were also consistent with the cluster analysis, which showed that a relatively higher percentage of not-on-track participants received signal alerts for the social support items and scale. Individuals whose progress goes off-track appear to have their greatest difficulty with social support, losses, and therapy task agreement.