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.

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.

Research has shown that psychotherapy patients experience increased physiological responsivity to stress which might negatively impact their experience in psychotherapy and their overall progress and outcome. The purpose of the present study was to investigate the effect of a heart rate variability biofeedback intervention on the physiological stress responsiveness and the psychotherapy outcomes of participants in psychotherapy. Forty college students attending psychotherapy at their university counseling center were divided into an experimental group and a control group. The experimental group participated in a 6-week biofeedback intervention and we assessed their physiological stress reactivity before and after implementation of the intervention, compared to a matched control group. The Trier Social Stress Test (TSST) was administered pre- and post-intervention to induce a stress reaction. It was hypothesized that psychotherapy patients involved in the biofeedback intervention would show decreased physiological stress reactivity to and faster physiological recovery from a laboratory induced stressor post-intervention compared to psychotherapy patients in the matched control group. It was also hypothesized that these participants would demonstrate larger distress reduction after implementation of the intervention. Results of the study found no significant main effect of the TSST on systolic blood pressure, heart rate, and HRV. There however was a main effect on diastolic blood pressure. The only variable that significantly differed between groups was the LF/HF ration. The results also revealed no significant change from pre-intervention baseline to post-intervention heart rate, blood pressure, and HRV, suggesting that the HRV biofeedback intervention was not effective in changing the stress response over time. Regarding levels of distress, results also revealed no statistical between group differences post-intervention, although the biofeedback group appeared to report significantly lower levels of distress post-intervention.