Summary Objective: Background regarding a recent debate between Cuijpers et al. (2019a, b) and the authors (Munder et al. 2019) about the efficacy of psychotherapy for depression is given. Method: A main reason for the discrepancy in Cuijpers et al.’s and our conclusions is discussed. Results: In our view the discrepancy is due, among other things, to a blurred distinction between questions of relative and absolute efficacy of psychotherapy. Although the efficacy of psychotherapy vis-à-vis alternative treatments may be ambiguous, there can be little doubt about the benefits of psychotherapy relative to no treatment. Conclusion: We do not think that raising fundamental concerns about the value of psychotherapy is a service to the field. We argue that moving the field forward requires a focus on how psychotherapy works and how the access to psychotherapy can be increased.
ABSTRACT Objective Increased attention has recently been paid to the well‐being and flourishing of patients in psychotherapy. This study investigated the occurrence of positive affect (PA) and strength‐based behaviours within psychotherapy sessions contrasting positive versus neutral imagery instructions. Methods This is a secondary analysis of a randomized controlled trial. Seventy‐eight sessions of cognitive behavioural therapy involving 26 patients (69.23% female; M age = 40.31) treated by 13 therapists were selected. PA and strength‐based behaviours of patients and therapists were coded on a minute‐by‐minute basis with the Resource‐Oriented Microprocess Analysis. Each session started with a brief mental imagery instruction. Data were analysed using multilevel modelling. Results Mild levels of PA were very common, whereas stronger expressions were occasional, especially at the beginning and end of sessions. Strength‐based behaviours were employed in one‐fifth of the videos analysed. Therapists in the positive imagery instruction showed more strength‐based behaviours in the beginning phase of sessions, p < 0.05. The two imagery instructions significantly differed in the session trajectories of PA, p < 0.05. A quadratic trend with higher initial values and a sharper decline in PA were found in the positive instruction, whereas the neutral instruction showed a flatter trend. Conclusion Patients and therapists experience PA and discuss strengths in psychotherapy sessions despite patients' distress. The positive imagery instructions potentially induced a positive focus at baseline for therapists but had a negligible effect on the subsequent session progression. Trial Registration ClinicalTrials.gov identifier: NCT03767101 (registered December 6, 2018).
Digital health interventions (DHIs) are designed to help individuals manage their disease, such as asthma, diabetes, or major depression. While there is a broad body of literature on how to design evidence-based DHIs with respect to behavioral theories, behavior change techniques or various design features, targeting personality traits has been neglected so far in DHI designs, although there is evidence of their impact on health. In particular, conscientiousness, which is related to therapy adherence, and neuroticism, which impacts long-term health of chronic patients, are two personality traits with an impact on health. Sensing these traits via digital markers from online and smartphone data sources and providing corresponding personality change interventions, i.e. to increase conscientiousness and to reduce neuroticism, may be an important active and generic ingredient for various DHIs. As a first step towards this novel class of personality change DHIs, we conducted a systematic literature review on relevant digital markers related to conscientiousness and neuroticism. Overall, 344 articles were reviewed and 21 were selected for further analysis. We found various digital markers for conscientiousness and neuroticism and discuss them with respect to future work, i.e. the design and evaluation of personality change DHIs.
Objective: Psychotherapists differ in their treatment effectiveness as measured by the therapy outcome of their patients. One possible factor for therapist effects seems to be the therapists’ interpersonal skills. Therapist assessments of interpersonal skills have demonstrated sufficient predictive validity, but little is known about underlying skills and related constructs. The purpose of the present study is to compare the different constructs of interpersonal skills with each other and to investigate possible underlying abilities. Study Population and Methods: In this exploratory study, the concept of interpersonal skills was investigated using three survey methods (questionnaires, computer tests, and assessments) and comparing two measurements each. For this purpose, 6 measures of interpersonal skills were collected from 20 prospective psychotherapists as well as 28 psychology students (total N = 48). Alongside more traditional methods, the correlations and overlaps of the constructs were examined using partial and Bayesian networks. Results: Moderate to high correlations are found within the self-report measures. The assessments, however, did not correlate with self-report measures nor with computer tests. Discussion and Conclusion: The similarities in the self-assessments indicate stable self-concepts of interpersonal skills, which, however, cannot be explained by the underlying skills nor by the observer-based evaluations. The marginal correlation between the assessments also indicates that interpersonal, therapy-related abilities must be interpreted in a situation-specific manner.
