Subjects: Other Disciplines >> Synthetic discipline submitted time 2023-10-09 Cooperative journals: 《心理学报》
Abstract： The COVID-19 pandemic has led to a shift from in-person face-to-face counseling (F2F) to online videoconferencing counseling (VCP), which poses the question: how does VCP affect treatment outcomes compared to F2F? Existing research has demonstrated the equivalence of VCP and F2F in terms of effectiveness. However, the working alliance, a key common factor in F2F, has been found to be lower in quality in VCP than in F2F in a recent meta-analysis. Moreover, only one study has examined the reciprocal relationship between working alliance and treatment outcomes in VCP at the within-patient level. The present study aims to (a) compare the treatment outcomes between VCP and F2F using longitudinal data from a naturalistic setting; and (b) explore the mutual influence of working alliance and treatment outcomes in VCP and F2F at the within-patient level. This study was conducted in a counseling center of a university in central China, and participants were arranged to receive VCP or F2F. The final sample consisted of 525 college students, of whom 117 received VCP and 408 received F2F. The only difference between the two conditions was the mode of delivery (VCP vs. F2F). Participants completed the CORE-OM-10 before each session and the Session Alliance Inventory (SAI) after each session. They also completed the PHQ-9, GAD-7, and CORE-OM-34 at pre- and post-treatment. The data from sessions 1 to 6 were analyzed using the Random Intercept Cross-Lagged Panel Model (RI-CLPM). A multi-group RI-CLPM comparison was conducted to examine the alliance-outcome relationship in VCP and F2F at the within-patient level. The within-patient analysis revealed that SAI was a significant predictor of CORE-OM in the subsequent session, and CORE-OM was a significant predictor of SAI in the same session. The multi-group comparison indicated that the predictive effect of SAI on CORE-OM did not differ significantly between VCP and F2F. However, the working alliance quality in VCP was significantly lower than that in F2F after the first and the fourth sessions, but not after the other sessions. The post-treatment analysis, using Propensity Score Matching with pretest CORE-OM34, PHQ-9 and GAD-7 as predictor variables, showed no significant difference in PHQ-9, GAD-7, and CORE-OM34 between VCP (N = 89) and F2F (N = 336). These findings indicate that VCP is as effective as F2F in reducing psychological distress, and that clients can establish a stable working alliance in VCP over time, even if they initially experience difficulties in adapting to the online mode. Moreover, the reciprocal influence of working alliance and treatment outcomes in VCP is similar to that in F2F. This study offers empirical support for the use of VCP, especially in the context of the COVID-19 pandemic.
Subjects: Psychology >> Clinical and Counseling Psychology submitted time 2023-05-09
Abstract： The COVID-19 pandemic has led to a shift from in-person face-to-face counseling (F2F) to online videoconferencing counseling (VCP), which poses the question: how does VCP affect treatment outcomes compared to F2F? Existing research has demonstrated the equivalence of VCP and F2F in terms of effectiveness. However, the working alliance, a key common factor in F2F, has been found to be lower in quality in VCP than in F2F in a recent meta-analysis. Moreover, only one study has examined the reciprocal relationship between working alliance and treatment outcomes in VCP at the within-patient level. The present study aims to (a) compare the treatment outcomes between VCP and F2F using longitudinal data from a naturalistic setting; and (b) explore the mutual influence of working alliance and treatment outcomes in VCP and F2F at the within-patient level.
This study was conducted in a counseling center of a university in central China, and participants were arranged to receive VCP or F2F. The final sample consisted of 525 college students, of whom 117 received VCP and 408 received F2F. The only difference between the two conditions was the mode of delivery (VCP vs. F2F). Participants completed the CORE-OM-10 before each session and the Session Alliance Inventory (SAI) after each session. They also completed the PHQ-9, GAD-7, and CORE-OM-34 at pre- and post-treatment. The data from sessions 1 to 6 were analyzed using the Random Intercept Cross-Lagged Panel Model (RI-CLPM). A multi-group RI-CLPM comparison was conducted to examine the alliance-outcome relationship in VCP and F2F at the within-patient level.
The within-patient analysis revealed that SAI was a significant predictor of CORE-OM in the subsequent session, and CORE-OM was a significant predictor of SAI in the same session. The multi-group comparison indicated that the predictive effect of SAI on CORE-OM did not differ significantly between VCP and F2F. However, the working alliance quality in VCP was significantly lower than that in F2F after the first and the fourth sessions, but not after the other sessions. The post-treatment analysis, using Propensity Score Matching with pretest CORE-OM34, PHQ-9 and GAD-7 as predictor variables, showed no significant difference in PHQ-9, GAD-7, and CORE-OM34 between VCP (N = 89) and F2F (N = 336).
These findings indicate that VCP is as effective as F2F in reducing psychological distress, and that clients can establish a stable working alliance in VCP over time, even if they initially experience difficulties in adapting to the online mode. Moreover, the reciprocal influence of working alliance and treatment outcomes in VCP is similar to that in F2F. This study offers empirical support for the use of VCP, especially in the context of the COVID-19 pandemic.
Subjects: Psychology >> Developmental Psychology submitted time 2023-03-28 Cooperative journals: 《心理科学进展》
Abstract： Psychological autopsy (PA) is a systematic and retrospective method in order to figure out the risk factors of suicide. Collecting materials from the informants and the proxy respondents of the deceased, Psychological autopsy could reconstruct the physical, psychological and social state of the deceased. Studies have shown that psychological autopsy is one of the most valuable tools for suicide research. This paper systematically introduces the research method of psychological autopsy, and its applications in the field of suicide research. Consequently, the paper discusses the research advancement on the risk factors of suicide using the method of psychological autopsy. Further studies should be carried out from a culturally sensitive perspective. It is also necessary to implement the method of psychological autopsy to explore the complex interaction among the multiple risk factors of suicide. Key words:
Subjects: Psychology >> Social Psychology submitted time 2023-03-27 Cooperative journals: 《心理学报》
Abstract： Leary’s circumplex model of interpersonal behavior categorizes the manifestation of personality in interpersonal interactions into two dimensions: affiliation (i.e., hostile-friendly) and control (i.e., dominant-submissive). Interpersonal complementarity refers to mutually adjusted and complementary behaviors along the affiliation and control dimensions during dyadic interactions, such that greater dominance in one partner invites greater submissiveness in the other (i.e., reciprocity) and greater friendliness invites greater friendliness (i.e., correspondence). The first aim of the study was to develop an assessment manual to reliably measure interpersonal complementarity using the computer joystick method. Using this innovative measurement method, the study tested the high-low-high pattern of interpersonal complementarity in early, middle and late stages of therapy sessions, and examined the relationships between interpersonal complementarity and therapists’ experience, working alliance, session depth and therapeutic outcomes. Segments of early (first session), middle (sessions between first and last sessions), and late (last session) stages of session videos were selected from the “Directiveness Research” database from a university counseling center in central region of China. 48 selected segments were from 16 clients (5 male and 11 female) working with 13 therapists (3 male and 10 female) for 4 to 8 sessions (M = 5.8). Using the Interpersonal Complementarity Evaluation Manual of Counseling, two well-trained raters performed joystick assessments of interpersonal complementarity. In addition, therapists and clients filled out WAI-SR and SEQ after each session, and clients filled out OQ-45 at the start of treatment and one week after termination. The results showed that: (1) Therapists’ experience and counseling stage had an interactive effect on interpersonal complementarity. Specifically, experienced therapists (more than 3 years of experience) showed higher correspondence of affiliation in the early stage than that in the middle and late stages, and higher complementarity of dominance in the late stage than that in the early and middle stages. In contrast, novice therapists (less than 3 years of experience) showed no significant change in interpersonal complementarity over the three stages; (2) In the middle stage, the affiliation correspondence negatively predicted working alliance and interpersonal complementarity negatively predicted session depth; (3) The cases with a high-low-high pattern of affiliation correspondence tended to have better therapeutic outcomes. Results provided partial support for the three-stage high-low-high model of interpersonal complementarity in psychotherapy. Findings help shed light on the underlying mechanism of the three-stage model of interpersonal complementarity, because lower interpersonal complementarity uniquely predicted greater working alliance and session depth in the middle stage of therapy.
Subjects: Psychology >> Social Psychology submitted time 2023-03-27 Cooperative journals: 《心理学报》
Abstract： Progress feedback involves collecting patients’ ratings on treatment outcome by session and providing feedback to therapists on patient progress. Research has indicated that the positive effect of progress feedback on psychotherapy outcome is a promising advancement. However, a recent meta-analysis showed that progress feedback may only have a small to medium effect for non-severe patients. Also, the theory which explains the effect of progress feedback is very much limited. Before implementing progress feedback in China, it is necessary to test its effect on working alliance and treatment outcomes in a natural setting.It is believed that Chinese are taught to obey their parents, respect elders, and restrain themselves to keep family harmony. Such schemas are subsequently transferred to their social life in the forms of respecting authority/superior, maintaining interpersonal harmony, which will lead to an indirect style of communication. Progress feedback from patients’ weekly reports can be used as a correction method for incongruences between therapists and patients without discussing it immediately and face-to-face, and thus can improve the quality of working alliance and treatment outcomes. The current study used a culturally-adapted version of progress feedback in a university counseling center. Research assistants collected patients’ ratings on working alliance and treatment outcomes and emailed the results with interpretations to the therapists, who were then encouraged to use feedback information to improve treatment outcomes.The participants included 48 therapists and 445 patients (of which 350 were used for analysis). Post survey indicated that 80% therapists read progress feedback information based on which they were divided into feedback and non-feedback group. CORE-OM10 was used to evaluate symptoms before each session, and WAQ was used to evaluate the working alliance after each session. PHQ-9, GAD-7, and CORE-OM-34 were used before and after treatment. Multi-level structural equation models were used to analyze the data. Results showed that progress feedback had a medium effect on working alliance but no effect on treatment outcomes (measured by CORE-OM) at the between-person level. At the within-person level, the results affirmed the reciprocal model of alliance-outcome, which indicated that the model is consistent and steady across cultures. In addition, the feedback group had better treatment outcomes measured by PHQ-9 and self-rated helpfulness measured after treatment.The results were discussed under the three possible mechanisms of progress feedback. Progress feedback may correct the bias of the therapist’s self-evaluation on treatment process, as well as the incongruence and alliance ruptures between therapists and patients. The cultural-specific factors may also contribute to the effect of progress feedback (e.g., indirect communication style). The support from regular supervision for therapists under progress feedback was emphasized as well. Overall, the present study suggested the positive effect of progress feedback on the working alliance and treatment outcomes in a Chinese counseling center based on practical evidence.
Subjects: Psychology >> Clinical and Counseling Psychology submitted time 2020-12-10
Abstract： Progress feedback involves collecting patients’ ratings on treatment outcome session by session and providing feedback to therapists on patient progress. Research has indicated that the positive effect of progress feedback on psychotherapy outcome is a promising advancement. However, a recent meta-analysis showed that progress feedback may only have a small to medium effect for non-severe patients. Also, there is a limited theory in explaining the effect of progress feedback. Before implementing the progress feedback in China, it is necessary to test its effect on working alliance and treatment outcomes in a natural setting. It is believed that Chinese are taught to obey their parents, respect elders, and restrain themselves to keep family harmony. Such schemas are subsequently transferred to their social life in the forms of respecting authority/superior, maintaining interpersonal harmony, which will lead to an indirect style of communication. Progress feedback from patients’ weekly reports can be used as a correction method for incongruences between therapists and patients without discussing it immediately and face-to-face, and thus can improve the quality of working alliance and treatment outcomes. The current study used a culturally-adapted version of progress feedback procedure in a university counseling center. Research assistants collected patients’ ratings on working alliance and treatment outcomes and sent the results with interpretations to therapists’ email address. Therapists were encouraged to use feedback information to improve treatment outcomes. The participants included 48 therapists and 445 patients (350 were used for analysis). Post survey indicated that 80% therapists read progress feedback information based on which feedback group was determined. CORE-OM10 was used to evaluate symptoms before each session and WAQ was used to evaluate the working alliance after each session. PHQ-9, GAD-7, and CORE-OM-34 were used before and after treatment. Multi-level structural equation models were used to analyze the data. Results showed that progress feedback had a medium effect on working alliance but no effect on treatment outcomes (measured by CORE-OM) at the between-person level. At the within-person level, the results affirmed the reciprocal model of alliance-outcome which indicated that the model is consistent and steady across cultures. In addition, the feedback group had better treatment outcomes measured by PHQ-9 and self-rated helpfulness measured after treatment. The results were discussed under the possible three mechanisms of progress feedback. Progress feedback may correct the blindness of the therapist’s self-evaluation on treatment process, can correct the incongruence and alliance ruptures between therapists and patients. The cultural-specific factors may also contribute to the effect of progress feedback (e.g., indirect communication style). The support from regular supervision for therapists under progress feedback was emphasized as well. Overall, the present study suggested the positive effect of progress feedback on the working alliance and treatment outcomes in a Chinese counseling center based on practical evidence.
Peer Review Status:
Awaiting Review
Subjects: Psychology >> Applied Psychology submitted time 2020-11-11
Abstract： Based on a new conceptual frame of mental health literacy (MHL), which refers to two structural dimensions including “coping with mental illness–mental health promotion” and “self–others” and three aspects including knowledge, attitude, and behavior tendency, a systematic nationwide sampling survey was conducted for the purpose of understanding the mental health literacy profile of the Chinese. This study further explored the influences of four group variables (geographical and gross domestic product (GDP) distribution, basic demographic variables, socio-economic status, and mental health background) on mental health literacy. Another aim of this study was to provide some strategies for improving mental health literacy more effectively. The Chinese Mental Health Literacy Questionnaire and Basic Background Information Questionnaire were used to assess the mental health literacy levels of the Chinese and their influencing factors. The Chinese Mental Health Literacy Questionnaire contains six sub-scales (knowledge and concepts related to mental health, knowledge and concepts related to mental illness, attitudes and behavior tendency to maintain and promote one’s mental health, attitudes and behavior tendency to cope with one's mental illness, attitudes and behavior tendency to maintain and promote the mental health of others, and attitudes and behavior tendency to cope with the mental illness of others). The questionnaires were administered to 8866 Chinese adults in nine cities (Beijing, Wuhan, Chengdu, Lishui, Kaifeng, Guilin, Zhangye, Baoding, and Linfen), which covered the well-developed, developing, and less-developed regions in China. With a balanced development considering geographical and GDP distribution, the results indicated that the mental health literacy levels among adults in different cities were low to moderate. Their influences on mental health literacy were small but significant with respect to geographical distribution, gender, age, familiarity with professional mental health service, and the frequency of contact with psychiatric patients. Regarding the structure of mental health literacy, the results of the development of national mental health literacy demonstrated that mental health maintenance and promotion literacy was better than mental illness coping literacy, and self-help literacy was better than helping others literacy. The survey found that the knowledge had relatively high individual differences, whereas attitudes and behaviors had relatively low individual differences concerning the contents of the mental health literacy. In addition, among the social influencing factors of mental health literacy this research tested, the socio-economic status was the most effective one, which showed large effect size in the knowledge and small to medium effect size in the attitudes and behavior tendency. These findings implicate that (1) improving mental health literacy is an arduous task; (2) improving the literacy of coping with mental illness should be the focus and breakthrough point of the current practice of mental health literacy promotion; (3) socio-ecological perspective should be adopted when developing a mental health literacy promotion policy; and (4) the mechanism of the attitude and behavior tendency change needs to be explored and clarified. "
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