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In recent times there has been increasing acknowledgement of the importance of attending to the agenda of people with lived experience in psychotherapy research. In particular, young people's voices have been recognised as central to the design and development of psychotherapies that work for them. It is important to recognise the limits of professional agendas and make sure that young people's own priorities are represented in the indicators against which we measure change in research evaluations of psychotherapy. This requires an extension of evaluation research indicators from psychiatric symptomatology, to include aspects of wellbeing that matter to young people themselves. This article joins others in calling for a shift from the focus on symptom change in the evaluation of psychotherapy with youth, to acknowledge subjective indicators identified through research conducted with young people. New indicators might, for example, be centred on the degree to which young people experience increased capacity for acceptance of their emotions, a comfortable sense of identity, improved relational trust, and a stronger sense of their own agency. If psychotherapy is to be meaningful to young people, it is vital that we tailor it to young people's own needs and priorities and evaluate it against the aspects of change that matter to them.

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Background: While most studies assessing psychotherapy efficacy are randomized-controlled trials conducted in research institutions or short clinical treatments, the understanding of psychotherapy effectiveness under regular, clinically representative conditions, particularly in outpatient practice, remains limited. Representative data examining the effectiveness of psychotherapy under real-world conditions in Austria is lacking. Aims and Methods: This paper introduces a naturalistic observational combined process- and outcome study, implementing a dual-perspective approach through standardised pre- and post-treatment questionnaires and evaluating changes in the therapeutic alliance after each session. Further, semi-structured qualitative interviews aim to illuminate the personal experiences of patients and therapists. The primary objective of the presented study is to discern whether symptoms markedly decrease following therapy. A significant secondary goal is to trace the therapeutic alliance's evolution from both patient and therapist viewpoints, emphasising the alliance-outcome association and gender dynamics within the pairs. This paper discusses the project's feasibility after three years and shares key insights. Discussion: Recruitment for this study has posed substantial challenges due to psychotherapists' concerns regarding data protection, extensive documentation, and philosophical reservations about the study design. Consequently, we recruited fewer participants than initially planned. Despite these hurdles, qualitative data collection has shown notable success. Given psychotherapists' busy schedules and reluctance to participate, more potent external incentives or a legal obligation may be necessary to encourage participation in future studies.

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BACKGROUND: After the COVID-19 pandemic, the conflict between limited mental health care resources and the rapidly growing number of patients has become more pronounced. It is necessary for psychologists to borrow artificial intelligence (AI)-based methods to analyze patients' satisfaction with drug treatment for those undergoing mental illness treatment. OBJECTIVE: Our goal was to construct highly accurate and transferable models for predicting the satisfaction of patients with mental illness with medication by analyzing their own experiences and comments related to medication intake. METHODS: We extracted 41,851 reviews in 20 categories of disorders related to mental illnesses from a large public data set of 161,297 reviews in 16,950 illness categories. To discover a more optimal structure of the natural language processing models, we proposed the Unified Interchangeable Model Fusion to decompose the state-of-the-art Bidirectional Encoder Representations from Transformers (BERT), support vector machine, and random forest (RF) models into 2 modules, the encoder and the classifier, and then reconstruct fused "encoder+classifer" models to accurately evaluate patients' satisfaction. The fused models were divided into 2 categories in terms of model structures, traditional machine learning-based models and neural network-based models. A new loss function was proposed for those neural network-based models to overcome overfitting and data imbalance. Finally, we fine-tuned the fused models and evaluated their performance comprehensively in terms of F1-score, accuracy, κ coefficient, and training time using 10-fold cross-validation. RESULTS: Through extensive experiments, the transformer bidirectional encoder+RF model outperformed the state-of-the-art BERT, MentalBERT, and other fused models. It became the optimal model for predicting the patients' satisfaction with drug treatment. It achieved an average graded F1-score of 0.872, an accuracy of 0.873, and a κ coefficient of 0.806. This model is suitable for high-standard users with sufficient computing resources. Alternatively, it turned out that the word-embedding encoder+RF model showed relatively good performance with an average graded F1-score of 0.801, an accuracy of 0.812, and a κ coefficient of 0.695 but with much less training time. It can be deployed in environments with limited computing resources. CONCLUSIONS: We analyzed the performance of support vector machine, RF, BERT, MentalBERT, and all fused models and identified the optimal models for different clinical scenarios. The findings can serve as evidence to support that the natural language processing methods can effectively assist psychologists in evaluating the satisfaction of patients with drug treatment programs and provide precise and standardized solutions. The Unified Interchangeable Model Fusion provides a different perspective on building AI models in mental health and has the potential to fuse the strengths of different components of the models into a single model, which may contribute to the development of AI in mental health.

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Rational Emotive Behavior Therapy's (REBT's) ABC model proposes that it is B, Beliefs about A, Activating events, not A, Activating events themselves, that create and control C, emotional Consequences. Codified beliefs such as scriptures and creeds are prominent in most religions. Integrating codified religious beliefs with REBT to help D, Dispute irrational beliefs has been studied in REBT for more than 50 years. Broad knowledge of religious cultures, scriptures, creeds, and wisdom literature is likely to help REBTers and other cognitive behavior therapists (CBTers) more effectively treat religious clients. We give a brief overview of the history, culture, doctrine, and scriptures of the Church of Jesus Christ of Latter-day Saints, then give examples of REBT Disputations excerpted from religion integrative sessions with practicing Latter-day Saint clients. We present practice-based evidence for the effectiveness of this approach and offer suggestions for future study and research in integrating religion with REBT and CBT.

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Background: Treatment of major depressive disorder (MDD) in men is complicated by the endorsement of traditional masculinity ideologies (TMI) often leading to reluctance toward psychotherapy, therapy interfering processes, or premature termination. In addition, it has been shown that men with MDD have a significantly increased risk of being hypogonadal (e.g., total testosterone levels <12.1 nmoL/L). Therefore, it is recommended to examine depressed men with regard to their testosterone status and if hypogonadism is present to combine psychotherapy with testosterone treatment (TT). Aim: This project aims to evaluate a male-specific psychotherapeutic program (MSPP) for MDD in depressed eugonadal and hypogonadal men receiving testosterone in comparison to a standard cognitive behavioral therapy (CBT) for MDD and a Waitlist. Methods: The study presents a 2×3 factorial study design. In total, 144 men aged between 25 and 50 will be stratified by testosterone status (eugonadal/hypogonadal) and then randomized into one of the three conditions (MSPP, CBT, or Waitlist). Additionally, a healthy control group of 100 men will be recruited, which will undergo only baseline assessments. Both standardized psychotherapy programs will encompass 18 sessions delivered in a weekly manner. Aligned with the TT-related medical visits of the 72 hypogonadal men, all participants will be followed up with clinical assessments and bio sampling at weeks 0, 6, 15, 24, and 36. Expected results: Compared to Waitlist control groups, treatment groups are expected to be more effective and efficacious (depression score reduction of ≥50%) at week 24 and at the follow-up at week 36. The MSPP is expected to show higher effectiveness and efficacy for depressive symptoms and higher acceptability (lower dropout rate) as compared to CBT. Discussion: This study represents the first attempt to test a male-specific psychotherapy for MDD in a single-setting compared to standard CBT and a Waitlist control condition using randomized clinical trial methodology. In addition, the potential positive adjunct effect of psychotherapy to TT in reducing depressive burden and improving quality of life in hypogonadal depressed men represents a neglected research area and might introduce new hypogonadism screening procedures in depressed men and combined treatment approaches for depressed men suffering from hypogonadism. Limitations are the rigorous inclusion and exclusion criteria, which limit the generalizability of the study results to first episode treatment naïve depressed men. Clinical Trial Registration: ClinicalTrials.gov, identifier NCT05435222.

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BACKGROUND: Patients with chronic depression (CD) typically have an early symptom onset, more psychiatric comorbidities, more treatment attempts, and more frequent and longer inpatient hospitalizations than patients with major depressive disorders. The main purpose of this study was to investigate the effectiveness of an intensive inpatient psychotherapy program for patients with chronic depression (CD). The primary research question was whether two intensive psychodynamic inpatient treatments, affect phobia therapy (APT) and VITA, were superior to an outpatient wait list condition, receiving treatment as usual (TAU), at completion of treatment. To investigate if a potential difference between the intensive treatment and the wait list control group was dependent on a specific psychotherapeutic model, the study contrasted two therapies with similar intensity, but different theoretical rationales. METHODS: Two hundred eighty patients with CD were included in a naturalistic study. Patients were assessed at four time points; assessment, start of therapy, end of therapy and 1-year follow-up. Three comparisons were performed with patients matched across groups; Intensive inpatient treatment program (APT + VITA) vs wait list during treatment, APT vs VITA during treatment and APT vs VITA during follow-up. The outcome measure was the BDI-II. RESULTS: Intensive inpatient treatment program vs. wait list showed a significant difference in favor of the intensive treatment. No significant differences were found between APT and VITA during therapy or follow-up; but both groups had large effect sizes during treatment, which were maintained during follow-up. CONCLUSIONS: The intensive inpatient psychotherapy program showed superior effect on chronic depression over an outpatient wait list condition receiving treatment as usual (TAU), but no significant differences were found between the two intensive inpatient psychodynamic treatments. The results provide support for the effectiveness of an intensive inpatient psychotherapy program in treatment of chronic and severe disorders, such as CD, which could be of benefit for policymakers and the health care sector as they are allocating recourses efficiently. TRIAL REGISTRATION: This study has been retrospectively registered on ClinicalTrials.gov (NCT05221567) on February 3rd, 2022.

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BACKGROUND: Dialectical behavior therapy (DBT) is an effective approach to decreasing suicidal behaviors; the adapted, family-based model for adolescents (through 18 years old; DBT-A) also demonstrates efficacy. Data on higher dropout rates based on age, initial research on DBT with young adults in the community, and the theory that underlies DBT suggest that adaptations may also be appropriate for young adults. This study examines the effectiveness of DBT-A, presents preliminary data on delivering DBT-A to young adults (ages 18-26), and compares clinical characteristics, service utilization, and outcomes to adolescent clients (ages 13-17) to guide clinical considerations and future research on implementing DBT-A. METHODS: Data were collected from a DBT-A clinic and included results from semi-structured diagnostic interviews, chart review, and scores on self-report measures. The Suicide Ideation Questionnaire and Beck Depression Inventory (BDI), given at program entry, after completion of one rotation through the skills modules, and at graduation, were used to evaluate outcomes. Outcomes were benchmarked against prior DBT-A trials. Adolescents' and young adults' clinical characteristics, service utilization, and outcomes were compared. RESULTS: The effect size observed was smaller than in efficacy trials. Few differences were observed between teens (n = 87) and young adults (n = 45). Young adults were more likely to have participated in intensive services before DBT-A. They participated in fewer family sessions and graduated in fewer months compared to teens. CONCLUSION: This study supports the use of the family-based model of DBT for suicidal teens and young adults although future research is needed to improve the effectiveness of this model when implemented in real-world settings.

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Psychotherapy research is a rapidly developing area of study that aims to explore the integration of inner and outer conditions of an individual's experience, the interplay between subjective and objective, as well as between individual and collective. Questions regarding a more integrative view and qualitative research in psychotherapy are discussed in the paper. The author introduces some ideas from the studies on psychotherapy effectiveness that were done at Vilnius University by a group of researchers who work in the 'Centre for research on the psychodynamics of personality'. Clinical psychologists who hold a doctorate degree or who are in doctoral studies in the Department of Psychology at Vilnius University are members of this research group. The subjective understanding about healing episodes and the development of depth premises were the main tasks of these studies. Among other methods, the researchers used the drawing a picture of a healing moment and telling a psychotherapy story recalled by the client to collect data. Two examples of drawing a picture of a healing moment and one example of telling a therapy story are analyzed in the paper. The themes of subjective experience of renewal in psychotherapy as well as the multiplicity of experience and results in psychotherapy are discussed in the paper with case illustrations. This study showed that drawing a picture opens one more dimension of reflection and that it can be an appropriate tool for developing individual narratives as well. Authoring and re-authoring one's life narrative is accepted as part of a productive therapy as well as discovering one's inner authorship. The ability to follow a succession of meanings, as well as a connection to nature and culture could be one of the ways of actualizing an integrative view in psychotherapy research.

La recherche dans le domaine de la psychothérapie est un domaine d'étude en croissance rapide qui vise à étudier l'intégration des conditions intérieures et extérieures dans l'expérience d'une personne, l'interaction entre le subjectif et l'objectif, ainsi qu'entre l'individuel et le collectif. L'article aborde des questions concernant une perspective plus intégrative et la recherche qualitative en psychothérapie. L'auteur introduit des idées provenant d'études faites par un groupe de chercheurs à l'université de Vilnius sur l'efficacité de la psychothérapie. Ces chercheurs travaillent au « Centre for research on the psychodynamics of personality ¼ (Centre de recherche sur les psychodynamiques de la personnalité). Ils sont docteurs en psychologie clinique ou doctorants dans le département de Psychologie à l'université de Vilnius. L'objet principal de ces recherches est la compréhension subjective d'épisodes de guérison et la construction de postulats de profondeur. Parmi différentes méthodes pour obtenir des données, les chercheurs ont utilisé celle consistant à faire un dessin d'un moment de guérison et celle consistant à raconter une histoire de psychothérapie telle que le client se la rappelle. Deux exemples de faire un dessin d'un moment de guérison ainsi qu'un exemple de raconter une histoire de psychothérapie sont analysés dans l'article. Les thèmes de l'expérience subjective du renouveau en psychothérapie, ainsi que la multiplicité d'expérience et de résultats en psychothérapie sont traités dans l'article et illustrés par des cas. Cette étude montre que de faire un dessin ouvre une dimension de plus dans la réflexion et que cela peut être un outil approprié pour le développement des récits individuels. Etre l'auteur de son récit de vie, ainsi que de sa réécriture, est considéré comme étant un aspect d'une thérapie productive. De même que découvrir sa capacité intérieure à « être auteur ¼. La capacité à suivre une succession de significations, ainsi qu'un lien avec la nature et la culture pourraient être une des manières d'actualiser une perspective intégrative dans la recherche en psychothérapie.

La investigación en psicoterapia es un área de estudio en creciente desarrollo cuyo objetivo es explorar la integración entre las condiciones internas y externas de la experiencia de un individuo, el inter-juego entre lo subjetivo y lo objetivo, así como entre lo individual y lo colectivo. Se plantean consideraciones respecto a una perspectiva más integradora y a la investigación cualitativa. La autora introduce algunas ideas, a partir de estudios sobre la efectividad de la psicoterapia llevados a cabo en la Universidad de Vilnius, por un grupo de investigadores que trabajan en el 'Centro de investigación en los procesos psicodinámicos de la personalidad'. Los miembros de este grupo de investigación son psicólogos clínicos que tienen un doctorado o están realizando un doctorado en el Departamento de Psicología en la Universidad de Vilnius. Las principales tareas de estos estudios fueron el desarrollo de premisas profundas y la comprensión subjetiva sobre los episodios de curación. Entre otros métodos, los investigadores para recoger data, utilizaban el dibujar un cuadro sobre un momento de curación y contar una historia de psicoterapia contada por el cliente. Dos ejemplos de dibujar un cuadro de un momento de curación y un ejemplo de contar una historia de terapia son analizados en el presente trabajo. Se da cuenta de la experiencia subjetiva de renovación en psicoterapia así como de la multiplicidad de experiencias y resultados a partir de la ilustración de casos. El estudio muestra que el dibujar un cuadro abre una nueva dimensión de reflexión y puede ser una herramienta apropiada para el desarrollo de narrativas individuales. Ser autor/a, y volver a ser autor/a de la propia narrativa de vida se acepta como parte de una terapia productiva así como del descubrimiento de la autoridad interna. La habilidad de dar cuenta de una sucesión de sentidos, así como una conexión con la naturaleza y la cultura podrían ser uno de los modos de actualizar una perspectiva integradora en la investigación en psicoterapia.

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OBJECTIVE: Though many studies have shown that psychotherapy can be effective, psychotherapy available in routine practice may not be adequate. Several methods have been proposed to evaluate routine psychological treatments. The aim of this paper is to demonstrate the combined utility of complementary methods, change-based benchmarking, and end-state normative comparisons, across a range of self-reported psychological symptoms. METHOD: Benchmarks derived from randomized controlled trials (RCTs) and normative comparisons were used to evaluate the effectiveness of psychotherapy in a large (N = 9895) sample of clients in university counseling centers (UCCs). RESULTS: Overall, routine psychotherapy was associated with significant improvement across all symptoms examined. For clients whose initial severity was similar to RCT participants, the observed pre-post effect sizes were equivalent to those in RCTs. However, treatment tended to lead to normative end-state functioning only for those clients who were moderately, but not severely, distressed at the start of psychotherapy. CONCLUSIONS: This suggests that although psychotherapy is associated with an effective magnitude of symptom improvement in routine practice, additional services for highly distressed individuals may be necessary. The methods described here comprise a comprehensive analysis of the quality of routine care, and we recommend using both methods in concert. Clinical or methodological significance of this article: This study examines the effectiveness of routine psychotherapy provided in a large network of counseling centers. By comparing multiple established methods to define outcomes in this sample we provide a detailed understanding of typical outcomes. The findings show that, across several different problem areas, routine psychotherapy provided substantial benefit, particularly to clients in the most distress. However, there is room to improve, especially by increasing the number of clients who return to normal functioning by the end of treatment. Using distinct methods provides complementary answers to the question: How effective is routine psychotherapy?

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AimsThe aim of this study was to reanalyse the data from Cuijpers et al.'s (2018) meta-analysis, to examine Eysenck's claim that psychotherapy is not effective. Cuijpers et al., after correcting for bias, concluded that the effect of psychotherapy for depression was small (standardised mean difference, SMD, between 0.20 and 0.30), providing evidence that psychotherapy is not as effective as generally accepted. METHODS: The data for this study were the effect sizes included in Cuijpers et al. (2018). We removed outliers from the data set of effects, corrected for publication bias and segregated psychotherapy from other interventions. In our study, we considered wait-list (WL) controls as the most appropriate estimate of the natural history of depression without intervention. RESULTS: The SMD for all interventions and for psychotherapy compared to WL controls was approximately 0.70, a value consistent with past estimates of the effectiveness of psychotherapy. Psychotherapy was also more effective than care-as-usual (SMD = 0.31) and other control groups (SMD = 0.43). CONCLUSIONS: The re-analysis reveals that psychotherapy for adult patients diagnosed with depression is effective.

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OBJECTIVES: The study aimed to determine the severity of trait and state anxiety in patients treated for neurotic and personality disorders with intensive, short-term group psychotherapy and to analyse the change of anxiety intensity in the course of treatment. METHODS: 116 patients (81 females and 35 males) participated in the study. The measurement of anxiety intensity was conducted with the State-Trait Anxiety Inventory (STAI) at the beginning and at the end of treatment. RESULTS: The majority of patients (69% of the study group) demonstrated a high intensity of state anxiety at the beginning of the treatment with 47.4% being classified as very high. High intensity of trait anxiety was observed in 64.7% of participants (50.9% -very high). RCI (Reliable Change Index) and RCV (Reliable Change Value) indicated a significant change in state anxiety intensity in 62.1% of participants (48.3% - significant decrease, 13.8% increase). At the end of treatment more than a half of patients manifested medium and low intensity of both trait and state anxiety. CONCLUSIONS: At the beginning of psychotherapy the majority of patients demonstrated high intensity of both trait and state anxiety. In the course of therapy a considerable reduction of intensity of trait and state anxiety is observed. Significant deterioration in trait anxiety is observed in one out of every thirteen treated patients. Polish adaptation of STAI questionnaire is a useful tool for monitoring effectiveness of psychotherapy and may be successfully applied for screening and detailed diagnosis of neurotic and personality disorders.

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OBJECTIVE: Three recent meta-analyses have made the claim, albeit with some caveats, that cognitive-behavioral treatments (CBT) are superior to other psychotherapies, in general or for specific disorders (e.g., social phobia). METHOD: The purpose of the present article was to examine four issues in meta-analysis that mitigate claims of CBT superiority: (a) effect size, power, and statistical significance, (b) focusing on disorder-specific symptom measures and ignoring other important indicators of psychological functioning, (c) problems inherent in classifying treatments provided in primary studies into classes of treatments, and (d) the inclusion of problematic trials, which biases the results, and the exclusion of trials that fail to find differences among treatments. RESULTS: When these issues are examined, the effects demonstrating the superiority of CBT are small, nonsignificant for the most part, limited to targeted symptoms, or are due to flawed primary studies. CONCLUSION: Meta-analytic evidence for the superiority of CBT in the three meta-analysis are nonexistent or weak.

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AIM: The study of group psychotherapy influence on the personality functioning of patients on treatment for neurotic disorders and selected personality disorders (F4-F6 under ICD-10). METHODS: The study concerned 82 patients (61 women and 21 men) who underwent intensive short-term group psychotherapy in a day ward. A comprehensive assessment of the patients' personality functioning was carried out at the outset and the end of the psychotherapy utilising the MMPI-2 questionnaire. RESULTS: At the treatment outset the majority of the study patients demonstrated a considerable level of disorders in five MMPI-2 clinical scales (Depression, Hysteria, Psychopathic Deviate, Psychastenia, Schizophrenia) and moderate pathology in Hypochondria. In the Mania scale most patients obtained results comparable to the healthy population when the treatment commenced. Having undergone the psychotherapy treatment, the majority of the examined were observed to demonstrate positive changes in those areas of personality functioning which were classified as severe or moderate pathology. CONCLUSIONS: Short-term intensive comprehensive group psychotherapy with elements of individual psychotherapy leads to desirable changes in personality functioning.

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UNLABELLED: AIM : The aim of this project was to conduct the cross-cultural factorial validation of the Outcome Questionnaire (OQ-45.2) using the Polish population. METHODS: Data were obtained from day-patients (n = 211), inpatients (n = 234), outpatients (n = 137) and non-patients (n = 426). Statistical analyses included: parallel analysis, exploratory factor analysis, confirmatory factor analysis, correlation analysis, criterion equivalence, clinical significance and reliable change index, and test-retest. RESULTS: Statistical analyses provided the strongest support for the bi-level model of the total score, five orthogonal (subscales specific for the Polish OQ, i.e. Social Conflicts and Addictive Behaviors; and original yet modified subscales, i.e. Symptom Distress, Interpersonal Relations, and Social Role), and two oblique factors (Somatization and Anxiety, Social Role 2). The psychometric properties of the Polish OQ were found to be adequate and similar to the original American OQ and its international adaptations. Specific for the Polish OQ cut-off scores for clinical significance were established. The role of cultural differences and the passage of time in the process of the cross-cultural validation were elaborated upon. CONCLUSIONS: The Polish version of the OQ 45-2 has been recognized as an instrument adequately measuring general functioning as well as specific areas of functioning of the individual (i.e. interpersonal relations; social role performance; social conflicts; symptom distress; somatization and anxiety; addictive behaviors). Results of this factorial analysis seem to be valuable for both clinicians using the OQ-45.2 and for creators of any psychotherapy outcome measure.

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UNLABELLED: A review of the literature on psychotherapy suggests that improvements in effectiveness, efficiency and accessibility have been hampered by a lack of understanding of how psychotherapy works. Central to gaining such understanding is an accurate description of the change process that occurs when someone solves a psychological problem. We describe the Perceptual Control Theory (PCT) model of human functioning, which can be used to understand the nature of psychological problems and how they are solved. PCT suggests that problems can be broadly grouped into two categories: those that can be solved using existing skills and those that require the generation of new skills. In general, psychological problems belong in the second category. PCT describes a fundamental form of learning in which existing structures and systems are reorganized to create new skills, perspective and insights. Psychotherapy based on PCT is aimed at directing reorganization to the source of the problem. KEY PRACTITIONER MESSAGE: Understanding the phenomenon of control is central to understanding how psychotherapy works. Conflict could be considered a general formulation for psychological distress. Therapy will be efficient when the reorganization process is focused at the right level of the client's control hierarchy. Therapy will be effective only when the client's reorganization system-not the therapist-has managed to come up with a solution to the client's problem. What the client says about the nature and reason for their problem is less important than the point of view from which these problems are being discussed.

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En este estudio se evalúa la efectividad de la psicoterapia individual realizada por terapeutas noveles en la Clínica Psicológica de la Universidad de La Frontera (Temuco - Chile) y su relación con la alianza terapéutica. La investigación es de carácter cuantitativo, con diseño de grupo único y evaluaciones al inicio y término de la terapia. En el estudio participaron 23 consultantes, cuyos procesos psicoterapéuticos eran conducidos por 11 estudiantes de los últimos niveles de la Carrera de Psicología, que realizaban su primera experiencia en atención psicoterapéutica supervisada, o se encontraban efectuando su práctica profesional. Los instrumentos utilizados fueron las versiones adaptadas para Chile del Outcome Questionnaire (OQ-45.2) de De la Parra y Von Bergen (2000, 2002) que permite evaluar el nivel de cambio en el curso de la terapia y sus resultados finales y del Working Alliance Inventory (Inventario de Alianza de Trabajo, IAT-P) de Santibáñez (2001) que evalúa la alianza terapéutica desde la perspectiva del paciente. Los resultados informan diferencias significativas entre la primera y última aplicación del OQ-45.2. Los puntajes obtenidos en el IAT-P están ubicados en los dos tercios superiores de la escala, observándose una restricción de rango con sesgo positivo. Se evidencia una asociación significativa entre la alianza terapéutica percibida por el paciente y el resultado de la psicoterapia, tanto en el puntaje total de la escala OQ-45.2, como en la Subescala de Síntomas. Estos resultados son discutidos considerando la investigación actual en el área y el trabajo realizado por terapeutas noveles.

The present study was aimed to assess the effectiveness of individual psychotherapy undertaken at the Psychological Clinic of the Universidad de La Frontera (Temuco, Chile) and its relationship with the therapeutic alliance. The investigation involved 23 adult patients with neurotic symptoms. Their therapeutic processes were carried out by 11 trainee students from the regular psychology training program. Out of these, 4 therapists were performing their first supervised psychotherapeutic experience, and 7 therapists were undertaking their professional training using either a psychodynamic or a humanistic- experiential approach. The therapeutic processes considered in this study lasted between 5 and 42 sessions, comprising the following closure modalities: agreed closure between the patient and therapist because of the fulfillment of objectives, closure requested by the patient, and withdrawal of the therapeutic process. The instruments used were the Outcome Questionnaire (OQ-45.2) adapted for Chilean population by De la Parra and Von Bergen (2000, 2002), an instrument that allows to evaluate the level of change in the final course of the therapy and its outcomes; and the Working Alliance Inventory (Inventario de Alianza Terapéutica, IAT-P) adapted for Chilean population by Santibánez (2001), an instrument that evaluates the level of therapeutic alliance from the perspective of the patient. The study was quantitative in nature, with a unique group design and evaluations at the beginning and at the end of the therapy. For each patient, the OQ-45.2 was administered at the end of the first, and after the last psychotherapy session. In addition, the IAT-P was administered once, at the fourth session. In order to assess the pre-post psychotherapy differences, a samples-related t test was performed. In addition, a Reliable Change Index was calculated using scores of the first and final OQ-45.2 administration; and finally, the percentage of patients with clinically significant change, was estimated. The administration of the IAT-P showed a restriction of range with positive bias both, on overall total scale scores as well on each subscale score. For this reason, using the median, two subgroups for the overall IAT were created. Also, two subgroups were generated for each subscale: a subgroup of subjects with scores higher than the median and a subgroup of subjects with scores below the median. Then, by using the Mann-Whitney U test, the Reliable Change Index from the groups with high or low levels of alliance were compared. Results of this study showed significant differences between the first and last application of the OQ-45.2. In order to estimate whether the change was clinically significant, cut-off scores and Reliable Change Index were used. In the OQ-45.2 scale, 17 patients left the clinical group, 12 people met the Reliable Change Index criterion, and 8 people showed a clinically significant change. In relation to the closure modality, 7 patients with clinically significant change ended the psychotherapy with a discharge given by the therapist, while one requested the closure of the therapy. Scores from the IAT-P were located in the upper two thirds of the scale. The Bond Subscale had the highest mean, while Tasks and Goals got a slightly lower value. With respect to the main issue, it was found a significant association between therapeutic alliance and the outcome of the psychotherapy both, on overall total scale scores of the OQ-45.2 as well Symptoms Scale of the same instrument. Results showed that the alliance between therapist and the patient especially helped to reduce patient's symptoms. In addition, it was evident that students in training were able to establish good alliance with their patients, and thus to promote the achievement of the therapeutic outcome. These results are discussed taking into account current research on this topic.