generated: 2024-11-23 04:02:16





Program at a Glance


Thursday September 12, 2024
10:00 AM - 11:30 AM
12:00 PM - 1:00 PM
1:00 PM - 1:45 PM
1:45 PM - 3:15 PM
3:15 PM - 3:45 PM
3:45 PM - 5:15 PM
5:15 PM - 5:45 PM
5:45 PM - 7:15 PM
7:15 PM - 9:00 PM
Friday September 13, 2024
8:30 AM - 10:00 AM
10:00 AM - 10:30 AM
10:30 AM - 12:00 PM
12:00 PM - 1:30 PM
1:30 PM - 2:30 PM
2:30 PM - 4:00 PM
4:00 PM - 4:30 PM
4:30 PM - 6:00 PM
6:00 PM - 6:30 PM
6:30 PM - 8:00 PM
8:00 PM - 9:00 PM
Saturday September 14, 2024
8:30 AM - 10:00 AM
10:00 AM - 10:30 AM
10:30 AM - 12:00 PM
12:00 PM - 1:30 PM
1:30 PM - 3:00 PM
3:00 PM - 3:30 PM
3:30 PM - 5:00 PM
5:00 PM - 5:30 PM
7:00 PM - 11:00 PM






SPR-EU-UK Program

1. Complexity Science in Psychotherapy [Interest Section Meeting]
Thursday | 10:00 am-11:30 am | P24

Organizer: Franco Orsucci, Norfolk and Suffolk NHS Foundation Trust
2. Evidence Production and Use for Guidelines (EPUG) [Interest Section Meeting]
Thursday | 10:00 am-11:30 am | U23

Organizer: Felicitas Rost, The Open University, UK
3. Therapist Training and Development (SPRISTAD) [Interest Section Meeting]
Thursday | 10:00 am-11:30 am | U32

Organizer: Thomas Schroder, University of Nottingham, UK
4. Advancing the Understanding and Measurement of Meaning in Life: Integrating Complexity in Psychotherapy and Trauma Research [Workshop]
Thursday | 10:00 am-11:30 am | U33

Organizer: Joel Vos, Metanoia Institute
5. European Consortium on Psychotherapy (EpoC) [Interest Section Meeting]
Thursday | 12:00 pm-1:00 pm | U23

Organizers: Miguel Gonçalves, Universidade do Minho, Braga, Portugal; Michael Barkham, University of Sheffield, UK;
6. Opening Ceremony [Special Event]
Thursday | 1:00 pm-1:45 pm | P31
7. Qualitative perspectives on therapist development: From initial inspirations to sustained growth. [Panel/Symposium]
Thursday | 1:45 pm-3:15 pm | P24

Organizer: Thomas Schroder, University of Nottingham, UK
  • The Whys and Wherefores of Becoming a Therapist. .....Thomas Schroder, University of Nottingham, UK; Jan Pirke, University Witten/Herdecke; Ulrike Willutzki, Witten/Herdecke University, Germany; Louise Hentschel, Witten / Herdecke University; and Lea Nagel, Witten / Herdecke University
  • Aspiring psychotherapists start their professional training for a variety of reasons, including personal and professional motives, theoretical and practical considerations, past experiences and hopes for the future. The SPRISTAD ‘Trainee Background Information Form’ (TBIF) elicits individual motivations in free-text format. Responses have previously been explored in qualitative inductive analyses by Messina et al. (2018) for an initial Italian sample, Serian (2023) for German language data, and Eilinghoff-Ehlers (2023) for non-German language data. A synopsis of these studies showed that identified themes partially overlap, providing the basis for a coding frame that can be used for a deductive content analysis of all TBIF data, once a category system has been created that can be reliably coded. The results would assign presence/absence ratings for each category relating to each individual response, allowing for quantitative analyses investigating associations with other TBIF variables. We present a coding frame that we have generated in German - using translations by native speakers of responses in other languages – together with its English equivalent. As a next step we will iteratively develop coding manuals to allow for reliable analyses of present and future data.
  • The “good trainee” from the perspective of psychotherapy trainers: a qualitative study. .....Giovanna Trimoldi, Mercatorum University, Rome; and Irene Messina, Mercatorium University
  • prThe person of the therapist has received growing attention in psychotherapy research, suggesting that training effectiveness may also depend on the person of the trainees, with relevant implications in terms of candidate selection or tailoring training to the person. In the present study, we focused on how and how much psychotherapy training can be related to and effective in fostering trainees’ characteristics associated with successful therapists and contrast trainees’ characteristics that could represent limitations as therapists. To this aim, we interviewed 14 training program directors with different psychotherapy approaches. Audio recordings of these semi-structured interviews were transcribed verbatim and analysed using NVivo software. According to our findings, qualities such as self-insight, awareness, and the ability to embrace uncertainty are largely recognized as the main characteristics of “good trainees”. With regard to training effectiveness, psychotherapy trainers underscored the importance to transition from rigid adherence to prescribed techniques toward a more nuanced approach built upon four foundational pillars: greater emphasis on experiential learning, a shift from rigidity to self-awareness, the cultivation of trust and affection in the trainee-trainer relationship, and a move from traditional supervision to a model of intervision.
  • What are the significant events reported by therapists? A study exploring their personal and professional development. .....Hubert de Condé, Université catholique de Louvain; Emanuelle Zech, (Université catholique de Louvain, Belgium); and Jochem Willemsen, Université Catholique de Louvain
  • Introduction: This presentation will lay out a doctoral study on therapists' personal and professional development. This project advocates for a self-integrated perspective on training, emphasizing the equal importance of nurturing personal development alongside professional skills cultivation. The concept of Significant Events (SE) was adapted from its original application for client change processes to the person-of-the-therapist. SE were defined as helpful or hindering events experienced in the therapy process. SE were adapted to the context of professional development (PD), because, similarly to therapy processes, PD is not a linear process of acquiring skills and knowledge. The goal of this study was to explore transformative moments in therapists' development. Method: 230 participants completed an online questionnaire, evaluating: (1) therapists' personal and professional characteristics (TC), such as their age, gender, supervision, personal therapy, and their level of training and (2) therapists' SE. TC were measured by the DPPCQ. Participants were asked to report helpful or hindering SE that influenced their personal and professional development. Results: Thematic analysis uncovered three main themes: (1) personal events (resilience, relationship dynamics, self-discovery, spirituality), (2) professional events (transitions, training and achievements, clinical experiences, shifts, peer-support, reflections on theoretical approaches), and (3) hybrid events where personal and professional aspects intertwine (health and well-being, loss and grief, life transitions, global awareness, ethical dilemmas). Discussion: This research contributes to ongoing discussions on professional development, revealing the interplay between the therapists’ personal and professional spheres. Findings suggest that some psychotherapy approaches focus more on the development of a more integrated person-of-the therapist.
8. Dealing Collectively with Trauma [Semi-Plenary [invited]]
Thursday | 1:45 pm-3:15 pm | P31

Organizer: Orya Tishby, Department of Psychology, The Hebrew University of Jerusalem, Israel
  • Between replicating, adapting, and inventing the wheel: Research & clinical dilemmas in the face of Israel's October 7 war and its aftermath. .....Rivka Tuval-Mashiach, Bar-Ilan University
  • Consequences of trauma associated with political persecution - "KZ-Syndrome" and Complex PTSD. .....Michał Mielimąka, Jagiellonian University Medical College; Edyta Dembińska, Jagiellonian University, Kraków, Poland; Karolina Piotrowicz, Jagiellonian University, Kraków, Poland; and Krzysztof Rutkowski, Jagiellonian University, Kraków, Poland
  • Psychological trauma at times of war. .....Larysa Didkovska, Ivan Franko National University of Lviv
9. Race in Psychotherapy [Panel/Symposium]
Thursday | 1:45 pm-3:15 pm | U23

Organizer: Naomi Moller, The Open University
  • Why it matters: Exploring Race in Psychotherapy!. .....Faisal Mahmood, Birmingham Newman University
  • The aim of this panel is two-fold: to further explore how we understand the experiences of minority ethnic clients in therapy and how we might use that understanding to foster therapists’ relational presence with them. Minority ethnic clients (and, indeed, minority ethnic trainees/therapists) are subject to racism and systemic racial minoritisation in the world ‘out there’ and in the microcosm of the therapeutic encounter. Such processes may be explicit or implicit, taking, for example, the form of racial microagressions (see paper 3) . In this presentation I draw on theory and research to argue that our profession’s relationship with race is complex and still troubled/troubling; we have moved from other-pathologisation to self-pathologisation (I’m aware of my white privilege’), refuting accusations of colour-blindness along the way in spite of its prevalence in both therapy and research (Bonilla-Silva, 2015; Jayakumar and Adamian, 2017). I ask whether we aren’t simply engaging in another form of self-protection which serves to other the client and hides continued racial ignorance and white privileged practice in the guise of pseudo-self-awareness. These seemingly different processes serve a single function: withdrawal from authentic meaningful relational contact and an attempt to ‘manage’ and ‘maintain’ the power imbalance within the therapeutic space. How best might we move away from the notion of white fragility (DiAngelo, 2018), drop our defensiveness and our denial of racial difference and its impact? A more in-depth exploration of microaggressions and other mechanisms of racial minoritisation in the therapy context seems overdue.
  • Reducing Stigma: Using Avatars in Therapy with Autistic Adults from Black and Minority Ethnic Backgrounds. .....Ariana Jordan, Metanoia Institute; and Biljana van Rijn, Metanoia Institute
  • Research Aims The project is a preliminary examination of the feasibility and accessibility of virtual world technology in therapy sessions with autistic adults from Black and diverse ethnic backgrounds. Methods The project was a participative enquiry co-designed by an academic team working in partnership with community organisations and aiming to develop empowerment and inclusion at project levels. There were four therapists and five client participants who received therapy. All were trained in the use of virtual world technology. The therapists were also trained in working with autistic adults. The clients chose their aims for the therapy sessions and used the outcome measures: CORE-10, Agnew Relationship Measure (ARM5), and Rosenberg Self-Esteem Scale (RSES). In addition to that, the therapists and the clients were interviewed individually at the end of counselling to gather feedback on the accessibility, feasibility and effectiveness of the intervention. Results The preliminary findings showed that all participants, achieved lowered scores on CORE-10 during therapy but self-esteem and self-efficacy scores showed little variation. Scores on the therapeutic relationship were consistently high. The analysis of the interviews suggested that virtual world therapy was accessible and acceptable to this client group and there was some evidence of well-being outcomes, although the participant numbers were too low for more detailed conclusions. Implications The early suggestions of this research follow the findings in literature that virtual world therapies may be particularly suitable for this client group and avoid stigmatisation. Further research, with more participants is needed to examine the effectiveness of the intervention.
  • Racialised minority clients’ experiences of racial microaggressions in counselling. .....Naomi Moller, The Open University; Faisal Mahmood, Birmingham Newman University; Biljana van Rijn, Metanoia Institute; and Andreas Vossler, The Open University
  • Research Aims Racial microaggressions are subtle incidents in which a White person says or does something to a racially minoritised person that implies that they are inferior or which discounts in some way their identity, experience, or knowledge. Racial microaggressions are a class of ‘everyday racism’ that may not be recognised as such by those who enact them but which damage the mental health and wellbeing of those who receive them. There is little research on the impacts of racial microaggressions enacted by counsellors on racially minoritised clients, but the available evidence suggests that (1) they are common and (2) they negatively impact the therapeutic relationship and client engagement and counselling outcomes. Methods The study utilises a qualitative survey (with open-ended questions and some demographic items) and aims to collect data from racially minoritized adults aged 18+ who identify as having experienced racial microaggressions in counselling/ psychotherapy. Because of the sensitivity of the topic and to ensure participant anonymity, the survey is conducted online, with participants recruited through the Psychology subject pool of one of the participating universities as well as through snowballing. Results Data collection is ongoing but will be complete by the conference, which will allow findings to be presented. Implications This project responds to the lack of research on this topic generally and absence of any UK research. The core project aim is to inform practice for working effectively across racial and ethnic difference in counselling by supporting counsellors to avoid, recognise and repair therapist-enacted racial microaggressions.
  • Exploring Whiteness within the context of antiracist psychotherapy education: A narrative inquiry into therapists’ experiences. .....Frances Basset, Metanoia Institute, UK
  • Research Aims Despite years of commitment to diversifying and becoming more inclusive, the psychological professions remain largely white. Concerns were especially raised during the Covid 19 global pandemic, and as a result of the murder of George Floyd on 25th May 2020 in the USA. At this time, all the professional bodies re-committed to tackling racism within the profession. Being an under-researched area, the aim was to expose and deconstruct meanings of whiteness within the context of antiracist psychotherapy education. Methods From a starting point of critical realism and social justice, a narrative inquiry involving six semi-structured interviews were undertaken with a group of culturally diverse, experienced psychotherapists. Using a Listening Guide method of narrative analysis, responses to experiences of whiteness produced fourteen ‘contrapuntal’ voices across the group of six participants. The researcher included aspects of her heuristic journey into white identity. Results Themes associated with the different experiences of whiteness were evident with the most significant being ‘whiteness as violence’ experienced by all participants of the global majority. Whiteness as hegemonic orientation, whiteness as ambivalence, and a theme of conscientizing whiteness were also significant findings. Implications Voices that resist, expose, acknowledge and disrupt whiteness are linked to cycles of hope. Voices of compromise, assimilation, ambivalence, and ‘pushback’ are associated with a cycle of hopelessness. Ending the violence that colleagues of the global majority experience cannot be overstated and specific recommendations for psychotherapy education are offered.
Coffee Break
Thursday | 3:15 pm-3:45 pm | Aula
10. Intersection of Psychotherapy Research and Environmental Psychology (SPReduce) [Interest Section Meeting]
Thursday | 3:45 pm-5:15 pm | Online

Organizer: Serena Chen, Pennsylvania State University
11. Perspectives on the Therapeutic Relationship and Technique in Psychotherapy sessions [Panel/Symposium]
Thursday | 3:45 pm-5:15 pm | P24

Organizer: Vera Bekes, Yeshiva University, New York
  • Differentiating the real relationship from transference relationship. .....Henriette Löffler-Stastka, Medical University of Vienna, Austria; Vera Bekes, Yeshiva University, New York; Katie Aafjes-van Doorn, Yeshiva University; and Daniel S Spina, University of Pennsylvania, Philadelphia, USA
  • Objective: The Real Relationship (RR) has been conceptualized as the aspect of the therapeutic relationship in which patient and therapist are genuine and perceive each other realistically. Therapist countertransference/emotional reaction is theorized to be related to the RR, and interferes with the perception of a patient. Using a novel measure of the RR, the Real Relationship Psychotherapy Q-sort Prototype (RR-PQS; Spina et al., 2023), we aimed to explore the relationship between RR and countertransference/emotional reaction in three treatments for depression. Method: We applied the RR-PQS to existing observer-rated codings of psychotherapy process and therapists’ countertransference/emotional reaction in the Munich Psychotherapy Study (MPS; Huber et al., 2012), comprising 81 treatments and 634 sessions. Multilevel models disaggregated state-like and trait-like countertransference and related these to the RR over time. Results: Cognitive-behavioral treatment showed significantly higher resemblance to the RR-PQS prototype compared to psychodynamic and psychoanalytic treatments. Sessions characterized by therapists’ feelings of Disengaged, Helpless/Inadequate and Criticized/Mistreated countertransference had lower levels of RR. Positive countertransference feelings were related to higher levels of RR. Conclusion: Our results support that observer-rated RR relates to countertransference in theoretically expected ways. The RR may be more observable in CBT as compared to psychodynamic and psychoanalytic treatments.
  • Can we observe how real a relationship is? Development of an observer-rated real relationship measure for psychotherapy sessions. .....Vera Bekes, Yeshiva University, New York; Daniel S Spina, University of Pennsylvania, Philadelphia, USA; and Katie Aafjes-van Doorn, Yeshiva University
  • Objective: The Real relationship (RR) has been found to be positively related to treatment outcome, and to predict unique variance in outcome over and above the working alliance. Previously, the measurement of RR has been limited to self-report, therefore, our team developed two observer-rated measures: the RR-PQS (Spina, Bekes, & Aafjes-van Doorn) and the RR-O (Bekes, Spina, & Aafjes-van Doorn) to assess RR in therapy sessions. Whereas the RR-PQS was introduced in the previous paper, the present paper will present the development and first results with the RR-O. Method: We adapted items from the self-report measures to an observer rated measure, resulting in a 24-item RR-O. The RR-O was rated in 540 psychoanalytic and 30 AEDT treatment sessions that already had existing self-report RR and outcome scores. Results: The RR-O showed good internal consistency and good interrater reliability. In hierarchical EFA, items clustered into a general RR factor, and client realism, client genuineness, therapist genuineness, and therapist realism group factors. In addition, the RR-O was positively related to another RR measure and to the therapeutic alliance. Assessment of the relationship between the observer-rated and self-report RR, as well RR-O and treatment outcome is in progress. Discussion: The RR-O has shown initial reliability and validity so far and is a promising observer-rated measure of the RR to be used in post-hoc psychotherapy research.
  • Process guiding and process following therapist interventions. .....Michael Kelber, Medical University of Vienna, Austria
  • Objective: Psychotherapy approaches differ in their degree of guidance and directing on the micro process level. This difference seems to be one of the main distinctions between them. Thus, it is of paramount importance to enquire the effects of process guiding and process following therapist interventions on the client organism via micro process research. In this research logic, the direction taken in therapist interventions is currently of secondary interest. The focus lies purely on whether the therapist follows or guides away from the client’s last information content. In this regard, repeating the main content of the client’s last speech act or finding an image for it are considered process following. Cleary departing from the last information unit in the client’s speech act is considered process guiding, e.g. leading towards psychoeducation, a method or the therapist’s own feelings. Method: A directivity scale is produced, and its reliability evaluated. Once reliability is satisfying, transcripts of CBT- and psychodynamic psychotherapy sessions for depression treatment (BDI) are rated and compared. Directivity curves from beginning, middle and the end of the therapy process are matched. Additionally, an overall directivity curve is produced comparing the overall therapy process. The relevance of directivity on therapy outcome (BDI for depression) is, eventually, focused. Results will be presented and discussed. Clinical or methodological significance: A reliable directivity scale will allow for measuring effects of therapist behavior on the client, e.g. through transcript analysis, but also in the future via biological markers, such as heart rate variability and skin conduction measurements. Indications for clear therapist behavior at different stages of the therapy process might, thus, be improved.
Discussant:
  • Orya Tishby, Department of Psychology, The Hebrew University of Jerusalem, Israel;
12. Supervision and personal therapy: how do these processes differ and what is their impact on clinical work? [Panel/Symposium]
Thursday | 3:45 pm-5:15 pm | P31

Organizer: Greta Kaluzeviciute, Vilnius University
Moderator: Evrinomy Avdi, Aristotle University of Thessaloniki
  • The impact of psychotherapeutic supervision on clinical practice across different paradigms. .....Greta Kaluzeviciute, Vilnius University
  • Aim: This review seeks to identify paradigm-specific features of supervision and to determine whether there are any universal processes prevalent across a variety of paradigms. Methods: A narrative review has been conducted to review both empirical and theoretical sources on therapeutic supervision. An open search strategy has been chosen in order to incorporate as many inter-theoretical sources as possible. Results: The review has identified essential aspects of supervisory relationships within each paradigm, focusing on: a) the key features of the supervision process, b) the supervisor’s role and engagement in the supervision, and c) the primary interventions and factors contributing to the effectiveness of supervision. We identify features that are unique and specific to supervisory relationships in each of the paradigms, as well as features that are common to all three traditions. Discussion: Supervision in the psychoanalytic/psychodynamic tradition is distinguished by its focus on deep unconscious processes as well as supervisee's relational dynamics that influence clinical work. The cognitive model of supervision prioritises didactic feedback, learning and goal-setting transmitted through psychoeducation. Existential and humanistic traditions seek to establish a non-hierarchical and dialogical relationship between the supervisor and the supervisee. The dyad is known as that of "co-researchers" - equal participants in the supervision process who together analyse the depth of each other's experiences. Considering the theoretical underpinnings of each tradition, we discuss epistemological assumptions that could determine the effectiveness of supervision in the context of each therapeutic paradigm.
  • A qualitative meta-analysis examining the impact of supervision on personal and professional development in psychotherapists who work with minority clients. .....Hubert de Condé, Université catholique de Louvain
  • Aim: This study explored how supervision is experienced by psychotherapists who work with minorities, focussing on its positive and negative impact on clinical work as well as personal and professional development. The term 'minorities' encompasses any individual belonging to a category that faces difficulty or insecurity resulting from socio-cultural, ethnic, monetary, religious, gender, or sexual orientation aspects. Research indicates that psychotherapeutic work with minority clients requires the acquisition of a set of competencies and ways of being that allow therapists to be responsive to specific client needs in this population. Method: A systematic review of the literature led to the identification of published qualitative research studies. The findings from individual studies were subjected to grounded theory meta-analysis. Results: The analysis is still ongoing. The preliminary results might illustrate the beneficial but also the hindering aspects of the supervision process for therapists working with this population. The results will probably show that the supervision process must be undertaken with care to have a positive effect on the development of minority clients. Supervision seems to be the place where therapists can address some personal aspects within their clinical practice, such as the influence of their own majority or minority identity on their clinical work. They can also reflect on critical incidents occurring within their practice with such clients. Discussion: This study may help to understand the best ways for supervisors to support therapists who work with minority clients.
  • Effectiveness of supervision: psychodynamic supervisors' perspective. .....Neringa Grigutyte, Vilnius University
  • Aim: There is a lack of research on effectiveness of psychodynamic supervision with a particularly low number of studies following a qualitative research strategy. The aim of this study is to present data revealing psychodynamic supervisors' perceptions of what constitutes effective supervision in the initial phase of supervision process. Methods: 6 semi-structured interviews were conducted with senior supervisors from psychodynamic psychotherapy training programmes. Results: Thematic analysis revealed elements that supervisors perceive to be important for the effectiveness of supervision at the beginning of the supervision process: 1) setting and structure, 2) contact (including initial expectations, mutual respect, cooperative attitudes), 3) characteristics of supervisee (such as anxiety, openness, fear of evaluation), 4) supervisor characteristics (such as full acceptance, ability to respond to supervisee’s goals, attentiveness), 5) topics covered during supervision (from expectations to boundaries). Discussion: Given the specific context of the Lithuanian psychodynamic training programme in which students start supervision as part of their psychotherapeutic case and diagnosis training, supervision takes place in a teaching-learning setting. Results indicate that the supervisory relationship is ideally built on feelings of safety, while the supervisory alliance should allow an open discussion of therapeutic processes, including supervisee’s thoughts, feelings, and mistakes. The preparation for supervision for both the supervisor and the supervisee by sending a session description in advance is emphasized. Evolving relationship between supervisee and supervisor which also includes transference-countertransference elements will be further discussed, along with the impact that this study had on supervisor-supervisee dyads.
  • The benefit of having one’s own therapeutic space, separate from supervision: results from a qualitative meta-analysis on personal therapy. .....Jochem Willemsen, Université Catholique de Louvain
  • Aim: Although personal therapy (PT) is often no longer a mandatory requirement for becoming a psychotherapist, a personal psychotherapeutic experience is generally considered to contribute in a unique way to the training and development of reflective psychotherapists. The purpose of this study is to review qualitative evidence on the role of PT. Methods: A systematic review of the literature led to the identification of 21 published qualitative research studies on the role of PT. A team of researchers used a grounded theory meta-method to identify helpful and hindering experiences during PT. Results: Five clusters were identified: (1) PT helps to increase self-awareness in general and within the therapeutic relations; (2) PT helps to adopt a therapeutic approach by observing and experiencing the impact of therapeutic interventions; (3) PT helps to support patients in the therapeutic process on the basis of one’s own experience of going through a therapeutic process; (4) PT helps to become more confident and authentic as a therapist because it fosters self-acceptance; (5) PT hinders clinical work and personal and professional development through exposure to inadequate interventions and by stirring up personal issues. Several studies included testimonies from participants about the benefit of having a unique therapeutic space that is distinctly separate from that of clinical supervision. Discussion: These results will be compared with the clusters found in a recently published meta-analysis on helpful and hindering experiences during supervision. The impact of PT on psychotherapists’ work and development cannot be replaced by other training experiences or supervision.
Discussants:
  • Greta Kaluzeviciute, Vilnius University
  • Hubert de Condé, Université catholique de Louvain
  • Neringa Grigutyte, Vilnius University
  • Jochem Willemsen, Université Catholique de Louvain
13. Exploratory studies on emotions in psychotherapy [Panel/Symposium]
Thursday | 3:45 pm-5:15 pm | U23

Organizer: João Salgado, University of Maia, Portugal
  • Dynamics of self-positions and levels of emotional processing in a good outcome case of Emotion-Focused Therapy: A case study. .....João Salgado, University of Maia, Portugal; Carla Cunha, University of Maia, Portugal; and Patrícia Pinheiro, ISMAI
  • In both experiential therapies and dialogical theories of meaning-making, the relationship between changes in the self and emotional states is widely acknowledged. Previous research has consistently demonstrated a correlation between heightened levels of emotional processing and substantial symptomatic improvements over the course of therapy, as well as within individual sessions. Furthermore, therapeutic change frequently coincides with shifts in self-dynamics and narratives. However, the precise nature of the association between emotional processing and alterations in self-identity remains unclear. To address this gap, the present exploratory study adopts a microgenetic and developmental approach to investigate a successful case of Emotion-Focused Therapy (EFT). Integrating two observational techniques, Positioning Micronalysis and the Experiencing Scale (EXP), the study aims to examine moment-to-moment changes in “self-positions” and clients' capacity to engage in affective and cognitive exploration of inner experiences. By using these complementary methodologies, the research seeks to explore the interplay between emotional processing and shifts in self-identity within the therapeutic context. The findings may contribute to theoretical understanding and clinical practice in psychotherapy, providing insights into mechanisms underlying transformative change in individuals undergoing therapeutic intervention.
  • Focusing with Cancer Patients: A Pilot Study of a Brief Online Group Intervention. .....Marta Gomes, University of Maia, Portugal; Eunice Silva, IPO-Porto; and João Salgado, University of Maia, Portugal
  • Focusing-Oriented Psychotherapy has had a long history and influence on psychotherapy. By “clearing a space” and “focusing”, individuals can enhance their emotional awareness and improve their ability to self-regulate. These tasks are particularly relevant in the context of Psycho-Oncology, although the research on their potential benefits for cancer patients is limited. Furthermore, the application of these tasks in a group or online setting has not been thoroughly explored. This study aimed to examine the effectiveness of a two-session online intervention based on Focusing for cancer-diagnosed participants and its impact on their mental health and well-being. The study involved three participants with a diagnosis of colorectal cancer who were undergoing palliative treatment. We used both qualitative and quantitative methods. PFC-2 was used to assess participants’ accomplishment of the task; FMS was used to assess the change in the focusing attitude, while CORE-OM and EPEP were used as mental health distress and psychological well-being measures; participant feedback was collected through questionnaires and a semi-structured interview. The results suggest that the tasks led to greater self-awareness, heightened self-reflection, and a sense of relief for the participants. These findings suggest that the group intervention protocol based on online Focusing sessions is potentially useful for broader applications.
  • Empty-Chair Task for Interpersonal Emotional Injury: Randomized Pilot Study of a Brief Online Group Intervention. .....Alexandra Paiva, University of Maia, Portugal; Marina Monteiro, University of Maia, Portugal; Marta Gomes, University of Maia, Portugal; and João Salgado, University of Maia, Portugal
  • Objective: This study investigates the feasibility and adequacy of an online group-based protocol intervention that uses the Empty Chair Task (EC) to address unresolved interpersonal emotional injuries with a significant other. The study aimed to evaluate the specific effects of EC on unfinished business resolution, participants’ affect towards the significant other, mental health symptoms, and psychological well-being.­ Method: Eleven participants (non-clinical/mild population) were randomly assigned to either an experimental or wait-list control group. The intervention consisted of 2 weekly two-hour online sessions. The study used several assessment measures for unfinished business resolution (UFBRS and PANAS) and for overall mental health and well-being, as well as open-ended questions. Repeated measures ANOVA was computed to compare the study variables between the groups and time interactions, spanning from the beginning of the intervention to the follow-up assessment. Results: Findings indicate that the intervention protocol was potentially more useful compared to the control group in a wait-list condition for resolving unfinished business, indicating emotional relief towards the significant other, and reducing anxiety symptoms. Conclusion: The study provides preliminary evidence that a brief online group intervention can be effective in resolving unfinished business with a significant other. However, further validation of these findings is required.
14. Beyond the Textbook: Deep Dive into Psychotherapy Higher Education and Research Culture [Panel/Symposium]
Thursday | 3:45 pm-5:15 pm | U32

Organizer: Erzsebet Fanni Toth, Sigmund Freud University, Vienna, Austria
Moderators: Erzsebet Fanni Toth, Sigmund Freud University, Vienna, Austria; Martin Kuska, Sigmund Freud University, Vienna, Austria;
  • “Dancing at the Seashore Between Coming Out & Staying in the Closet” Contact modifications used by Iranian homosexual men, in a relationship with a woman in their coming-out process from a gestalt therapeutic point of view. .....Masoud Eshagi, Sigmund Freud University, Vienna, Austria
  • This is a presentation of an article as a part of a broader study that aims to discuss the topic of "coming-out process among Iranian homosexual men, in a relationship with a woman, from a gestalt point of view". In this presentation and the related article, the focus is on gestalt contact modifications between their homosexual identity and other people in the field. It is discussed which contact modifications participants used to modify the contact between their homosexuality and certain people, in which stage(s) of the contact cycle (Clarkson, 1989) it happened, and the way it was done, which has been interpreted as a certain contact modification. The contact modifications (Mann, 2010; PHG, 1951) basically consist of desensitization, deflection, introjection, projection, confluence, retroflection and egotism. The research was carried out through the phenomenological method with the purpose of studying a specific aspect of the lived experience of participants. The gathered data from unstructured interviews was analyzed in an inductive manner based on the grounded theory method. The sample consisted of eight homosexual men (research criteria: self-definition as homosexual man, with Iranian origin and socialization, over 18 years old). The results can help such people in the previously mentioned community to have a deeper insight into their situation by being informed about the experiences of others, psychotherapists and health professionals to understand such clients better for offering a more efficient accompaniment on their coming-out process and researchers of different related fields to use it as a start point for further studies.
  • “And how is it in your country?” –With supervision towards a trauma-Informed Higher Education. .....Erzsebet Fanni Toth, Sigmund Freud University, Vienna, Austria
  • This presentation examines the implementation of trauma-informed practices within a graduate psychotherapy research workshop at Sigmund Freud University in Austria, focusing on a multicultural classroom setting. The frequently used prompt, "How is it in your country?" is critically analysed to reveal its potential to deepen understanding of trauma's impact on learning and well-being. While this question aims to bridge cultural divides, it can inadvertently trigger dislocation and identity struggles for students from war-affected regions like Russia and Ukraine. The presentation advocates for a trauma-informed higher education framework that supports students with posttraumatic experiences, emphasizing the need for educators to recognize and address the effects of trauma on academic engagement and mental health. Reflective supervision is highlighted as a vital tool for faculty development, grounded in trauma-informed care principles such as safety, transparency, mutuality, voice, and choice. This process facilitates educators' exploration of their reactions to student trauma and the development of strategies for managing complex classroom dynamics. By fostering self-reflection and peer support, reflective supervision equips faculty to implement trauma-informed practices confidently, ultimately enhancing the learning environment and bridging the gap between psychotherapy theory and practice in supporting both student and faculty well-being. (Key words: trauma-informed higher education, supervision, psychotherapy)
  • Results of the participatory observation of the process of reaccreditation of the international faculty of psychotherapeutic science from the perspective of its vice-dean for research: First person’s account / Introspective case study.. .....Martin Kuska, Sigmund Freud University, Vienna, Austria
  • This contribution reports on a project of re-accreditation of the Faculty of Psychotherapy Science at the Sigmund Freud University (SFU), which operates in Vienna, Berlin, Paris, Linz and Ljubljana. It summarises two years of participatory observation conducted by the Vice Dean for Research, who is responsible for the area of psychotherapy research in the context of the Austrian state accreditation of this faculty. The goals, strategies and results of the reaccreditation process in the arena of psychotherapeutic research will be presented and interpreted in the context of international criteria for the evaluation of research outputs, the requirements of the state accreditation board and the visions and motivations of colleagues and fellow researchers. Within its time limit, the presentation will also touch upon the topics of interdisciplinarity of psychotherapy research, the possibilities of cooperation among own international network of psychotherapeutic outpatient clinics and the different legislative situation in the field of psychotherapy in various countries where the Faculty operates (Austria, Germany, Slovenia, France). Since the Faculty of Psychotherapy Science at SFU is a unique institution providing academic training and research in seven psychotherapeutic modalities, psychoanalysis, integrative gestalt therapy, systemic family therapy, cognitive-behavioral therapy, psychodrama, existential analysis, and individual psychology, this contribution also questions the future of such a diverse landscape of psychotherapeutic modalities in relation to their academisation, which is necessarily connected to the practising of psychotherapeutic research. The presentation of the results of this participatory observation provides broader implications in the areas of the development of research strategies in psychotherapy, including its aims, their integration into bachelor's, master's and doctoral degree study programmes in psychotherapeutic science and the following career paths of psychotherapists.
  • Violent extremism: Cross cultural perspectives and implications for psychotherapists. .....Denis Mekolle, Sigmund Freud University, Vienna, Austria
  • Violent extremism poses a worldwide danger to peace and security, necessitating comprehensive awareness and concerted response by governments, civil society organizations, and international partners. Sociocultural hazards are predictive of violent extremist tendencies, particularly in non-Western civilizations and in connection with the stigmatization of religion. Altering the narrative around violence and lowering engagement in violent conflicts entails the implementation of sustainable cultural, political, and economic reforms. Governments, civil society organizations and stakeholders are attempting to establish a context-based reality of violent extremism and put in place counter violent extremism policies. Complex psychological mechanisms that are influenced by a range of factors underly radicalization and violent behavior leading to terrorism. Psychotherapy plays a crucial role in understanding the psychological mechanisms that underly radicalization and violent behavior and assists in developing programs to counter violent extremism. The Achilles heel of mental health delivery for developing nations include inadequate mental health staffing, sociocultural stigma, and government insufficient policies and funding hindering Counter Violent Extremism measures.
Discussants:
  • Denis Mekolle, Sigmund Freud University, Vienna, Austria
  • Masoud Eshagi, Sigmund Freud University, Vienna, Austria
  • Martin Kuska, Sigmund Freud University, Vienna, Austria
  • Erzsebet Fanni Toth, Sigmund Freud University, Vienna, Austria
15. Alliance [Brief Paper Session]
Thursday | 3:45 pm-5:15 pm | U33

Moderator: Celia Faye Jacobsen, University of Copenhagen, Denmark
  • Comparing Therapeutic Alliance Strengths and Trajectories in Different Types of Therapies. .....Pelinsu Bulut Özer, Istanbul Bilgi University; and Sibel Halfon, Istanbul Bilgi University
  • Therapeutic alliance is viewed as one of the core mechanisms that predict symptomatic change in child psychotherapy. Previous literature shows that alliance may function differently in different types of therapies. This current study was part of a randomized controlled trial investigating the effectiveness of Mentalization-based Therapy for Children (MBT-C) compared to a Parenting and Child Social Skills Group (PSSG). Participants were 193 children (103 in MBT-C group, 90 in PSSG group) aged between 5-12 who applied for the randomized controlled trial with emotional/behavioral problems. Observer-rated alliance measurements were gathered at three different time points from both therapy groups in order to compare alliance strengths and trajectories. We hypothesized that PSSG group will have a significantly higher alliance strength (mean) and that both groups will show a similar linearly increasing trajectory of alliance throughout therapy. In addition, we expected alliance strength to predict the change in outcome. Multilevel modeling analysis results showed that hypotheses were partially supported: PSSG group did show higher alliance strength however there was a linear decrease in alliance overall. Mean alliance scores significantly predicted symptomatic change as measured by Child Behavior Checklist Total Problems score. Results on alliance strength and trajectories are discussed in relation to different therapy types and future directions are indicated.
  • Capturing both sides of the therapeutic dyad: A validation study of the revised Rupture Resolution Rating System (3RSv2022). .....Jenny Lou Eis, International Psychoanalytic University Berlin, Germany; Christian Sell, International Psychoanalytic University Berlin; Günther Klug, Technical University Munich, Germany; J. Christopher Muran, Adelphi University, New York, USA; and Dorothea Huber, International Psychoanalytic University Berlin
  • Background: The clinical importance of rupture-repair for the patient-therapist alliance has been demonstrated repeatedly, but underlying processes require further investigation. To address this, the recently revised Rupture Resolution Rating System (3RSv2022) is the most promising observer-based measure for assessing patient and therapist contributions to ruptures and repairs. Therefore, this study aims to establish the 3RSv2022’s interrater-reliability and examine its convergent validity by relating it to two construct-near measures: patient emotional experiencing and session quality rated by psychotherapists. We aim to test the hypotheses that the 3RSv2022 successfully predicts session quality and in-session emotional experiencing. Method: The sample consisted of N=67 patients from the Munich Psychotherapy Study, who were diagnosed with depressive disorders and received long-term psychoanalytic, psychodynamic, or cognitive-behavioral psychotherapy. 242 audio-recorded sessions were rated using the 3RSv2022, while patient experiencing was assessed with the Experiencing Scale. Interrater-reliability for the 3RSv2022 was examined using Gwet’s Agreement Coefficient at the level of 5-minute segments and for the entire session. The relationship between the 3RSv2022 variables, experiencing, and session quality was examined using mixed models to account for nested data. Results: Initial findings suggest that in its application to audio-recorded sessions, the 3RS v2022 is a reliable measure, demonstrating moderate to excellent interrater-reliability. The 3RSv2022 variables successfully predicted patient experiencing and session quality. Conclusion: This study provides an important contribution to validating the 3RSv2022 as an observer-rated measure for comprehensively capturing rupture-repair processes in process-outcome research. Our findings serve to strengthen the reliability of the 3RSv2022 for its application to audio-recorded sessions.
  • Therapeutic alliance and its relation with structure of personality organization among patients diagnosed with anxiety and personality disorders. .....Joanna Mostowik, Jagiellonian University, Kraków, Poland; Michał Mielimąka, Jagiellonian University Medical College; and Krzysztof Rutkowski, Jagiellonian University, Kraków, Poland
  • Background: Most empirical studies demonstrate a link between higher level of personality organization and better treatment outcomes, such as symptom reduction and improved psychosocial functioning. This can hypothetically be attributed to the therapeutic alliance. However, the available empirical analyses lack data verifying the relationship between the level of personality organization and the quality of the therapeutic alliance. The aim of the study is to present this phenomenon. Methods: Data were obtained from 81 patients diagnosed with anxiety and personality disorders (ICD-10 groups: F4x, F60.x and F61) treated in intensive short-term group psychotherapy combined with individual psychotherapy at the Department of Psychotherapy University Hospital in Krakow. All variables were measured at the beginning and end of the treatment, while the therapeutic alliance (TAQ 36-2) was also measured in between. The patients also completed the Inventory of Personality Organization. The outcomes of the psychotherapy were measured with OQ 45.2. Results: According to preliminary hypotheses, it has been demonstrated that the level of personality organization is associated with the overall assessment of the quality of the therapeutic alliance at each phase of the treatment, as well as with the patterns of alliance development throughout the treatment process. Additionally, the analysis showed that the pre-treatment level of personality organization moderates the relationship between the therapeutic alliance assessed at the end of treatment and the final outcomes. Conclusions: The data obtained indicate the complex development of the therapeutic alliance during intensive, short-term group psychotherapy. The results provide useful information, deepening the understanding of patient functioning during treatment.
  • The Effect of Therapist Self-representations, Professional Self-doubt, and Coping Strategies on the Process and Outcome of Psychotherapy. .....Celia Faye Jacobsen, University of Copenhagen, Denmark; Fredrik Falkenström, Linnæus University; Susanne Lunn, University of Copenhagen, Denmark; Libby Igra, Copenhagen University; Karen-Inge Karstoft, University of Copenhagen, Denmark; Jan Nielsen, University of Copenhagen, Denmark; and Stig Poulsen, University of Copenhagen, Denmark
  • Aims: The first aim of this study is to replicate previous research findings that higher levels of therapist professional self-doubt (PSD), when interacting with a loving self-affiliation, are associated with improved alliances and symptoms in therapy, and to expand upon this finding by exploring whether the positive effect of PSD might be similarly moderated by lower levels of anxious or avoidant therapist attachment. The second aim of the study is to replicate previous research findings that higher levels of PSD, when interacting with less practice experience, are associated with alliance and symptom deterioration. The final aim of the study is to explore whether the effect of PSD on alliance and symptom change is moderated by the therapist’s use of either constructive or avoidant coping strategies in therapy. Methods: The study examines approximately 500 adults seeing 50 therapists in individual psychotherapy. The associations between professional self-doubt as predictor, self-affiliation, attachment style, years of experience and constructive or avoidant coping as moderators, and rates of change in alliance and affective symptoms as outcome, are analyzed using multilevel growth curve modeling. Results and Discussion: The statistical analyses are ongoing and will be finalized before the conference. The study results and their clinical implications will be presented and discussed at the conference.
Coffee Break
Thursday | 5:15 pm-5:45 pm | Aula
16. Approaches to predict outcomes in psychological treatments: insights from factorial mediation analysis, Psychopathology Networks, and Routine Outcome Monitoring [Panel/Symposium]
Thursday | 5:45 pm-7:15 pm | P24

Organizer: Rodrigo Teixeira Lopes, University of Bern, Switzerland
  • What mediate outcomes of internet-based cognitive-behavioral therapy for social anxiety disorder? Results from a factorial design. .....Rodrigo Teixeira Lopes, University of Bern, Switzerland; Dajana Šipka, University of Bern, Switzerland; and Thomas Berger, University of Bern, Switzerland
  • Social Anxiety Disorder (SAD) is the third most common mental disorder and is highly impairing. Although evidence-based psychological treatments exist, there is a lack of understanding about how they work. The goal of this presentation is to examine the possible mediation role of five hypothesized mechanisms of change (i.e., knowledge gain of SAD, decrease of dysfunctional social cognitions, decrease of self-focused attention, decrease of avoidance of social situations, and decrease of the use of safety behaviors) in reducing symptoms of SAD after doing an internet-based CBT program. In this factorial trial, 464 participants diagnosed with SAD received an internet-based program called Shyne for 8 weeks with minimal guidance. The program is composed of four typical CBT components for treating SAD (psychoeducation, cognitive restructuring, attention training, and exposure). These components were combined in sixteen conditions, allowing us to compare the intention to treat effects of each component alone (n = 232) against its absence (n = 232). Mediation analysis by employing bootstrapping to estimate indirect effects and their confidence intervals were used. Results will be presented and discussed.
  • Network flow and network feedback – a new approach to measure psychopathology in symptom networks and predict therapy outcome. .....Hanna Deflorin, University Hospital, Heidelberg, Germany; Markus Moessner, Center for Psychotherapy Research, Heidelberg University Hospital; and Stephanie Bauer, Center for Psychotherapy Research, Heidelberg University Hospital
  • In network theory, psychopathology is based on the patterns of causal relationships between symptoms. It is hypothesized that denser network structures, in which symptoms cause and reinforce each other, are associated with pathology. Yet, current network measures, like network strength, do not take structural aspects into account. In this work, we propose two new measures, network flow and network feedback, that quantify indirect effects between symptoms based on higher order adjacency matrices, and explore their predictive value for treatment outcome. A transdiagnostic sample of N = 1533 patients was assessed at intake and discharge from inpatient treatment. Treatment was classified into successful and unsuccessful based on outcome (median split on the change in psychological distress from admission to discharge). Transdiagnostic symptom networks at the time of admission were estimated separately for the groups. Network flow, network feedback and global strength were calculated. Based on bootstrapping procedures and permutation tests we compared them in respect to sensitivity and specificity in outcome classification, and statistical significance of group differences. Network flow and network feedback resulted in higher sensitivity, specificity and greater statistical significance of group differences. The two measures proved to be largely independent of global strength and outperformed it in predicting unsuccessful treatment. Network strength as a measure of overall pathology proved insufficient. Taken the structures of relationships between symptoms into account
  • Predicting early dropout in the treatment of substance use disorders: A longitudinal multicenter study of Routine Outcome Monitoring (ROM) data. .....Heidi Brattland, Norwegian University of Science and Technology, Tordheim, Norway; Øyvind Grindheim, Norwegian University of Science and Technology, Tordheim, Norway; and Christian Moltu, Department of Psychiatry, District General Hospital of Førde, Førde, Norway
  • The use and abuse of substances may have wide-reaching consequences for individuals’ physiological, cognitive, emotional, relational, and social functioning, and as such, might represent additional challenges to psychological treatment. For instance, dropout rates have been reported to be higher in SUD treatment than in mental health care. Yet the treatment of substance use disorders (SUDs) remains understudied. Capitalizing on the clinical implementation of a patient feedback measure, this study investigates SUD treatment as it unfolds over time in naturalistic settings, aiming to identify predictors of early treatment dropout. Participants are 700 patients across five SUD treatment facilities and one mental health clinic. The data material consists of session-by-session responses to the Norse Feedback system. Dimensions assessed are Symptom expression (seven subscales), Sustaining factors (eight subscales), Consequences (two subscales), Resources (three subscales), Alliance, and Needs in treatment. The analyses will seek to identify predictors of early dropout (sessions 1-6) among intake characteristics and treatment process indicators, such as the development of the alliance, symptoms, and sustaining factors. Implications for clinical practice and recommendations for future research will be discussed.
Discussant:
  • João Tiago Oliveira, University of Minho;
17. New measurements of client & therapist factors in session [Panel/Symposium]
Thursday | 5:45 pm-7:15 pm | P31

Organizer: Rudolf Agner, Medical University of Vienna, Austria
Moderator: Henriette Löffler-Stastka, Medical University of Vienna, Austria
  • Applying the Levels of Emotional Awareness Scale to transcripts of psychotherapy sessions. An exploratory case study. .....Rudolf Agner, Medical University of Vienna, Austria; Jürgen Fuchshuber, Medical University of Vienna, Austria; and Henriette Löffler-Stastka, Medical University of Vienna, Austria
  • Objective: The Levels of Emotional Awareness Scale (LEAS) is a well-established research instrument to measure Emotional Awareness. The software VETA allows one to rate large amounts of data according to LEAS rules. This creates opportunities to investigate shifting, “state” aspects of Emotional Awareness but requires the development of an adequate methodology. This study contributes to this development. Method: We conducted a case study of using VETA to rate transcripts of trainee psychotherapists diagnosing actors playing psychiatric patients and looked at the rating’s relationship to diagnostic success Results: VETA’s detection rate for German words relevant to LEAS scoring was improved by 42 % by expanding the existing wordlist to include more grammatical inflections of existing keywords. The LEAS scores generated from dialogue transcripts cannot be seen as analogous to scores achieved within the LEAS test, i.e. measures of Emotional Awareness. Transcript-scores rather measure a way of using language indicative of Emotional Awareness and shall therefore be called “emotion word repertoire”-scores (EWR).
  • Initiating sustaining structural changes. .....Ursula Narath, Medical University of Vienna, Austria; and Henriette Löffler-Stastka, Medical University of Vienna, Austria
  • Background: Psychoanalytic research provides evidence that high-dose psychoanalysis produces long lasting therapeutic success. Different research designs have shown positive results on the symptom level and psycho-structural changes. Further research was undertaken to find if the improvement stated in the outcome studies is lasting. It was even found in individual studies that after the end of analysis a positive development has continued. Objective: In this study the correlation between analytic interventions and patient’s changes of psychic structure is investigated. The hypotheses formulated intend to prove that interventions based on psychoanalytic core competencies bring about greater psychic flexibility. Method: We use audios of therapy sessions from the Munich Psychotherapy Study, (Huber & Klug, 2016), take already existing data into account and generate additional data using the “Psychoanalytic Core Competency (PCC) Q-Sort” which enables us to draw conclusions on the transformation of personality functioning. The sample contains ratings established with the “Psychotherapy Process Q-Set” aimed at measuring the process of a single therapeutic session from the perspective of the analyst, the perspective of the patient concerning characteristic categories and dyadic interactional data. The same cohort is checked with the “Psychoanalytic Core Competency (PCC) Q-Sort”. We rate sessions at the beginning, in the middle phase and at the end of analysis and correlate them with the initial data of the Munich study. Results concerning the psychoanalysts’ ability to provide their psychoanalytic core competencies to progress and sustain psycho-structural change and changes in personality functioning are presented and discussed.
  • Identifying changes of prosodic voice characteristics of patients with depression during long term therapy.. .....Christoph Holzweber, Medical University of Vienna, Austria
  • Objective: Our voice is a central component in interacting with the world and a major factor defining the relationship between patient and therapist. The complex system enabling us to produce a vocal tone is influenced by several physical and psychological components and inevitably transports information about our feelings and emotions. Especially the voice of patients with depression is often described as muted and monotone. An examination of voice and its prosodic characteristics can be achieved in different ways. This research focusses on the evolution and change of the fundamental vocal frequency of patients with depression during long lasting psychotherapy. Method: A method was produced to identify the fundamental frequency of sequences of sessions recorded by the Munich Psychotherapy Study, (Huber & Klug, 2016). This method was applied to multiple sequences from the psychotherapies of 25 individual patients. Sessions were selected from the beginning of therapy and from the end of therapy. Phonetic analysis was performed by software. The output of the analysis is then crosschecked with the output parameters (BDI for depression) and converted into a formula to calculate a ratio between fundamental frequency and BDI rating scores. Results will be presented and discussed on the overall scope and drilled down for specific patients. Conclusion: Voice is individual and there are several studies considering voice a biomarker of health. Focusing on the change of voice parameters of depressed patients will provide an additional, objective measurement of patient’s progress during psychotherapy.
Discussant:
  • Irene Messina, Mercatorium University;
18. Interpreter-mediated psychotherapy: Benefits and challenges [Panel/Symposium]
Thursday | 5:45 pm-7:15 pm | U23

Organizers: Claudio Scarvaglieri, Lausanne University, Switzerland; Peter Muntigl, Ghent University, Belgium; July De Wilde, Ghent University, Belgium;
  • The challenges of building the therapeutic alliance in interpreted psychotherapy. .....Anne Delizée, University of Mons
  • In bilingual mental health settings, the interpreter ensures interlinguistic transfer and may exercise cultural agency (Leanza et al. 2014). According to some studies (Goguikian Ratcliff et al. 2019), the interpreter may also co-create the therapeutic alliance (TA). This issue, which has been largely understudied until now, is crucial, as research in monolingual settings clearly shows that the effectiveness of care is determined by the establishment of a positive TA, regardless of the underlying theoretical model (Falkenström et al. 2013). The objective of this communication is therefore to help identify the structural, organisational, identity and interactional factors that either positively or negatively influence the TA in interpreter-mediated psychotherapy (IMP). In particular, the discursive elements that favour the establishment of a positive TA will be highlighted through the thematic analysis of 19 semi-structured interviews and the discursive analysis of an interpreter-mediated therapeutic conversation (Brown and Levinson 1978; Kerbrat-Orecchioni 1992). The results show that the interpreter actively co-weaves a supportive relationship in each of the three dyads, with the dyads influencing each other. The analysis illuminates the type of speech acts and of paraverbal and non-verbal elements performed by the interpreter for the benefit of TA. An understanding of discursive, cognitive, and emotional procedural mechanisms that constitute TA in IMP, as well as the influence of the interpreter on the formation of a positive TA, will enhance the quality of care and prevent treatment breakdowns in the migrant clinic.
  • Understanding Interpreter-mediated psychotherapy: Findings from interviews and interaction analysis. .....July De Wilde, Ghent University, Belgium; Peter Muntigl, Ghent University, Belgium; and Claudio Scarvaglieri, Lausanne University, Switzerland
  • Outline and Questions: This paper presents preliminary findings from on ongoing research project on interpreter-mediated psychotherapy. We investigate how therapists perceive the specific benefits and challenges of this setting and which conversational methods they employ to manage the therapeutic relationship (Norcross & Lambert 2018) in a situation in which no direct verbal communication between therapists and patients is possible (cf. Scarvaglieri & Muntigl 2022). Data: Data stem from two different sources from the Flemish region of Belgium: 11 semi-structured interviews with therapists and interpreters about interpreter-mediated therapy and 10 recordings of therapy sessions with an interpreter. The patient’s and interpreter’s native language is Arabic. The interpreter and therapist communicated in English. The treatment method is systemic therapy. Methods: We use qualitative content analysis (Mayring 2010) and grounded theory (Glaser & Holton 2004) to examine topics identified by interviewees in the interview data. We draw on conversation analysis to examine the verbal and non-verbal contributions used during the therapy sessions (Sidnell & Stivers, 2013). Results: From our interview data, we were able to identify benefits and challenges of working with interpreters. Benefits include a slower conversational pace – due to the need for translation – leaving the therapist more time to observe client behavior. Challenges, on the other hand, included issues of trust in the interpreter and an inability to intervene directly, while the client is talking. Analyses of the interactional data demonstrate how therapists work with and through such challenges; e.g., using non-verbal resources more expressively and addressing alliance ruptures more explicitly.
  • Interpreting in psychotherapy: Reflecting language- and self-understanding. .....Kristin Bührig, Hamburg University; and Anna Wamprechtshammer, Hamburg University
  • The relevance of multilingual psychotherapy for migrants is becoming increasingly apparent due to current demographic developments. It is therefore essential that mental health care for clients is promoted in the official language or a common lingua franca, regardless of language competence. Although interpreters often serve to bridge the language barrier between therapists and patients, current research indicates that it is not a standard practice for therapists to work with interpreters or language mediators. In an interview study conducted by Gartner et al. (2024), psychotherapists named structural as well as subjective barriers and concerns that may prevent the use of interpreters. In the context of an exploratory contribution at the interface between psychotherapy (process) and professional research, dimensions of the interlocking of professional self-understanding and language understanding will therefore be examined based on topic-focused expert interviews. The expert interviews were conducted in accordance with the ideas of episodic interviews (cf. e.g. Flick 2011) which involved the use of a series of stimuli, such as questions or quotes, to encourage reflection on the interaction process within IMP. The objective of this study is to find out the extent to which a decision against cooperating with interpreters is influenced by the self-perception of the therapeutic activity. Furthermore, the po-tential benefits and risks of IMP are considered in greater depth. Additionally, the differences perceived by the actors between interpreting in psychotherapy and other discourses are also addressed. To this end, extracts of the transcribed data are presented and analysed linguistically (cf. e.g. Rehbein 2001).
Discussant:
  • Jarl Wahlström, University of Jyväskylä;
19. Psychotherapy training: Developmental processes and the impact of training elements [Panel/Symposium]
Thursday | 5:45 pm-7:15 pm | U32

Organizer: Ulrike Willutzki, Witten/Herdecke University, Germany
  • Trainees’ Developing Experiences of Healing Involvement and Stressful Involvement: A Longitudinal Analysis. .....Armin Hartmann, University Clinic of Freiburg, Germany; David Orlinsky, University of Chicago, USA; Ulrike Willutzki, Witten/Herdecke University, Germany; Helge M. Ronnestad, University of Oslo, Norway; and Thomas Schroder, University of Nottingham, UK
  • Aim. The SPR Interest Section on Therapist Training and Development (SPRISTAD) longitudinal study of psychotherapy trainees aims to delineate and understand the processes by which candidates for training become professional psychotherapists. One way we assess this is by tracking trainees’ experiences of Healing Involvement (HI) and Stressful Involvement (SI) in their therapeutic work over time, as well as the circumstances that under which changes in their work occur. This paper presents initial findings on the longitudinal analysis of trainees’ currently experienced development. Method. Reliable muti-item scales of Healing Involvement and Stressful Involvement were included in the SPRISTAD study’s Trainee Current Practice Report (TCPR) to assess the quality of trainees’ therapeutic work experience. Levels of HI show the extent to which therapists perceive themselves as skillfully, warmly, and effectively interacting with their patients; capable of coping constructively if difficulties arise; and deeply interested and absorbed in their work. Levels of SI show the extent to which therapists find themselves having difficulties in practice; coping non-therapeutically with those difficulties (e.g., by blaming patients, or avoiding dealing with them); and experiencing anxiety or boredom in sessions. HI and SI were assessed at 3 (or 4) six month intervals for 148 trainees who provided data for at least 3 timepoints. Results. Hierarchical linear models show that HI generally starts at high levels and increases over time. SI starts at low levels and still decreases moderately. Predictors of change are explored and reported. Discussion. Implications for training and practice will be discussed.
  • The influence of supervision on work experience and development of psychotherapists in training. .....Jan Pirke, University Witten/Herdecke; Ulrike Willutzki, Witten/Herdecke University, Germany; Helge M. Ronnestad, University of Oslo, Norway; and David Orlinsky, University of Chicago, USA
  • Introduction: A central objective of supervision is to facilitate professional development of supervisees at all levels of experience (Knox, & Hill, 2021). Professional development of psychotherapists can be conceptualized as changes in skillfulness, attitudes, cognitive capacities, emotional and interpersonal functioning as well as vocational identity (Rønnestad et al. 2019). Method: In the international SPRISTAD study 144 trainees from 11 different countries rated their supervision and work experience in the beginning of their therapeutic work with patients, after 6, and after 12 months. Supervision experience was measured with 4 items, assessing trainees’ satisfaction with supervision resp. the impression of receiving support or criticism from supervisors. The relationship between supervision and trainees' experience of therapeutic work is examined using correlational and regression analyses. Results: Supervision experiences show substantial correlations with various aspects of trainees’ practice (e.g. perceived difficulties, coping strategies, skills). Moreover, perceived support from supervision at the beginning of training is a predictor for many aspects of positive professional development after one year into training. Discussion: Implications for training and professional development will be discussed. References Rønnestad, M. H., Orlinsky, D. E., Schröder, T. A., Skovholt, T. M., & Willutzki, U. (2019). Professional development of counsellors and psychotherapists: Implications of empirical studies for supervision, training and practice. Counselling and Psychotherapy Research, 19 (3), 214-230. Knox, S., & Hill, C. E. (2021). Training and supervision in psychotherapy. In M. Barkham, W. Lutz, & L. G. Castonguay (Eds.), Bergin and Garfield’s handbook of psychotherapy and behavior change (pp. 327–349). Wiley.
  • Developing Therapist Self-Efficacy in Clinical Psychology Students: A Randomized Controlled Study of an Apprenticeship Training. .....Steffen André Fagerbakk, Norwegian University of Science and Technology, Trondheim, Norway; Heidi Brattland, Norwegian University of Science and Technology, Tordheim, Norway; Nina Jakhelln Laugen, Norwegian University of Science and Technology, Tordheim, Norway; and Truls Ryum, Norwegian University of Science and Technology, Tordheim, Norway
  • Objective. Therapist self-efficacy has been identified as a factor that influences therapists’ clinical performance and job-satisfaction. For trainees, their therapist self-efficacy is also important for motivation and learning. The objective of the current study was to investigate if an apprenticeship training intervention for clinical psychology students can increase therapist self-efficacy compared to training-as-usual, in their first year of education. Method. First year students of clinical psychology (n = 107) were recruited and randomized to either a) training-as-usual or b) training-as-usual plus an apprenticeship intervention. In the apprenticeship the students participated in one therapy session per week with various professional therapists for 10 weeks. Students in both groups self-reported therapist self-efficacy and stress before and after the intervention phase. Additionally, students in the intervention group self-reported levels of therapist self-efficacy and stress in relation to each therapy session they attended in the apprenticeship training. Results. Students’ therapist self-efficacy increased significantly for participants in the apprenticeship training group from pre to post, whereas no significant change was observed for participants in the control group. Apprenticeship training also led to decreasing levels of stress during the training period, but this was not correlated with therapist self-efficacy. Discussion. The results suggest that apprenticeship training may improve therapist self-efficacy and reduce stress in undergraduate trainee therapist during their first year of training and could therefore be a viable add-on to the more traditional teaching forms typically employed at this stage.
Discussant:
  • Anton-Rupert Laireiter, Paris-Lodron-University Salzburg;
20. Anxiety [Brief Paper Session]
Thursday | 5:45 pm-7:15 pm | U33

Moderator: Danielle Mullins, Universitat de Barcelona, Spain
  • Efficacy of Emotion-Focused Therapy in the treatment of anxiety and depression in university students: experimental study. .....Petr Mikoška, Palacký University Olomouc; Ľubor Pilárik, Matej Bel University in Banska Bystrica; Lukáš Novák, Palacký University Olomouc; Michaela Ladmanová, Masaryk university; Martin Fülep, Palacký University Olomouc; Tomáš Bok, Palacký University Olomouc; and Ladislav Timuľák, Trinity College, Dublin, Ireland
  • Emotion-focused therapy (EFT) is an evidenced-based humanistic therapeutic approach whose efficacy has been successfully verified in the treatment of depression or complex trauma. It has also shown promising results in the treatment of anxiety or eating disorders. Within the study, the intervention followed the transdiagnostic model (EFT-T), which integrates EFT adaptations for various disorders (anxiety, depression, trauma etc.). In this study, we examined an assessment of the efficacy of EFT-T (online form) in the treatment of university students who experience anxiety or depression. The study provided information on recruitment, therapist training, intervention, adherence, and client retention. Therapy was offered in a 12 – 16 sessions format. 40 students were assigned to 8 certified therapists trained in EFT-T. Outcomes were assessed using several measures, with the Overall Anxiety Severity and Impairment Scale (OASIS), Overall Depression Severity and Impairment Scale (ODSIS), and Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) being the primary outcomes. Delayed start (baseline) design with a delayed start by 4 weeks in which students were assigned to the same active treatment was used. Clients were assessed four weeks before intervention, at the start, week 20, and at 6-month follow-up. The EFT-T showed large pre–post changes and similar outcomes across all measures, with these benefits retained at 6-month follow-up. Results of this study suggest that EFT-T can be an effective treatment for anxiety and affective disorders. Further investigation is indicated to establish the potential of EFT-T as a treatment for the wider population with the above conditions.
  • Understanding Psychological Variations Across PCOS Phenotypes: Possible Implications For Psychotherapy. .....Witold Urban, Jagiellonian University, Kraków, Poland; Michał Mielimąka, Jagiellonian University Medical College; Katarzyna Klasa, Jagiellonian University, Kraków, Poland; Robert Jach, Jagiellonian University, Kraków, Poland; Olga Kacalska-Janssen, Jagiellonian University, Kraków, Poland; and Krzysztof Rutkowski, Jagiellonian University, Kraków, Poland
  • Introduction: Polycystic ovary syndrome (PCOS) is one of the most common gynecological-endocrine disorder affecting 5-20% of women. PCOS diagnosis requires the presence of two of the following criteria: oligomenorrhea (OA), clinical and/or biochemical hyperandrogenism (HA) and polycystic ovaries in ultrasonography (PCOM). The diagnostic criteria distinguish the following phenotypes of PCOS: Phenotype A (OA+HA+PCOM), Phenotype B (OA, HA), Phenotype C (HA+PCOM), and Phenotype D (OA+PCOM). Phenotypes A and B are classified as „classic” NIH phenotypes while phenotypes C and D are considered as less severe non-NIH phenotypes. „Classic” phenotypes correlate with intensified PCOS symptomatology, and an increased risk of developing multiple somatic diseases compared to non-NIH phenotypes. We aimed to assess if specific PCOS phenotypes vary in state-anxiety, trait-anxiety, and self-esteem and its subscales. Methods: 49 patients with „classic” phenotypes and 27 patients with non-NIH phenotypes were included in the study. Enrolled patients underwent endocrinological and gynecological diagnostics and completed the STAI and MSEI questionnaires. Results: Patients with „classic” phenotypes presented significantly higher scores in trait-anxiety. Although general self-esteem did not differ between groups, patients with NIH phenotypes showed lower scores in physical attractiveness, identity integration, lovability, and competence. Conclusion: Differences between NIH and non-NIH phenotypes occurred in characteristics that developed before the onset of PCOS symptoms. This may suggest a psychosomatic component in PCOS, and indicate that certain personality traits and associated behaviors may contribute to the development of more severe PCOS phenotypes, which could be relevant in the context of conducting psychotherapy with these patients.
  • Exploring the Efficacy of Virtual Reality in Identity-Based Transdiagnostic Therapy for young people with anxiety and depression. .....Danielle Mullins, Universitat de Barcelona, Spain; Giuseppina Rametti, Nou Barris Adult Mental Health Centre; Irene Álvarez Tomás, Badalona Serveis Assistencials; Sergi Corbella, Universitat Ramon Llull; and Guillem Feixas, Universitat de Barcelona, Spain
  • The integration of technology in psychotherapy for youth represents a rising trend in the international community of psychotherapy researchers. Leveraging innovative solutions to enhance engagement in the psychotherapy process is of great scientific and clinical interest. In recent decades, Virtual Reality (VR) has made advancements as a tool for psychological treatments especially for anxiety. We aimed to build on this trend by developing a novel intervention centered on the immersive exploration of individuals’ identity systems. Our proposal is Identity-Based Transdiagnostic Treatment (IBTT), involving a collaborative exploration of patients’ sense of identity, perception of self and others, and identification of potential internal conflicts or identity dilemmas. IBTT employs the repertory grid technique with EYME-Explore Your Meanings, a digital platform incorporating an automated interview to elicit the person’s construal about self and significant relationships, and a personalized VR scenario to explore their identity system. IBTT strives to address the unique challenges of youth, many of which are intricately linked to the processes involved in the development and reconstruction of a sense of personal identity. We aim to elevate the efficacy and engagement of young people’s psychotherapy treatment through our innovative use of VR and focus on self-identity. The efficacy of IBTT will be compared to the Unified Protocol, another cognitive-behavioral therapy-based transdiagnostic intervention. A multi-center randomized clinical trial will be conducted with an aim to recruit 138 patients with depression and/or anxiety. Assessments will be implemented pre-, post-therapy, and six-month follow-up to monitor symptoms, psychological functioning, well-being, and therapeutic alliance quality.
  • Dynamic-Relational Therapy for Perfectionism: Efficacy, Effectiveness, and Process. .....Paul Hewitt, University of British Columbia, Vancouver, Canada
  • Dynamic-Relational Therapy (DRT), an integration of psychodynamic/interpersonal therapies (Hewitt et al., 2017), has been shown to be both effective (Hewitt et al., 2015) and efficacious (Hewitt et al., 2023; Kealy et al., 2024) in the treatment of pernicious personality vulnerabilities such as perfectionism. Moreover, we have begun looking at various processes within DRT that are predictive of treatment outcome in order to further delineate and refine the treatment. In this presentation, a brief review of the construct of perfectionism, the evidence for DRT in the treatment of perfectionism and mechanisms that may account for the change in perfectionism, symptoms. and satisfaction with and quality of life will be presented.
21. Welcome Reception [Welcome Reception]
Thursday | 7:15 pm-9:00 pm | Aula
This event is included in the registration fee.
22. Race, Privilege, and Intersectionality in Therapy [Semi-Plenary [invited]]
Friday | 8:30 am-10:00 am | P24

Organizer: Faisal Mahmood, Birmingham Newman University
Discussants:
  • Biljana van Rijn, Metanoia Institute
  • Frances Basset, Metanoia Institute, UK
  • Deepti Ramaswamy, The Open University
  • Orya Tishby, Department of Psychology, The Hebrew University of Jerusalem, Israel
23. Digital technologies and AI in psychotherapy [Semi-Plenary [invited]]
Friday | 8:30 am-10:00 am | P31

Organizer: Jaime Delgadillo, University of Sheffield, UK
Discussants:
  • Derek Richards, Amwell
  • Zac Imel, University of Utah, Salt Lake City, USA
  • Brian Schwartz, University of Trier, Germany
  • Christian Webb, Harvard Medical School
Coffee Break
Friday | 10:00 am-10:30 am | Aula
24. Meaningful measurement of mental health - problems & solutions [Panel/Symposium]
Friday | 10:30 am-12:00 pm | P24

Organizer: Femke Truijens, Erasmus University Medical Center, Rotterdam, Netherlands
  • “I feel 4 out of 5 depressed” - Meaningful measurement of mental health. .....Femke Truijens, Erasmus University Medical Center, Rotterdam, Netherlands; Sashank Nyapati, Erasmus University Rotterdam; Rebeka Pázmányová, Erasmus University Rotterdam; Rick Weimar, Erasmus University Rotterdam; and Lisa Koch, Duisburg-Essen University
  • In the evidence-based era, measurement is considered the cornerstone of clinical research and practice. Validated self-report measures are used in the whole range from diagnosis to routine outcome measurement and treatment efficacy. In self-report measures, people are asked to translate their experiences into numbers. The validation of measures is often taken as a guarantee that ‘the numbers’ validly represent individual experiences and can be used interchangeably and context-free for group level comparison. But what do people actually mean when they quantify their experiences in a pre-structed questionnaire format? And do these meanings match what we take them to mean? I present findings from the “I feel 4 out of 5 depressed” study. A ‘Thinking Aloud Procedure’ was utilized to scrutinize participants’ meaning making while scoring the Beck Depression Inventory (BDI). Reflexive Thematic Analysis showed an array of idiosyncratic variation, confusion, lack of fit and change or nuance of perspective in interpreting and scoring the standardized BDI items. Furthermore, the scoring process itself affects the understanding of depression and initiates a form of self-monitoring that feeds back into the scores. The findings of this study emphasize that quantitative self-report data are produced in active meaning-making processes, and empirical scrutiny of such processes is vital for valid data collection. As attention to such meaning-making processes and validity of data is virtually absent in our field, in the Meaningful Measurement (MEANS) Lab, I develop a hermeneutic approach of meaningful measurement, and a contextualized perspective on validation of measurement data.
  • The role of comparisons in wellbeing judgements among individuals with and without psychopathology. .....Thomas Meyer, Munster University; Marthe Sickinghe, Munster University; and Nexhmedin Morina, Munster University
  • People can express their current levels of wellbeing on the spot, yet the cognitive processes underlying these judgments remain poorly understood. We investigated the role of comparisons in individuals’ subjective wellbeing judgments in two studies among individuals with and without psychopathology. The first study was a semi-structured face-to-face interview in which participants (n=56) rated their wellbeing in general and relative to specific comparison standards (social, past temporal, criteria-based, counterfactual, prospective temporal, and dimensional). We coded participants’ responses for the presence and type of comparisons. Here, most respondents spontaneously reported some type of comparison, with more upward comparisons among clinical than among non-clinical participants. In the subsequent study, participants recorded their subjective affect for each distinct daily episode for one week. Moreover, they briefly described current, best, and worst daily episodes. Participants also rated their engagement with comparison standards and the respective affective impact. Findings revealed that best (vs. worst) daily episodes were characterized by downward (vs. upward) comparisons. In best and worst episodes, we most frequently identified past-temporal and criteria-based comparisons, respectively. The clinical group engaged more often with all potential standard types during worst daily episodes and was more negatively affected by comparative thoughts, amid consistently more negative affect levels across all episode types. Overall, these studies indicate that judgments of affect and wellbeing indeed rely on comparative thinking, whereby certain standards may characterize states of negative affect and poor mental health.
  • A complex systems approach to meaningful measurement. .....Chawwah Grünberg, Witten/Herdeck University; and Benjamin Aas, sysTelios Health Care Center
  • Theoretical Background. Complexity science describes phenomena in terms of agents and their interactions. In addition, feed-back loops and bottom-up order-parameters arise (=emergence). These order parameters are irreducible to agent-level and exert top-down causal effects. For the understanding of a system, one should aim at mapping individually active agents, their interactions, and emerging order-patterns. Consequently, meaningful measurement of a system and its change asks for a framework that rests on assumptions of hyper-individuality (=subjective), non-linearity and un-predictability. Objective. We hypothesize that objectivity, linearity, predictability, and invariance across time as basic assumptions of standardized measurement (and therefore practically all psychotherapeutic research) are in violation to theoretical aspects of complexity science (and clinical experience). Methods. The presenters will use their prior qualitative and quantitative research into idiographic system models to co-creatively reflect as a team on how meaningful measurement can be achieved. Results and discussion. Most likely, this will result in arguing, that meaningful measures should • individualize entities of content (beyond symptoms), • conceptualize psychotherapeutic progress as a change of interactions, • adopt a constructivist view of co-creation of meaning (and measures), and • assume responsiveness and variance of measures over time (“response shifts”)
Discussant:
  • Brian Schwartz, University of Trier, Germany;
25. Advancing Group Psychotherapy: Bridging Science and Practice [Panel/Symposium]
Friday | 10:30 am-12:00 pm | P31

Organizer: Marjolein Koementas, GGZ Noord-Holland Noord and Radboud University Nijmegen
  • The effectiveness of group psychotherapy for common mental health disorders: it is time to close the gap between scientific evidence and practice guidelines. .....Marjolein Koementas, GGZ Noord-Holland Noord and Radboud University Nijmegen; and Jenny Rosendahl, Jena University, Jena University Hospital, Germany
  • Globally, there is an increasing demand for mental health care for patients with common mental health disorders. Offering more group therapy is a proposed solution, with specific advantages over individual forms. Evidence-based group treatment (EBGT) protocols are available, but it is unclear whether they are recommended by various practice guidelines. The aim of this study is to provide an overview of EBBTs for common mental health disorders and compare them with recommendations in practice guidelines. We identified EBGTs on the EBGT website (APA Division 49, 2023) and conducted a systematic search to select the most common and most recent practice guidelines. Efforts have been made to investigate possible causes for any observed differences, identify gaps, and provide recommendations for future research and clinical practice.
  • Group leader modelling in group counseling: The influence of the leader’s in-session intimate behavior on group members’ intersession and in-Session behavior. .....Arianna Teti, University of Palermo, Italy; Gianluca Lo Coco, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy; Salvatore Gullo, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy; Cecilia Giordano, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy; Maria Maria Di Blasi, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy; Francesca Giannone, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy; and Dennis Kivlighan, Department of Counseling, Higher Education and Special Education, University of Maryland, College Park, Maryland, USA
  • We examined the effect of group leader modelling by examining how group members’ perceptions of the group leader’s in-session intimate behaviors were related to both their next session in-session behaviors and next week intersession behaviors. Participants were 122 graduate students (89% identifying as women) participating in eight session interpersonal growth groups led by 6 experienced group therapists. Before each session group members completed the Interpersonal Relations Scale Checklist (IRScl; Shadish, 1984) indicating their intersession intimate behaviors in the previous week. After each session, group members completed the IRScl indicating their own and their leader’s in-session intimate behaviors. Member ratings of leader’s in-session intimate behaviors were used to calculate actor and partner ratings of leader modeling through the APIM model. We used dynamic structural equation modeling (DSEM) to examine the temporal relationships between actor and partner ratings of leader’s in-session behavior and the subsequent in-session and intersession behaviors of group members. Actor but not partner ratings of leader’s in-session intimate behaviors, in the previous session, significantly and positively predicted member’s in-session intimate behaviors in the current session. In addition, both actor’s and partner’s perceptions of leader’s in-session intimate behaviors, in the previous session, significantly and positively predicted actor intersession intimate behaviors in the current week. The results confirm theories that group leader modelling of in-session behaviors is associated with members using new intimate behaviors in group sessions and in their life outside of group.
  • Individual add-on interventions for persistently not on track patients in group therapy: A multiple case study. .....Jasmin Gryesten, University of Copenhagen, Denmark; Stig Poulsen, University of Copenhagen, Denmark; Christian Moltu, Department of Psychiatry, District General Hospital of Førde, Førde, Norway; Kirstine Dichmann, Psychiatric Research Unit, Copenhagen University Hospital – Psychiatry Region Zealand, Slagelse, Denmark; Elisabeth Belmudez Biering, Mental Health Centre Ballerup, Mental Health Services of the Capital Region of Denmark, Ballerup, Denmark; Kirsten Møller, Mental Health Centre Ballerup, Mental Health Services of the Capital Region of Denmark, Ballerup, Denmark; and Sidse Arnfred, Psychiatric Research Unit, Copenhagen University Hospital – Psychiatry Region Zealand, Slagelse, Denmark
  • Introduction: While group Cognitive Behavioral Therapy (CBT) has demonstrated efficacy in alleviating depressive symptoms, some patients experience persistent difficulties in making progress despite participation in group sessions. Incorporating Routine Outcome Monitoring (ROM) alongside individualized add-on interventions within group CBT presents a potential strategy to enhance treatment outcomes. This multiple case study aims to examine the impact of this approach on patients with depression. Methods and analysis: 29 patients with depression participated in group CBT and ROM. 18 patients were NOT during therapy and participated in a ‘what’s at stake’-session, 10 patients were persistently Not On Track (pNOT) and participated in a shared-decision-making session and individual add-on interventions. Individual interviews with these patients and their therapists were analyzed through Interpretative Phenomenological Analysis (IPA). Results: The work is in process, and preliminary results will be presented at the conference, including cross-case and within-case results. Discussion: Combining group CBT with personalized individual add-on interventions can enhance the likelihood of benefiting from therapy. However, despite the customization offered in the add-on sessions, some patients may find group CBT less conducive to their needs, particularly those seeking more interpersonal or psychodynamic approaches. In these cases, group CBT and add-on interventions may not fully address the unique therapeutic needs of every individual. Additionally, relying solely on ROM outcomes to determine the need for additional treatment may have limitations, especially in instances of paradoxical outcomes.
26. Assessment 1 [Brief Paper Session]
Friday | 10:30 am-12:00 pm | U23

Moderator: Josip Razum, Ivo Pilar Institute of Social Sciences
  • Empowering Outpatient Psychotherapy: Integrating comprehensive anamnesis for enhanced treatment in mind-body health. .....Stella Becher-Urbaniak, Sigmund Freud University, Vienna, Austria; Birgitta Schiller, Sigmund Freud University, Vienna, Austria; and Paul Rach, Sigmund Freud University, Vienna, Austria
  • Aim: In an era characterized by rapid changes, the significance of thorough and unified anamnesis in psychotherapeutic practice is increasingly recognized. Not only does it offer the opportunity to proactively address new challenges, but also ensures optimal treatment outcomes. The implementation of a comprehensive body anamnesis at the SFU Outpatient Clinic for Adults to establish a detailed holistic database focused on body and physicality for further research will be introduced. Method: The anamnesis questionnaire is designed to capture quantitative and qualitative aspects of body-mind interactions comprehensively. The questionnaire functions as a screening tool, blending quantitative elements for basic surveying with qualitative components for nuanced exploration. The questionnaire aims to uncover diverse dimensions to enrich the psychotherapeutic process. Results: Initial findings from a pilot survey highlight pertinent basic data and qualitative correlations across various body-specific areas. Enhanced understanding of the role of comprehensive anamnesis in prevention and treatment of mental health issues, as well as its significance in treatment quality assurance. Highlighting the significance of an unified anamnesis form for optimizing psychotherapeutic treatment, improving therapeutic outcomes, and ensuring treatment quality within the framework of psychotherapeutic outpatient clinics. Preliminary results of the anamnesis interviews with patients are being analyzed and discussed. Discussion: Thorough and unified anamnesis not only plays a significant role in proactively addressing but also serves as a vital tool for ensuring quality treatment. The integration of a comprehensive body anamnesis into psychotherapeutic practice to enhance treatment approaches by deepening the understanding of the intricate interplay between body and mind.
  • Micro-level analysis of psychodynamic therapy sessions: Adaptation of a Therapeutic Objectives Coding System (TOCS). .....Luís Janeiro, Universidade do Algarve; and Laura Ferreira, Universidade do Algarve
  • Background: Describing therapist-client interaction is crucial for analyzing psychotherapeutic processes and enhancing our comprehension of the change process. In psychodynamic psychotherapy, there is a notable scarcity of observational measures, stressing the need for refined tools that can capture the nuanced interactions between therapist and client during therapy sessions. Aim: This study aims to adapt and refine the Achievement of Therapeutic Objectives Scales (ATOS), originally developed based on the therapeutic principles of McCullough et al.'s (2003) Affect Phobia Therapy. Our newly developed measure, the Therapeutic Objectives Coding System (TOCS), is designed to identify therapeutic objectives within therapist-client interactions by categorizing each speaking turn. Method: We applied the TOCS in a diverse set of psychodynamic psychotherapy sessions, analyzing six cases that included five with successful therapeutic outcomes and one dropout case. Results: Preliminary findings suggest that the TOCS has robust psychometric properties. An exploratory analysis of therapeutic interactions with the TOCS showed that the therapist and the client’s interventions are related with the treatment objective addressed during the session. Furthermore, the observed cycles of interaction within those treatment objectives suggest a collaborative effort between the therapist and client in facilitating therapeutic progress. Conclusion: By providing a structured framework for observing and coding therapeutic interactions, the TOCS enhances our ability to investigate the therapeutic process in psychodynamic psychotherapy. We propose that innovative computational methodologies, when used in combination with the TOCS could not only enhance the study of therapeutic processes but also serve as a valuable tool for training trainees in psychodynamic therapy.
  • The Couples’ Closeness–Distance Scale: Observation Through Joint-Drawing A Pilot Dyadic Validation Study. .....Sharon Egozi, Tel-Hai academic college; and Sharon Snir, Tel-Hai acdemic college
  • The study aimed to evaluate the Couples’ Closeness–Distance Scale (CCDS), an observational assessment reflecting couples’ relational dynamics; based on joint-drawing, it offers measurable dimensions. Forty cohabiting Israeli couples participated in the joint-drawing task and answered self-report questionnaires for attachment, differentiation of self, and relationship satisfaction. The paintings were assessed by trained observers on the CCDS scales (too distant, too close, autonomy, engagement) for both the women’s and men’s experiences. A two-level-dyadic-model showed that differentiation and relationship satisfaction predicted the CCDS and revealed a “pursue–withdraw cycle”: Women sensed the men as too distant, while men sensed the women as too close. Participants’ sense of discomfort from their partners’ distance related to less autonomy and engagement during the painting, with a greater effect on the women. The pilot implies that the CCDS enables observing dyadic-systemic aspects of couple dynamics and may enrich clinical evaluation.
  • Personalized networks in case conceptualization: an experimental study. .....Josip Razum, Ivo Pilar Institute of Social Sciences; Laura Bringmann, University of Groningen, Netherlands; Jasmina Mehulić, University of Zagreb; and Dominique Maciejewski, Tilburg University
  • Personalized networks derived from data collected with ecological momentary assessment (EMA) have shown promise in helping create case conceptualizations of patients’ problems. However, they have statistical and other drawbacks, which makes it questionable whether they are useful to patients and clinicians. This study aimed to answer two research questions: 1.) Do person-specific networks based on real data appear more useful and appealing to prospective clients than generic networks? and 2.) Do person-specific networks appear more useful and appealing to prospective clients than the descriptive ESM data? One hundred university students filled in questionnaires five times a day for three weeks. The questionnaires contained questions about the intensity of six emotions: cheerful, pleasant experience, tired, stressed, connected to others, and relaxed. After this, participants were invited to individual feedback sessions where they were told that they will be presented with three types of personalized networks of their symptoms that were created with different statistical procedures. In fact, only one of these networks was really their own, one belonged to a random other participant, and one was the same for all participants, i.e., a theoretical network. Participants were asked how interesting they thought the different networks were, how many new insights did they bring to them and how useful they were. Participants were also asked to compare the networks to the descriptive feedback. During the presentation we will discuss the results and their implications for the personalized networks literature and for the clinical practice.
27. Psychoanalytic Conceptualizations for Couple and Family Therapy and a Simple Way to Assess Effectiveness [Panel/Symposium]
Friday | 10:30 am-12:00 pm | U32

Organizer: Nestor Kapusta, Medical University of Vienna, Austria
  • Psychoanalytic Operationalization of Couple Object Relations. .....Nestor Kapusta, Medical University of Vienna, Austria
  • Psychoanalytic theory on couple relations over the past 70 years has generated a complex theoretical framework. However, the theories are awaiting an operationalization for clinical or quantitative scientific research purposes. Based on the object relations theories of Melanie Klein, Wiliam Fairbairn, Henry Dicks, David and Jill Scharff and Otto Kernberg, we propose a unified psychoanalytic model of couple communication and interaction, consisting of separate components such as ‘ability to acknowledge one’s own aggression’ or the ‘capability for concern for the object’. The clinical and research value of such a model will be discussed and further steps of operationalization and validation will be drafted.
  • Psychoanalytic Conceptualization of the Role of the Father in Family Therapy. .....Andrew N Briggs, Sussex Partnership NHS Foundation Trust
  • The role of the father is often overlooked by psychoanalytic clinicians largely because they have not been trained to observe it. Further, the role is near invisible in the literature. In this presentation I conceptualize the role and give a case illustration to illuminate how I see the parental couple in clinical work with families. This is based upon the Tavistock understanding of couples and so central to the discussion will be the internal parental couple. The case discussed is of a child with a mental ill-health diagnosis. The clinical work revealed that the symptoms of this diagnosis were manifestations of parenting that did not include the father who had been excluded by his partner, the child's mother. This exclusion was due to her denial of an internal father and pre-oedipal relationship with an internal mother. Therefore, ipso facto the internal parental couple was denied and thus so too the external couple as both a romantic/sexual and parental couple.
Discussant:
  • Shayne Anderson, Brigham Young University, Provo, USA;
28. Assessment 2 [Brief Paper Session]
Friday | 10:30 am-12:00 pm | U33

Moderator: Tatjana Rožič, Sigmund Freud University - Ljubljana branch
  • Using Machine Learning Methods to Identify Trajectories And Predict Non-responders to Short-Term Dynamic Therapy. .....Refael Yonatan Leus, The College of Management Academic Studies; Gershom Gwertzman, Department of Psychology, The Hebrew University of Jerusalem, Israel; and Orya Tishby, Department of Psychology, The Hebrew University of Jerusalem, Israel
  • Objectives: A significant percentage of patients do not respond to therapy. Selecting treatment better in advance can have significant clinical benefits. This study aims to predict responders and non-responders to short-term dynamic therapy. Methods: Machine learning algorithms analyzed data from 95 patients who completed a 16-session short-term dynamic therapy. Progress was monitored weekly using the Outcome Questionnaire (OQ45) and Target Complaints (TC). Change trajectories of responders versus non-responders were identified using a machine learning model adapted for repeated measures. A random forest algorithm predicted trajectory belonging using pre-treatment data. Results: Significant predictors of OQ45 trajectories included initial symptom severity, neuroticism, coldness, interpersonal problems, emotional clarity, emotion regulation difficulties, and openness to experience. Initial problem severity was the sole predictor for TC trajectories. A weak positive relationship between the trajectories of the two outcome variables was found. Conclusions: These findings provide empirical, data-driven insights for selecting therapeutic modules for individual patients. The ability to predict response in the OQ45, a nomothetic outcome variable, does not translate to predicting response in the TC, an idiographic variable. This underscores the need for a multidimensional evaluation of outcomes for optimal personalized treatment selection.
  • Dimensions of dysfunctional attitudes in treatment pathway assignment and prediction of outcome. .....Gary Brown, Royal Holloway University of London; Jaime Delgadillo, University of Sheffield, UK; Jonathan Wheatley, Homerton Hospital University Trust; and Mirko Cirkovic, Homerton Hospital University NHS Trust
  • The Dysfunctional Attitude Scale (DAS) measures depression-related enduring beliefs and is one of the central measures of cognitive behavioral (CBT) research and theory. It has been the central marker of etiological claims of CBT. Recently, a richer and more precise measurement structure of the DAS has become available (Brown, Delgadillo, & Golino, 2023). The enriched DAS was administered at intake assessment to nearly 4000 consecutive outpatients in a UK NHS Talking Therapies (formerly IAPT) service, about a third of whom mainly presented with depression. The ability of the DAS to predict need for treatment to be stepped up and to predict outcome was evaluated. Demographic moderators were also considered, including index of multiple deprivation. The results have implications for personalization of psychotherapy and, more broadly, measuring what matters with regard to clinical depression.
  • Treatment Integrity Assessment in Emotion-Focused Therapy: Is Segment-Based Assessment as Effective as Whole-Session Analysis?". .....Marina Monteiro, University of Maia, Portugal; Daniela Nogueira, University of Maia; Edgar Mesquita, EPIUnit – Institute of Public Health of the University of Porto; Portugal; Robert Elliott, Strathclyde University, UK; João Salgado, University of Maia, Portugal; and Carla Cunha, University of Maia, Portugal
  • Objective: Research in psychotherapy draws attention to the importance of observing and evaluating the therapist's performance since, potentially, differences can occur in the implementation of the treatment, reinforcing the pertinence of including the evaluation of the integrity of the treatment in the research design. However, the time, labor, high costs become an invisible enemy to its implementation. The purpose of the present study was to explore to what extent segments could accurately generalize for an entire session with consistency and reliability. Method: A total of 22 sessions (66 segments) videos and audios from 11 cases were coded. A model of mixed-design analysis of variance was implemented to assess differences between the three segments of therapy assessed, adjusted for observation method (video/ audio) and session (session 5 or 10). The interrater reliability was good (ICC .75). Results: Video sessions showed higher reliability for session 5, whereas audio sessions showed higher reliability for session 10. Correlations between segments were high (>0.7), with segments 2 and 3 sharing the most variance (88.9%). Multiple linear regression models showed that either segment 2 or 3 alone was sufficient to predict global assessment scores, explaining 87.7% and 92.2% of the variance, respectively. Conclusion: This study provides initial evidence supporting that segment two or three, each by itself, is sufficient to predict the results of the global assessment. The implications of these results are significant as they can help reduce the time and costs involved in the therapist adherence and competence assessment.
  • The use of a single-item scale in a non-clinical population – monitoring the well-being of students and forgiveness levels in relation to practicing gratitude. .....Tatjana Rožič, Sigmund Freud University - Ljubljana branch; Katarina Kompan Erzar, University of Ljubljana; and Nuša Kovačević Tojnko, Nova univerza
  • The experience of injustice deeply ingrains in an individual's experience and often prevents them from breaking free from the role of victimhood and liberating themselves from unpleasant emotions such as anger, resentment, and powerlessness. The purpose of our study was to examine whether regular gratitude exercises over a four-week period contribute to reducing negative mood and fostering greater willingness to forgive. We translated a single-item scale into the Slovenian language and utilized it in a non-clinical population. Students from various disciplines at the Faculty of Theology of the University of Ljubljana and at the University of Sigmund Freud -Ljubljana branch were invited to participate in the study. The eight-week study consisted of three consecutive parts. During the first two weeks, students completed the single-item scale daily on an open-source application for online surveys and also completed The Enright Forgiveness Inventory (EFI) once during this period. The second part of the study spanned four weeks, during which participants completed the single-item scale daily and performed the gratitude exercise as instructed. The third part of the study lasted for two weeks: students rated their emotional and psychological well-being daily on the single-item scale and completed the EFI again. The research is currently in the third phase of data collection, with the number of participants ranging from 15 to 20 daily. Expected outcomes: we anticipate that the four-week gratitude training will show improvements in participants' well-being and higher ratings regarding their willingness to forgive someone who has deeply and unfairly hurt them.
Lunch Break [Lunch Break]
Friday | 12:00 pm-1:30 pm | Aula
29. European Chapter Business Meetting [Chapter Meeting]
Friday | 1:30 pm-2:30 pm | P31
30. UK Chapter Business Meetting [Chapter Meeting]
Friday | 1:30 pm-2:30 pm | U33
31. Mentalization-Based Interventions for Parents: Enhancing Parental Skills [Panel/Symposium]
Friday | 2:30 pm-4:00 pm | P24

Organizers: Yael Enav, Haifa University, Israel; Yael Mayer, University of Haifa, Israel;
  • Home Within the Heart” - A Family Mentalization Play-Based Intervention to Enhance Familial Mental Health and Resilience for Displaced Families. .....Yael Enav, Haifa University, Israel; and Yael Mayer, University of Haifa, Israel
  • On October 7th, an attack in Israel led to the tragic loss of civilian lives and forced thousands of families to leave their homes. This displacement has profoundly affected parents and young children, exacerbating stress levels and negatively impacting parental reflective functioning. These families face challenges such as uprootedness from familiar settings and disruptions to their routines, significantly affecting their mental well-being. The 'Home within the Heart' program, a mentalization-based short-term group intervention, is designed to support these displaced families in Israel, specifically targeting parents and children aged 3-6. The intervention utilizes narrative and play therapy, effective methods that enhance parent and child mentalization skills, allowing children to express themselves and adapt to new realities. The program operates in group sessions with five families each, meeting once a week for four weeks. This group setting helps normalize the experience and reduce feelings of isolation. Our preliminary study on the program’s effectiveness has shown positive outcomes in parental and child mental health, parent-child relationship and resilience, suggesting that even short-term interventions can be beneficial. These promising results support further research through a randomized controlled trial to expand our understanding of the intervention's impact.
  • The Role of Maternal Reflective Function in the Transition to Motherhood: A Pioneer Model and RCT Study. .....Lee Barel Refaeli, University of Haifa, Israel; Talmon Anat, Hebrew University, Jerusalem, Israel; and Yael Enav, Haifa University, Israel
  • Introduction: The transition to motherhood can evoke anxiety and stress, exerting a profound impact on mother's psychological well-being, with postpartum depression being a prevalent challenge. These challenges are more common among primiparas. These increases the risk of harmful parenting behaviors, possibly impairing the infant’s development. Previous studies indicated that Maternal Reflective Function (MRF) is linked to appropriate childcare. It also found to mediate the effect of stressors on parental functioning. Aim: Study 1 examined whether MRF moderates the effect of depression levels on mother-infant bonding and maternal self-efficacy (MSE). Study 2 examined whether an online short intervention would enhance MRF. Method: Study 1 included 47 primiparas during 1st-5th months postpartum from the general population measured by questionnaires for Postpartum depression, MRF, bonding, and MSE. Study 2 was RCT with 50 primiparas who were randomly assigned to intervention (n=24) or control (n=26) group. intervention group participated in an online intervention. Primiparas underwent FMSS-RF semi-structured interviews to assess their MRF before and after intervention. Conclusions: In Study 1, a path analysis revealed that the connection between depression and MSE and bonding was partially mediated by MRF. In Study 2, results indicated a significant increase in MRF in intervention group, and no change in control group. The results indicate that MRF plays a significant role in mitigating the negative effects of depression level and could be enhanced by a short intervention. Further studies are warranted to continue exploring these connections using larger samples and investigating additional factors that might impact this relationship.
  • A Randomized Controlled Trail: Mentalization Based Group Intervention for Parents of Children with Autism. .....Natalia Kirsman, Haifa University, Israel; James Gross, Stanford University, Palo Alto, USA; and Yael Enav, Haifa University, Israel
  • Parents of children with Autism Spectrum Disorder (ASD) often face elevated stress levels compared to those of typically developing children. This increased stress frequently coincides with a decrease in mentalization—the ability to understand the mental states of oneself and others—which can adversely impact both parental and child mental health. The challenges are intensified for parents of children with autism due to the difficulty in interpreting their children’s mental states. However, mentalizing is particularly crucial for these children as it significantly contributes to their developmental needs. The objective of the current study was to assess the effectiveness of a mentalization-based group intervention in enhancing the mental health of both parents and children with ASD, compared to a waitlist control group. In this randomized control trial, 170 parents of children with autism were divided into two groups: an intervention group and a waitlist control group. The intervention comprised four online group sessions that focused on enhancing mentalization skills through targeted exercises. Preliminary results indicate that the intervention group experienced significant improvements in various outcomes for both parents and children. These findings suggest that mentalization-based interventions can play a vital role in supporting the mental health of families affected by ASD, providing a promising avenue for future research and application
  • Psychological First Aid for Children and Parents Following the Mass Trauma of October 7th.. .....Maayan Shorer, Clinical Psychology Department, Ruppin Academic Center; Avigal Snir, Schneider Children’s Medical Center; and Adi Shamia Atzmon, Schneider Children’s Medical Center of Israel
  • An immense demand for psychological first aid for children and their families has arisen following the October 7th mass-trauma in Israel. This large-scale need led to the establishment of a new acute stress unit at Schneider Children's Medical Center of Israel. The focus of psychological interventions in the unit was on guiding and supporting parents as they provide their children basic psychological needs following traumatic experiences. Thus far, over 150 children (aged 0-18), and their parents, have been treated in the unit. In this presentation we aim to: (a) Present a focused, systemic, integrative layered intervention model. The first layer, based on the PFA model (Psychological First Aid; Hobfoll et al., 2021), is guided by five principles: promote sense of safety, promote calming, promote sense of self efficacy, promote connectedness, and promote hope. The second layer aimed to identify the main difficulty for each family and to individually tailor an appropriate intervention (e.g., trauma-focused CBT, IPT, anxiety management, parental counseling, family intervention, grief processing). (b) Describe the adaptation of the intervention model to the specific developmental needs of young infants and toddlers (0-6). (c) Provide descriptive data on families and therapy interventions and illustrate the main themes through Clinical vignettes. (d) Provide general conclusions and guidelines for the delivery of psychological first aid in multilayered traumatic circumstances. We focus on parenting strategies and roles, in the establishment of a safe and stable environment for children while facing a reality of trauma and war.
Discussant:
  • Yael Mayer, University of Haifa, Israel;
32. Neuroimaging in psychotherapy research [Panel/Symposium]
Friday | 2:30 pm-4:00 pm | P31

Organizer: Irene Messina, Mercatorium University
  • Understanding humour in borderline personality disorder: biomarkers of change in brief psychotherapy. .....Ueli Kramer, Lausanne University, Switzerland; Fabio Briner, Florida International University, Miami, USA; Loris Grandjean, Centre Hospitalier Universitaire Vaudois; Ferath Kherif, Centre Hospitalier Universitaire Vaudois; and Bogdan Draganski, Centre Hospitalier Universitaire Vaudois
  • Understanding humour recruits a complex variety of psychological processes, including theory of mind, emotion regulation and awareness. These are core psychological processes affected in patients with borderline personality disorder (BPD). Facing interpersonally humorous stimuli, it was demonstrated that there is a decoupling between activation in the neurofunctional networks of theory of mind and the neurofunctional networks of emotional processing (O’Neill et al., 2015), in comparison with healthy controls. In a pilot study, biomarkers of change were associated with increased levels of understanding interpersonal humour and decreased emotional arousal (Kramer et al., 2018). No study has demonstrated that understanding humor functions as potential biomarker of change in psychotherapy for BPD, as explanation for symptom decrease. Methods: A total of N = 18 female patients with BPD, as sub-sample of a larger randomized controlled study on brief psychiatric intervention compared to a treatment as usual were included (Kramer et al., 2024). In addition, N = 28 healthy participants were included. They were assessed pre- and post-treatment with the humour task in the fMRI environment (O’Neill et al., 2015). Hemodynamic responses to interpersonal humorous stimuli were compared to non-interpersonal humorous stimuli and control (non-humorous) stimuli. All stimuli were cartoon-type pictures. All patients and controls were clinician-assessed using the ZAN-BPD (Zanarini, 2003). Results: An increase over the course of the active treatment in the bilateral precuneus was associated with the response to the interpersonal humorous stimuli, this change was not found in the treatment as usual nor in the healthy controls over time. Change in the theory of mind and emotion regulation networks were related with the reduction of the interpersonal problems as assessed on the ZAN-BPD. Discussion: Psychotherapy for BPD works, but it remains unclear how it works. Understanding humour in interpersonal exchanges is crucial for the individual’s effectiveness in social contexts. The neurofunctional activity in the structures involved in self-awareness and theory of mind, in conjunction with emotion regulation, are at the core of the treatment of the functions related with humour in effective ways. Interpersonal humour may be important for explaining psychotherapy outcomes across different diagnostic categories.
  • Neural predictor of response to psychotherapy in borderline personality disorder. .....Irene Messina, Mercatorium University; Alessandro Grecucci, University of Trento; Mariarita Infurna, University of Palermo, Italy; Giorgio Falgares, University of Palermo, Italy; Osmano Oasi, Catholic University of Sacred Heart, Milan, Italy; and Roberta Rossi, Ospedale Fatebenefratelli, Brescia
  • Psychotherapy is considered the primary treatment for borderline personality disorder (BPD). However, there is evidence of high rates of psychotherapy non-response in BPD patients. In line with ‘precision medicine’ approaches, the identification of biological patterns of variation in subgroups of patients could help in the direction of tailoring treatments to specific cases characteristics. Factors relating to non-response in BPD are both elusive and inconsistently reported in the literature. Most previous studies have investigated individual factors in association to failures of psychotherapy using traditional linear models that are not well suited for analysing multidimensional data and are not useful to maximise prediction accuracy. In the present study, we overcome this limitation by the application of machine learning techniques, with the aim to generate a clinically useful prediction model, which can be used in clinical practice before the first session has occurred to classify patients on the basis of individual prognostic factors. We considered both self-reported psychological factors (encompassing socio-demographic factors, the severity of BPD symptomatology across various domains, emotion regulation, impulsivity levels, interpersonal difficulties, alexithymia, and attachment orientations) and neurobiological factors (grey and white matter across the entire brain) as potential predictors of psychotherapy response. Building upon the groundwork laid by prior investigations, we employed advanced machine learning techniques to describe the predictive potential of individual variations in these psychological dimensions relevant to BPD, alongside features extracted from brain regions. Data analysis is currently ongoing.
  • The Psychodynamic Psychotherapy and Changes Visible in fMRI. .....Krzysztof Rutkowski, Jagiellonian University, Kraków, Poland; Edyta Dembińska, Jagiellonian University, Kraków, Poland; Michał Mielimąka, Jagiellonian University Medical College; Anna Sobczak, Jagiellonian University, Kraków, Poland; Tadeusz Marek, Jagiellonian University, Kraków, Poland; Jerzy Sobanski, Jagiellonian University Medical College; Katarzyna Klasa, Jagiellonian University, Kraków, Poland; and Patrycja Jeda, Jagiellonian University Medical College
  • The study aims to determine the representation in neuroimaging of mental state changes resulting from psychotherapy treatment. In the etiology of personality disorders stressful experiences in life act as an important factor. The study aims to demonstrate changes in the CNS functioning resulting from the treatment of group psychotherapy (integrated and psychodynamic) among patients with diagnoses of F4-F6. The development of neuroimaging techniques made it possible to demonstrate functional changes which were previously characterized solely by observational methods (mood or behavior). The study is planned to be observational and prospective and involves two examinations of the same group of patients carried out prior to psychotherapy and on its completion. The treatment procedure which was applied in between the first and second examination was a complex psychotherapy program for patients with personality disorders. In the first and the final week of treatment the patients undergo the examination by means of questionnaires and an fMRI scan. The study includes patients of both genders with the age ranging from 18 who were diagnosed with personality disorders according to ICD-10 or neurotic disorders (F40.0 - F69). All participants gave their informed consent to be part of the study group. The number of findings is 42 patients. The results showed in general that the correlation of activity was higher in T1 comparing to T12, which suggests the normalization of the brain activity. The study reveals significant changes in brain regions responsible for, among others: the integration of information related to the perception of the environment, reactivity to stimuli, mentalization, retrieval of episodic memories, and affective responses to pain, self-awareness, motivation.
33. The merits and challenges of method and evidence-integration [Structured Discussion]
Friday | 2:30 pm-4:00 pm | U23

Organizers: Femke Truijens, Erasmus University Medical Center, Rotterdam, Netherlands; Felicitas Rost, The Open University, UK;
Moderator: Felicitas Rost, The Open University, UK
Discussants:
  • Dana Tzur Bitan, Haifa University, Israel
  • Stig Poulsen, University of Copenhagen, Denmark
  • Jochem Willemsen, Université Catholique de Louvain
  • Naomi Moller, The Open University
  • Femke Truijens, Erasmus University Medical Center, Rotterdam, Netherlands
34. Attachment [Brief Paper Session]
Friday | 2:30 pm-4:00 pm | U32

Moderator: Torbjørn Nilsen, Norwegian University of Science and Technology, Tordheim, Norway
  • Widening the Perspective: Integrating Qualitative Research Methodologies by using the B.A.S.E.®- Babywatching programme as an example. .....Katharina Scherfler, Sigmund Freud University, Vienna, Austria
  • The B.A.S.E.®- Babywatching programme, as a preventive programme, has been further developed by Karl-Heinz Brisch for the German kindergarten and school landscape aiming to bolster the emotional development of children. The core methodology of the programme is for the children to observe the natural interaction between a parent and its infant to increase the children’s sensitivity and empathy. At the Sigmund Freud University in Vienna, the B.A.S.E.®- Babywatching programme was used to explore, what happens when students of psychotherapy science participate in a systematic observation of mother-infant interaction lead by a B.A.S.E. ® group leader. The methodology adopted for this investigation was a qualitative approach that leverages a blend of observational, reflexive, and ethnographic research techniques. This blend of approaches enriched the research design, offering a multifaceted approach of the investigated phenomenon. By embracing the merging of these qualitative measures, the researcher aspired to capture the nuanced essence of the process and explores how the act of observation could potentially impact the participants individual process regarding his or her own personal and professional growth an experience. The ultimate aim of presenting this research is two-fold: firstly, to showcase the synergistic potential of integrating various qualitative research techniques and secondly, to support fellow researchers in considering the integration of techniques to dive deeper into the participants’ experience through an alternative perspective.
  • The Therapist as a Secure Base: Does Training Matter? For All?. .....Anne Plantade-Gipch, School of Practitioners’ Psychologists of the Catholic Institute of Paris, France; Slimane Djillali, School of Practitioners’ Psychologists of the Catholic Institute of Paris; and Yves De Roten, Lausanne University, Switzerland
  • Background It is generally accepted that therapists function as a secure base for their clients. Therapists possess the same characteristics as other secure attachment figures, such as parents towards children. Little is known, however, about whether and how this capacity develops during training and in different cultural contexts. Objectives This study aims to documents the following research questions: (1) how the therapist as a secure base develops with usual training and (2) whether the quantity or quality of training in France and Algeria influences the development of the therapist as a secure base for these clients. Methods A total of 300 students with different levels of training in psychotherapy, from France and Algeria, participated in the study and completed 4 questionnaires: the Secure Base Questionnaire, the Experiences in Close Relationships Scale, the Therapist Attitudes Scale, and the Interpersonal Problems Inventory. Results Results showed that the therapist’s ability to represent himself as secure base for the client varied according to level of training and some attitudes towards psychotherapy in the French sample but not in the Algerian sample. Indeed in the Freneh simple, older participants, with the highest levels of training and experience in psychotherapy, perceived themselves as secure base for thers client’s more than younger ones. This résuts were not observated in the Algerian simple. In addition multiples régressions analysis showed that Frensh therapit’s attitudes and beliefs regarding psychotherapy predicted significantly and positively the therasit’s hability to represent oneself as a support for the client. Discussion This result in two simples allows us to discuss the differences in the quantity and quality of initial training in psychology in France and Algeria. In fact, the French sample was recruited from a private higher education establishment, where training is mostly provided by teachers who are practitioners psychologists passing their experience to the students, and practical training is highly regulated in France in terms of hourly volume and supervision. Unlike in Algeria, where most initial psychology training is provided in majority by teacher-researchers without clinical practice and experience, and practical training is not highly regulated in terms of hourly volume, with a total absence of supervision. In addition to the need to reflect on the initial training of psychologists, this research highlights the importance of integrating training in interpersonal skills into inital psychology training programs, particularly that of being a secure base for the client, as this enables novice therapists to progress, particularly in terms of their responsiveness the client's interpersonal needs . Some cultural differences in terms of representation of the attachment relationship and therapit’s attitudes and beliefs regarding psychotherapy will be also discussed.
  • Attachment And Epistemic Trust Among Youth Engaged In Relationships Through Online Platforms. .....Sanober Memon, National Institute of Mental Health and Neuro Sciences, Deemed University, Bangalore, India; and Poornima Bhola, National Institute of Mental Health and Neuro Sciences, Deemed University, Bangalore, India
  • Background: There is substantial evidence for the interplay of attachment vulnerabilities and experiences in romantic relationships, however, relatively less is known about its manifestations in modern online relational contexts. Online platforms are becoming increasingly popular among young individuals, and relational patterns such as attachment vulnerabilities and levels of epistemic trust may influence the way one engages with and experiences their digital connections. Objective: The study explored the relationship between attachment, epistemic trust & perceptions and experiences and perceptions of youth engaged in relationships through online platforms. Method: 101 participants, aged 18-32 years completed the Experiences in Close Relationships - Short form (ECR-S) and Epistemic Trust, Mistrust and Credulity Questionnaire (ETMCQ), and a survey assessing their subjective experiences and perceptions of online relationships. Results: The findings indicated that participants used a range of online platforms, with prominent interpersonal motivations including seeking romantic relationships, friendships and reducing loneliness. A majority of the participants reported vigilance and concerns about safety, with a proportion reporting negative experiences of ‘breadcrumbing’, ‘ghosting’ and ‘benching’, with select gender differences related to these experiences. Higher levels of attachment & epistemic trust vulnerabilities were associated with distinct online behaviours, attitudes and perceptions. Attachment anxiety was positively correlated with hypervigilance in online chats, engagement in ghosting (both as initiator and recipient), and reluctance to meet others face-to-face, accompanied by a higher likelihood of initiating romantic relationships. Conversely, attachment avoidance was significantly associated with ease of emotional expression online, and reduced inclination towards safety measures, harboring negative expectations, maintaining secrecy about online engagements/relationships, and difficulties in disengaging from online connections when in a committed relationship. Epistemic trust was associated with a preference to meet people in person while exercising vigilance, taking safety precautions, and being open about their online engagement with friends. Epistemic mistrust was associated with more frequent checking for messages and matches, keeping online engagement hidden and misrepresenting personal characteristics. Higher levels of epistemic credulity were associated with greater comfort in emotional expression, forming quicker emotional connections with strangers, greater likelihood of personal misrepresentation and reluctance towards safety precautions. Epistemic credulity was also associated with a higher likelihood of experiencing negative interpersonal interactions such as ‘ghosting’, ‘benching’ and missing warning signs or ‘red flags’. Conclusion: The findings provide a perspective to clinicians regarding how attachment vulnerabilities and impairments in epistemic trust may influence the way individuals perceive and utilize these platforms, and guide interventions to mitigate the associated risks.
  • The personal characteristics of students entering a clinical psychology study program in Norway. .....Torbjørn Nilsen, Norwegian University of Science and Technology, Tordheim, Norway; Nina Jakhelln Laugen, Norwegian University of Science and Technology, Tordheim, Norway; and Truls Ryum, Norwegian University of Science and Technology, Tordheim, Norway
  • Background: There are variations among therapists regarding their level of therapeutic skills, or their ability to produce therapeutic change in patients. Besides differences in clinical training and experience, personal characteristics are often assumed to contribute to one’s individual therapeutic style and effectiveness. Thus, such personal characteristics should also be of interest for clinical training programs, as they may be important contributors to the students’ future therapy skills. Also, knowledge of students’ strengths and challenges at the time of enrolment can inform study program development and facilitate effective clinical training programs. The purpose of the present study is to describe the characteristics of students entering a clinical psychology study program in Norway. Methods: Students were invited to the study during their first semester of a 6-year study program in clinical psychology. Over three years, 122 students (34 male) were recruited. Also, students from another non-clinical study program (pedagogy; n=29) were included. Participants completed questionnaires on symptoms of psychopathology, personality, mentalization skills, and attachment style. Results: Descriptive data on clinical psychology students, and comparisons with comparison group and normative data will be presented. Discussion: The characteristics each student brings along into their training is an important element in the study of therapist skills and individual differences among therapists. These characteristics are also likely to vary between study programs as admission requirements will vary and therefore the student population will also vary. Clinical and educational implication of our findings will be discussed.
35. Emotion and Trauma [Brief Paper Session]
Friday | 2:30 pm-4:00 pm | U33

Moderator: Adi Duchin, Bar-Ilan University
  • Movement shadow in diagnostics and intervention: Use of dance movement therapy and Laban movement diagnostics in therapeutic work with trauma. .....Zuzana Vasicakova Ocenasova, POPI Institute Slovakia
  • The presentation is based on my PhD research project at Masaryk University in Brno, enriched by insights from my practice as EMDR practitioner. I had been mapping use of movement diagnostics in therapeutic process. The research question was formulated as how does an individual's movement pattern carry information about his/her personality tendencies and psychological state., I aim to offer some examples of the work with movement characteristics and the movement shadow (the movement qualities not accesible) within therapeutic process with clients with unprocessed trauma. The research is theoretically based on the principles of body-oriented psychotherapeutic schools and uses the analytical tools of Laban movement analysis (LMA) and process-oriented psychology (POP). We mapped the movement profiles of five healthy adults. The research confirmed that the movement pattern of an individual does carry information. The movement manifestations of individual psychiatric diagnoses tend to appear as mutually overlapping entities with the relevance in the areas, which are missing. Thus, the key is not only what is in the foreground, but also what is absent. Trauma dissociates the person from emotions, manifested through body. Interoception becomes inaccessible and even basic hints to body-perception become often terrifying. Movement expression then offers a safe space for starting a process of re-connecting with one’s self. Western trauma therapies (even EMDR) do not center body as part of treatment (Hartwell, Melsom, 2022). However, trauma is not the event, but what happens in the body. Moreover, trauma brings about specific movement expressions connected with hypo, - or hyper arousal.
  • Trauma and extremism: Unravelling narratives and pathways to disengagement and reintegration.. .....Deepti Ramaswamy, The Open University
  • Globally, escalating polarisation and dehumanisation of the ‘other’ driven by complex social, economic, political and environmental challenges is breeding an increase in violent extremism. While evidence suggests that childhood trauma and adversity often intertwine with the narratives of extremists, childhood trauma and adversity are not direct causes of extremism as many people who experience trauma do not go on to become extremists. While childhood trauma is prevalent among extremists, its relevance and an understanding of how it might influence extremist engagement, disengagement and reintegration remains poorly understood. This research combines Eye Movement Desensitisation and Reprocessing (EMDR) with Dialogical Narrative Analysis (DNA) to explore the narratives of former far-right, Islamists and Incel extremists. Through repeated life story collection as participants engage in EMDR therapy, the research investigates: how trauma shapes self-perception, how this evolves as adverse life experiences are processed in therapy and its impact on disengagement from extremism and reintegration into society. Early findings suggest that trauma-focused psychotherapy with its relational safety fosters an openness to trusting others and engaging with interventions and structures that can support disengagement and reintegration. However, it also requires a comprehensive approach inclusive of access to meaningful education and employment and collaboration with ‘receiving’ communities and institutions to reduce barriers to acceptance and foster mutual re-humanisation.
  • Needs of Collective Trauma Survivors from October 7th in Israel, and Implications for Psychotherapy. .....Adi Duchin, Bar-Ilan University; Rivka Tuval-Mashiach, Bar-Ilan University; and Rami Benbenishty, Hebrew University, Jerusalem, Israel
  • The present study explores the immediate needs of survivors from the massacre that took place in Israel on October 7th, 2023. During the events citizens were exposed to tangible danger and were evicted from their homes without knowing if, or when, they will return. Since then, many citizens have been living in temporary housing around Israel separated from their homes and communities. A survey exploring the needs of these trauma survivors was conducted a month after October, on purpose of gaining understanding of the types of help that will be most beneficial for them. It included both quantitative questions whose purpose was to examine the concrete needs of the evacuees, and open-ended questions whose purpose was to let the evacuees express their experience and needs in their own words. Eight hundred people responded to the quantitative questions, and less than a hundred responded to the qualitative part. The qualitative analysis of the survey generates several central themes, including concrete and existential loneliness that is present in the evacuees' stories. The need to regain a sense of control over their lives and to be the ones who tell their stories, stood in the basis of the survivors' narratives. They expressed a wish to create a bridge of agency between the lives that they had before the trauma, and the lives that they have at present, as evacuees. Implications of these needs to psychotherapy with collective trauma survivors, who lost their communities and their sense of security, will be addressed.
Coffee Break
Friday | 4:00 pm-4:30 pm | Aula
36. Maximizing the Potential of Routine Outcome Monitoring: Innovations and Implementation [Panel/Symposium]
Friday | 4:30 pm-6:00 pm | P24

Organizer: Tomáš Řiháček, Masaryk University
  • Psychotherapists’ Experience of Barriers and Facilitators to Implementing Routine Outcome Monitoring: A Qualitative Meta-Analysis. .....Klára Jonášová, Masaryk University; Michal Čevelíček, Masaryk University in Brno; Petr Doležal, Masaryk University; and Tomáš Řiháček, Masaryk University
  • Objective: Routine outcome monitoring (ROM) has become an increasingly utilized tool in therapeutic practice that has the potential to improve therapy outcomes. This study aimed to synthesize the findings of existing qualitative studies investigating what facilitates or hinders the implementation of ROM in clinical practice. Method: A systematic search of qualitative studies on clinicians’ experience with the use of ROM in mental health services was conducted via PsycInfo, PsycArticles, Medline, Web of Science, and Scopus databases. Qualitative meta-analysis was used to synthesize the finding of the primary studies. Findings: Fifty-five studies met the inclusion criteria. 22 meta-categories organized into five clusters reflected facilitators and barriers to ROM implementation, namely (1) Clinical relevance, (2) Institutional setting, (3) Practical level, (4) Client variables, and (5) Professional-personal level. Discussion: A meta-analysis showed several spheres that influence the successful use of ROM in clinical practice. Each area includes aspects that therapists perceive as facilitators or barriers to ROM use. The findings of this study can thus serve institutions as well as therapists who are considering the implementation of ROM in clinical practice. Key words: Routine outcome monitoring; qualitative meta-analysis; therapists’ experience; facilitators and barriers to implementation
  • The Psychotherapeutic Intersession Process Scale (PIPS): Development and Validation of a New Intersession Process Measure. .....Louisa Jagmetti, University of Zürich; Marie Drüge, University of Zürich; and Birgit Watzke, University of Zürich
  • Background: In the interval between psychotherapy sessions, individuals engage with and digest therapy content through intersession processes. Previous research has mainly focused on internalizing mental representations of therapy or the therapist from a psychodynamic perspective. Other approaches, as in cognitive behavioral therapy, have explored the explicit transfer of therapy to daily life through homework tasks. Significant associations between intersession processes, in-session processes, and psychotherapy outcomes have been identified. This project aimed to develop a new scale, which expands the established intersession theory to encompass concepts of general change mechanisms in psychotherapy, providing a broader process-measure for the intersession period. Methods: The PIPS was developed through a multi-stage process relying on pre-existing theory and literature, patient interviews and consultation with experts. The psychometric properties and factor structure were examined in an online study of psychotherapy recipients, using a cross-sectional design (target sample size of N = 290) with an additional longitudinal component in a voluntary subgroup. Results: The PIPS comprises 29 items covering significant life experiences (4), overall intensity of in- and inter-session periods (2), and specific intersession processes (23), including general change mechanisms such as resource activation, problem mastery and the internalisation of the therapeutic relationship. Results regarding the scale's psychometric properties, including reliability and construct validity, are reported. Conclusions: A new approach to the intersession concept and associated process measurement is presented. Further investigation of the PIPS using longitudinal designs as well as in specific populations and therapy settings is required.
  • From Routine Outcome Monitoring (ROM) to Routine Process Feedback (RPF): Empirical and clinical findings from ten years of idiographic system modeling. .....Benjamin Aas, sysTelios Health Care Center; Merlijn Olthof, sysTelios Think Tank; Florens Goldbeck, sysTelios Health Center; Nora Daniels-Wredenhagen, sysTelios Health Center; Konstantin Hegewald, sysTelios Health Center; Robin van den Bergh, sysTelios Health Center; Florian Pommerien-Becht, sysTelios Health Center; Rineke Bossenbroek, sysTelios Health Center; Silvia Scholz, sysTelios Health Center; and Anna Lichtwarck-Aschoff, sysTelios Health Center
  • Background. Clients and therapists report difficulties in adopting ROM to everyday practice. Reported are e.g. redundancy of items, too narrow focus (symptoms) or lack of training in how to feedback data to clients. Objective. We introduce as method to map, monitor and feedback individual processes, the use of idiographic system models, daily monitoring and feedback of data: Routine Process Feedback (RPF). Method. ISM data of >400 clients collected at Systelios were analyzed qualitatively for their degree of individualization and commonality (thematic analysis, Braun & Clark, 2006) and quantitatively for identification of shift patterns (PCA and change profile analysis). Results. We found large individuality within the concepts. Of the 4908 concepts recorded, 87% were mentioned by a single client only. These could be abstracted to seven common themes: autonomy, connectedness, emotions, self-care, identity, self-efficacy and bodily sensations. Classification methods yielded the following change profiles: no-shift (n = 55; 14%), gradual change (n = 52; 13%), one shift (n = 233; 58%), reversed shift (n = 39; 10%) and multiple shifts (n = 25; 6%). The multiple-shifts group had better treatment outcome than the no-shift group on all outcome measures. Discussion. ISM does justice to the individuality of clients and is capable of monitoring personal change on a broad set of factors. When change happens, it occurs mostly in sudden fashion. For therapists to make actual use of ROM, it needs to evolve towards RPF with individualized, frequent measures and routine feedback of the data to the therapeutic dyad within sessions.
  • Analyzing Symptom Trajectories After Inpatient Treatment to Design Algorithms for an Adaptive Aftercare Intervention for Agoraphobia. .....Maximilian Wilhelm, Center for Psychotherapy Research, Heidelberg University Hospital; Markus Moessner, Center for Psychotherapy Research, Heidelberg University Hospital; and Stephanie Bauer, Center for Psychotherapy Research, Heidelberg University Hospital
  • Objective: Patients with agoraphobia experience a heterogeneous course of symptoms after acute inpatient treatment. Tracking patients’ individual symptoms over time, known as routine outcome monitoring, makes it possible to adapt an intervention as it progresses. In this way, personalized, adaptive treatment strategies can dynamically adjust the level of support over time to better match individual needs with the intensity of support. At present, there is insufficient knowledge for the meaningful development of algorithms, which is why high-quality longitudinal data are required. Therefore, this study investigated the naturalistic symptom course of agoraphobia after discharge to develop and evaluate an algorithm for an innovative adaptive aftercare intervention. Method: A total of 56 inpatients with agoraphobia were recruited. After discharge, the participants were monitored online on a weekly basis for three months. Decision rules for an adaptive aftercare intervention were derived from the symptom courses. Results: Over the course of the three months, the individual symptom courses developed very heterogeneously. The majority of patients (70%) reported considerable symptoms over time, indicating need for further support. The weekly symptom monitoring proved feasible as 93% of assessments were completed. Applying the decision rules to the data resulted in early (86% before week 6) and relatively even group allocation (no, medium or high support needs). Discussion: Findings indicate that internet-based adaptive aftercare approaches are necessary, feasible, and promising. By dynamically adapting the intensity of care for individual patients, resource allocation and overall care can be optimized.
37. Strengths Based Strategies: Exploring Innovative Moments and Resource Activation in Psychological Interventions [Panel/Symposium]
Friday | 4:30 pm-6:00 pm | P31

Organizer: João Batista, University of Minho
  • Giving feedback in online writing interventions: A feasibility study. .....João Batista, University of Minho; Ana Sofia Fernades, University of Minho; Janine Marinai, University of Minho; and Miguel Gonçalves, Universidade do Minho, Braga, Portugal
  • Writing-based interventions (WBIs) have proven to be effective in helping people to deal with their difficult emotions and experiences. A recently explored add-on to WBIs is the use of feedback, as a way to deal with some limitations of these interventions and optimize their effects. This study tested a feedback system based on three sources: questionnaires, linguistic analysis and the identification of innovative moments and ambivalence. Innovative moments are instances where participants present a reasoning detached or alternative to the problematic one. Twelve participants from the Psychology course were recruited, and wrote four texts about their academic stress (two focused on the problematic experience and two focused on the resources to deal with it). After each writing participants received a writen feedback; the writing assignments lasted four weeks (one text per week). Self-report measures on psychological distress, academic stress, ambivalence and rumination were completed at pre-test, after each writing task and at post-test. At the end of the intervention participants were invited to a focus group to discuss their experience. Results show that the intervention and the feedback were evaluated as useful by the participants, with M= 7.7 (SD= 1.31) on a 10 points Likert scale. Pre-post test comparisons shown a significant decrease in psychological distress, academic stress and ambivalence. Participants emphasized how feedback allowed them to think differently and change their perspectives. Nonetheless, the individual tailoring of feedback is a time consumming process, indicating its use for particular situations, such as unmotivated participants, and not for large samples.
  • Client resources and the prediction of therapeutic change using the Feedback Initiated Narrative Development (FIND) Protocol. .....Carina Magalhães, University of Minho; João Tiago Oliveira, University of Minho; Andreia Milhazes, University of Minho; Pablo Fernández-Navarro, University of Minho; Rui Braga, Universidade do Minho, Braga, Portugal; Patrícia Pinheiro, ISMAI; Robert Neimeyer, Portland Institute for Loss and Transition; and Miguel Gonçalves, Universidade do Minho, Braga, Portugal
  • Feedback Initiated Narrative Development (FIND) protocol aims to activate clients’ resources in psychotherapy, comprising three components. This study assesses the feasibility of FIND 1, an interview, examining clients' self-perceived resources, their correlation with initial psychological distress, and their predictive value for distress and working alliance throughout sessions. Thirty cases were randomized to the FIND Protocol as an add-on to Cognitive Behavioral Therapy. FIND 1 interviews were analyzed using categorical content analysis. The association between resource proportion and psychological distress at intake assessment was explored. Multilevel analyses were conducted to investigate the possible effect of resources on psychological distress and working alliance. Adaptative and problematic resources were identified. Psychological distress and adaptative resources were negatively associated whereas problematic resources and psychological distress were positively correlated. Moreover, clients with a higher frequency of adaptative resources had a faster evolution of distress reduction and a higher increase in the therapeutic alliance. Clinicians should not take at face value resources that are self-reported, as they may reflect the problematic functioning of the client. The finding that clients with higher resources at onset have lower distress points to the need to study how resources may be elicited effectively during therapy, and if this improves psychotherapy outcomes.
  • Resource Activation & Innovative Moments: An Exploratory Case Study. .....Dario Paiva, University of Minho; Daniela Araújo, University of Minho; Rui Braga, Universidade do Minho, Braga, Portugal; Carina Magalhães, University of Minho; Helena Ferreira, University of Minho; João Tiago Oliveira, University of Minho; Miguel Gonçalves, Universidade do Minho, Braga, Portugal; and Christoph Flückiger, University of Kassel
  • Introduction: The practice of psychotherapy can focus on the deficits or resources of the client. While the latter has been more prevalent, research indicates that capitalizing on clients’ resources can be more effective than compensating for their deficits. In this study, we compare, in session, resource activation with Innovative Moments (IMs), which have also been associated with good outcomes in psychotherapy. It is postulated that the activation of resources in the therapeutic setting may facilitate the emergence of Innovative Moments (IMs), which are defined as instances where the client transitions from a maladaptive to an adaptive mode of meaning-making. Methods: In an exploratory case study from an archive case of major depression, treated with the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP), with 16 sessions, which were coded with the Innovative Moments Coding System and Resource-Oriented Microprocess Analysis (ROMA) for both the therapist and client. Results: We found that resource activation from the therapist is associated with the total emergence of IMs in the same session (r = .50, p < .05). Furthermore, resource activation from the client was associated with level 2 IMs emergence in the same session (r = .64, p < .05) and the emergence of IMs promotes resource activation in the next session (r = .43, p < .05). Discussion: The results will be discussed in light of the differences and similarities between the two coding systems utilized, and the potential amplification effect of therapist resources activation in session on clients' IMs.
Discussant:
  • Ulrike Willutzki, Witten/Herdecke University, Germany;
38. Experiential Therapy [Brief Paper Session]
Friday | 4:30 pm-6:00 pm | U23

Moderator: Anna Robinson, University of Strathclyde, Glasgow, UK
  • Exploring Emotional Processes in Complicated Grief: An Analysis of the Emotion-Focused Therapy´s Empty-Chair Task for Unfinished Business. .....José Gamoneda, Clinical Psychology Unit (UNINPSI) - Comillas Pontifical University (Madrid, Spain); Rafael Jódar, Comillas Pontificial University; and Ladislav Timuľák, Trinity College, Dublin, Ireland
  • The Empty-Chair Task for Unfinished Business has been studied in various problems such as depression or trauma, and despite it was originally proposed for grief work, it has not been sufficiently investigated, both in relation to clinical outcomes and the client processes that facilitate such changes. In this regard, this qualitative study, based on discovery-oriented phase of task analysis, aimed to appreciate the client's emotional processes related to therapeutic change in an intervention based on the Emotion-Focused Therapy’s Empty-Chair Task for Unfinished Business for Complicated Grief. This intervention consisted of 3 sessions of Emotion-Focused Therapy in which the task was performed once or twice in an online format (videoconference). To achieve this goal, a sample of n=7 patients who were in a process of complicated grief and achieved good therapeutic results after the intervention (clinically significant change and fall to non-clinical ranges) was analyzed. Additionally, observer-based measures such as CAMS, CEAS or CEPS were utilized. Quantitative scales were also utilized in the analysis, including the following measures: SA-45, ICG, UBBS, AAQ-II and the Ryff's Psychological Well-Being Scale. Emotional categories that occurred throughout the sessions (e.g., gratitude) were thus created. Subsequently, it was compared with clients (n=4) who had not obtained good results, in order to contrast the relevance of the categories previously found and to generate a model based on emotionally relevant processes. As the main result, this research presents a model of emotional processing in this task with important clinical and training implications.
  • Exploring the emotional impact of Sadness vs. Anger on Reflective Functioning in relational conflict. .....Yotam Strifler, Ben Gurion University, Beer Sheva, Israel; and Gary Diamond, Ben Gurion University, Beer Sheva, Israel
  • The ability to openly consider the mental states of others, and reflect on their experience, is termed other reflective functioning (RF). RF is believed to be an essential component of successful corrective episodes, the putative primary change mechanism in attachment-based family therapy. This study examined the impact of participants’ specific negative emotions (anger and sadness) on their ability to reflect on the state-of-mind of a significant other with which they are in conflict. We hypothesized that participants would evidence greater RF when feeling sad (as opposed to anger). Methods: 54 participants were interviewed about their conflict with a significant other. During the interview they were subjected to a mood induction (either sadness or anger). Finally, participants willingness to engage in information gathering regarding their significant others state-of-mind was measured. An adapted version of the RF scale was used to code RF at the level of speech-turns. Results RF can reliably be measured at the speech-turn level (ICC=.79). We have not yet found between-emotion differences in RF, though the data is still being collected. Discussion: Thus far, our results suggest that induced sadness and anger do not differentially affect reflective functioning in relational conflict. One question is whether our induction indeed led participants to experience the intended dominant emotion. To explore this possibility, we are now currently examining the results based on emotions actually expressed rather than assigned induction group.
  • Experiences of chairwork and working with parts in emotion-focused therapy for clients with autistic/neurodivergent process. .....Anna Robinson, University of Strathclyde, Glasgow, UK; and Robert Elliott, Strathclyde University, UK
  • Clients with autistic/neurodivergent process can experience difficulties in emotion processing and often report unsuccessful experiences of psychotherapy. In this brief paper, we present findings drawn from both individual and emotion-focused group therapy (EFGT) for clients with autistic/neurodivergent process. We demonstrate how chairwork and working with parts of self within session and across treatment can contribute to successful outcomes in EFT for clients with autistic/neurodivergent process. Specifically, how these tasks are instrumental to the change process across treatment: activation, deepening and transformation of emotions, accessing of core pain and associated unmet needs. Using the Client Emotional Processing Scale for Autism Spectrum (CEPS-AS; Robinson & Elliott, 2016) we report preliminary outcome data. Finally, we present a single case study of one client’s change process across EFT, which lends support for emotion-focused therapy as an effective intervention for people with autistic/neurodivergent process. The small number of participants in the study mean that the findings have limited generalizability. However, preliminary findings are promising but replication and further research are required.
39. Child and Adolescent [Brief Paper Session]
Friday | 4:30 pm-6:00 pm | U32

Moderator: Diana Lemmer, Heidelberg University, Germany
  • Children and young people’s experience of psychoanalytic psychotherapy: a qualitative meta-synthesis. .....Guilherme Fiorini, University College, London, UK; Meryl Westlake, University College, London, UK; Ritika Chokhani, University College, London, UK; Maryam Javed, University College, London, UK; Holly Norcop, Anna Freud Center, London, UK; and Nick Midgley, Anna Freud Center, London, UK
  • Background: The development of evidence-based practice guidelines for psychotherapy is based primarily on the findings from randomised controlled trials, but there is also a need to understand and learn from the experience of those who attend therapy. Some studies have begun to examine the experience of children and adolescents who have been in psychoanalytic psychotherapy. However, no investigations to date have synthesised this body of work and drawn clinical implications from this research. Aim: to provide the first qualitative meta-synthesis of empirical studies examining children and young people’s experiences of psychoanalytic psychotherapy. Methods: This systematic review followed the PRISMA guidelines and employed the JBI approach to meta-aggregation. Results: Articles meeting the inclusion criteria (n= 11) addressed treatments taking place in the UK, Scandinavia and Western Europe, and most of them focused on those who were in therapy as adolescents. The overall methodological quality of the studies was high. Based on the qualitative meta-synthesis, four over-arching themes were identified: (1) Children and adolescents learn to navigate their role during therapy; (2) The importance of the therapeutic relationship; (3) Psychoanalytic psychotherapy as a ‘painful’ process; and (4) Perceived impact of psychotherapy varies and is difficult to gauge. Some of the findings were consistent with the literature on adults’ experiences of psychoanalytic therapy, as well as young people’s experiences of other types of therapy. However, the findings also point to certain unique features of psychoanalytic psychotherapy for children and adolescents. The clinical implications of the findings are discussed.
  • The association between treatment onset and modality and suicidality in a three-year ‎follow-up study of suicidal adolescents seen in the emergency department: effectiveness, ‎multi-wave ‎longitudinal study.‎. .....Tamar Axelrad Levy, McGill University, Montreal, Canada; Freddy Ateba‎, McGill University, Montreal, Canada; Brian Greenfild, McGill University, Montreal, Canada; and Ashley Wazana, McGill University, Montreal, Canada
  • Suicidality among adolescents is currently considered as the second leading cause of death. ‎In an earlier study, we compared adolescents who received a Rapidly Responsive Outpatient ‎Treatment (RROP) and Treatment as Usual (TAU) and found that while the two groups achieved ‎similar increases in functioning and decrease in levels of suicidality, the adolescents in RROP had a ‎lower hospitalization rate. ‎ The current study goes beyond treatment arm analysis to examine specific treatment received ‎over the 4 years of follow up to examine the associations between treatments and adolescents’ ‎suicidality levels. Specifically, we ask whether treatment’s intensity and modality reduced suicidal ‎levels and increases well-being at 6-month and four-years after recruitment. ‎ The sample consisted of 286 adolescents who presented with suicidality in the emergency-room and ‎were randomized to RROP (N=158) or TAU (N=128). Patients in the RROP group received an ‎outpatient intervention from an experimental Emergency Follow-Up team immediately after their ‎discharge from the hospital, while patients in the TAU group received the usual treatments available ‎in their community. The randomization insured all subjects received equal opportunities, irrespective ‎of their sex, age, cultural or ethnicity background.‎ Data were collected at baseline, 2 and 6 months, and four years follow-up, and included ‎clinical diagnostic, suicidal levels, ER visits, treatments received, sociodemographic and ‎psychological traits.‎ To estimate the effectiveness of therapy on suicidality, individual-patient data analysis will be ‎performed. To detect small effects on therapy, analysis will be performed with subgroups ‎ The first findings for the effectiveness of therapies will be presented.‎
  • Differences in youths’ stigma and help-seeking attitudes between five mental health problems: An online experiment.. .....Diana Lemmer, Center for Psychotherapy Research, Heidelberg University Hospital & Heidelberg University, Germany; Markus Moessner, Center for Psychotherapy Research, Heidelberg University Hospital; Nicolas Arnaud, University Medical Center Hamburg-Eppendorf, Germany; Harald Baumeister, Ulm University, Germany; Agnes Mutter, Ulm University, Germany; Sarah-Lena Klemm, University of Leipzig Medical Center, Germany; Elisa König, University Hospital, Ulm, Germany; Paul Plener, University Hospital Ulm, Germany & Medical University of Vienna, Austria; Christine Rummel-Kluge, University of Leipzig Medical Center, Germany; Rainer Thomasius, University Medical Center Hamburg-Eppendorf, Germany; Michael Kaess, University of Bern, Switzerland & University Hospital Heidelberg, Germany; and Stephanie Bauer, Center for Psychotherapy Research, Heidelberg University Hospital & Heidelberg University & German Center for Mental Health (DZPG), Partner site Mannheim/Heidelberg/Ulm, Germany
  • Background: Previous research has identified differences in stigma and help-seeking attitudes between mental health (MH) problems. However, studies on youths and certain MH conditions such as anxiety or eating disorders are lacking. Objective: To compare youths’ public stigma and potential help-seeking between five MH problems (generalized anxiety disorder [GAD], depression, bulimia nervosa [BN], non-suicidal self-injury [NSSI], problematic alcohol use). Methods: In this online-experiment, N=554 youths aged 14 to 29 years (M=20.86, SD=3.60) were randomized to an animated video vignette depicting one of the MH problems. After viewing the respective vignette, participants completed the Universal Stigma Scale (USS) and the General Help Seeking Questionnaire (GHSQ), assessing public stigma and potential help-seeking. Differences between the MH problems on the outcomes were evaluated using Kruskal-Wallis tests. Bonferroni-corrected Dunn’s post-hoc tests were calculated for statistically significant differences. Results: Statistically significant differences between MH problems were found with regard to blame, distrust (USS), formal, informal, and no potential help-seeking (GHSQ). Compared to the other conditions, problematic alcohol use was more stigmatized. Formal potential help-seeking was more likely for problematic alcohol use as compared to depression, whereas not seeking any help was less likely for problematic alcohol use than for depression, BN, and NSSI. The BN characters were blamed more for their condition than the depression characters, whereas the reverse pattern emerged for distrust. However, this sample generally held positive MH attitudes. Conclusions: Our results confirm previous findings on attitudinal differences towards different MH problems and may inform the development of targeted anti-stigma and help-seeking campaigns.
40. Change Processes [Brief Paper Session]
Friday | 4:30 pm-6:00 pm | U33

Moderator: Jo Levy, King’s College London
  • What takes place within the periods of the therapeutic process characterised by high flexibility?. .....Giulio de Felice, Sapienza University of Rome, Italy; and Günter Schiepek, Paracelsus Medical University, Salzburg, Austria
  • The good therapeutic process is characterised by the alternation of periods of high stability and high flexibility. Usually in periods of high flexibility new and more functional information is introduced into the therapeutic relationship. On the other hand, in periods of high stability the patient's new functioning consolidates. However, we don't know in detail what takes place within periods of high flexibility. There are no micro-analytical studies that investigate this phase of psychotherapy. For this reason, the present study, based on a sub-sample of 20 patients of a larger sample with n=251 patients, analyses the changes occurring within these periods. In particular, for each patient we studied a) his/her initial state, b) the high flexibility period, c) the high stability period, d) his/her functioning at the end of the therapeutic process. The results highlight that the periods of high flexibility hold the elements of the patient's change which, later, will be included in his new stable functioning at the end of the treatment. In particular, the therapeutic dyad brings out a previously latent principal component, and then integrates it into the patient's general functioning. Overall, the results confirm the centrality of periods of high flexibility within good therapeutic processes.
  • Psychotherapy process expectations and their association with mental illness attributions. .....Dana Elberg, Haifa University, Israel; and Dana Tzur Bitan, Haifa University, Israel
  • Introduction: Psychotherapy change process expectations refer to what individuals perceive to be the mechanism of change in psychotherapy. Studies demonstrate that change process expectations are linked to therapy process and outcomes, however, not much is known about their origins. In this study we aimed to explore whether causal attributions to mental illness are associated with change process expectations. The study was initiated as a joint sub-project of the international committee of Division 29 of the APA. Methods: Participants (n = 291) completed assessments regarding mental illness attributions and their expectations of the active processes in psychotherapy. Univariate linear regressions were preformed to assess whether attributions are associated with change process expectations. Results: Social/stress attributions (i.e., the belief that traumatic experiences cause mental illness) predicted expectancy that therapy will foster resilience (b=.308, p=.000) and focus on the ability to share sensitive contents openly and securely. Hereditary/biology attributions (i.e., the belief that mental illness is a result of a brain disfunction) were associated with all expectation factors which were not related to patient-therapist interactions (factor 3: b=.179, p=.003, factor 4: b=.164, p=.007, factor 5: b=.259, p=.000, factor 6: b=.196, p=.001, factor 7: b=.265, p=.000). Supernatural attributions (i.e., the belief that fate or destiny cause mental illness) were associated with expectancy that psychotherapy will include exploration of therapist-patient relations (b=.275, p=.003). Conclusions: Individuals perceptions about the origins of mental illness are linked to their expectations about the therapeutic processes, however, additional research is needed to evaluate the mechanisms leading to these covariations.
  • The Impact of Gender on Pathways into Psychotherapy: Insights from the POPP Study. .....Yvonne Schaffler, Danube University Krems; Elke Humer, Sigmund Freud University, Vienna, Austria; Brigitte Schigl, Karl Landsteiner Universität; Thomas Probst, Paris Lodron Universität Salzburg; and Erwin Schweitzer, Universität für Weiterbildung Krems
  • Background: While studies suggest that gender might influence the dynamics of psychotherapy in nuanced ways, little is known about the external and internal processes mediating between the onset of suffering and the actual entry into psychotherapeutic treatment. Previous studies have shown that women are more likely than men to talk about their mental health problems with family, relatives, friends and professionals due to social and cultural norms, as they respond more expressively to emotional issues. Aim: This study aims to delineate the pathways through which men and women seek a psychotherapist in private practice in Austria. By exploring the underlying decision-making processes that guide their choices, we hope to provide novel and up-to-date insights into the gender dynamics of mental health seeking. Methods: Data were drawn from the POPP study, a naturalistic, observational study combining process—and outcome-oriented approaches. This extensive study's methodology included standardised pre- and post-treatment questionnaires, a post-session questionnaire, and semi-structured qualitative interviews with patients and therapists. For the presented project, 43 patient interviews were analysed using Atlas.ti to capture personal experiences and considerations regarding psychotherapy-seeking. Results: The results suggest that while male and female patients are represented similarly across facilitators, such as having mentioned several therapy-encouraging members of their supportive social network, having met therapy-encouraging professionals, having drawn on certain types of information, etc., women and men show a different pattern when it comes to decision-making styles, e.g., in terms of deeper self-reflection, analytical reasoning, or the expression of intuitive decisions.
  • Exploring Identity & Belonging. .....Jo Levy, King’s College London
  • What are the experiences of Gender & Sexuality Diverse Therapists in University Counselling Services? How does this link to psychosocial assumptions made around clinical matching? This research will explore the experiences of Gender and Sexuality Diverse (GSD) therapists who work in university counselling services. It seeks to demonstrate how this links to and impacts psychosocial assumptions around clinical matching in this setting. This research sets the context of working in a university counselling service as a psychodynamic therapist in a multidisciplinary team, and Head of Service, who identifies as GSD. The current landscape of working in the sector and coming from a marginalised and minoritised group will be outlined. Links will be made to psychosocial assumptions made around clinical matching. In this research I will explore and highlight some experiences of GSD therapists who come from marginalised groups who may experience minority stress, within their own institutions. Understanding their experiences will help inform the research. I will consider why this is important? How these impacts psychosocial assumptions made around assumed matching? I aim to demonstrate matching clients and therapists around GSD is complex and may be clinically beneficial. Conversely, this research may demonstrate where this has been contraindicative to the work. That to assume similarity when there is so much difference, might negatively impact both therapist and client. Making psychosocial assumptions about similarity and difference in the matching process of therapist to client may be detrimental. The setting and structure (of the university setting/ organisation) itself will be carefully considered.
41. Poster Pitch 1: Alliance and Change Processes [Poster Session]
Friday | 6:00 pm-6:30 pm | U23

Moderator: Miguel Gonçalves, Universidade do Minho, Braga, Portugal
  • Effectiveness and mechanisms of feedback: An experimental study protocol. .....Ondřej Fajstavr, Masaryk University, Brno, Czech Republic; Tomáš Řiháček, Masaryk University; Petr Doležal, Masaryk University; Michal Čevelíček, Masaryk University in Brno; and Jan Nehyba, Masaryk University, Brno, Czech Republic
  • The idea that feedback improves outcome in therapy is now supported by several studies and meta-analyses. The primary aim of this study will be to test the effectiveness of client-reported feedback through the DeePsy platform (a Czech feedback system). Furthermore, it is hypothesized that several mechanisms mediate the effect of feedback on outcomes; we will test the mediating effect of these variables. The experimental group (with feedback) and the control group (without feedback) will be compared through a within-therapist between-client design: each client will be randomly assigned to the experimental or control condition. In addition, the two conditions above will be compared to a no-feedback archival comparison group. Therapists will be trained prior to the experiment. The findings on feedback mechanisms will have important consequences for implementing feedback in routine care and for training psychotherapists.
  • Therapist multicultural orientation as predictors of therapeutic alliance and therapy outcomes in multicultural psychotherapy dyads (Jewish therapist-Arab client) compared to same-culture dyads. .....Eyad Hatoom, University of Haifa, Israel; and Hadas Wiseman, University of Haifa, Israel
  • Aim: Based on the Multicultural Orientation model, the main purpose of the study is to examine the relationships between psychotherapists multicultural competencies of cultural humility, cultural comfort, and racial microaggressions to the therapeutic alliance and psychotherapy outcomes in inter-cultural psychotherapy dyads compared to same culture dyads. Additionally, we expected that therapeutic alliance would mediate cultural humility with therapy outcomes, and cultural humility would mediate microaggression with therapeutic alliance. Method:56 clients and 32 therapists were recruited, resulted in three types of therapy dyads: Inter-cultural dyads, Jew therapists- Arab clients, same-cultural dyads, composed of Jew therapists -Jew clients and Arab therapists- Arab clients. The participants completed the questionnaires before the first, third, tenth and fifteenth sessions. The clients completed OQ-45, IIP at the beginning of therapy, at fifteenth session. the MCO measures and therapeutic alliance was completed at third, tenth and fifteenth session. The therapists completed the therapeutic alliance at third, tenth and fifteenth sessions. Results: Our first hypothesis that the dyad type would not moderate the outcome variables was supported. Also the predicted association between positive cultural humility with OQ-45 and therapeutic alliance supported . In addition, Racial microaggression was associated with positive cultural humility and working alliance. The predicted models that the therapeutic alliance would mediate the negative cultural humility with therapy outcome was not supported. However, the therapeutic alliance mediated the positive cultural humility with therapy outcomes. Additionally, the hypothesis that positive cultural humility mediates the microaggression occurrence with therapeutic outcomes was supported. Discussion: This study deepens our understanding whether and how the therapists' cultural competencies, specifically, multicultural orientation is associated with the therapeutic alliance and therapy outcomes in the common Jew therapist and Arab clients dyads in Israel, compared to same culture dyads.
  • The strength of the therapeutic relationship and the effectiveness of psychotherapy treatment. .....Karolina Skrobol-Bojarczuk, Jagiellonian University Medical College, Doctoral School of Medical and Health Sciences; Michał Mielimąka, Jagiellonian University Medical College; Jerzy Sobanski, Jagiellonian University Medical College; Joanna Mostowik, Jagiellonian University, Kraków, Poland; and Krzysztof Rutkowski, Jagiellonian University, Kraków, Poland
  • Purpose: The purpose of this study is to evaluate the relationship between the strength of the therapeutic alliance and treatment effects in psychotherapy. The strength of the therapeutic relationship is defined according to Bordin's model as the result of the occurrence of three elements. In the project, patients' recovery was defined multidimensionally. Not only changes in symptoms and personality structure were taken into account, but also certain permanent characteristics of patients (early maladaptive schemas and psychological flexibility). The network of social relationships built by the subjects was also taken into account. Methodology: The project is questionnaire-based. A repeated-measurement method was used. Patients completed tests at the beginning and at the end of the process. The first part of the study involved 33 participants (k = 19, m = 14). Results: The results of the preliminary study indicate that building a stronger therapeutic relationship is associated with improvements in the severity of presenting symptoms. The strength of the therapeutic alliance at the end of the process was also found to be associated with a reduction in the severity of childhood schemas. In addition, patients establishing a stronger relationship with the therapist reported higher levels of perceived and received support and a better ability to seek it. No changes in psychological flexibility were observed. Conclusions: The therapeutic relationship is a significant factor in the psychotherapy treatment process. Its intensity, however, does not explain all the changes that occur during treatment.
  • Flexibility between immersion and distancing: Relationship with depressive symptoms and therapeutic alliance. .....Ricardo Lisboa, Maia University; Eunice Barbosa, Maia University; Inês Moura, Maia University; João Salgado, University of Maia, Portugal; and Marlene Sousa, University of Maia
  • Objectives: High levels of change are linked to the flexibility between immersion and distancing, as well as to higher levels of therapeutic alliance. This study aims to explore the evolution of flexibility between immersion and distancing throughout the entire therapeutic process and its relationship with therapeutic alliance and depressive symptoms in a clinical case. Method: We analyzed 5 sessions of a good outcome case of depression undergoing cognitive-behavioral therapy. We assessed the distancing/immersion of these sessions using the Measure of Immersed and Distanced Speech, and therapeutic alliance with the Working Alliance Inventory-Short Form. The depressive symptoms were assessed from the Beck Depression Inventory-II Results: Flexibility increased throughout the therapeutic process. Flexibility and therapeutic alliance increased throughout the therapeutic process. Strong negative correlation was found between flexibility and depressive symptoms. The therapeutic alliance from both the client's and therapist's perspectives evolved alongside the flexibility between viewpoints throughout the sessions. Conclusions: The increase in flexibility can be an adaptive pattern associated with the decrease in depressive symptoms, the increase in therapeutic alliance (from both the client's and the therapist's perspective), and therapeutic success.
  • Reciprocal Relationship Between Self-Criticism and Outcome in Inpatient Psychotherapy. .....Tamara Ringel, Clinic for Psychosomatic Medicine and Psychotherapy, Clinic of the Heinrich-Heine-University Duesseldorf, Germany; Simone Jennissen, Institute for Medical Psychology, University Heidelberg, Germany; Hans-Christoph Friederich, Clinic for General Internal Medicine, University clinic Heidelberg; and Ulrike Dinger, Clinical Institute for Psychosomatic Medicine and Psychotherapy, University Clinic Duesseldorf, Germany
  • Background Self-criticism is a personality variable (Blatt, 1974) that is related to various mental disorders. It is conceptualized as state-trait model, meaning that it varies both between persons (trait) and within individuals over time (state) (Zuroff et al., 2016). This distinction is meaningful in psychotherapy research to investigate change mechanisms (Zilcha-Mano, 2021). We know that self-criticism as trait impairs the psychotherapeutic process and predicts a worse outcome (Löw et al., 2020). However, less studied is the role of self-criticism as a potential change mechanism: whether a reduction of self-criticism during psychotherapy predicts future symptom reduction – and vice versa. Therefore, the aim of this study was to investigate the reciprocal relationship between self-criticism and symptom severity over the course of inpatient treatment. Method Over the course of an eight-week inpatient treatment, patients (N = 1.490) weekly filled in one self-report measure of self-criticism (DEQ-12) and one of symptom severity (SCL-K11). Using a dynamic panel-model, we analyzed the interaction of the two variables over time. This model is particularly suited for longitudinal data, to infer causality and to differentiate between state- and trait-effects. Results The data point to a reciprocal relationship between self-criticism and symptom severity during inpatient psychotherapy: a reduction in self-criticism of one patient predicted the same patient’s future symptom reduction and vice versa. This effect was particularly strong in the middle of treatment. Discussion As self-criticism lead to symptom reduction, it can be interpreted as change mechanism that might be notably prominent during the working phase of treatment.
  • Brief Narrative Interventions using Online Videoconferencing and Synchronous Chat: A Clinical Trial in the Making. .....Fritz Mende, CPUP; and Margarida Rangel Henriques, CPUP
  • Many people in need of support turn to online services delivering psychological interventions through videoconferencing and text-based chat, while researchers seek to determine if, how, and for whom such interventions are effective. Findings so far are encouraging, however, further empirical evidence on intervention effectiveness, and insights into how psychological interventions work in different online environments, are needed. We will present the protocol for a clinical trial on psychological intervention through videoconferencing or synchronous chat, currently under development. The trial will include two intervention groups that will receive a brief therapist-delivered intervention based on general counselling and narrative principles, either through videoconferencing or chat, and a waiting list condition. Participants will be recruited through Psic.ON, an online service that provides cost-free psychological support at the University of Porto. Pre and postintervention, and follow-up assessments of psychological distress will be used to test intervention effectiveness, while session-by-session monitoring of symptoms, session experience and working alliance, will help to shed light on how the interventions unfold. Further, postintervention interviews will be carried out to explore participants’ experiences and perceptions, and session transcripts from videoconferencing and chat participants will be analysed to explore instances of meaningful changes, so further insights into the intervention processes in these two delivery modalities may be gained. This study will contribute to the evidence base on effectiveness of online interventions, deepen our understanding of how different delivery modalities work, and inform clinical practice. The project is supported by national funding from the Portuguese Foundation for Science and Technology (UIDB/00050/2020).
  • Development and First Validation of a New Self-Rating Scale for the Assessment of the Group Therapeutic Alliance: The TAQ 36-2 Group. .....Joanna Mostowik, Jagiellonian University, Kraków, Poland; Michał Mielimąka, Jagiellonian University Medical College; and Krzysztof Rutkowski, Jagiellonian University, Kraków, Poland
  • Background: Our research interest was to develop a questionnaire to measure the perspectives of the therapeutic alliance (TA) of patients in group psychotherapy, especially when led by the team of two psychotherapists. The questionnaire is designed to measure the quality of the whole TA developed up to the moment of measurement, not only the quality of the particular therapeutic session. The development of the TAQ 36-2 - items, its factorial structure and psychometric criteria, will be presented. Methods: First, the items were evaluated twice by seven competent judges. The reliability and validity of the TAQ 36-2 questionnaire were tested in an outpatient sample in Poland. The group of 167 patients treated in intensive short-term group psychotherapy in the day center completed the questionnaire. A confirmatory factor analysis was performed, followed by an exploratory factor analysis. Internal consistency was calculated for the scales obtained. Theoretical validity was tested by correlating the TAQ 36-2 scales with the WAI-SR scales. Results: Exploratory factor analysis confirmed four dimensions: (1) shared sense of goals and task, (2) emotional bond, (3) patient attitude and commitment, and (4) patient therapy working capacity. The scales showed good internal consistency (0.71-0.92). Conclusions: The results obtained underline the good psychometric criteria of TAQ 36-2 and its potential use in further empirical research on the therapeutic alliance within group psychotherapy. The questionnaire may also provide useful data to qualitatively monitor the quality of TA during treatment.
  • Therapist responsiveness in the first therapy session: A pilot study. .....Agathe Scappini, Radboud University, Nijmegen, Netherlands; Ger Keijsers, Radboud University, Nijmegen, Netherlands; and Giel Hutschemaekers, Radboud University, Nijmegen, Netherlands
  • Background: Therapist Responsiveness (TR) refers to therapists’ ability to adapt their therapeutic approach to clients’ emerging needs during sessions. Preliminary evidence suggests TR to be associated with positive treatment indicators, however, no solid operationalization of TR exists yet. Objectives: We aim to gain more insights into how TR is manifested during sessions and how it is perceived by clients. We investigate whether therapy moments (in the first session) that are perceived as helpful by clients are characterized by greater objective display of Facilitative Interpersonal Skills (FIS) by therapists, compared to unhelpful and random moments. We also investigate whether helpful and unhelpful moments differ in client-perceived TR and whether client-perceived TR relates to the display of FIS. Method: The first session of 70 pairs of students undertaking clinical training is video-recorded. ‘Clients’ rewatch the recording and identify the most and least helpful moments (3-minute clips) from the session. For each moment, clients rate TR. A third moment is randomly selected by the research team. Independent coders assess the display of FIS in the extracted clips. The FIS ratings for the helpful, unhelpful, and random clips are compared with a RM-ANOVA. Results: Pilot data (N=11 dyads) indicate that helpful moments are characterized by greater client-rated TR compared to unhelpful moments, and greater observer-rated FIS, compared to unhelpful and random moments. Client-rated TR is not significantly associated with observers-rated FIS. Conclusion: These preliminary results provide partial support for a novel operationalization of TR as “the timely display of FIS”.
  • What are the ingredients of a "good" therapeutic relationship in substance use treatment? Preliminary results from a qualitative study. .....Paula Alves, University of Greenwich; Natalia Gheorghiu, University of Greenwich; and Melisa Eyuboglu Eyuboglu, City University London
  • The therapeutic relationship is considered to be one of the most important elements that contribute to successful treatment outcomes. However, little is know what elements, or ingredients, contribute to a good relationship in the field of substance use treatment. In this phenomenological qualitative study, we conducted semi-structured interviews 9 counsellors and therapists working delivering individual session to adults in substance use treatment across the UK and Portugal. Interviews focused on what elements contribute to a "good" and "bad" relationship with this client group, from their perspective. Interviews lasted approximately 40 minutes and were conducted online via MS Teams, and later transcribed verbatim and analysed following a thematic analysis approach. In this brief paper, we will present the preliminary results of this analysis, which to date, has already uncovered aspects such as empathy or trust as positive elements, or frustration towards clients lack of progress as hindering to the therapeutic process. The implications of these findings will also be discussed.
42. Poster Pitch 2: Couple, Group, Family, Child, & Trauma
Friday | 6:00 pm-6:30 pm | U32

Moderator: Biljana van Rijn, Metanoia Institute
  • Studying interpersonal synchrony in short segments of multi-actor therapy conversations. .....Virpi-Liisa Kykyri, University of Jyvaskyla; Petra Nyman-Salonen, University of Jyvaskyla; Anu Tourunen, University of Jyväskylä, Finland; Mikko Ruhanen, University of Jyvaskyla; Markku Penttonen, University of Jyväskylä; Joana Coutinho, university of Minho; Wolfgang Tschacher, University of Bern, Switzerland; and Jaakko Seikkula, University of Jyväskylä
  • Background: Interpersonal synchrony in psychotherapy has mainly been studied in entire sessions. To detail the meanings of synchrony, we need to focus on how synchronies vary in moment-by-moment interactions of the session. Aims: The aim of this presentation is to illustrate problems and possibilities involved in studying interpersonal synchronies in segments of varying length. We present observations from three studies, in which synchrony values were integrated with qualitative analyses of the emotional and conversational aspects of the social interaction. Methods: In study 1, synchronies in movement and skin conductance (SC) were calculated in 30-second segments of 12 couple therapy sessions. In study 2, synchronies in respiration and SC were calculated in 31 reflection periods of varying length (two minutes or longer). In study 3, a couple therapy session was divided into 18 topical episodes (two minutes or longer), in which synchronies were calculated. Results: In study 1, synchronies were more prominent in SC than in movements. In study 2, significant synchrony in SC, but not in respiration, was found in reflection periods. In study 3, significant synchronies in SC and movements were found in each topical episode. Regression models showed that SC synchrony was associated with the emotional aspects of the session and targets of the conversation, while movement synchrony was only related to emotional valence. Discussion: It may be more feasible to calculate synchrony in SC than in movements in very short segments. Movement synchrony was observed more in longer segments and only rarely in 30-second segments.
  • The level of intensity of envy versus determinants of improvement in patients treated in intensive group psychotherapy. .....Aleksandra Ściegienny-Lemler, Jagiellonian University, Kraków, Poland; Michał Mielimąka, Jagiellonian University Medical College; and Krzysztof Rutkowski, Jagiellonian University, Kraków, Poland
  • Objective: The goal of the research is to investigate whether the level of identity integration in patients treated in intensive group therapy impacts the relationship between their envy and reparation levels. The presentation also aims to explore the dynamics of change in the psychotherapy process, and make predictions regarding the possibility of reparation. Method: The research, initiated in 2022, focuses on randomized group therapy patients with anxiety and personality disorders, treated for 3 months. The level of intensity of envy and determinants of improvement were measured three times using KON-2006, MMPI-2, SSIE, STAR, IPOPL questionnaires. Results and conclusion: Analysed data show a correlation between the levels of envy intensity and reparation. The lower the level of envy, the higher the feeling of guilt. Decreased level of envy entails strengthened motivation for treatment and improved perception of the psychotherapeutic relationship. Contrary to our expectations, our research suggests that the level of identity integration does not act as a mediator or moderator between the envy and reparation levels. The level of intensity of envy is a strong, negative predictor of the feeling of guilt, and moderately predicts negative attitude to psychotherapy while the level of identity integration is a strong predictor of a positive perception of the therapeutic relationship. The preliminary analysis of the dynamics of changes in the psychotherapeutic relationship is still being completed. A comparative analysis between the different measurements is also considered. Results could be applied to clinical practice as well as treatment prognosis.
  • Do the level of relational functioning in adolescents influence treatment response in psychoanalytic psychotherapy?. .....Thea Schønning, University of Oslo, Norway; Benjamin Hummelen, Oslo University Hospital, Norway; Per Andreas Høglend, University of Oslo, Norway; Hanne-Sofie Johnsen Dahl, University of Oslo, Norway; and Randi Ulberg, University of Oslo, Norway
  • Background: Moderator effects on transference interpretations have been reported for Quality of Object Relations (QOR) in adult psychotherapy. The usefulness of Short-Term Psychoanalytic Psychotherapy (STPP) may be enhanced for adolescents by exploring possible moderators. The current paper examined the relation between QOR and outcome in two treatments for Major Depressive Disorder (MDD) in adolescents. Method: Participants included 69 adolescents aged 16-18 years (84% female) who met diagnostic criteria for MDD. They were randomly assigned to receive 28 weeks of STPP, either with or without transference interpretations (TI). QOR was assessed at baseline, and psychological capacities were assessed at baseline, post-treatment, and one-year follow-up using the Psychodynamic Functioning Scale (PFS). Linear mixed models were utilized to investigate the effects of QOR and time on PFS. A linear spline model provided a detailed examination of effects during therapy and from post-treatment to one-year follow-up. Results: The linear mixed model for the entire study period did not show a moderator effect of QOR. The results from the linear spline model indicated that the initial level of QOR did not significantly moderate treatment response differences between the two treatment groups during treatment. From post-treatment to one-year follow-up, adolescents with higher initial QOR scores benefited significantly more from STPP without TI, while those with low QOR scores benefited more from STPP with TI. Conclusion: This study underscores the importance of incorporating transference work for adolescents with low relational functioning
  • Emotional Processing in Psychological Interventions for Breast Cancer Patients: A Systematic Review. .....Karina Schlegel Eliachar, University of Maia, Portugal; Marta Gomes, University of Maia, Portugal; Marina Monteiro, University of Maia, Portugal; and João Salgado, University of Maia, Portugal
  • Objective: Breast cancer is the leading cancer in women globally, including Europe, with profound health and psychological effects. While psychological interventions can ease stress from breast cancer diagnosis and treatment, there remains a gap in research regarding the emotional processing in these interventions. This review aims to identify how psychological interventions for breast cancer patients correlate with different stages of emotional processing. Method: A literature search was performed in scientific databases, namely Scopus, Web of Science, PubMed, Academic Search Complete, and PsycArticles. Articles published from 2013 until 2023 were included. Results: Of 112 abstracts, 49 were deemed eligible for inclusion. A total of 53 interventions were categorized into five groups: Psychoeducational (n = 6), Coping Skills (n = 25), Emotional-based (n = 2), Cognitive-based (n = 17), and Trans-theoretical (n = 3). Regarding emotional processing stages based on Greenberg's model, emotion regulation (85%) and emotional awareness (57%) were the most addressed processes among these interventions. Conclusion: Although most studies found benefits for breast cancer patients in some dimensions, such as quality of life, psychological distress and physical symptoms associated with the disease, such interventions might not fully explore the depth of emotional experiences, especially in alignment with Greenberg's emotional processing framework. Further studies are needed to evaluate emotional processing in psychological interventions, thereby guaranteeing that patients receive optimal care throughout their cancer journey.
  • Working alliance expectations and changes in insight influencing psychotherapy outcomes in group dynamic psychotherapy. .....Benita Wielgus, Psychotherapy Unit, The University Hospital, Krakow, Poland; Michał Mielimąka, Jagiellonian University Medical College; and Krzysztof Rutkowski, Jagiellonian University, Kraków, Poland
  • Background: Working alliance (WA) and insight (IN) are considered as the active ingredients of psychotherapy. There is a lack of previous evidence about expectations for WA (WAE) at the beginning of psychotherapy, how expectations change during the process and its associations with changes in IN and outcomes. The study aimed to examine (1) the trajectories of change in the active ingredients (WA and IN) and two outcome domains of resilience (RS) and neurotic symptoms (NS); (2) the impact of WAE and IN changes in different phases of the psychotherapy process on outcome. Method: Patients with neurotic and personality disorders (N=49) were tested at the 1st, 4th, 8th and 12th session using the Working Alliance Interview – Short Version, the Psychological Insight Questionnaire, the Connor-Davidson Resilience Scale and the Neurotic Symptoms Checklist. Results: By using hierarchical linear modelling with repeated assessments, linear increase in WA, RS, IN and decrease in NS were observed. Moreover, separated models for NS and RS were created to compare two domains of outcomes. In NS model, IN growth in the middle phase of psychotherapy was associated with NS decrease over time. The pretreatment WAE were not associated with NS decrease, however the impact of the level of IN growth in middle phase of psychotherapy on NS decrease was moderated by pretreatment WAE. On the other hand, in RS model, increase in RS over time was associated with pretreatment WAE and WA growth in initial phase of psychotherapy. In the RS case, results did not reveal interactions between WAE and IN growth. Conclusion: More research is needed to understand how interactions between WAE and IN influence psychotherapy process.
  • Speaking vs. Engaging: Predictors of Session Satisfaction in Online Work Supervision. .....Anu Tourunen, University of Jyväskylä, Finland; Mikko Pohjola, Terveystalo, Finland; Joona Muotka, University of Jyväskylä, Finland; Miriam Nokia, University of Jyväskylä, Finland; and Virpi-Liisa Kykyri, University of Jyvaskyla
  • Background: Since the COVID-19 pandemic, the use of online platforms for work meetings and therapy sessions has increased significantly. However, understanding what makes an online session effective, particularly in terms of active participation and session satisfaction, remains limited. Aims: This study explored the impact of the amount of speaking and broader, observed measures of engagement on the session ratings of online work supervision sessions among healthcare professionals. Methods: Data were collected from 24 online Zoom supervision meetings involving 31 mental health and substance abuse professionals. Four groups of 7-9 supervisees each met six times under the guidance of two supervisors. During the sessions, participants recorded their facial video and completed a modified Session Rating Scale tailored for work supervision after each session. Engagement was coded every 0.5 seconds from videos using a scale from -10 (full disengagement) to +10 (full engagement). Path analyses were conducted in Mplus using MLR and complex model to adjust for nested data. Results: Full engagement during the working phases of the sessions, as coded from facial videos, was a better predictor (12.9%) of session ratings than the sheer amount of speech (6.7%). When both predictors were included in the model, the influence of speech became non-significant, while full engagement retained a significant positive effect. Discussion: Active participation in online work supervision, including speech, minimal vocalizations, nods, and facial expressions, relates to higher session evaluations. Engagement that also involves nonverbal aspects is a more robust predictor of satisfaction than merely the quantity of speaking.
  • Barriers to engaging in family based treatment. .....Gabriel Peer, Ben Gurion University, Beer Sheva, Israel
  • Family-based treatments (FBTs) for young adults are efficacious for treating a wide range of clinical disorders, including depression, eating disorders, disruptive disorders, substance use and relationship concerns (Friedlander et al, 2022; Tanner-Smith et al, 2013). Nevertheless, many young adults seem to prefer individual treatments. This study examined the rates at which young adults preferred individual therapy versus FBT, and the psychological/emotional factors driving their preference. Methods: University students reporting ruptures in their relationships with their parents and being interested in psychotherapy completed a survey asking them to describe the nature of the rupture, to what degree they would prefer individual versus family therapy, and the psychological/emotional reasons for their preference. Results: Preliminary results suggest that 95% of participants would prefer individual therapy over FBT. Their reasons were: fear of getting hurt by the parents during conjoint sessions, skepticism about parents’ motivation or ability to change, and fear of hurting parents or being a burden on them. Discussion: Our findings will provide insight regarding how to reduce barriers to engaging young adults in FBTs, and contribute to improving initial engagement strategies for FBT.
  • Daring Birth study - the impact of a digital coaching solution on perinatal mental health. .....Riikka Lemmetyinen, Aalto University; Henni Tenhunen, Aalto University; and Erkki Heinonen, University of Oslo, Norway
  • 1. AIM Fear of childbirth, often comorbid with other perinatal mental health problems, is a prevalent public health concern that is highly correlated with a negative childbirth experience and impaired postpartum, threatening the psychological progression of pregnancy and early interaction between parent and child. We introduce a digital coaching solution for supporting childbirth and mental health, based on self-report emotion tracking and cognitive-behavioral and emotion-focused exercises. 2. DATA AND METHODS The study is a randomized controlled trial with two arms (treatment and control) comprising a total of 200 nulliparous women. Treatment group uses the mobile application developed as a collaboration between a perinatal psychologist, an obstetrician, a doula and a service designer. Fear of childbirth is assessed with Visual Analogue Scale (VAS) and the Wijma Delivery Expectancy Questionnaire (W-DEQ A), and perinatal anxiety problems with the General Anxiety Disorder 7-item scale (GAD-7). 3. RESULTS We report the effectiveness of the solution in reducing fear of childbirth and perinatal anxiety. We expect greater reduction in the treatment group. 4. DISCUSSION We postulate that digitally conveyed psychological exercises - based on verbalization of feelings, validation, and strengthening self-compassion via emotion-focused and cognitive behavioral principles - can enhance self-understanding, self-soothing skills, and self-efficacy in relation to emotions and pregnancy. Scalable, easily accessible solutions are needed to address this prevalent problem.
43. Poster Pitch 3: Qualitative, Case-study, Assessment, and Other
Friday | 6:00 pm-6:30 pm | U33

Moderator: Tomáš Řiháček, Masaryk University
  • Measuring Deliberate Practice - Exploratory Findings. .....Stefan Blümel, University of Bamberg, Germany; and Sabine Steins-Löber, University of Bamberg
  • Objective: Deliberate practice (DP) in psychotherapy has sparked considerable interest as a means to enhance skills, expertise and therapy outcomes. However, the field faces ongoing challenges in establishing assessment methods. Existing scales primarily rely on retrospective self-reported time tracking or diary methods , limiting either their robustness or being time consuming. Consequently, there's a need to devise more efficient, reliable, and valid assessment tools for measuring DP in psychotherapy and training. To address this gap, two scales were constructed: one assessing attitudes towards DP (DPA), and the other assessing DP related behaviors (DPB). These scales aim to enable more efficient assessments to deepen insights into the potential benefits of DP. Method: An initial item pool was created in German based on various descriptions of DP in the field of psychotherapy and following discussions by researches familiar with the topic. After content validity ratings of items, a pool of 15 items (DPA) and 34 items (DPB) for the respective scales was established and analyzed using exploratory factor analysis and furthermore tested for construct validity. Results: Results based on 138 responses from practicing psychotherapy trainees and undergraduate and graduate psychologists intending to become psychotherapists supported internal consistency, convergent and discriminant validity with a three-factor structure for the DPA and a two-factor structure for the DPB. Discussion: Both scales show promise in measuring DP within psychotherapy and training, offering efficient assessment of attitudes and behaviors. Future research should focus on confirmatory research and on establishing the link between diary measured DP time and DPB.
  • Psychotherapy development in Serbia in the 20th century. A qualitative narrative approach.. .....Snezana Petrovic, Sigmund Freud University, Vienna, Austria; and Kathrin Moertl, Sigmund Freud University, Vienna, Austria
  • To understand the phenomenon of a fast changing world it is invalueable to give considertation to changing worlds of the past. The key focus of this poster is the changing world of psychotherapy development in the 20th century in Serbia. From 1945 to 1970, the development of psychotherapy in Serbian society faced a number of challenges from the ideological constraints of the communist government. The research aim of this study is to explore how psychotherapy developed under communism times with focus on the interplay of psychotherapy institutions, the impact of the state, the effort of key people, educational practices, and exchanges with the international psychotherapy community. Some published sources serve as a basic starting point but, because few accounts were recorded during that period, the research has been based on narrative interviews with a sample of six senior practitioners of psychotherapy who were active during that time. The data analysis was narrative analysis with an oral history approach. The results include a list of the most important academic and clinical institutions and key educators in psychotherapy at the time. The crucial challenges cover constraints in applying knowledge from foreign (capitalist) countries, the abrupt closure of one institution and the effect on psychotherapy practitioners, including the issues of emigration and restrictions on publishing. It was concluded that the ruling communist ideology, and the social organisation imposed by it, hampered and slowed the development of psychotherapy, but did not stop it.
  • Naturalistic change trajectories within the DeePsy ROM system. .....Adam Klocek, Masaryk University; Tomáš Řiháček, Masaryk University; Michal Čevelíček, Masaryk University in Brno; and Petra Hubatková, Masaryk University
  • This study investigates the trajectories of change among clients undergoing psychotherapy, utilizing data collected through the DeePsy web platform for routine outcome monitoring and providing feedback to the therapist. Approximately 100 clients provided over 30 self-reported repeated measurements using the CORE-10 and WHO-5 tools in a session-by-session manner, while approximately 1000 clients provided over 10 measurements so far. Our aim is to analyze this data employing growth mixture modeling allowing for random slope and random intercept. Building upon the findings of Owen et al. (2015), we hypothesize the identification of three distinct latent groups exhibiting differing trajectories of change. Furthermore, we will predict the assignment to each latent group by other variables collected in the dataset. Additionally, we aim to explore change trajectories on the individual level, offering insights into the personalized nature of psychotherapeutic outcomes. Through this comprehensive analysis, we anticipate uncovering nuanced patterns of change over time, shedding light on the dynamic processes inherent in psychotherapeutic interventions. This study might contribute to the growing body of literature on psychotherapy outcomes and could have implications for tailoring treatment strategies to individual client’s needs.
  • "I feel 4 out of 5 depressed". .....Femke Truijens, Erasmus University Medical Center, Rotterdam, Netherlands; Rebeka Pázmányová, Erasmus University Rotterdam; Rick Weimar, Erasmus University Rotterdam; Sashank Nyapati, Erasmus University Rotterdam; and Lisa Koch, Duisburg-Essen University
  • In psychological research and practice, standardized questionnaires are used as a valid method to gather information about one’s symptomatology. While participant’s answers are shaped by their idiographic context and meaning-making, these processes are not captured in their responses. It is often assumed that this is not a problem as people’s answers are standardized, however, this remains an assumption rather than empirically established. Gaining insight into meaning-making helps us understand how one answers mental-health measures, and empirically validate our interpretation and use of the data. In the mixed-methods study “I feel 4 out of 5 depressed”, we utilize qualitative methods (Thinking-Aloud Method) to capture the meaning-making processes while scoring the Beck Depression Inventory-II (BDI; Beck, Steer & Brown, 1996). This method allows for real-time exploration of meaning-making during scoring, recall of which is explored in a follow-up interview. In this poster, we present the primary findings from reflexive thematic analysis of all qualitative data. Meaning-making during scoring appeared highly individual, and while some of these processes are already known (e.g., varied interpretation of items), we also found indicators of performativity of the measure, meaning that measurement scoring can actively affect or even change one’s perspective on self and symptoms. The poster presentation will highlight 1) The strength of the use of mixed methods in mental health measurement to capture meaning-making 2) The importance of understanding questionnaire data as act of meaning-making and 3) A method that can be used to validate the data captured by standardized questionnaires.
  • Machine learned topics from patient messages as transdiagnostic and disorder-specific predictors of treatment adherence in internet-delivered psychotherapies. .....Sanna Mylläri, University of Helsinki; Suoma Saarni, Helsinki University Hospital and Helsinki University; University of Tampere, Faculty of Medicine and Health Technology; Ville Ritola, Helsinki University Hospital, University of Helsinki; Jan-Henry Stenberg, University of Helsinki; Grigori Joffe, Helsinki University Hospital, University of Helsinki; and Tom Rosenström, University of Helsinki
  • Internet-delivered cognitive behavioral therapies (iCBT) are effective treatments for various mental disorders, but high drop-out rates limit their potential. Messages written by patients during iCBT can be useful in understanding factors related to drop-out. Some of these factors may be transdiagnostic and affect various types of iCBT, whereas some might be specific for a particular disorder-specific treatment program. In this study, we aim to identify text topics from multiple therapist-supported iCBT programs for different disorders and assess whether the topics predict drop-out risk in one or many treatment programs. In addition, we examine the association of drop-out risk predicting topics with transdiagnostic symptomology. We use patient messages written during iCBT programs provided by the HUS Helsinki University Hospital. The data is from 30,000 patients from five disorder-specific programs: depression, generalized anxiety disorder, obsessive compulsive disorder, panic disorder, and social phobia. To identify text topics, we use latent Dirichlet allocation. We use survival models to predict drop-out risk with the topics. Based on treatment initiation time, we leave the latest 10% of the patients as a test set to assess the predictive models trained on the rest of the data. As a proxy of transdiagnostic symptomology, we use registry-based information of the number of psychiatric diagnoses a patient has and study their association with the drop-out risk predicting topics. We expect our results to be useful in treatment development and identification of at-risk patients, while improving understanding on what is shared and what is specific for different disorders in internet-delivered treatments.
  • MEANS Lab: Meaningful Measurement of Mental Health. .....Femke Truijens, Erasmus University Medical Center, Rotterdam, Netherlands
  • Measurement is considered the cornerstone of evidence-based psychotherapy research and practice. In psychological research and practice, measurement is commonly conducted using validated self-report measures. In the Meaningful Measurement (MEANS) Lab, we challenge core but often taken-for-granted assumptions in quantitative measurement. First, we scrutinize whether interpersonal variation in how people make meaning of self-report measurement ‘evens out’ over people. We utilize qualitative methods to empirically explore how respondents interpret items and translate experiences into numerical scores. Secondly, we challenge the idea that constructs principally stay the same and can thus be compared over time. Response shifts are likely to happen when people go through life-changing events/interventions such as psychotherapy, but are seldomly explored empirically in psychotherapy research. We compare qualitative and quantitative analyses of response shifts in RCT data. Third, provided that self-report measurement contains meaning (1) and is prone to change through treatment (2), it is vital for the users of self-report data (researchers, clinicians) to validate their interpretation based on the actual meaning making by the respondent. This requires validation in the action of administration – beyond the psychometric validation of the measure – in which the respondent and de administrator both play an active and continuous role. The Meaningful Measurement (MEANS) Lab develops an evidence-base for meaningful understanding and validation of self-report data in clinical research and practice. In this poster, we present our innovative hermeneutic approach to measurement, and invite the audience to reflect on their own methodological assumptions and ways to scrutinize and justify them.
  • Eradicating stigma: Hours with Mary. .....Timo Sampolahti, Jyväskylä University
  • This presentation is comprised of a theoretical essay and the qualitative illustration of a psychotherapeutic process with a woman diagnosed as having a psychotic illness. Startingpoint is Michel Foucault’s view of the development of the scientific psychiatry. He claims that at the same time when madness was interpreted as a mental illness, the dialogue with the madness was silenced. The dialogue about madness took its place. Following Jukka Aaltonen’s original idea both psychosis and its recovery can be conceptualized with the help of the three-partite understanding of a sign by Charles Sanders Pierce. Bringing all together I claim that the dumbed dialogue can be revitalized in a process where indexical signs become transformed and returned to the symbolic universe. Additionally, I underline that the recovery of a psychotic illness also requires the restoration of the silenced dialogue and that this process might often be neglected in psychiatric care.
  • Online Group Psychological Counseling to Contrast Academic Burnout. .....Tatiana Rossi, Universitas Mercatorum; and Irene Messina, Mercatorium University
  • Background: Academic burnout, marked by exhaustion and reduced fulfillment, poses a significant challenge for students, necessitating targeted interventions (Maslach, 1976; Fredenbeger, 1974). Existing studies emphasize the multifaceted nature of student burnout, advocating for tailored interventions (Tomaszek & Muchacka-Cymerman, 2021; Wan, 2020). Tang et al.'s (2021) work on integrated approaches suggests the potential value of combining strategies.This research aims to assess the effectiveness of an online group psychological intervention, incorporating insights from Transactional Analysis (Berne, 1961; Vos & van Rijn, 2021), to address the gap in evidence-based strategies for student well-being. Method: The study follows a longitudinal design with four phases: Screening, Recruitment, and Randomization (T0) utilizing Personal Information and Eligibility Form (PIEF) and Maslach Burnout Inventory-Student Survey (MBI-SS); Baseline assessment (pre-intervention, T1) utilizing primary outcomes: Maslach Burnout Inventory-Student Survey (MBI-SS). Psychological General Well‐Being index – short version (PGWB-S), Academic achievement, and secondary outcomes: Basic Psychological Need Satisfaction and Frustration Scale (BPNSFS), Effort-Reward Imbalance student questionnaire (ERI-SQ), Cognitive Emotion Regulation Questionnaire - Short Version (CERQ-18), Difficulties in Interpersonal Emotion Regulation (DIRE), Coping Orientation to Problems Experienced (Brief-Cope), The Multidimensional Scale of Perceived Social Support (MSPSS); Outcome Assessment (post-intervention, T2); Follow-up Assessment (3 months after, T3). Results: Data collection is currently in progress. Discussion: The current study protocol marks the beginning of empirical exploration into the effectiveness of psychological interventions for academic burnout, shedding light on crucial aspects of organizational dynamics in academia.
  • Group Psychological Counseling to Contrast Academic Burnout. .....Tatiana Rossi, Universitas Mercatorum; Paola Cardinali, Mercatorum University, Rome; Irene Petruccelli, Mercatorum University, Rome; Pietro Spataro, Mercatorum University, Rome; Flavia Bonaiuto, Mercatorum University, Rome; Claudio Loconsole, Mercatorum University, Rome; Roberto Maniglio, Mercatorum University, Rome; and Irene Messina, Mercatorium University
  • Academic burnout, marked by exhaustion, cynicism, and reduced self-efficacy, impacts students' academic engagement and success. While interventions for work burnout show potential for addressing academic burnout, evidence from randomized controlled trials is lacking. This study aimed to assess the effectiveness of an online group psychological intervention in alleviating academic burnout. Participants with high burnout levels were assigned to either a psychological counseling group or a waiting list control group. The research followed multiple phases: (T0) Screening, Recruitment, and Randomization; (T1) Baseline assessment (pre-intervention); (T2) Outcome Assessment (post-intervention). Primary outcomes included burnout symptoms, general well-being, and academic achievement, while secondary variables such as effort-reward imbalances, psychological needs satisfaction/frustration, emotion regulation, coping strategies, and social support were examined. The intervention strategies comprised psychoeducation, self-awareness enhancement, cognitive restructuring, and social support promotion. Data collection is currently in progress.
44. Poster Session [Poster Session]
Friday | 6:30 pm-8:00 pm | Atrium
Guided Walk [Special Event]
Friday | 8:00 pm-9:00 pm | City Center
For a guided walk around the city center, register at the registration desk.
45. ‘A World on Fire’: What Contribution can Psychotherapy Research Make (if any) to Addressing Contemporary Global Challenges? [Semi-Plenary [invited]]
Saturday | 8:30 am-10:00 am | P24

Organizer: Mick Cooper, University of Roehampton
Discussants:
  • Mick Cooper, University of Roehampton
  • Faisal Mahmood, Birmingham Newman University
  • Ariana Jordan, Metanoia Institute
  • Eva Fragkiadaki, University of the West of England
46. Practice-based evidence: From local measurement to applications and national implementation [Semi-Plenary [invited]]
Saturday | 8:30 am-10:00 am | P31

Organizer: Michael Barkham, University of Sheffield, UK
  • The early stages of practice-based evidence. .....Vera Gergov, Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki
  • In the past few decades routine change measurement in psychological treatments using self-report questionnaires has increased remarkably diminishing the research-practitioner gap. Using outcome measuring more ordinarily has raised questions on how to select, translate and adapt the developed outcome measures so they could be used in linguistically and culturally diverse countries and different service systems. Many measures used to assess treatment outcomes have originally been developed for other purposes, e.g. assessing symptom severity. To be useful, outcome measures must be relevant to the areas in which the treatment goals were set, comparable across different patient groups and service types, and meaningful to both patients and clinicians. When translating and implementing a new measure, it is essential to involve not just professionals, but also service users in the process to ensure a perceivable measure. With younger patients, the age-appropriateness of the measure should be considered carefully. In order to be able to systematically gather treatment outcome data that could be used for improving not just individual patient-outcomes, but also the service system, building a strong collaboration between the clinicians and stakeholders in the service management is crucial. The presentation will provide perspectives on the first steps that are necessary to begin with when you aim for gathering practice-based evidence on service level through the experiences gained from translating and implementing the Clinical Outcomes in Routine Evaluation-measures (CORE-OM/YP-CORE) in Finland.
  • The struggles with practice-based data. .....Pauline Janse, Pro Persona/ Radboud University
  • Measuring treatment outcome of psychological treatments is valuable on different levels: it provides feedback to clients and therapists regarding progress, enables therapists and teams to identify their strengths and weaknesses (identifying which issues they address effectively and which less so), and supplies researchers with data to examine treatment effectiveness. However, the frequency of outcome monitoring varies among therapists and agencies, and there are differences in how it's utilized (whether discussed with clients and used for clinical decisions). Moreover, implementation challenges are common in research studies. These challenges relate to therapists' attitudes, knowledge gaps, and organizational issues. Consequently, missing data isn't random and may be linked to various factors across different levels, potentially biasing conclusions drawn from practice-based data. The discussion will focus on insights from successful and less successful implementation experiences in research and agency contexts.
  • Modelling & predicting change with practice-based data. .....Brian Schwartz, University of Trier, Germany
  • Practice-based data can inform clinical practice by predicting changes in psychological therapies. Using data from routine care practice increases the likelihood that the so-called expected treatment response (ETR) curves, which depict the anticipated treatment course, closely match a realistic course in routine care, resulting in an increased generalizability and better adaptability to individual settings. Using such ETR curves, observed treatment courses can be evaluated, problematic developments can be identified early, and therapists can be supported in decision-making. To achieve this, a modeling approach is presented, which is implemented in the Trier Treatment Navigator (TTN) and routinely used in clinical practice at a university outpatient clinic with approximately 250 incoming patients per year. Furthermore, this system is currently being expanded to psychological therapists working in private practice. In addition to predicting curvilinear changes throughout treatment based on similar previously treated patients (so-called nearest neighbors), an outlook is provided on modeling possibilities for non-linear courses, thereby considering data privacy issues, addressing the complexity of treatment courses in psychological therapy, and being adaptable to new information.
  • Transforming the effectiveness and equity of a psychological therapy service: A case study in the English NHS Talking Therapies program. .....Katy James, University of Sheffield, UK
  • The Talking Therapies (previously known as Improving Access to Psychological Therapies) program in England is likely the largest ever social experiment in delivering a national model of psychological therapies. Fundamental to the program is the mandated use of routinely patient-completed PHQ-9, GAD-7, and WSAS at every attended therapy session. All local service higher-level summary data is logged on a publicly accessible website (NHS Digital) for the purposes of transparency, with patient outcomes monitored against targets in the form of 50% patient recovery rate. While such routine data enables outcomes to be monitored, it is also the key component in framing a service as a learning health service in which it both generates and utilizes its own internal data. Along with external research evidence, benevolent leadership, and data-analytic resources, such a service is able to self-correct. This ability is critical when a standard service yields overall outcomes viewed as substandard by a national monitoring agency. The 10-minute case-study presentation reports on one such Talking Therapies service and how it utilized components of a learning health system to implement a recovery program leading to improvement in both patient clinical outcomes and also in the equity of outcomes via reducing therapist variability. The argument is made that routinely collected practice-based data provides the basis for enabling a standard service to transform into a learning health system.
  • National Implementation of routine outcome measures. .....Suoma Saarni, Helsinki University Hospital and Helsinki University; University of Tampere, Faculty of Medicine and Health Technology; Tom Rosenström, University of Helsinki; Aino Plattonen, University of Helsinski; Jan-Henry Stenberg, University of Helsinki; and Samuli I Saarni, University of Helsinki
  • The Finnish Psychotherapy Quality Register (FPQR) was established as a national initiative to standardize and improve the quality and outcomes of psychotherapy. Developed collaboratively between 2016 and 2018 by all five Finnish university hospitals, FPQR integrates a comprehensive framework for monitoring and evaluating psychotherapeutic services. FPQR collects data treatment outcomes by validated measures e.g. CORE-OM, PHQ-9, GAD-7, and data on waiting times, therapeutic alliance, patient satisfaction. Altogether over 20 different symptom and functionality measures are available to adjust patient need according to diagnosis. CORE-OM/YP-CORE are used in all adult and adolescent psychotherapies independently of diagnosis. Questionnaires are mandatory at the beginning and end of treatment, but therapist can flexibly add measures and time-points at every session to allow feedback informed treatment. FPQR was initially launched in 2018 the Helsinki University Hospital (HUS) area, serving about 1.6 million people. In April 2024 the FPQR in HUS are includes data on >10 000 individual therapies. Since 2018 the FPQR has been progressively adopted across different regions and is currently in use in several districts. Also, the national Social Insurance Institute, which is funding the major part of Finnish psychotherapies, has followed the suite and implemented CORE-OM as a single mandatory structured outcome measure. In conclusion, the FPQR serves as a pivotal tool in advancing the national implementation of structured and evidence-based psychotherapy practices in Finland. Its comprehensive data collection and analysis capabilities support continuous improvement in therapy quality and effectiveness, demonstrating the potential of integrated health informatics in enhancing mental health services.
Coffee Break
Saturday | 10:00 am-10:30 am | Aula
47. The role of the heart in states of hurt: Therapists’ feelings and heart rate in the process of rupture and repair [Panel/Symposium]
Saturday | 10:30 am-12:00 pm | P24

Moderator: Maayan Levy, Hebrew University, Jerusalem, Israel
  • Changes in therapists’ feelings and their relation to ruptures. .....Orya Tishby, Department of Psychology, The Hebrew University of Jerusalem, Israel; and Maayan Levy, Hebrew University, Jerusalem, Israel
  • Objective This study examined the association between changes in therapists' feelings from pre to post session , rupture intensity, and therapists’ contribution to ruptures. Method: Early sessions from 42 short-term psychodynamic therapies were rated on the Rupture Resolution Rating System. Therapists filled the Feelings Word Checklist-58 before and after each session. Results: Therapists’ feelings of lower confidence pre-session predicted greater intensity of confrontation ruptures and higher ratings of therapists’ contribution to ruptures. Moreover, the decrease in feeling confident from pre-to post session was associated with greater intensity of withdrawal ruptures and higher ratings of therapists’ contribution to ruptures. Lower Therapists’ parental feelings pre-session, predicted higher ratings of therapists’ contribution to ruptures. Disengaged feelings were not associated with ruptures. Conclusion: Therapists’ feelings play a role in the formation of both withdrawal and confrontation ruptures. Therapists’ feelings may lead to greater contribution to the occurrence of ruptures.
  • Zooming in on therapists’ feelings and their relationship to the resolution process. .....Maayan Levy, Hebrew University, Jerusalem, Israel; and Orya Tishby, Department of Psychology, The Hebrew University of Jerusalem, Israel
  • Objective This study examined the association between changes in therapists' feelings from pre to post session and the rupture-resolution process. We examined how changes in therapists' feelings relate to global resolution ratings in the session, and with the impact of specific resolution strategies on the alliance. The strategies we explored were disclosure, validation, and linking the rupture to patients’ interpersonal patterns. Method: Early sessions from 42 short-term psychodynamic therapies were rated on the Rupture Resolution Rating System. Therapists filled the Feelings Word Checklist-58 before and after each session. Results: Therapists’ feelings of lower confidence pre-session predicted lower global resolution ratings. Moreover, the decrease in feeling confident was also associated with lower global resolution and with lower effectiveness of specific resolution strategies, such as validation, disclosure and link to interpersonal patterns. The decrease in parental feelings from pre to post session was associated with lower global resolution ratings and with lower effectiveness of validation and disclosure. The increase in disengaged feelings was associated with lower effectiveness of disclosure. Conclusion: These findings demonstrate how therapists' feelings may be associated with the rupture repair process. They enhance the understanding of the dynamics between therapist feelings and therapeutic process of repair and specific resolution strategies. Attention to the therapists’ feelings in training and practice may be valuable in managing this process.
  • The effect of therapists’ self-doubt and inadequate feelings on the resolution of alliance ruptures. .....Libby Igra, Copenhagen University; Celia Faye Jacobsen, University of Copenhagen, Denmark; Jan Nielsen, University of Copenhagen, Denmark; Susanne Lunn, University of Copenhagen, Denmark; and Stig Poulsen, University of Copenhagen, Denmark
  • Objectives: The current study examined the moderating role of therapists’ compassion satisfaction and adequate feelings on a) professional self-doubt and b) a decrease in adequate feelings during a rupture session in predicting the resolution of alliance ruptures. Method: Therapists (N=53) completed the Professional Quality of Life scale (ProQOL) and the Development of Psychotherapist Common Core Questionnaire (DPCCQ) before therapy and the Feeling Work Checklist (FWC-10) every third session. Clients (N=535) completed Session Alliance Inventory (SAI) after each session. Rupture sessions were identified based on deteriorations in clients’ alliance ratings. Data from 4,986 sessions in a naturalistic study were analyzed using multilevel models. Results: Compassion satisfaction and adequate feelings moderated the relationship between professional self-doubt and resolution of alliance ruptures. For therapists with high compassion satisfaction or high overall adequate feelings, higher levels of professional self-doubt were associated with better clients’ alliance ratings after a rupture session. Compassion satisfaction did not moderate the effect of a decrease in adequate feelings during a rupture session and adequate feelings marginally (p=0.07) moderated the effect of a decrease in adequate feelings during a rupture session on clients’ alliance ratings after a rupture session. Conclusions: The findings contribute to identifying therapists factors that promote the process of repairing alliance ruptures. Furthermore, the findings contribute to mapping the context in which professional self-doubt serve as constructive factor for the therapeutic relationship versus the context in which it could be harmful. A tentative take-home message from this study could be: ‘Doubt yourself as a therapist, but only if you have enough adequate feelings or compassion satisfaction’.
  • Alliance rupture and repair processes in psychotherapy with borderline personality disorders: A multimodal single case study. .....Stine Steen Høgenhaug, Aalborg University, Denmark; Franco Orsucci, Norfolk and Suffolk NHS Foundation Trust; and Günter Schiepek, Paracelsus Medical University, Salzburg, Austria
  • The therapeutic alliance is a relatively robust predictor of outcomes in psychotherapy. Patients diagnosed with borderline personality disorder (BPD) show a higher tendency to establish an unstable alliance compared to people without personality disorders. The pathology of BPD challenges therapeutic collaboration, and the therapeutic process is more frequent than in other disorders characterized by ruptures, understood as tension or breakdowns in the therapeutic process. Failure to identify and address ruptures may cause stagnation, deterioration, or premature dropout. Increased knowledge of the underlying mechanisms of rupture management is crucial to better navigate challenging moments of interaction and potentially increase alliance quality and treatment outcome. We will present results from a multi-method single case study investigating alliance rupture and repair processes in BPD treatment across and within the treatment process. The study integrated implicit and explicit alliance processes by including ratings of alliance rupture and repair using the Rupture and Resolution Rating Manual and physiological measurements of heart rate calculated by Recurrence Quantification Analysis. The analyses were connected through a qualitative multimodal interaction analysis to enlarge our understanding of the underlying mechanisms of the therapeutic collaboration between patient and therapist within sessions. The results show that implicit non-verbal processes are central to mutual emotion regulation, trust, security, sense-making, and empathy during ruptures and repairs. The findings also highlight context sensitivity to rupture negotiation within sessions. Clinical implications concerning treatment and supervision are discussed.
Discussant:
  • Franco Orsucci, Norfolk and Suffolk NHS Foundation Trust;
48. New directions in understanding and improving outcome monitoring [Panel/Symposium]
Saturday | 10:30 am-12:00 pm | P31

Organizer: Emma Broglia, University of Sheffield, UK
  • Measuring session reactions: Insights into the process of therapeutic change. .....Petra Hubatka, Masaryk University
  • Objective: Routine outcome monitoring (ROM) is becoming a crucial part of a psychotherapy session. This contribution introduces the Session Reaction Scale-3 (SRS-3), a measure to assess the immediate impacts of psychotherapy sessions, as perceived by the client. The SRS-3 comprises 14 items aiming at clients' helpful and hindering reactions to the most recent session. Method: The longitudinal nature of the data obtained on a session-by-session basis in the context of ROM enables the exploration of temporal interactions and relational dynamics among distinct responses. Network analysis will be used to explore these patterns, using data from DeePsy, a Czech ROM system. Results: Both within- and between-person relationships among clients’ session reactions will be reported. Conclusions: Routine measurement of session reactions has the potential to enhance our understanding of the process and outcomes of psychotherapy.
  • Development and Validation of a Scale to Assess the Helpfulness of Using Measures in Psychotherapy: The Patient-Perceived Helpfulness of Measures Scale (ppHMS). .....Mick Cooper, University of Roehampton
  • The Patient-Perceived Helpfulness of Measures Scale (ppHMS) was developed to assess the helpfulness—as perceived by patients—of using measures, particularly those for ROM, in psychological treatment. Measure development consisted of four stages. In Stage 1, the construct of patient-perceived helpfulness of measures was explored using thematic analysis with 15 clients. Six helpful and three unhelpful themes were identified and informed item development. Stage 2 consisted of expert ratings, psychometric shortening in a sample of 76 clients, and CFA. In Stage 3, we established a best fit 5-item model using a stratified online sample of 514 U.K. psychotherapy patients. The final ppHMS had excellent internal consistency (McDonald’s omega = .90), convergent validity with psychotherapy satisfaction (r = .5; p < .001), divergence from social desirability (r = .1), and metric and scalar invariance. In Study 4, analyses were replicated and confirmed in a stratified U.S. sample (n = 602). The ppHMS is a freely-available reliable and valid scale that can be used to assess and compare patients’ perceptions of the helpfulness of different ROM measures. It’s five items, rated from 1 (Strongly disagree) to 5 (Strongly agree) are: ‘1) I got something out of using this form’, ‘2) The form was a useful addition to what we did in therapy’, ‘3) This form got me thinking about what matters to me in therapy’, ‘4) Using this form made the therapy better’, ‘5) I learnt something from using the form in therapy’.
  • Comparing outcome measures in pursuit of a single item for cross-country adoption. .....Emma Broglia, University of Sheffield, UK; and Michael Barkham, University of Sheffield, UK
  • The complexities of employing and aligning outcome measures in psychotherapy research pose significant obstacles to understanding their utility across diverse settings and populations. Understanding the relationship between different measures and moving towards adopting a single item across different countries holds promise for developing cross-country comparisons and datasets. These datasets can provide new insights into psychological outcomes across diverse populations while streamlining data collection, particularly in under-funded services, and fostering consensus across varied research contexts. This presentation presents preliminary findings from a battery of eight measures conducted in a UK student community sample (n = 4190) alongside qualitative insights into students’ reflections on the helpfulness of different measures. The measurement battery will include findings from a UK validation of the Emotional and Psychological Outcomes (EPO-1) single item (n = 249) as part of the European Psychotherapy Consortium (EPoC) to streamline data collection and enable cross-country comparisons. Through these preliminary findings, this presentation aims to facilitate discussion about practical steps to achieving cross-country data across different psychotherapy groups and settings.
  • Why use idiographic tools for routine outcome monitoring?. .....Célia Sales, University of Porto
  • Routine Outcome Monitoring, the regular assessment of patient outcomes to evaluate clinical progress during the course of therapy, has received increasing acceptance to support clinical decision making and enhance the effectiveness of interventions. However, a central question remains: How can brief measurement capture the uniqueness of complex and heterogeneous change processes of each individual patient? Patients with similar diagnoses may want very different things from psychotherapy, and different psychotherapeutic models possess different conceptualizations of treatment success. So what assessment tools should we use to monitor therapeutic change? Idiographic tools for patient-reported outcome measures (I-PROMS) allow the tailoring of items to each patient, supporting the monitoring of progress in their specific problems, goals, and priorities. This paper reviews the most frequently used I-PROMS and critically synthetizes existing evidence on its clinical utility and psychometric properties. Based on the strengths and limitations of I-PROMS, we offer recommendations for its use in routine outcome monitoring systems.
Discussant:
  • Michael Barkham, University of Sheffield, UK;
49. Outcome 1 [Brief Paper Session]
Saturday | 10:30 am-12:00 pm | U23

Moderator: Jana Bernroitner, Sigmund Freud University, Vienna, Austria
  • A combined group-based stabilization and skill training intervention for out-patients with long lasting posttraumatic reactions - Protocol for a randomized controlled trial. .....Katrine, Høyer Holgersen, Norwegian University of Science and Technology, Trondheim, Norway; Anne Elisabeth Skjervold, Norwegian University of Science and Technology, Tordheim, Norway; Ingunn Brønstad, St.Olavs University hospital; Marianne Jensen, St. Olavs University hospital; Heidi Brattland, Norwegian University of Science and Technology, Tordheim, Norway; and Solveig K. Reitan, Norwegian University of Science and Technology, Tordheim, Norway
  • Background: Complex PTSD (C-PTSD) is a widespread, highly debilitating condition included in ICD-11 in 2018. Diagnostic criteria are classical PTSD symptoms (re-experiencing, avoidance, and hyperarousal) and persistent and debilitating “disorders of self-organization”, i.e.: affect dysregulation; negative self-concept; and disturbances in relationships. The debate of whether C-PTSD requires treatment plans different in format from recommended treatment guidelines for PTSD has intensified. Understanding of what interventions are efficacious remains limited. This presentation will discuss the protocol for a randomized controlled trial with a longitudinal and mixed design, where effect of a combined group-based stabilization and skill-training intervention added to individual treatment will be compared to treatment as usual. Methods: Participants (N = 160) with ongoing and long-lasting reactions related to past adverse life events are recruited at a general outpatient clinic in a community mental hospital in mid-Norway. Following baseline assessment and randomization, participants will complete follow-up measures at 4, 8, 13 and 19 months. The primary outcome is personal recovery (The questionnaire about the process of recovery, QPR). The study also comprises symptoms of posttraumatic stress, general mental and somatic health, well-being, functional impairment, and client satisfaction as well as immunological and endocrine response measured in blood samples and register data. Qualitative interviews with a subset of participants will be carried out. Discussion: The present study will examine the effect and user satisfaction of a combined group-based intervention designed for a vast patient group in general mental health care. Design choices and preliminary findings in the ongoing study will be discussed.
  • Early Change as a Predictor of Treatment Outcome in Patients with a Personality Disorder. .....Pauline Janse, Pro Persona/ Radboud University; Sophie Vercauteren, Pro Persona; Rianne Weggemans, Pro Persona; and Bea Tiemens, Radboud University, Nijmegen, Netherlands
  • Background: A significant proportion of patients with a personality disorder do not benefit from treatment. Monitoring treatment progress can be used to adjust ineffective treatments. The current study examined whether the change in symptoms and personality pathology and dysfunction during the first phase of therapy (early change) in patients with a personality disorder predicted their treatment outcome. Method: Data from 841 patients who received specialized treatment for a personality disorder were analyzed to determine whether changes in the Outcome Questionnaire-45.2 (OQ-45.2) symptom distress scale, the General Assessment of Personality Disorder (GAPD) and Severity Indices of Personality Problems (SIPP) in the first phase of therapy predicted case-mix corrected post-treatment personality pathology and dysfunction as measured by the SIPP and GAPD, respectively. Results: The results showed that early change in personality pathology was the strongest predictor of posttreatment personality pathology, with the exception of the SIPP domain identity integration, which was predicted best by early change on the OQ-45. Post-treatment personality functioning was best predicted by early change in personality dysfunction followed by early change in symptom distress but not by early change in personality pathology. Conclusion: Monitoring early change can be useful in assessing progress during the treatment of patients with personality disorders. Overall, disorder-specific measures seem to be best suited topredict post-treatment personality pathology, but concerning post-treatment personality dysfunction, only changes in dysfunction and distress and not pathology predicted outcome.
  • Capturing the complexity of therapeutic processes: Nomothetic and idiographic patterns in psychodynamic psychotherapy. .....Laura Ferreira, Universidade do Algarve; Eugénia Ribeiro, Universidade do Minho, Braga, Portugal; and Luís Janeiro, Universidade do Algarve
  • Background: Affect Phobia Therapy, a psychodynamic psychotherapy, posits that adaptive emotional experiences within a strong therapeutic alliance are key to successful treatment. Yet, this rationale lacks empirical validation, largely due to research design and methodological limitations. Recent methodological advancements highlight the need to analyze temporal variations and interdependencies of variables within therapy, advocating for robust statistical approaches that integrate nomothetic and idiographic approaches. Aim: Our study systematizes three investigations that used Group Iterative Multiple Model Estimation (GIMME), a time-series data approach, to explore the interrelations among emotional experience, therapist-client alliance, focus on treatment objectives, and symptoms. Method: The first two studies involved samples of five and seven dyads, and the third analyzed three case studies (good outcome, poor outcome, and dropout). Measures of therapeutic alliance, emotional experience, and symptomatology were used across studies. In the second study, the therapist's focus on treatment objectives was also evaluated. Results: Data underscore the fundamental roles of emotional experience (EE) and therapeutic alliance (TA) in psychodynamic psychotherapy. In both sample studies, two distinct subgroups of process configurations within the dyads were identified. Studies demonstrate that EE contributes, either directly or indirectly through AT, to symptom reduction. However, the dynamics of these interrelations seem to differ depending on the subgroup or the type of therapeutic outcome. Conclusion: These studies highlight the capabilities of GIMME in identifying distinct configurations of relationships between variables in psychodynamic psychotherapy. Our findings help to shed light on potential client, therapist, and relationship factors that could influence the therapeutic change process.
  • Exploring Disappointments in Psychotherapy: A Taboo amongst Therapists in training. .....Jana Bernroitner, Sigmund Freud University, Vienna, Austria; Birgitta Schiller, Sigmund Freud University, Vienna, Austria; Stella Becher-Urbaniak, Sigmund Freud University, Vienna, Austria; Birgit Scheiner, Sigmund Freud University, Vienna, Austria; Elisa Urban, Sigmund Freud University, Vienna, Austria; Maximiliane Mitterhauser, Sigmund Freud University, Vienna, Austria; Sarah Schrattenecker, Sigmund Freud University, Vienna, Austria; Stephanie Weibold, Sigmund Freud University, Vienna, Austria; and Zelie Bajrami, Sigmund Freud University, Vienna, Austria
  • Aim: Disappointments are inherent in the therapeutic journey, yet the impact on beginning therapists remains underexplored. This study aims to investigate the experiences and consequences of disappointments among therapists in training, shedding light on an overlooked aspect of psychotherapy. Methods: Through purposive sampling, 11 semi-structured interviews were conducted with therapists in training, supplemented by 5 interviews with supervisors. Data analysis, employing Grounded Theory methodology, identified eight second-level codes: 1) Processing disappointments; 2) Varieties of disappointments; 3) Challenges in training; 4) Communicating disappointments; 5) Coping strategies; 6) Awareness of disappointments; 7) Learning from disappointments; 8) Defence mechanisms. Results: The core code suggest that disappointments are often undiscussed or selectively addressed, despite their integral role in therapy. Consequently, disappointments are treated as taboos within therapeutic settings, highlighting a disparity between their significance and acknowledgment. Discussion: Understanding therapists' experiences is vital for a comprehensive understanding of therapeutic dynamics. Normalizing discussions around disappointments is crucial for fostering openness and addressing potential implications, thus enriching the therapeutic relationship. The research context pertains to outpatient clinic research and training research, contributing significantly to quality assurance within the psychotherapy profession. Breaking the silence of the phenomenon of disappointments is a necessary first step in opening a discussion.
50. Qualitative and Case Studies [Brief Paper Session]
Saturday | 10:30 am-12:00 pm | U32

Moderator: Michaela Ladmanová, Masaryk university
  • The Assimilation of Traumatic War-Related Experiences in Elderly Veterans: A case study. .....Beatriz Almeida, Universidade da Maia; Patrícia Pinheiro, ISMAI; Isabel Basto, Universidade da Maia; Catarina Pinhel, Universidade da Maia; Leonor Pereira, Universidade da Maia; André Barbosa, Universidade da Maia; Andreia Figueiredo, Universidade da Maia; and William Stiles, Miami University, Oxford, USA
  • Militaries are directly exposed to traumatic war-related experiences, being at high risk of long-lasting impacts. More specifically, elderly war veterans, due to aging-related processes/stressors or exposure to trauma-related stimuli, can suffer from a late onset of PTSD, aggravation, and/or change in the PTSD symptoms experienced. Theoretically, the assimilation of traumatic experiences can facilitate their psychosocial adjustment. However, remains unclear (1)how elderly veterans assimilate the war-related experiences, and (2)what the impact of such assimilation on their aging process is. The Assimilation Model suggests that an increase in the assimilation level of problematic experiences is associated, in psychotherapeutic contexts, with an increase in well-being; however, such association was not investigated regarding the war experiences. The current exploratory study aimed to investigate what is the current assimilation level of war-related experiences, and how this level of assimilation impacts in the aging process of elderly veterans. One elderly veteran was interviewed regarding his war experiences. The interview was analyzed with the Problematic Experience Assimilation Scale to assess the assimilation level of such experiences. The impact on veterans’ aging process was assessed by questionnaires: The Clinical Outcome Routine Evaluation assessed psychological distress, the World Health Organization Quality of Life-Older Adults assessed the quality of life, and the Posttraumatic Stress Disorder Checklist for DSM-5 assessed the PTSD symptoms. The results will be discussed. It is hoped that they will contribute to a better understanding of the relationship between levels of assimilation of the traumatic war experience and levels of psychological distress, quality of life and PTSD.
  • Effects of Specialized Academic Bereavement Care Training on the Competency of Therapists in the Aftermath of 7 October. .....Sharon Ziv-Beiman, The Academic College of Tel-Aviv-Yaffo; and Avital Gershfeld-Litvin, The Academic College of Tel-Aviv-Yaffo
  • The aim of the presented study is to investigate the impact of a specialized academic training course, designed to prepare therapists for the challenges of treating complex grief, on their sense of confidence and perceived therapeutic abilities. Specifically, this research was conducted as part of an emergency training project that aimed to prepare therapists to cope with the heavy load of complex bereavement, after the horrific terror events of October 7th, 2023, in Israel. The study focuses on the relationships between death anxiety, level of expertise, and therapists’ prior knowledge, and their perceived competence. We hypothesized: (1) There will be a positive correlation between the rating of expertise level and prior knowledge and perceived competence; (2) There will be a negative correlation between the rating of death anxiety and perceived competence; (3) Levels of death anxiety will moderate the positive effect of expertise level and prior knowledge on perceived competence; and (4) Levels of death anxiety will be reduced and perceived competence will be enhanced after the training course. The study combined quantitative and qualitative methods in two stages. In the first stage, a quasi-experimental within-subjects research design, without a control group was applied. 91 therapists completed the Grief Counseling Experience and Training Survey, the Grief Competency Counseling Scale, and the Death Anxiety Scale. In the second stage, we interviewed 50 therapists on their experience and benefits from the training using semi-structured interviews. Quantitative and qualitative data analysis is underway and preliminary results will be presented at the conference.
  • Outcomes of psychotherapy from client’s perspective: A meta-method study. .....Michaela Ladmanová, Masaryk university; Tomáš Řiháček, Masaryk University; and Ladislav Timuľák, Trinity College, Dublin, Ireland
  • A meta-method is a part of a meta-study that focuses on the methodological quality of primary studies and examines how specific approaches used in these studies might have impacted their findings.The aim of the meta-method is to uncover the underlying assumptions that lead researchers to adopt particular methodological approaches and to understand their role in shaping the whole area of research. This paper presents a meta-method analysis of a substantial body of qualitative research comprising 177 studies focused on client-identified outcomes of psychotherapy. The aspects of primary studies that are being appraised are: theoretical framework, research aims and objectives, researchers and setting, sampling procedures, data collection and data analysis techniques, reliability and validity checks, inclusion of original data to mediate between evidence and interpretation.
51. Treatment Resistance in Obsessive-Compulsive Disorder Treatment: Understanding and Intervening [Panel/Symposium]
Saturday | 10:30 am-12:00 pm | U33

Organizer: João Tiago Oliveira, University of Minho
  • Assessing and understanding the interplay between ambivalence and resistance in psychotherapy. .....João Tiago Oliveira, University of Minho; and Dario Paiva, University of Minho
  • A multitude of studies have indicated that patients' ambivalence and resistance to change are crucial factors for successful treatment. Ambivalence is linked to a patient's motivation, readiness to change, and recognition of the benefits of changing, despite being unable to do so. Resistance involves interpersonal tensions that arise from the patient-therapist interaction and can result in poor outcomes if left unaddressed. Therefore, resistance may result from therapeutic mismanagement of ambivalence. This paper examines the mechanisms associated with intra- and interpersonal tensions that emerge in psychotherapeutic sessions. A multi-method and multi-informant approach was employed to assess psychological distress, ambivalence, and resistance to change in 50 patients undergoing psychotherapy. Hierarchical Linear Models and Cross-Lagged Models will be utilized to analyze the predictive power of each variable. It is anticipated that elevated levels of patient ambivalence at the outset of each session will be associated with heightened resistance and psychological distress during that session. This is because the mismanagement of ambivalence is believed to contribute to resistance. Furthermore, resistance levels observed during a session can predict ambivalence in the subsequent session. The discussion will examine the significance of ambivalence and resistance in the context of psychotherapy processes and outcomes.
  • Understanding OCD Treatment Attrition: A meta-analysis on contributing factors. .....Maria João Faria, Universidade do Minho, Braga, Portugal; Divo Faustino, Universidade do Minho, Braga, Portugal; Rui Braga, Universidade do Minho, Braga, Portugal; Miguel Gonçalves, Universidade do Minho, Braga, Portugal; Joshua Swift, Idaho State University; and João Tiago Oliveira, University of Minho
  • Background: Obsessive-compulsive disorder (OCD) is a prevalent mental health condition, affecting 1.1% to 2.3% of the population. Existing data support Exposure and Response Prevention (ERP) and Selective Serotonin Reuptake Inhibitors (SSRIs) as the most effective OCD treatments. However, when the notable dropout rates, particularly in ERP, are considered, treatment efficacy can be compromised. This underscores the contemporary research focus on the treatment discontinuation phenomenon, recognizing its impact on the therapeutic process. While most evidence synthesis centers on the gold-standard treatments individually (ERP and SSRIs), there remains a gap in comprehensively understanding dropout rates across the diverse psychopharmacological and psychotherapeutic interventions for OCD. This study aims to investigate and compare dropout rates between OCD psychopharmacological and psychotherapeutic interventions and to identify potential moderating and predictive variables of dropout. Method: This study was pre-registered in PROSPERO (CRD42023480156). A systematic literature review was conducted across five databases and previous meta-analyses to identify randomized controlled trials testing interventions for adult OCD treatment. Studies reporting dropout rates for psychotherapeutic, pharmacological, or combined treatments for OCD were selected. Results: The screening and evaluation of 2024 studies have been completed, with 137 studies undergoing comprehensive review for potential eligibility and analysis. Data on dropout rates has been extracted, and preliminary findings will be discussed. The potential moderating and predictive effects of sample sociodemographic and clinical variables, study design information, and intervention characteristics on dropout rates will be examined. Study conclusions may inform treatment optimization and enhance understanding of OCD treatment challenges, outcomes, and efficacy.
  • Daily assessment of ambivalence in OCD patients: From the Literature to Practice. .....Rui Braga, Universidade do Minho, Braga, Portugal; Divo Faustino, Universidade do Minho, Braga, Portugal; Maria João Faria, Universidade do Minho, Braga, Portugal; Julian Rubel, Universität Osnabrück, Germany; Miguel Gonçalves, Universidade do Minho, Braga, Portugal; and João Tiago Oliveira, University of Minho
  • Introduction: Obsessive-compulsive disorder (OCD) is characterized by the dynamic nature of its symptoms, necessitating innovative assessment approaches. This presentation integrates findings from a systematic review of Ecological Momentary Assessment (EMA) studies in OCD with insights from a pilot study aimed at developing an EMA tool tailored to assess ambivalence in OCD. Methods: The systematic review synthesized data from 34 studies, identifying diverse methodological approaches. Drawing upon these insights, a pilot study was conducted to tailor EMA items specifically for assessing ambivalence in OCD patients. Results: The systematic review revealed high methodological variability between studies, and different trends in the type of schedule, and devices utilized to collect EMA data, it also highlighted the variety of items used in these studies. Meanwhile, the pilot study leaned on the insights provided by the systematic review to develop a set of items that allow the assessment of the ambivalence of OCD patients in their day-to-day lives. Discussion: The integration of the systematic review insights, with the pilot study outcomes underscores the evolving landscape of EMA in OCD research. This synthesis offers valuable data for researchers aiming at designing EMA protocols that capture the dynamic nature of OCD while accommodating individual variability and particular research interests. By sharing the systematic review database and pilot study findings, these studies hope to contribute to the ever-growing advancements in EMA methodologies in OCD research.
  • Innovative Moments in Exposure and Response Prevention: A Case Study. .....Divo Faustino, Universidade do Minho, Braga, Portugal; Rui Braga, Universidade do Minho, Braga, Portugal; Maria João Faria, Universidade do Minho, Braga, Portugal; Miguel Gonçalves, Universidade do Minho, Braga, Portugal; and João Tiago Oliveira, University of Minho
  • Objective: Focusing on client’s strengths while addressing the difficulties that brought them to therapy has been shown to positively impact psychotherapy outcomes. Innovative Moments (IMs) are client strength-based events with the potential of being capitalized on psychotherapy. This phenomenon is present in different types of dialogue-centered psychotherapies, such as Narrative Therapy and CBT. However, IMs have never been studied in a problem-focused behavioral-centered type of therapy. This study aimed to explore whether IMs emerge in an exposure-based treatment. Methods: This was a case study of a male young adult diagnosed with obsessive-compulsive disorder who received nine sessions of exposure and response prevention therapy. The client was considered improved and recovered according to the Outcome Questionnaire 10.2. Results: The proportion of session time spent on innovation spanned from 3.6% (session 4) to 37.2% (session 9) with an average proportion of 15.4% per session. From session 5 onwards, more high-level IMs began to emerge, overall distress tended to decrease, and the quality of the working alliance tended to increase. Conclusion: The IM pattern found in this study was similar to the ones previously found in success cases from more dialogue-based types of psychotherapy. These results support the idea that IMs might be a transtheoretical phenomenon that is present and can potentially be capitalized upon, even in behaviorist and problem-centered treatments such as exposure and response prevention. Priming clinicians’ attention to IMs may prove particularly beneficial in anxiogenic exposure-based therapies.
Lunch Break [Lunch Break]
Saturday | 12:00 pm-1:30 pm | Aula
52. Synthesizing multiple data sources in intensive case studies [Panel/Symposium]
Saturday | 1:30 pm-3:00 pm | P24

Organizer: Jarl Wahlström, University of Jyväskylä
  • Triangulation in case study research in psychotherapy. .....Jochem Willemsen, Université Catholique de Louvain
  • Aim: Triangulation involves the use of multiple methods, investigators, theories, and/or data sources to study a phenomenon of interest. The outcome of triangulation is a better understanding of the phenomenon by drawing on multiple perspective on it. Although this outcome of triangulations seems obvious and important, the process to achieve triangulation is often less clear. The purpose of this study is to review the different ways in which triangulation can be applied to improve psychotherapy case study research. Methods: A review of the methodological literature as well as recently published psychotherapy case studies led to the identification of different ways to integrate or combine multiple methods, investigators, theories, and/or data sources. Results: Different approaches to triangulation in case studies can be distinguished, based on the stage at which the principle of triangulation is applied (either being implemented from the design stage or being added at a later stage of the research process). Moreover, different approaches to triangulation can be distinguished based on the degree to which the different perspectives are assumed to converge, complement, or contrast with each other. Discussion: These results will be illustrated with some recently published case studies. It is important that methods of data collection and analysis used in triangulation are appropriate to the research question as well as epistemologically compatible with one another.
  • Alliance events and physiological synchrony in a couple therapy session characterized by relationship conflict. .....Anu Tourunen, University of Jyväskylä, Finland; Aune Karhumäki, University of Jyväskylä; Markku Penttonen, University of Jyväskylä; Jaakko Seikkula, University of Jyväskylä; and Virpi-Liisa Kykyri, University of Jyvaskyla
  • Background: Capturing authentic, prolonged emotional disputes within close relationships is rare in scientific research. Furthermore, psychotherapy studies seldom connect embodied phenomena such as physiological synchrony with moment-to-moment alliance events. Aims: The study aimed to examine the synchrony in electrodermal activity (EDA) between participants of a couple therapy session marked by ongoing conflict. The couple was actively arguing upon arrival and continued to engage in disputes, leading to numerous alliance ruptures and repairs throughout the session. This session included two clients and two therapists. Methods: Alliance events were coded from therapy videos using the Rupture Resolution Rating System (3RS v2022; Eubanks & Muran, 2023), identifying occurrences of withdrawal ruptures, confrontation ruptures, and repairs. A multivariate analysis of variance followed by subsequent post hoc analyses were employed to examine the three types of alliance events and the mean dyadic synchrony in EDA. Results: The therapy session included 26 confrontation ruptures, 23 withdrawal ruptures, and 34 repairs. Only the couple’s EDA synchrony was associated with alliance events, revealing statistically significant differences between confrontation ruptures and withdrawal ruptures (p = .014), and between confrontation ruptures and repairs (p = .007). Discussion: Romantic partners may exhibit lower synchrony in arousal during confrontations than other alliance events. The findings are discussed in terms of confrontation being a pursuit of agency at the expense of communion, whereas withdrawal seeks communion at the expense of agency.
  • Physiological synchrony, therapeutic alliance and meaning construction in couple therapy. .....Evrinomy Avdi, Aristotle University of Thessaloniki; and Evangelos Paraskevopoulos, Aristotle University of Thessaloniki
  • Background: In line with the growing recognition of the role of embodiment, affect and implicit processes in psychotherapy, several recent studies examine in-session therapy process through multiple modalities of interaction and attempt to synthesize explicit, discursive processes with embodied responses. This literature often includes measures of physiological arousal and physiological synchrony in describing the process of psychotherapy. Method: This study adopts a single-case, mixed method design and examines interpersonal physiological synchrony (IPS) in one couple therapy. IPS is studied in relation to the therapeutic alliance and a narrative analysis of meaning construction in the sessions. IPS was calculated, via a windowed approach, through Partial Directed Coherence (PDC) of a heart rate variability-derived physiological index, which was measured in the third and penultimate sessions. Stimulated Recall Interviews with the therapists and clients were also conducted and these were used to inform the analysis. Findings: Our mixed-method analysis of the two sessions showed that PDC quantified significant moments of interpersonal physiological synchrony, both within and across the sessions, modelling the characteristics of interpersonal interaction as well as the effects of therapy on the interactional dynamics. Discussion: The findings of this study point to the complex interplay between explicit and implicit levels of interaction in psychotherapy and the potential contribution of including physiological measures and physiological synchrony in the study of interactional processes in psychotherapy.
  • What is the impact of Stimulated Recall Interviews on meaning making in couple therapy?. .....Jarl Wahlström, University of Jyväskylä; and Virpi-Liisa Kykyri, University of Jyvaskyla
  • Background. When qualitative analysis of actual couple therapy talk is combined with data from Stimulated Recall Interviews (SRI), access to private experiences and inner dialogues which serve as resources for the participants in their in-session meaning making work, can be attained. The participants’ private content of inner dialogue is continuously present in the public formulations of expressions in outer dialogue, remaining, however, to a great part non-articulated. The SRI procedure affords participants explicit access to this private content and hence the possibility to adopt a reflective position towards their subjective meaning making. In this single case study, we investigate the potential impact of SRIs on the subsequent therapy process. Method. Data was obtained from SRIs collected in the Relational Mind research project on interaction in couple therapy. Each participant (two clients and two therapists) was individually, within one day following the therapy session, shown four video clips from episodes in the session and asked about their thoughts, feelings, and bodily sensations during each episode. Transcripts of SRIs of episodes from two sessions were subjected to qualitative content analysis. Findings. In the SRIs each participant reported and commented on how they perceived the evolving meanings in the therapy conversation, on their own way of participating, and on their emotional experience of the social interaction. Changes in these aspects in subsequent therapy sessions are shown. Conclusions. The study shows how the SRI can be used as an innovative process research method, and a novel means to enhance the impact of therapeutic practices.
53. ‘Can you and I really collaborate in psychotherapy?’ Studies on the therapeutic relationship, challenges and tensions in intercultural/ethnic client-therapist encounters [Panel/Symposium]
Saturday | 1:30 pm-3:00 pm | P31

Organizer: Yael Mayer, University of Haifa, Israel
  • Psychotherapy in a Highly Polarized Society: Exploring Challenges and Tensions in Intercultural Encounters for Arab and Jewish Psychotherapists. .....Yael Mayer, University of Haifa, Israel; Neta Raz, University of Haifa, Israel; and Maha Natoorm, Tel-Aviv University
  • Aim: Psychotherapy in Israel presents unique challenges amidst a highly polarized society. In the public professional setting, Arab and Jewish therapists not only commonly encounter one another but are also required to collaborate in providing culturally safer care to their clients. Moreover, they are expected to cultivate respectful and productive relationships with colleagues from their in and out-group, ensuring effective teamwork and optimal patient outcomes. Despite the prevalence of these encounters, little is known about the experiences of Arab and Jewish Israeli psychotherapists when encountering patients and colleagues from their out-group and how they manage the conflicts that inevitably arise. This study aims to explore the personal and professional challenges that psychotherapists encounter when working in such a polarized societal context. Method: This study, utilizing a qualitative approach, delves into the experiences of 22 experienced mental health clinicians with diverse backgrounds, who were interviewed using semi-structured interviews. We used the dialectical construction of knowledge method to analyze the data. Results: The data revealed four key axes guiding clinicians' navigation: disclosure–concealment, Trust–suspicion, Acceptance–resistance, and Protecting–challenging identity boundaries. The data highlights the omnipresence of cultural tensions in psychotherapists' daily practice. Discussion: Examining inter-group dynamics sheds light on how cultural, social, and institutional factors shape client-therapist and colleague interactions in a high-tension societal context. This study offers insights into cultural competence and intercultural communication within psychotherapy, addressing the multifaceted challenges of providing culturally sensitive care in Israel's diverse landscape.
  • Transference and countertransference in the treatment of Beduine-Israeli women by a Jewish-Israeli female therapist. .....Tamar Zisenwine, Ben Gurion University, Beer Sheva, Israel; and Wisam Maree, Ahva College, Israel
  • Aim: This case study focuses on unique transference and countertransference experiences that arose in two long-term psychodynamic treatments of Beduine-Israeli women treated by a Jewish-Israeli female therapist. The case study analyses the effects of these experiences on the therapist’s interventions, focusing on interventions that led to ruptures related to the cultural gap between clients and therapist, and the subsequent repairs. Method: The case study analyses three main vignettes through the lenses of three theoretical constructs: Freud’s ‘Unheimlich’ (1919), Jessica Benjamin’s ‘Doer-and Done to’ (1988), and cultural humility in psychotherapy (Mosher et. al, 2017). Emotions such as client’s shame, therapist’s guilt and the client-patient’s dyad’s shifts from closeness and familiarity to strangeness and distance, are discussed. Results: The analysis of the ruptures led to the understanding that the cause of the ruptures could not be attributed to the cultural gap alone, but also to the link between the client’s attachment needs at a specific moment in treatment, the therapist’s countertransference, and her attempt to engage in a culturally sensitive intervention. Discussion: This case study contributes to the clinical understanding of the nature of transference experienced by a client who is part of a discriminated minority and a collectivist, conservative Bedouin culture, and countertransference of a therapist who is part of the hegemonic majority and western-Jewish culture in Israel. Moreover, the understanding of the need to be mindful of the client’s attachment needs and transference while engaging in culturally sensitive psychotherapy could contribute to training and point towards directions for future research.
  • Client-therapist cultural matching and its impact on the alliance and microaggressions in short-term psychotherapy. .....Hadas Wiseman, University of Haifa, Israel; and Eyad Hatoom, University of Haifa, Israel
  • Aim: Research on the impact of client-therapist cultural/ethnic matching on psychotherapy process and outcome remains inconclusive. Our aim was to examine differences between client-therapist multicultural dyads and same-culture client-therapist dyads on the working alliance and the occurrence of racial microaggressions. We expected that multicultural dyads would achieve a weaker alliance and would report more occurrence of microaggressions in comparison to same-culture dyads. Method: The study is a naturalistic study of short-term psychotherapy. Clients and therapists comprised three types of Israeli cultural dyads: Multicultural dyads, Arab client- Jewish therapist (n=15), and two types of same-cultural dyads, Jewish client-Jewish therapist (n=21) and Arab client-Arab therapist (n=20). Clients and therapists completed the working alliance at the 3rd, 10th and 15th session, and racial microaggression was reported by clients at the three time points. Clients and therapists completed ECR attachment. Results: Clients in multicultural dyads reported lower alliance than same-culture Arab dyads, but no different from same-culture Jewish dyads, while controlling for therapist attachment. Therapists in same-culture Arab dyads similar to their clients reported higher alliance than same- culture Jewish dyads, but the multicultural dyads were no different from either of them. In contrast, clients in multicultural dyads reported more occurrence of microaggression than the same-culture dyads. Alliance was negatively associated with microaggressions in the same- culture dyads, but was not associated in the multicultural dyads. Discussion: The challenges of achieving a therapeutic collaboration in complex ethnic-cultural-social-political contexts, and implications for training, will be discussed.
Discussant:
  • Irene Messina, Mercatorium University;
54. Synchrony, rupture, and repair in clinical conversation. [Structured Discussion]
Saturday | 1:30 pm-3:00 pm | U23

Organizer: Franco Orsucci, Norfolk and Suffolk NHS Foundation Trust
Moderator: Miguel Gonçalves, Universidade do Minho, Braga, Portugal
Discussants:
  • Günter Schiepek, Paracelsus Medical University, Salzburg, Austria
  • Orya Tishby, Department of Psychology, The Hebrew University of Jerusalem, Israel
  • Franco Orsucci, Norfolk and Suffolk NHS Foundation Trust
55. Therapists [Brief Paper Session]
Saturday | 1:30 pm-3:00 pm | U32

Moderator: Belinda Ford, Open University
  • Therapist personality and the use of self in change: A narrative review of contemporary studies and research protocol. .....John Hills, Metanoia Institute
  • Objective Therapist factors such as personality, maturity, and personal signature are considered influential but under-researched in studies of therapeutic change. The presentation summarises a narrative review of contemporary studies on therapists’ own beliefs about change. A resulting research protocol seeks a finer-grained analysis of therapist factors, and the intentional use of self as an active ingredient of change, through the generation of longitudinal qualitative data, co-produced through a supervision group. Methods A narrative review was conducted of contemporary research into therapists’ own views on mechanisms of change in their practice. Search terms related to therapist factors were applied using the PsycInfo database. An updated search on 25th April 2024 resulted in 633 items, and 13 studies were selected for analysis. Results The review resulted in a conceptual mapping of therapist factors that therapists themselves believed were active ingredients in their own practice. The resultant research protocol centres upon the following research question: How do therapists intentionally leverage their own personality and self in the promotion of change? The protocol calls for a monthly supervision group generating data through dialogue and other creative methods associated with focus group methodology, and collaborating on refining working theories. Data will be analysed at within-case level (the individual practitioner) and cross-case level (emerging consensus). Discussion The findings may offer nuance to conventional emphasis on variables such as modality in efficacy research and the commissioning of psychological therapies, may offer insights into the developmental parameters of psychotherapy training, and the meaning of self of two-person therapy.
  • Differences Between Cognitive-Behavioural and Psychodynamic Therapies from the Perspectives of Therapists: A Qualitative Study. .....Mark Sleiman, University of Greenwich; and Paula Alves, University of Greenwich
  • This paper sought to understand the underlying mechanisms and usage of cognitive-behavioural therapy (CBT) and psychodynamic psychotherapy (PDT) in treating depression from the perspective of their therapists. Five CBT and five PDT experienced accredited therapists were interviewed online for 45 minutes to one hour using semi-structured questions. Their responses were analysed using inductive thematic analysis. Three superordinate themes were extracted: Therapy fundamentals, PDT modality and CBT modality. Therapy fundamentals were given 9 themes: therapeutic relationship, attachment, self-esteem, self-agency, insight, behaviour patterns, therapists development, and challenges. PDT Modality and CBT Modality both were given the same 5 themes each: approach, key aspects, unconscious learned patterns (PDT)/internalised learning theories (CBT), response, and disadvantages. Therapists expressed the therapeutic relationship to be the most important factor in therapy. The study also learned that CBT and PDT have unique approach characteristics but underly a similar procedure to help patients. Many parallels were found between the two supposedly opposing categories, highlighting differences in language but with similar meanings. Implications suggest the possible synergy of the two modalities and future research into the underlying processes and mechanisms of psychotherapies.
  • The lived experience of Relate supervisors of providing supervision. .....Belinda Ford, Open University
  • Aim: This qualitative research sheds a phenomenological perspective on the topic of supervision. There is little material in the literature which considers the lived experience of supervisors. This research helps to fill this gap. The research was completed from an insider researcher position as I am a Relate supervisor myself. The research questions that underpin the study concern the lived experience of supervisors with respect to: a definition of supervision; the functions of supervision; role tension and power relations with supervisees. Method: A mixed methods approach was used, which consisted of: • A quantitative/qualitative survey which was sent to all Relate supervisors, analysed through reflective thematic analysis. • Semi-structured interviews with 10 Relate supervisors, analysed through interpretative phenomenological analysis. Findings: Key findings are: • Out of the functions of education, support and administration participants consider that supporting counsellors is their primary function. • Participants reflect that they experience tension through having to enforce standards with supervisees; synthesise the conflicting functions of the role; and be pulled into supervisee line management. • Participants recognise a power dynamic between them and their supervisees and consider this is partly caused by supervisees’ expectations. • Participants reflect a preference for working collegially and holding power lightly. They are reluctant power takers. Conclusions/implications for practice: In shedding a phenomenological light on the experience of being a Relate supervisor, this study brings a unique perspective to the literature. There is potential for the research to improve professional practice across supervision through awareness raising and training programmes.
Coffee Break
Saturday | 3:00 pm-3:30 pm | Aula
56. Monitoring and Modeling of Nonlinear Change Dynamics in Psychotherapy: Bridging the Gap Between Theory and Practice [Panel/Symposium]
Saturday | 3:30 pm-5:00 pm | P24

Organizer: Günter Schiepek, Paracelsus Medical University, Salzburg, Austria
  • On the Validation of a Mathematical Model of Psychotherapeutic Change. .....Helmut Schöller, Paracelsus Medical University, Salzburg, Austria; and Günter Schiepek, Paracelsus Medical University, Salzburg, Austria
  • Some years ago, a theoretical model was published which should explain (simulate) the nonlinear dynamics of psychotherapeutic change (Schiepek et al., 2017; Schöller et al., 2018). It includes fife variables, which could be seen as states (in terms of psychology) or as order parameters (in terms of Synergetics): problem severity, motivation for change, insight, experience success, and intensity of emotions). The shape of the functions relating these variables are modified by four control parameters (traits or dispositions): alliance/attachment, cognitive competencies, resources, and trait motivation/self-efficacy. The model explains some basic features of change dynamics like chaoticity, sensitive dependency on initial conditions and small input, or pattern transitions. Based on this, it can be specified for individual clients with their specific initial conditions of all variables, their specific values of control parameters (which can be assessed by questionnaires), and also by the experienced input onto the variables (may this be interventions or other day-by-day experiences). As the time series of all variables, the control parameters, and the experienced input can be assessed during psychotherapy of each client (N=30) of a validation study, a direct comparison between the simulated dynamics and the empirical dynamics can be realized. Here we report on first results.
  • Short Term Forecast of Intervention Effects for a Decision Support Tool in Psychotherapy: How AI Can Optimize Mathematical Algorithms. .....Tine Kolenik, Paracelsus Medical University, Salzburg, Austria; Helmut Schöller, Paracelsus Medical University, Salzburg, Austria; and Günter Schiepek, Paracelsus Medical University, Salzburg, Austria
  • Based on the time series data and the daily diaries from clients, the Synergetic Navigation System (SNS) supports treatment and treatment decisions in close cooperation between client and therapist (continuous cooperative process control). Now a decision support tool will be developed which supports decisions on the ongoing process and potential interventions. In addition to early warning signals of upcoming pattern transitions (e.g., changed inter-item synchronization, critical instabilities), the new decision support tool uses the existing theoretical model for personalized short-term prediction of the process. Therapists can make an input onto the fife variables of the model which represents the intended intervention in order to predicts potential benefits or risks of doing this with a real client. The prediction can be optimized beyond the mathematical algorithm of the model by using machine learning and Artificial Intelligence (AI), which will improve the predictions. The AI algorithms can be trained by data from the empirical change course when a specific intervention is applied. The decision support tool will be available in a newly to be developed therapist app of the SNS.
  • Data-Driven Personalized Psychotherapy and Its Effects: From Idiographics to Nomothetics and Back. .....Günter Schiepek, Paracelsus Medical University, Salzburg, Austria; Yvonne Hülsner, Praxis Yvonne Hülsner, Bielefeld, Germany; and Helmut Schöller, Paracelsus Medical University, Salzburg, Austria
  • High-frequency process monitoring (sampling rate: self-assessments once per day) by using the Synergetic Navigation system (SNS) is applied in routine inpatient and outpatient psychotherapy since about 15 years. Many therapists not only use the standardized Therapy Process Questionnaire (TPQ) for inpatient and outpatient settings but create personalized process questionnaires for each patient. The questionnaires (items and “factors”) are developed from case conceptualizations (resource-focused interviewing and idiographic system modelling) in close cooperation with the patient. The resulting time series can be visualized and analyzed by the nonlinear analysis methods which are available in the SNS. Therapy sessions are based on this visualized feedback, what can be called an idiographic approach. Data from personalized measurement and feedback (quantitative and qualitative, resulting from daily diaries) can be integrated into big data sets and can be analyzed in order to work on nomothetic research questions. A user survey (therapists and clients) produced very promising results showing the therapeutic effects of feedback and feedback-driven psychotherapy.
Discussant:
  • Franco Orsucci, Norfolk and Suffolk NHS Foundation Trust;
57. Somatic Symptoms [Brief Paper Session]
Saturday | 3:30 pm-5:00 pm | P31

Moderator: Patrycja Jeda, Jagiellonian University Medical College
  • Longitudinal and idiographic methods of developing and evaluating tailored psychological interventions for people with MS: findings from a pilot study and future directions. .....Eva Fragkiadaki, University of the West of England; Isabella Nizza, Birkbeck University of London; Jonathan Smith, Birkbeck University of London; Claire Rice, University of Bristol; and Nikki Cotterill, University of the West of England
  • Multiple Sclerosis (MS) is a complex and heterogeneous condition which makes the development of effective psychological interventions a challenging task. Research so far has focused on well-established protocols which do not always fit the individualised needs of people with MS. This pilot study investigated the feasibility and acceptability of “MyMS-Ally”, an online group intervention tailored to address the identified needs and preferences of people with MS. Over eight weekly sessions, five people with MS participated employing a longitudinal mixed-methods approach to assess intervention relevance, sustainability and adherence (feasibility) as well as emotional and cognitive responses, satisfaction and perceived effectiveness (acceptability). Additionally, outcome and change processes were evaluated as secondary aims of the study. Qualitative data were collected at baseline, termination and three-month follow up following Longitudinal Interpretative Phenomenological Analysis principles. Quantitative data were collected at baseline, termination, one-month and three-month follow up, focusing on within-subject effects, within an idiographic framework. Participants reported the benefits of sharing in the group, experiencing increasing empowerment and integration of MS in their everyday lives and identity. Openly discussing their MS and fostering a sense of belonging were valued, although confronting aspects of their condition proved challenging. Participants explored their representations of disability, the physical and mental facets of their MS, connecting with more authentic image of their future with the condition. The findings underscore the importance of tailored and individualised psychological interventions that meet the unique preferences and experiences of people with MS. Future research suggestions for idiographic, process-based therapy studies will be discussed.
  • Body related symptoms in patients seeking psychotherapy. .....Michał Mielimąka, Jagiellonian University Medical College; Krzysztof Rutkowski, Jagiellonian University, Kraków, Poland; Jerzy Sobanski, Jagiellonian University Medical College; Katarzyna Klasa, Jagiellonian University, Kraków, Poland; Patrycja Jeda, Jagiellonian University Medical College; and Edyta Dembińska, Jagiellonian University, Kraków, Poland
  • Introduction and aim Body related complaints are an important area of concern among patients seeking psychotherapy. In this research the prevalence and distribution of body related symptoms among patients seeking treatment in a specialized psychotherapy day clinic was investigated. Method 131 patients seeking psychotherapy treatment were included in the study. All have been initially screened by a licensed psychiatrist and qualified for an extensive diagnosis before admittance for a specialized psychotherapy treatment program for neurotic and personality disorders. Symptoms distribution and prevalence was evaluated with the use of the Symptoms Checklist Questionnaire “O”. In includes 135 symptoms, out of which 67 are body related. Extensive statistical analysis was performed to ascertain the prevalence and distribution of those symptoms. Five subgroups were analyzed: a) somatic disfunction, b) conversion, c) sexual activity, d) sleep disturbance and e) hypochondria. Results Body related symptoms ascertained for 42% of global intensity of reported disfunctions. The median of the number of reported symptoms was 28. Only about 5% of patients reported ten or less body relates symptoms. The intensity of dysfunction in the analyzed groups was: sleep disturbance (72,1% of attainable intensity), hypochondria related symptoms (40,2% correspondingly), somatic disfunction (38,5%), sexual activity (36%), conversion (32,5%). Conclusions Due to high prevalence body related symptoms should be considered a major cause of concern for practicing psychotherapists, especially in the phase of diagnosis for psychotherapy. Often an appropriate, extensive evaluation is needed to correctly identify and understand the cause and mechanisms of reported symptoms. In some clinical cases a multi-specialty care should be considered as the best and required option.
  • The connection between pain, hypnosis, and psychotherapy. .....Anna Kaczmarska, Department of Psychotherapy, Jagiellonian University Medical College, Krakow, Poland; Michał Mielimąka, Jagiellonian University Medical College; and Krzysztof Rutkowski, Jagiellonian University, Kraków, Poland
  • Patients with anxiety and personality disorders often suffer from bodily complaints of unclear etiology, including pain. The randomized controlled trial evaluated the relative efficacy of 3 clinical hypnosis sessions in 60 patients undergoing group psychotherapy, with nociplastic pain. Participants were allocated randomly to one of two conditions: hypnosis with analgesic suggestions or hypnosis with nonspecific suggestions (nature scenes). Pain intensity, pain quality, and pain interference as outcome measures were assessed before and after treatment. A mixed-design analysis of variance model showed no significant differences between randomization groups. Large effect size improvements in pain intensity and pain quality emerged for both conditions, but were only meaningful for patients not taking pain medications, according to the adjusted model. Not specific therapeutic techniques, but shared mechanisms and common factors may play a primary role in beneficial outcomes of hypnotherapy at the beginning of chronic pain management, since both interventions demonstrated similar positive effects. Hypnosis introduces the experience of influencing pain symptoms through the psyche, which may encourage patients to bring the topic of bodily complaints into psychotherapy.
  • The relationship between the dynamics of change in headache prevalence and personality traits in patients with neurotic and personality disorders treated with psychotherapy - an indicator of change or a sign of resistance?. .....Patrycja Jeda, Jagiellonian University Medical College; Michał Mielimąka, Jagiellonian University Medical College; Edyta Dembińska, Jagiellonian University, Kraków, Poland; Jerzy Sobanski, Jagiellonian University Medical College; Katarzyna Klasa, Jagiellonian University, Kraków, Poland; and Krzysztof Rutkowski, Jagiellonian University, Kraków, Poland
  • The socio-economic and medical consequences of the increasing prevalence of headache are currently being felt on a global scale. The emergence of a group of patients suffering from medication-overuse headache (MOH) points to the need to search for non-pharmacological treatments. The undeniable symbolism of headache leads us to re-examine its importance, especially in the context of its frequent co-occurrence with neurotic and personality disorders. We included 233 patients who completed a course of intensive, short-term, psychodynamically oriented group psychotherapy at the Neurosis and Behavioural Disorders Treatment Outpatient Clinic of the University Hospital in Krakow. The presence and severity of headaches were assessed using the Symptom Checklist "O" . The severity of personality dysfunction traits was assessed using the Neurotic Personality Questionnaire - 2006. In 32% (n=74) of the patients, the headaches were reduced in intensity. 20% (n=51) experienced a worsening, including headaches occurring during treatment (n=37). ANOVA analysis showed that there were differences between groups (no change, worsening, improvement) in personality dysfunction measured before and after the treatment cycle, in traits such as asthenia (p=.005), negative self-esteem (p=.03), impulsivity (p=. 01), difficulty in making decisions (p=.0007), sense of alienation (p=.03), demobilisation (p=.002), lack of vitality (p=.028), conviction of inadequacy in life (p=.008), sense of lack of control (p=.02), imagination, fantasising (p=.003), guilt (p=.01), irritability (p=.009) and meticulousness (p=.009). A detailed analysis of each group and a description of clinical cases will be presented in order to demonstrate a possible understanding of the phenomenon in question and its role in the treatment process.
58. Outcome 2 [Brief Paper Session]
Saturday | 3:30 pm-5:00 pm | U23

Moderator: Vânia Silva, Universidade do Minho, Braga, Portugal
  • Targeted Learning for Optimal Patient Assignment to Psychotherapy. .....Veera Malkki, University of Helsinki; Suoma Saarni, Helsinki University Hospital and Helsinki University; University of Tampere, Faculty of Medicine and Health Technology; Wolgfang Lutz, University of Trier; and Tom Rosenström, University of Helsinki
  • Objective: The treatment effects across different psychotherapeutic frameworks are often comparable, especially among the most prevalent mood disorders. However, past research has primarily focused on overall treatment effects. Our aim was to estimate individual treatment effects by utilizing statistical counterfactuals, thereby identifying the most suitable treatment for each individual. Methodology: Employing a targeted learning framework, we estimated causal effects using observational data sourced from the Finnish Psychotherapy Quality Registry, encompassing adult patients diagnosed with various mental disorders (n = 2255). We compared counterfactual outcomes among four different treatment groups: psychodynamic, solution-focused, cognitive-behavioral, and integrative or cognitive-analytic therapies. Finally, we estimated the average treatment effect between the optimal individualized treatment and the treatment actually received, measured through changes in self-assessed depression symptoms, general psychopathology, and clinician-assessed functioning. Results: Compared to the observed treatment effects, the optimized counterfactual treatment yielded better treatment effects across all outcomes. Under the assumption that each patient underwent psychotherapy within the same therapeutic framework, we observed no differences between different frameworks in treatment effects for symptom scores. Conclusion: Optimal treatment allocation produces superior treatment effects compared to observed or non-personalized treatment allocation, and these effects are quantifiable. In the future, efforts to integrate this type of decision-support system into clinical practice should be investigated.
  • Brief Transactional Analysis Psychotherapy for Depression: A Pilot Randomized Controlled Trial. .....Joel Vos, Metanoia Institute; and Biljana van Rijn, Metanoia Institute
  • Background: Transactional Analysis Psychotherapy (TAP) has demonstrated clinical benefits, yet most manuals lack specificity and evidence-based interventions. This study tested the semi-structured 16-session Brief Transactional Analysis Psychotherapy (BTAP) manual for depression, which was previously systematically developed incorporating evidence-based components. Methods: Individuals with mild to moderate depression were assigned to BTAP or Brief Cognitive Behaviour Therapy (BCBT) through block randomisation alongside a control group receiving Care As Usual (CAU) relational-humanistic therapies in a community clinic. Mental health outcome instruments included depression (PHQ-9), anxiety (GAD-7), distress (CORE-10), and quality-of-life (WHOQOL-bref). BTAP-related skills were measured with the Life Position Scale, Schema Mode Inventory, and Conceptual Well-Being Scale. TA-therapist Competencies were measured with Transactional Analysis Psychotherapy Self-Report Competencies Scale. Cohen’s D in SPSS29.0. analysed differences, and Cross-lagged Regression Analysis in MPlus v.4.7. analysed the relationships between outcomes, client’s TA-related skills and TA-therapist competencies. Findings: Of the participants, 28 completed BTAP, 10 BCBT, and 28 were matched to CAU. Post-therapy, BTAP clients showed large, significant improvements in depression, anxiety, distress, and quality of life (Cohen’s D: 5.67, 5.72, 4.99, .43), outperforming CAU (Cohen’s D for BTAP-CAU differences: .97, .81, .78, .69), with comparable effects to BCBT (no significant BTAP-BCBT differences). Cross-lagged analyses only found significant predictions of outcomes by client’s TA-related skills, and client’s TA-related skills by TA-therapist skills predicted. Discussion: BTAP significantly enhances mental health and quality-of-life in depressed clients by improving client’s TA-related skills and TA-related therapist competencies. While further validation is necessary, BTAP emerges as a bona fide treatment option for depression.
  • Navigating psychotherapy in the COVID-19 Era: overcoming challenges, harnessing benefits, and practical recommendations. .....Vânia Silva, Universidade do Minho, Braga, Portugal; Laura Koppensteiner, Universidade do Minho, Braga, Portugal; and Eugénia Ribeiro, Universidade do Minho, Braga, Portugal
  • Aim: The protective measures implemented due to the COVID-19 pandemic have brought some changes for the psychotherapeutic setting, with therapists shifting to videoconference (VT) and/or in-person wearing face masks therapy (IPTFM) with little or no training. Identifying challenges, benefits and recommendations may support the effective delivery of psychotherapeutic care in future similar conditions. Recent literature has highlighted mostly the therapists’ perspectives on those challenges, benefits, and recommendations. Since therapists and clients seem to differ on what they expect to take place in therapy, to improve psychotherapeutic care clients’ perspectives should as well be considered. Thus, the present study aims to understand therapists’ and clients’ perspectives on challenges, benefits, and recommendations for VT and IPTFM and if there are differences regarding those perspectives. Methods: We analyzed the open-ended questions of a larger online survey on the quality of relational processes in psychotherapy under the COVID-19 pandemic. The participants responses were collected worldwide between December 2022 and July 2023. 139 therapists and 71 clients consented to participate in the study. We conducted a deductive content analysis to examine trends in participants’ answers, and Fisher-Freeman-Halton tests to determine differences between therapists and clients across categories. Results: While clients tended to focus on normalizing and trusting the new therapeutic environments, therapists were concerned with improving communication and refining their therapeutic skills to maintain the effectiveness of therapy under the new therapy conditions. Discussion: This understanding enabled the formulation of targeted recommendations that address the unique needs of each group to enhance their therapeutic experiences.
59. Innovative ways of working psychotherapeutically with Complex Emotional Needs [Panel/Symposium]
Saturday | 3:30 pm-5:00 pm | U32

Organizers: Felicitas Rost, The Open University, UK; Dana Tzur Bitan, Haifa University, Israel;
  • A Health Economic Analysis of the Cost of Highly Complex Relational Disturbance (HEARD): A study focusing on the hidden costs to make a case for a new national treatment strategy in the UK. .....Felicitas Rost, The Open University, UK; Susan Mizen, The University of Exeter UK; Frederico Cordoso, Centre for Mental Health; and Hope Kent, Exeter University
  • Objectives: Individuals with Highly Complex Emotional Needs (HCEN) are a hidden high-cost population. In the absence of appropriate specialist therapeutic services, they are hospitalised in mental and physical health inpatient settings. The aim was to undertake a health economic cost analysis of their health and social care utilisation with a focus on pattern of service use, pattern of spending and prediction of service needs. Methods: The data was collected from electronic clinical and local authority records from one rural and one inner-city setting in the UK from 2015-218. Search criteria for inclusion include meeting HONOS Clusters 7 and 8 and specific ICD diagnostic codes. Of most interest are service use outliers whose costs fall outside 3 Standard Deviations of the mean of the whole sample. Results: 1.1-1.8% are high-cost outlier and account for 23.9-36.2% of the spend on HCEN across mental health, physical health and social care at a cost of £8M p/a for 85 patients at one site and £15M p/a for 272 patients at the second. Specific patterns of service use, spending and predictions will be presented. Discussion: Findings from both localities confirm high costs, poor therapeutic outcomes, and unacceptable service user experience. It highlights the urgency to provide strategic direction to the future planning of therapeutic pathways and services for this population to policy makers. Clinical Significance: Individuals with HCEN are uniquely vulnerable to iatrogenic harm and institutionalisation when inappropriately hospitalised. Findings indicate the critical need to develop HCEN therapeutic pathways from inpatient to community settings.
  • Findings from the Devon Specialist Personality Disorder Service (PDSS).. .....Susan Mizen, The University of Exeter UK; Felicitas Rost, The Open University, UK; and Hope Kent, Exeter University
  • Objectives: In 2009 a health economic business case was presented to the commissioners of NHS services in Devon (UK) making the case for a psychotherapy service for patients with Highly Complex Emotional Needs (HCEN) (Personality Disorder) who were hospitalised long-term in mental or physical health settings. £1.4M p.a. was invested in a four day a week psychodynamic therapeutic community day programme and outpatient service. The service accepted PD patients above a severity threshold which selected patients with high suicide risk and co-morbid eating disorders, functional somatic disorders, autistic spectrum disorder and substance misuse. Method: A new formulation based psychoanalytic and neuroscientific approach, The Relational Affective Model (Mizen, 2015; Mizen, 2022), was used to treat individuals. Cost-effectiveness was assessed in terms of reduced out of area hospital placements, lengths of stay and overall cost per patient through reviewing health and social care records. Results: Between 2011 and 2020, the service was cost effective reducing out of area hospital placements, length of stay and cost per case. Use of local emergency services also fell and clinical outcomes improved. Discussion: On the basis of these findings the HEARD study was undertaken to make the case for a national programme of intensive inpatient and day-patient therapeutic pathways for patients with HCEN. The Health Economic case, the therapeutic model and the outcomes will be presented in this session.
  • Interactive effects of Oxytocin and inflammation on psychotherapy outcomes among patients with severe distress. .....Omer Sedoff, University of Haifa, Israel; and Dana Tzur Bitan, Haifa University, Israel
  • Introduction: Working with individuals with severe distress challenges the psychotherapeutic process, especially in inpatient settings. Innovative study conducted in our lab has demonstrated that Oxytocin (OT) administration facilitates therapy outcomes, however, the mechanism responsible for this facilitation remained unclear. Theoretical formulations aimed to disentangle the physical and psychological impact of OT has previously suggested a connection between OT and the immune system. According to such formulation, OT and its interpersonal correlates might strengthen the immune system, thereby leading to improved outcome. Objectives: In this study we aimed to explore this formulation, by assessing whether the association between the immune system function and therapy outcomes is moderated by OT or placebo administration. Methods: A retrospective sub-analysis was performed on the same population of patients (N=65) using the systemic immune-inflammation index (SII) as a marker for inflammatory response. Results: The results indicated a significant interaction effect (t = -2.00, p < .05), whereby changes in SII were significantly associated with changes in state anxiety only in the OT group, but not in the placebo. Contrary to our hypothesis, simple slope analysis indicated that in the OT group, a decline in SII was significantly associated with a deterioration in therapy outcomes (t = -2.12, p < .05), whereas in the placebo group, the directional pattern was non-significantly reversed (t = 0.95, p = .34) indicating that a decline in SII may be associated with improvement in psychotherapy outcomes. Conclusions: Findings underscore the complex interplay between OT, inflammation, and psychotherapy outcomes, suggesting a need for further investigation into potential interactive relationships between OT and the immune system in driving therapeutic efficacy.
  • Challenges of innovation: cross-cultural implementation of Dynamic Deconstructive Psychotherapy for patients with personality disorders. .....Dana Tzur Bitan, Haifa University, Israel; and Omer Sedoff, University of Haifa, Israel
  • Objectives: One of the main challenges of effective dissemination of novel psychotherapeutic approaches is cross-cultural adaptation, defined as the adjustment of the therapeutic approach to specific cultural beliefs, attitudes, and ways of living. This challenge is especially pronounced when it comes to psychodynamically oriented approaches, which tend to rely on non-verbal and less explicit communicative elements. In this study we aimed to demonstrate the challenges and opportunities of cross-cultural implementation of dynamic deconstructive psychotherapy (DDP), and specifically how these challenges manifest during cross-cultural supervision. Method: Nine Israeli therapists participating in the implementation of DDP in a public psychiatric hospital supervised by a US clinical supervisor were interviewed. The Braun and Clarke (2006) approach for thematic analysis was employed to assess the main themes expressed by the therapists. Results indicated that therapists reported some challenges such as the use of clinical manuals and language barriers. On the other hand, cultural differences in the interpersonal aspects of supervision were viewed as an opportunity. Overall, the most frequent theme expressed was related to cultural differences in the interpersonal aspects of supervision (22.8%), followed by language barriers (14.9%), use of a clinical manual (13.2%), use of the approach in other settings (11.4%), and the shift to non-interpretive therapeutic position (10.5%). Conclusion: These results highlight the multifaced nature of cross-cultural dissemination of psychotherapeutic approaches and provides potential guidelines to inform therapists and researchers practicing cross-cultural supervision.
60. Closing Ceremony
Saturday | 5:00 pm-5:30 pm | P31
61. Banquet [Banquet]
Saturday | 7:00 pm-11:00 pm | VIDA Science Center
Moravian Science Centre Brno, Křížkovského 554/12, 603 00 Brno. This event requires prior registration and is not included in the conference fee.






Index to Participants

Aafjes-van Doorn, Katie: 11
Aas, Benjamin: 24 , 36
Agner, Rudolf: 17
Almeida, Beatriz: 50
Álvarez Tomás, Irene: 20
Alves, Paula: 41 , 55
Anat, Talmon: 31
Anderson, Shayne: 27
Araújo, Daniela: 37
Arnaud, Nicolas: 39
Arnfred, Sidse: 25
Ateba‎, Freddy: 39
Avdi, Evrinomy: 12 , 52
Axelrad Levy, Tamar: 39
Bajrami, Zelie: 49
Barbosa, André: 50
Barbosa, Eunice: 41
Barel Refaeli, Lee: 31
Barkham, Michael: 5 , 46 , 48
Basset, Frances: 9 , 22
Basto, Isabel: 50
Batista, João: 37
Bauer, Stephanie: 16 , 36
Bauer, Stephanie: 39
Baumeister, Harald: 39
Becher-Urbaniak, Stella: 26 , 49
Bekes, Vera: 11
Belmudez Biering, Elisabeth: 25
Benbenishty, Rami: 35
Berger, Thomas: 16
Bernroitner, Jana: 49
Bhola, Poornima: 34
Blümel, Stefan: 43
Bok, Tomáš: 20
Bonaiuto, Flavia: 43
Bossenbroek, Rineke: 36
Braga, Rui: 37 , 51
Brattland, Heidi: 16 , 19 , 49
Briggs, Andrew N: 27
Briner, Fabio: 32
Bringmann, Laura: 26
Broglia, Emma: 48
Brown, Gary: 28
Brønstad, Ingunn: 49
Bührig, Kristin: 18
Bulut Özer, Pelinsu: 15
Cardinali, Paola: 43
Čevelíček, Michal: 36 , 41 , 43
Chen, Serena: 10
Chokhani, Ritika: 39
Cirkovic, Mirko: 28
Cooper, Mick: 45 , 48
Corbella, Sergi: 20
Cordoso, Frederico: 59
Cotterill, Nikki: 57
Coutinho, Joana: 42
Cunha, Carla: 13 , 28
Daniels-Wredenhagen, Nora: 36
de Condé, Hubert: 7 , 12
de Felice, Giulio: 40
De Roten, Yves: 34
De Wilde, July: 18
Deflorin, Hanna: 16
Delgadillo, Jaime: 23 , 28
Delizée, Anne: 18
Dembińska, Edyta: 8 , 32 , 57
Diamond, Gary: 38
Dichmann, Kirstine: 25
Didkovska, Larysa: 8
Dinger, Ulrike: 41
Djillali, Slimane: 34
Doležal, Petr: 36 , 41
Draganski, Bogdan: 32
Drüge, Marie: 36
Duchin, Adi: 35
Egozi, Sharon: 26
Eis, Jenny Lou: 15
Elberg, Dana: 40
Elliott, Robert: 28 , 38
Enav, Yael: 31
Eshagi, Masoud: 14
Eyuboglu, Melisa Eyuboglu: 41
Fagerbakk, Steffen André: 19
Fajstavr, Ondřej: 41
Falgares, Giorgio: 32
Falkenström, Fredrik: 15
Faria, Maria João: 51
Faustino, Divo: 51
Feixas, Guillem: 20
Fernades, Ana Sofia: 37
Fernández-Navarro, Pablo: 37
Ferreira, Helena: 37
Ferreira, Laura: 26 , 49
Figueiredo, Andreia: 50
Fiorini, Guilherme: 39
Flückiger, Christoph: 37
Ford, Belinda: 55
Fragkiadaki, Eva: 45 , 57
Friederich, Hans-Christoph: 41
Fuchshuber, Jürgen: 17
Fülep, Martin: 20
Gamoneda, José: 38
Gergov, Vera: 46
Gershfeld-Litvin, Avital: 50
Gheorghiu, Natalia: 41
Giannone, Francesca: 25
Giordano, Cecilia: 25
Goldbeck, Florens: 36
Gomes, Marta: 13 , 42
Gonçalves, Miguel: 5 , 37 , 41 , 51 , 54
Grandjean, Loris: 32
Grecucci, Alessandro: 32
Greenfild, Brian: 39
Grigutyte, Neringa: 12
Grindheim, Øyvind: 16
Gross, James: 31
Grünberg, Chawwah: 24
Gryesten, Jasmin: 25
Gullo, Salvatore: 25
Gwertzman, Gershom: 28
Halfon, Sibel: 15
Hartmann, Armin: 19
Hatoom, Eyad: 41 , 53
Hegewald, Konstantin: 36
Heinonen, Erkki: 42
Henriques, Margarida Rangel: 41
Hentschel, Louise: 7
Hewitt, Paul: 20
Hills, John: 55
Holgersen, Katrine, Høyer: 49
Holzweber, Christoph: 17
Høgenhaug, Stine Steen: 47
Høglend, Per Andreas: 42
Hubatka, Petra: 48
Hubatková, Petra: 43
Huber, Dorothea: 15
Hülsner, Yvonne: 56
Humer, Elke: 40
Hummelen, Benjamin: 42
Hutschemaekers, Giel: 41
Igra, Libby: 15 , 47
Imel, Zac: 23
Infurna, Mariarita: 32
Jach, Robert: 20
Jacobsen, Celia Faye: 15 , 47
Jagmetti, Louisa: 36
Jakhelln Laugen, Nina: 19 , 34
James, Katy: 46
Janeiro, Luís: 26 , 49
Janse, Pauline: 46 , 49
Javed, Maryam: 39
Jeda, Patrycja: 32 , 57
Jennissen, Simone: 41
Jensen, Marianne: 49
Jódar, Rafael: 38
Joffe, Grigori: 43
Johnsen Dahl, Hanne-Sofie: 42
Jonášová, Klára: 36
Jordan, Ariana: 9 , 45
Kacalska-Janssen, Olga: 20
Kaczmarska, Anna: 57
Kaess, Michael: 39
Kaluzeviciute, Greta: 12
Kapusta, Nestor: 27
Karhumäki, Aune: 52
Karstoft, Karen-Inge: 15
Keijsers, Ger: 41
Kelber, Michael: 11
Kent, Hope: 59
Kherif, Ferath: 32
Kirsman, Natalia: 31
Kivlighan, Dennis: 25
Klasa, Katarzyna: 20 , 32 , 57
Klemm, Sarah-Lena: 39
Klocek, Adam: 43
Klug, Günther: 15
Koch, Lisa: 24 , 43
Koementas, Marjolein: 25
Kolenik, Tine: 56
Kompan Erzar, Katarina: 28
König, Elisa: 39
Koppensteiner, Laura: 58
Kovačević Tojnko, Nuša: 28
Kramer, Ueli: 32
Kuska, Martin: 14
Kykyri, Virpi-Liisa: 42 , 52
Ladmanová, Michaela: 20 , 50
Laireiter, Anton-Rupert: 19
Lemmer, Diana: 39
Lemmer, Diana: 39
Lemmetyinen, Riikka: 42
Levy, Jo: 40
Levy, Maayan: 47
Lichtwarck-Aschoff, Anna: 36
Lisboa, Ricardo: 41
Lo Coco, Gianluca: 25
Loconsole, Claudio: 43
Löffler-Stastka, Henriette: 11 , 17
Lunn, Susanne: 15 , 47
Lutz, Wolgfang: 58
Maciejewski, Dominique: 26
Magalhães, Carina: 37
Mahmood, Faisal: 9 , 22 , 45
Malkki, Veera: 58
Maniglio, Roberto: 43
Maree, Wisam: 53
Marek, Tadeusz: 32
Maria Di Blasi, Maria: 25
Marinai, Janine: 37
Mayer, Yael: 31 , 53
Mehulić, Jasmina: 26
Mekolle, Denis: 14
Memon, Sanober: 34
Mende, Fritz: 41
Mesquita, Edgar: 28
Messina, Irene: 7 , 17 , 32 , 43 , 53
Meyer, Thomas: 24
Midgley, Nick: 39
Mielimąka, Michał: 8 , 15 , 20 , 32 , 41 , 42 , 57
Mikoška, Petr: 20
Milhazes, Andreia: 37
Mitterhauser, Maximiliane: 49
Mizen, Susan: 59
Moertl, Kathrin: 43
Moessner, Markus: 16 , 36 , 39
Moller, Naomi: 9 , 33
Moltu, Christian: 16 , 25
Monteiro, Marina: 13 , 28 , 42
Morina, Nexhmedin: 24
Mostowik, Joanna: 15 , 41
Moura, Inês: 41
Møller, Kirsten: 25
Mullins, Danielle: 20
Muntigl, Peter: 18
Muotka, Joona: 42
Muran, J. Christopher: 15
Mutter, Agnes: 39
Mylläri, Sanna: 43
Nagel, Lea: 7
Narath, Ursula: 17
Natoorm, Maha: 53
Nehyba, Jan: 41
Neimeyer, Robert: 37
Nielsen, Jan: 15 , 47
Nilsen, Torbjørn: 34
Nizza, Isabella: 57
Nogueira, Daniela: 28
Nokia, Miriam: 42
Norcop, Holly: 39
Novák, Lukáš: 20
Nyapati, Sashank: 24 , 43
Nyman-Salonen, Petra: 42
Oasi, Osmano: 32
Oliveira, João Tiago: 16 , 37 , 51
Olthof, Merlijn: 36
Orlinsky, David: 19
Orsucci, Franco: 1 , 47 , 54 , 56
Paiva, Alexandra: 13
Paiva, Dario: 37 , 51
Paraskevopoulos, Evangelos: 52
Pázmányová, Rebeka: 24 , 43
Peer, Gabriel: 42
Penttonen, Markku: 42 , 52
Pereira, Leonor: 50
Petrovic, Snezana: 43
Petruccelli, Irene: 43
Pilárik, Ľubor: 20
Pinheiro, Patrícia: 13 , 37 , 50
Pinhel, Catarina: 50
Piotrowicz, Karolina: 8
Pirke, Jan: 7 , 19
Plantade-Gipch, Anne: 34
Plattonen, Aino: 46
Plener, Paul: 39
Pohjola, Mikko: 42
Pommerien-Becht, Florian: 36
Poulsen, Stig: 15 , 25 , 33 , 47
Probst, Thomas: 40
Rach, Paul: 26
Ramaswamy, Deepti: 22 , 35
Rametti, Giuseppina: 20
Raz, Neta: 53
Razum, Josip: 26
Reitan, Solveig K.: 49
Ribeiro, Eugénia: 49 , 58
Rice, Claire: 57
Richards, Derek: 23
Řiháček, Tomáš: 36 , 41 , 43 , 50
Ringel, Tamara: 41
Ritola, Ville: 43
Robinson, Anna: 38
Ronnestad, Helge M.: 19
Rosendahl, Jenny: 25
Rosenström, Tom: 43 , 46 , 58
Rossi, Roberta: 32
Rossi, Tatiana: 43
Rost, Felicitas: 2 , 33 , 59
Rožič, Tatjana: 28
Rubel, Julian: 51
Ruhanen, Mikko: 42
Rummel-Kluge, Christine: 39
Rutkowski, Krzysztof: 15 , 20 , 32 , 41 , 42 , 57
Rutkowski, Krzysztof: 8
Ryum, Truls: 19 , 34
Saarni, Samuli I: 46
Saarni, Suoma: 43 , 46 , 58
Sales, Célia: 48
Salgado, João: 13 , 28 , 41 , 42
Sampolahti, Timo: 43
Scappini, Agathe: 41
Scarvaglieri, Claudio: 18
Schaffler, Yvonne: 40
Scheiner, Birgit: 49
Scherfler, Katharina: 34
Schiepek, Günter: 40 , 47 , 54 , 56
Schigl, Brigitte: 40
Schiller, Birgitta: 26 , 49
Schlegel Eliachar, Karina: 42
Schöller, Helmut: 56
Scholz, Silvia: 36
Schønning, Thea: 42
Schrattenecker, Sarah: 49
Schroder, Thomas: 3 , 7 , 19
Schwartz, Brian: 23 , 24 , 46
Schweitzer, Erwin: 40
Ściegienny-Lemler, Aleksandra: 42
Sedoff, Omer: 59
Seikkula, Jaakko: 42 , 52
Sell, Christian: 15
Shamia Atzmon, Adi: 31
Shorer, Maayan: 31
Sickinghe, Marthe: 24
Silva, Eunice: 13
Silva, Vânia: 58
Šipka, Dajana: 16
Skjervold, Anne Elisabeth: 49
Skrobol-Bojarczuk, Karolina: 41
Sleiman, Mark: 55
Smith, Jonathan: 57
Snir, Avigal: 31
Snir, Sharon: 26
Sobanski, Jerzy: 32 , 41 , 57
Sobczak, Anna: 32
Sousa, Marlene: 41
Spataro, Pietro: 43
Spina, Daniel S: 11
Steins-Löber, Sabine: 43
Stenberg, Jan-Henry: 43 , 46
Stiles, William: 50
Strifler, Yotam: 38
Swift, Joshua: 51
Teixeira Lopes, Rodrigo: 16
Tenhunen, Henni: 42
Teti, Arianna: 25
Thomasius, Rainer: 39
Tiemens, Bea: 49
Timuľák, Ladislav: 20 , 38 , 50
Tishby, Orya: 8 , 11 , 22 , 28 , 47 , 54
Toth, Erzsebet Fanni: 14
Tourunen, Anu: 42 , 52
Trimoldi, Giovanna: 7
Truijens, Femke: 24 , 33 , 43
Tschacher, Wolfgang: 42
Tuval-Mashiach, Rivka: 8 , 35
Tzur Bitan, Dana: 33 , 40 , 59
Ulberg, Randi: 42
Urban, Elisa: 49
Urban, Witold: 20
van den Bergh, Robin: 36
van Rijn, Biljana: 9 , 22 , 42 , 58
Vasicakova Ocenasova, Zuzana: 35
Vercauteren, Sophie: 49
Vos, Joel: 4 , 58
Vossler, Andreas: 9
Wahlström, Jarl: 18 , 52
Wamprechtshammer, Anna: 18
Watzke, Birgit: 36
Wazana, Ashley: 39
Webb, Christian: 23
Weggemans, Rianne: 49
Weibold, Stephanie: 49
Weimar, Rick: 24 , 43
Westlake, Meryl: 39
Wheatley, Jonathan: 28
Wielgus, Benita: 42
Wilhelm, Maximilian: 36
Willemsen, Jochem: 7 , 12 , 33 , 52
Willutzki, Ulrike: 7 , 19 , 37
Wiseman, Hadas: 41 , 53
Yonatan Leus, Refael: 28
Zech, Emanuelle: 7
Zisenwine, Tamar: 53
Ziv-Beiman, Sharon: 50