UNASSIGNED: There is a growing recognition of the key role of the therapeutic relationship in the outcomes of psychotherapy. However, current understanding of its specific components, their interplay and related patient-therapist dynamics is limited.
UNASSIGNED: (a) To validate two self-report measures to assess subjective affective reactions of patients toward their psychotherapists during specific therapy sessions, and (b) to explore the relationships and dynamics among four elements of the therapeutic relationship: patient reactions toward the therapist, working alliance, alliance ruptures and repairs, and the real relationship.
UNASSIGNED: This study uses a nonrandomized, two-time point longitudinal design. The target population is adult patients currently engaged in individual psychotherapy for heterogeneous mental conditions. Participants are recruited through two online recruitment platforms: Research for Me and ResearchMatch. Data collection involves administering two surveys through the Qualtrics online survey platform. The baseline survey assesses information about the most recent therapy session and the preceding week, while the follow-up survey collects data on the subsequent therapy session and the days leading up to it.
UNASSIGNED: This research offers three main contributions: (a) it furthers evidence-based assessment in psychotherapy by creating and validating two novel, succinct self-report tools; (b) it enhances theoretical understanding within therapeutic relationship research by exploring the significant impact of patients\' perceptions of relationship elements on session outcomes variability; and (c) it will identify therapeutic relationship elements that can either enhance or hinder the overall relationship quality and session outcomes.
UNASSIGNED: The study protocol was approved by the Institutional Review Board of the University of North Carolina at Chapel Hill. The results will be published in indexed peer-reviewed journals and presented at relevant psychology and psychiatry conferences.

All contemporary psychotherapies agree that (failing) emotion regulation is central to psychological disorders and that psychotherapy is about improving emotion regulation. In his research on the \"emotion-laden\" complex Jung put an emphasis on the role of failing emotion regulation in contributing to psychological disorders as well as to change in the process of psychotherapy, but he left this field of research and took a very different direction in favour of his archetype concept. Psychodynamic approaches generally argue that changes in emotion regulation are accomplished through corrective emotional experiences in the therapeutic relationship. Insights from affective neurosciences and attachment research have had a major influence on how the therapeutic relationship is constructed in contemporary psychodynamic approaches. There is a lack of similar developments in analytical psychology, which leads to substantial differences between the models of Jungian psychotherapy in contrast to other contemporary psychodynamic approaches. The implications of these differences for the practice of psychotherapy and especially the role of the therapeutic relationship are pointed out.
Toutes les psychothérapies actuelles s’accordent sur le fait que la régulation (défaillante) de l’émotion est au centre des désordres psychologiques et que la psychothérapie vise à améliorer la régulation de l’émotion. Dans sa recherche sur le « complexe à haute charge émotionnelle », Jung a mis l’accent sur le rôle de la régulation défaillante de l’émotion comme participant aux désordres psychologiques ainsi qu’au changement dans le processus de psychothérapie. Mais il a abandonné ce champ de recherche et pris une direction très différente, y préférant son concept de l’archétype. Les approches psychodynamiques plaident généralement en faveur de l’idée que les changements dans la régulation de l’émotion sont atteints par les expériences émotionnelles corrective dans la relation thérapeutique. Des apports venant des neurosciences affectives et des recherches sur l’attachement ont eu une influence majeure sur comment la relation thérapeutique est construite dans les approches psychodynamiques actuelles. De tels développements font défaut dans la psychologie analytique, ce qui conduit à des différences considérables entre les modèles de psychothérapie jungienne en contraste avec les autres approches psychodynamiques actuelles. L’article souligne les conséquences de ces différences dans la pratique de la psychothérapie, tout particulièrement en ce qui concerne le rôle de la relation thérapeutique.
Alle zeitgenössischen Psychotherapien stimmen darin überein, daß (fehlende) Emotionsregulation für psychische Störungen von zentraler Bedeutung ist und daß es bei der Psychotherapie um die Verbesserung der Emotionsregulation geht. In seiner Forschung zum \"emotionsbeladenen\" Komplex legte Jung den Schwerpunkt auf die Rolle von fehlgeschlagener Emotionsregulation bei der Entstehung psychischer Störungen sowie bei Veränderungen im Prozeß der Psychotherapie, verließ aber dieses Forschungsgebiet und schlug eine ganz andere Richtung zugunsten seines Archetypenkonzeptes ein. Psychodynamische Ansätze argumentieren im Allgemeinen, daß Veränderungen in der Emotionsregulation durch korrigierende emotionale Erfahrungen in der therapeutischen Beziehung erreicht werden. Erkenntnisse aus der affektiven Neurowissenschaft und der Bindungsforschung haben großen Einfluß darauf, wie die therapeutische Beziehung in zeitgenössischen psychodynamischen Ansätzen konstruiert wird. Es mangelt an ähnlichen Entwicklungen in der Analytischen Psychologie, was zu erheblichen Unterschieden zwischen den Modellen der Jungianischen Psychotherapie und anderen zeitgenössischen psychodynamischen Ansätzen führt. Die Implikationen dieser Unterschiede für die Praxis der Psychotherapie und insbesondere die Rolle der therapeutischen Beziehung werden aufgezeigt.
Tutte le psicoterapie contemporanee concordano sul fatto che la (fallita) regolazione delle emozioni è centrale per i disturbi psicologici e che la psicoterapia riguarda il miglioramento della regolazione delle emozioni. Nella sua ricerca sul complesso “carico di emozioni”, Jung ha posto l’accento sul ruolo della fallita regolazione delle emozioni nel contribuire ai disturbi psicologici e al cambiamento nel processo della psicoterapia, ma ha poi abbandonato questo campo di ricerca ed ha preso una direzione molto diversa, centrata sul suo concetto di archetipo. Gli approcci psicodinamici generalmente sostengono che i cambiamenti nella regolazione delle emozioni avvengono tramite esperienze emozionali correttive nella relazione terapeutica. Le intuizioni delle neuroscienze affettive e della ricerca sull’attaccamento hanno avuto un’influenza importante sul modo in cui la relazione terapeutica è costruita negli approcci psicodinamici contemporanei. C’è una mancanza di analoghi sviluppi nella psicologia analitica, che porta a differenze sostanziali tra i modelli della psicoterapia junghiana, in contrasto con altri approcci psicodinamici contemporanei. Vengono qui sottolineate le implicazioni di queste differenze per la pratica della psicoterapia, ed in particolare il ruolo della relazione terapeutica.
Все современные психотерапевты сходятся во мнении, что (недостаточная) регуляция эмоций является центральным фактором психологических расстройств и что психотерапия направлена на улучшение регуляции эмоций. Исследуя “эмоционально нагруженный” комплекс, Юнг подчеркивал роль нарушения эмоциональной регуляции в развитии психологических расстройств, а также изменения в процессе психотерапии, однако он отказался от изучения этой сферы в пользу совершенно иного направления исследования – концепции архетипа. Для психодинамических подходов характерно представление, что изменения в регуляции эмоций достигаются посредством корректирующих эмоциональных переживаний в терапевтических отношениях. Данные, полученные в нейробиологии эмоций и исследованиях привязанности, оказали значительное влияние на характер построения терапевтических отношений в современных психодинамических подходах. Аналитической психологии недостает аналогичных исследований, вследствие чего между моделями юнгианской психотерапии, в отличие от других современных психодинамических подходов, имеются существенные различия. Показано, как отражаются эти различия на практике психотерапии и, в частности, на представлениях о роли терапевтических отношений.
Todas las psicoterapias contemporáneas coinciden en que la regulación (fallida) de las emociones es central a los trastornos psicológicos y que la psicoterapia consiste en mejorar la regulación de las emociones. En su investigación sobre el complejo \"de tonalidad afectiva\", Jung hizo hincapié en el rol de una fallida regulación emocional en el desarrollo de los trastornos psicológicos, así como al cambio en el proceso de psicoterapia, pero abandonó este campo de investigación y tomó una dirección muy diferente en favor de su concepto de arquetipo. En general, los enfoques Psicodinámicos sostienen que los cambios en la regulación de las emociones se logran a través de experiencias emocionales correctivas en la relación terapéutica. Los conocimientos de las neurociencias afectivas y la investigación sobre el apego han tenido una gran influencia en cómo comprender la conformación de la relación terapéutica en los abordajes psicodinámicos contemporáneos. Faltan desarrollos similares en la psicología analítica, lo que conduce a diferencias sustanciales entre los modelos de la psicoterapia Junguiana en contraste con otros enfoques psicodinámicos contemporáneos. Se señalan las implicaciones de estas diferencias para la práctica de la psicoterapia y se destaca especialmente el rol de la relación terapéutica.
心理治疗中情绪的角色 所有当代心理疗法都认为, (失效的)情绪调节是心理障碍的核心, 而心理疗法就是要改善情绪调节。荣格在研究 \"情绪负荷 \"情结时, 强调了情绪调节失灵在导致心理障碍以及在心理治疗过程中对促进改变所起的作用, 但他离开了这一研究领域, 转而采用了与此截然不同的研究方向, 原型概念。心理动力学方法一般认为, 治疗关系中矫正性的情绪体验, 可以带来情绪调节的改变。情绪神经科学和依恋研究对当代心理动力学方法如何构建治疗关系产生了重大影响。在分析心理学中却缺乏类似的发展, 这导致荣格心理治疗模式与其他当代心理动力学方法之间存在着巨大差异。本文指出了这些差异对心理治疗实践的影响, 尤其是对治疗关系的作用的影响。.

OBJECTIVE: Recovering from a first psychosis is a highly individual process and requires the person to make sense of their experiences. Clinicians, in turn, need to comprehend these first-person perspectives, creating a mutual sense-making dynamic. Antipsychotic medication is a substantial part of psychosis treatment. Providing insight in the lived experience of recovery with antipsychotics could improve the mutual understanding and help bridge the gap between the perspective of the clinician and that of the person recovering from psychosis.
METHODS: 14 persons in recovery from a first psychosis with the use of antipsychotics were interviewed. Their narratives were analyzed using Interpretative Phenomenological Analysis (IPA).
RESULTS: Five overarching themes were found, representing important and meaningful experiences in recovering with antipsychotic medication. Theme 1: antipsychotics as external dampening (4 subthemes); Theme 2: shifting of realities; Theme 3: pace of recovery; Theme 4: antipsychotics\' influence on identity; and Theme 5: is it truly the antipsychotics?
CONCLUSIONS: Our findings show that recovery from psychosis with antipsychotics is an all-encompassing, multi-faceted, and ambivalent experience. The themes found in this research could inspire clinicians to discuss less obvious aspects of the experience of recovering with antipsychotics. Even more so, paying attention to the first-person perspective could lead to a more thorough understanding and benefit therapeutic relationships.

UNASSIGNED: Therapeutic relationship and social support are critical components in physiotherapy that shape patient outcomes. However, defining these constructs, discerning their similarities and differences, and measuring them pose challenges. This article aims to facilitate scientific and clinical advancement on social support and the therapeutic relationship in physiotherapy by (a) providing conceptual clarity, (b) discussing measurement tools, and (c) offering practical recommendations for the deliberate incorporation of these constructs in clinical practice.
UNASSIGNED: This is a perspective paper drawing on examples from existing research.
UNASSIGNED: Assessing the nature and strength of social support and promoting naturally occurring social support networks are practical ways for physiotherapists to foster social support in physiotherapy clinical practice. Physiotherapists can offer direct support, facilitate the development of an individual\'s social skills, and promote participation in group activities. To strengthen the therapeutic relationship, it is important to maintain good communication, foster connectedness with the patient, demonstrate professional skills, and adopt a reflective practice. Physiotherapists are encouraged to establish clear roles and responsibilities, prioritize individualized patient-centered care, and involve patients in shared decision-making, ensuring congruence in goals and expectations. Willingness to dedicate time and energy within and beyond direct patient-therapist interactions can foster connections. Moreover, using the body - which is the main point of contact with patients - and physical touch can help physiotherapists to connect with patients. Finally, physiotherapists must be prepared to address and mend any conflicts which can impact the relationship\'s trajectory.
UNASSIGNED: Social support and therapeutic relationships are complementary aspects of one\'s health care, and it is crucial to purposefully account for both in physiotherapy practice to optimize person-centered care and rehabilitation outcomes.

UNASSIGNED: Real relationship (RR) refers to a genuine human relationship between client and therapist, that has been found to be positively related to treatment outcome, and to predict unique variance in outcome over and above the working alliance. However, thus far, the measurement of RR has been limited to self-report. We aimed to develop an observer-rated version of the RR measure (RR-O) to assess RR in therapy sessions.
UNASSIGNED: We adapted items from the self-report measures to an observer rated measure, which was reviewed by RR experts. The final 24-item RR-O was rated in 540 session transcripts from 27 psychoanalytic treatments that already had existing process and outcome scores.
UNASSIGNED: 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.
UNASSIGNED: The RR-O shows initial reliability and validity as an observer-rated measure of the RR to be used in post-hoc psychotherapy research. Future research should clarify the relation between RR-O and treatment outcome.

UNASSIGNED: The therapeutic relationship serves as a cornerstone in psychiatric mental health nursing practice, providing a basis for implementing various interventions.
UNASSIGNED: This study aimed to explore the perspectives of psychiatric mental health nurses regarding factors that facilitate and impede the therapeutic nurse-patient relationship.
UNASSIGNED: A descriptive study was conducted among psychiatric mental health nurses employed at two community psychiatric hospitals in the northeast area of the United States. A list of facilitators and barriers was developed based on an extensive literature review and subsequently validated by three experts in the field of psychiatric mental health nursing. Participants rated these factors on a 10-point scale.
UNASSIGNED: The study included 74 registered nurses from two psychiatric hospitals, yielding a 24% response rate. The highest-ranked facilitator was awareness that the relationship enables collaborative goal setting with patients. The most significant barrier was insufficient time due to administrative tasks.
UNASSIGNED: This study highlights the importance of understanding facilitators and barriers in the therapeutic nurse-patient relationship. Replicating the study nationally on a larger scale among psychiatric mental health nurses is recommended.

Relationships, built on trust, knowledge, regard, and loyalty, have been demonstrated to be fundamental to health care delivery. Strong relationships between patients and providers have been linked to more compassionate care delivery, and better patient experience and outcomes, and may be particularly important in primary care. The rapid adoption of digital technologies since the onset of COVID-19 has led health care systems to seriously consider a \"digital-first\" primary care delivery model. Questions remain regarding what impact this transformation will have on the therapeutic relationship. Using a rapid ethnographic approach this study explores how patient and provider understandings of therapeutic relationships and digital health technologies may influence relationship-building or maintenance between patients with complex care needs and their care providers. Three team-based primary care sites in Toronto, Ontario, Canada were included in the study. Across the three sites 9 patients with chronic health conditions, 1 caregiver, and 10 healthcare providers (including family physicians, family medicine residents, social workers, and nurse practitioners) participated. Interviews were conducted with all participants and 8 observations of virtual clinical encounters (phone and video visits) were conducted. Using social representation theory as a lens, analysis revealed that participants\' constructions of therapeutic relationships and digital technologies were informed by their identities, experiences, and expectations. For participants to see technologies as enabling to the therapeutic relationship, there needed to be alignment between how participants viewed the role of technology in care and in their lives, and how they recognized (or constructed) a good therapeutic relationship. This exploratory work suggests the need to think about how both patients\' and providers\' views of technology may determine whether digital technologies can be leveraged to meet patient needs while maintaining, or building, strong therapeutic relationships.

OBJECTIVE: Dietitians have a central role in eating disorder (ED) treatment, however few studies exist investigating therapeutic aspects of dietetic care and factors influencing the dietitian-patient relationship. To address the gap, this study aimed to use a qualitative description approach to explore the experiences of delivering and receiving dietetic care in ED treatment in the UK.
METHODS: Semi-structured interviews were conducted with 6 specialist ED dietitians and focus groups with 11 recovered ED patients. Interviews were transcribed and inductive thematic analysis was performed to identify key themes describing the data.
RESULTS: Six key themes were generated: (1) Building trust, (2) Appropriate timing, (3) Adapting, (4) Dietitians as experts, (5) Boundaries, and (6) Difficult relationships. Participants highlighted the importance of building trust and considering nutritional risk and readiness in treatment approach. Patients expressed a desire for dietitians to have experience in EDs, facilitating understanding of their illness. However, dietitians identified the nature of EDs making their role challenging at times.
CONCLUSIONS: This study described various factors affecting dietetic care in EDs and provided a valuable insight into patients\' perceptions of treatment. The findings support advancements in ED dietitians\' knowledge and understanding, helping to enhance quality of care.

UNASSIGNED: In psychotherapy, it is important to establish and deepen a therapeutic trusting relationship, but patients who have experienced extreme adversity in childhood tend to have difficulty in building such a relationship. This paper reports a case of fibromyalgia with adverse childhood experiences (ACEs) in which a nonverbal approach was successful in building a trusting relationship.
UNASSIGNED: The patient is a woman in her late 40s. She had strong anger rooted in ACEs, including neglect by her father, a feeling of unfair parenting by her mother compared to her younger brother, overcontrol of her life by her mother, and sexual abuse by her uncle. She was filled with strong interpersonal distrust and anger, and the experience of an unsuccessful surgery compounded her distrust of medical care. The therapist initially had severe difficulty in verbal interaction with the patient. When conducting \"drawing\" therapy, she ignored the therapist\'s comments and completely blacked out the drawing paper. However, the patient-therapist relationship gradually changed, and verbal interaction became possible through the use of nonverbal approaches such as framing her drawing paper and \"Towel Baby Holding.\"
UNASSIGNED: The therapist was able to understand the patient\'s emotions through these nonverbal approaches and to communicate with the patient that she understood her feelings. This approach was also successful in the patient\'s understanding of her own pathology. The patient became able to honestly express her feelings in words, which eventually enabled her to be introduced to mindfulness therapy, leading to a favorable treatment course.
UNASSIGNED: For patients with ACEs, a nonverbal approach helps build a therapeutic relationship and plays an important role in understanding the patient.

UNASSIGNED: Psychotherapists need effective tools to monitor changes in the patient\'s affective perception of the therapist and the therapeutic relationship during sessions to tailor therapeutic interventions and improve treatment outcomes. This study aims to evaluate the factor structure, reliability, and validity of the in-Session Patient Affective Reactions Questionnaire (SPARQ), a concise self-report measure designed for practical application in real-world psychotherapy settings.
UNASSIGNED: Validation data was gathered from (N = 700) adult patients in individual psychotherapy. These patients completed the SPARQ in conjunction with additional measures capturing sociodemographic details, characteristics of therapeutic interventions, individual personality traits, mental health symptom severity, elements of the therapeutic relationship, and session outcomes. This comprehensive approach was employed to assess the construct and criterion-related validity of the SPARQ.
UNASSIGNED: The SPARQ has a two-factor structure: Positive Affect (k = 4, ω total = .87) and Negative Affect (k = 4, ω total = .75). Bifactor confirmatory factor analysis (CFA) yielded the following fit indices: X2[df] = 2.53, CFI = .99; TLI = .98; RMSEA = .05; and SRMR = .02. Multi-group CFAs demonstrated measurement invariance (i) across patients who attended psychotherapy sessions in person versus in remote mode, and (ii) across patients with and without psychiatric diagnoses confirmed metric invariance. Furthermore, the SPARQ showed meaningful correlations with concurrently administered measures.
UNASSIGNED: The SPARQ proves to be a valuable instrument in clinical, training, and research contexts, adept at capturing patients\' session-level affective responses towards their therapist and perceptions of the therapeutic alliance. Comprehensive descriptive statistics and a range of score precision indices have been reported, intended to serve as benchmarks for future research.