More than Meets the “I”: A Panoramic View of Epistemic Trust in Psychotherapy DOI Creative Commons

Shimrit Fisher,

Peter Fonagy, Sigal Zilcha‐Mano

et al.

Psychopathology, Journal Year: 2024, Volume and Issue: unknown, P. 1 - 14

Published: Oct. 28, 2024

Introduction: Epistemic trust (ET), the authenticity and personal relevance we assign to interpersonally transmitted knowledge, is considered an essential component of any effective therapy. Despite its clinical significance, comprehensive empirical support still lacking regarding whether ET inherent characteristic patient or acts as a catalyst for therapeutic change. Consequently, unlike other critical components, clear distinction between aspects – patient’s attributes, therapist’s contribution, their unique relationship remains elusive, leaving our understanding incomplete. The current study examines constituents in therapy related effects through three distinct lenses: blended snapshot lens, prognostic lens focusing on state-like changes. were measured follows: attributes using attachment orientation interpersonal functioning scales; therapist contribution was evaluated scales assessing use techniques; patient-therapist gauged working alliance scale. Methods: We collected analyzed data from 116 patients who participated manualized psychodynamic psychotherapy sessions investigate trait-like components ET. Results: results offer panoramic view with small medium, but meaningful, correlations patients’ (ranging 0.18 −0.26); therapists’ contributions 0.15 0.28); 0.17 0.23). Conclusion: While some findings consistent expectations, others contrary, highlighting necessity considering variations within they have theoretical, clinical, implications. Employing these lenses helps therapists gain better picture reflected by over different treatment periods. This broad perspective importance encourages clinicians adjust focus meet evolving needs patients.

Language: Английский

Contrasting individual-specific resilience and compensation personalization frameworks: The case of rumination DOI Creative Commons
Sigal Zilcha‐Mano

Biological Psychiatry Global Open Science, Journal Year: 2025, Volume and Issue: unknown, P. 100478 - 100478

Published: March 1, 2025

Rumination has been identified as a potential mechanism of therapeutic change, particularly in directive and focused psychotherapies for depression. Previous research predominantly on either trait-like individual differences or state-like changes rumination without integrating these aspects. In the current study, we propose computational approach to investigating whether serves compensatory resilience by effects. depressive symptoms were assessed (in N = 100) pretreatment repeatedly throughout treatment. Mixed-level models used examine interacted with time-variant variable in-treatment predict subsequent treatment outcomes. These determine individuals higher lower levels benefited more from reductions rumination, thus contrasting theoretical frameworks. As hypothesized, findings supported framework; most greater during treatment, evidenced symptom reduction (p .04). The refine our understanding an individual-specific dependent individual's rumination. proposed enabled empirical comparison 2 main frameworks personalization, resilience, offering new insights into mechanisms that drive change. Future studies could leverage paradigm here which patients what contexts change function versus mechanisms.

Language: Английский

Citations

0
Is Targeting Depression Sufficient to Alleviate Anxiety Comorbidity? Exploring Between-Individuals Heterogeneity in Within-Individuals Processes DOI Creative Commons
Sigal Zilcha‐Mano

Clinical Psychological Science, Journal Year: 2025, Volume and Issue: unknown

Published: March 3, 2025

The well-documented between-individuals correlation between anxiety and depression cannot address within-individuals questions, such as whether targeting subsequently alleviates comorbidity. Recent studies have demonstrated the importance of focusing on processes to provide evidence-based guidelines commonly encountered questions in clinical practice. This study examined within-patient effect reduction subsequent during a treatment depression, well potential variability this patients. Data from randomized controlled trial more than 3,220 observations nested within 100 patients treated for were used. Findings indicate that at sample level, reduced which, turn, predicted anxiety. Although no qualitatively distinct subgroups emerged, quantitative differences individuals found. pretreatment interplay explains heterogeneity individuals. findings implications personalizing comorbidities.

Language: Английский

Citations

0
Using virtual reality to understand mechanisms of therapeutic change DOI
Sigal Zilcha‐Mano, Tal Krasovsky

Nature Reviews Psychology, Journal Year: 2024, Volume and Issue: 3(5), P. 295 - 296

Published: March 28, 2024

Language: Английский

Citations

2
Thinking transtheoretically about alliance and rupture: Implications for practice and training DOI Creative Commons
Sigal Zilcha‐Mano, J. Christopher Muran

Clinical Psychology in Europe, Journal Year: 2024, Volume and Issue: 6(Special Issue)

Published: April 9, 2024

Repairing alliance ruptures has the potential to serve as a powerful mechanism of change in psychotherapy. In this article, transtheoretical individual-specific framework for repairing is proposed. According proposed framework, at intake session, therapist evaluates trait-like tendencies individual patients face interpersonal relationships. We propose typology based on which are assigned one following therapeutic strategies: (a) treatment where rupture and repair main (Type A), (b) an added module that augments another treatment, focusing B), or (c) no resolution work carried out C). The cumulative clinical knowledge, its validity utility need be assessed future research.

Language: Английский

Citations

2
More than Meets the “I”: A Panoramic View of Epistemic Trust in Psychotherapy DOI Creative Commons

Shimrit Fisher,

Peter Fonagy, Sigal Zilcha‐Mano

et al.

Psychopathology, Journal Year: 2024, Volume and Issue: unknown, P. 1 - 14

Published: Oct. 28, 2024

Introduction: Epistemic trust (ET), the authenticity and personal relevance we assign to interpersonally transmitted knowledge, is considered an essential component of any effective therapy. Despite its clinical significance, comprehensive empirical support still lacking regarding whether ET inherent characteristic patient or acts as a catalyst for therapeutic change. Consequently, unlike other critical components, clear distinction between aspects – patient’s attributes, therapist’s contribution, their unique relationship remains elusive, leaving our understanding incomplete. The current study examines constituents in therapy related effects through three distinct lenses: blended snapshot lens, prognostic lens focusing on state-like changes. were measured follows: attributes using attachment orientation interpersonal functioning scales; therapist contribution was evaluated scales assessing use techniques; patient-therapist gauged working alliance scale. Methods: We collected analyzed data from 116 patients who participated manualized psychodynamic psychotherapy sessions investigate trait-like components ET. Results: results offer panoramic view with small medium, but meaningful, correlations patients’ (ranging 0.18 −0.26); therapists’ contributions 0.15 0.28); 0.17 0.23). Conclusion: While some findings consistent expectations, others contrary, highlighting necessity considering variations within they have theoretical, clinical, implications. Employing these lenses helps therapists gain better picture reflected by over different treatment periods. This broad perspective importance encourages clinicians adjust focus meet evolving needs patients.

Language: Английский

Citations

0