CLINICAL PSYCHOLOGY & PSYCHOTHERAPY临床心理学与心理治疗
CLINICAL PSYCHOLOGY & PSYCHOTHERAPY(英文缩写 CLIN PSYCHOL PSYCHOT),ISSN 1063-3995,eISSN 1099-0879,中文译名:临床心理学与心理治疗 是一本学术期刊。本页汇总该期刊的最新影响因子、分区信息以及最新收录于 PubMed 的文献,帮助您快速了解期刊全貌。
发文量统计区间：2025-10-01 至 2026-09-30，按本站收录文献的发表日期统计。
期刊介绍
历年影响因子趋势
| JCR 数据年份 | 影响因子 | JCR 分区 |
|---|---|---|
| 2021 | 3.198 | Q3 |
| 2022 | 3.600 | Q2 |
| 2023 | 3.200 | Q1 |
| 2024 | 2.700 | Q2 |
| 2025 | 2.900 | Q2 |
CLINICAL PSYCHOLOGY & PSYCHOTHERAPY 最新收录文献
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1. Self-Criticism as a Mechanism of Change in Compassion-Based Interventions: A Meta-Analytic Structural Equation Modelling Approach and Systematic Review.
PMID:Compassion-based interventions (CBIs) are effective transdiagnostic treatments for a wide range of psychopathological symptoms. While their efficacy is well established, their mechanisms remain insufficiently understood. Self-criticism (SC) has been proposed as a promising mechanism of change (MoC), given its central role in psychopathology and its theoretical link with CBIs. This study synthesises evidence from randomised controlled trials to examine whether reductions in SC mediate the effects of CBIs on psychopathological symptoms. Systematic searches in PubMed, Web of Science, Scopus and ProQuest identified 57 randomised controlled trials (n = 4877) of CBIs in adults reporting SC and psychopathological symptom outcomes, analysed using One-Stage Meta-Analytic Structural Equation Modelling (OMASEM). SC partially mediated the effects of CBIs on symptom reduction (e.g., depression, anxiety, eating disorders; indirect effect = -0.054, 95% CI [-0.085, -0.030]). Stronger mediation effects were observed in studies prescribing more daily home-practice minutes and shorter intervention duration. At posttreatment, CBIs achieved moderate reductions in SC (r = -0.20, 95% CI [-0.27, -0.13]) and psychopathological symptoms (r = -0.21, 95% CI [-0.27, -0.15]). Moreover, SC was positively correlated with psychopathological symptoms (r = 0.48, 95% CI [0.42, 0.54]), supporting partial mediation by SC. Considerable heterogeneity was observed across interventions and designs; 76.4% showed high risk of bias. These findings support SC as a potential MoC in CBIs and provide quantitative evidence for process-based formulations of CBIs. The results also highlight the clinical relevance of directly targeting SC in therapeutic practice and contribute to understanding the psychological processes underlying CBIs.
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2. Effectiveness of Emotion-Focused Therapy for Self-Criticism: A Systematic Review and Meta-Analysis.
PMID:Problematic self-criticism has been widely recognised as a transdiagnostic factor associated with a range of mental health disorders. Emotion-focused therapy (EFT) targets self-criticism primarily via two-chair dialogue for self-criticism, a core intervention within the approach. An increasing number of pre-post studies and randomised controlled trials (RCTs) have examined the effectiveness of EFT in reducing self-criticism. The present meta-analysis synthesised existing quantitative studies utilising EFT to reduce self-criticism and evaluated its overall effectiveness across study designs. Four pre-post studies and seven RCTs were identified through a systematic literature search. Effect sizes were calculated separately for 11 within-group pre-post EFT intervention groups (four single-arm pre-post studies and seven RCT intervention groups) and seven between-group RCT comparisons. Study quality, risk of bias and sensitivity analyses were conducted. Using random-effects models, the pooled within-group effect size (Hedges' g) was -0.86, and the pooled between-group effect size in RCTs was -0.73, indicating moderate to large effects of EFT in reducing self-criticism. Leave-one-out sensitivity analyses showed that these effects remained robust after the removal of outliers. This meta-analysis provides the first quantitative synthesis of EFT for self-criticism and offers preliminary evidence supporting its effectiveness in addressing this transdiagnostic factor linked to the number of mental health difficulties.
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3. Addressing Schemas, Modes and Interoceptive Disconnection in Chronic Binge Eating Disorder: A Temperament-Informed Schema Therapy Case Series.
PMID:Binge eating disorder (BED) is often chronic and accompanied by trauma, comorbidity and neurodiversity, for whom existing treatments can be less effective. This study examined a manualised, temperament-informed schema therapy protocol (ST-BED-TI) targeting early maladaptive schemas (EMS), schema modes and interoception in adults with complex BED. A prospective case series was conducted with five adult women with long-standing BED and high clinical complexity, who received between 25 and 35 sessions of ST-BED-TI in outpatient services in Australia and the United Kingdom. Individual change was evaluated with reliable change indices and clinical significance for global eating disorder (ED) symptom scores. This trial was pre-registered on the Australian New Zealand Clinical Trials Register (ID: ACTRN12623001259639). Four of five participants showed reliable and clinically significant improvement in global ED symptoms at post-treatment; three of the four measured at 6-month follow-up maintained these gains. All participants reported reductions in binge eating frequency. Most demonstrated reliable improvements in key EMS, schema modes and at least one interoceptive awareness domain, with one case showing marked interoceptive gains despite limited measurable EMS or mode change. Within the limits of a small uncontrolled case series, ST-BED-TI appears acceptable, clinically manageable and promising in this pilot context. These preliminary findings warrant larger controlled and mechanism-focused studies.
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4. Mechanisms of Change in the Treatment of Depression: On the Role of Attachment, Reappraisal and Suppression.
PMID:Identifying mechanisms of change in psychotherapy is imperative to optimize treatment effectiveness for depression. Research has identified specific mechanisms, primarily in outpatient pathology. However, the transdiagnostic robustness of these mechanisms remains to be quantified in more severely affected populations. This study aims to delineate the role of anxious and avoidant attachment, expressive suppression and cognitive reappraisal as within-person mechanisms of change in inpatient schema therapy and cognitive behaviour therapy for patients acutely and severely affected by major depressive disorder. A secondary analysis of a randomized clinical trial in an intensive multimodal inpatient and day-clinic setting with 198 patients was conducted. To differentiate stable between-person traits from therapeutic within-person shifts, Bayesian random-intercept cross-lagged panel models were employed. The data provided evidence that schema therapy and cognitive behaviour therapy do not differentially affect the mechanisms of change, that these mechanisms do not predict subsequent symptom change and that they do not mediate treatment effects on depressive symptoms. In contrast, a significant reverse association was identified: Symptom reduction was associated with subsequent improvements in cognitive reappraisal and expressive suppression. This temporal precedence suggests that alterations in cognitive reappraisal and expressive suppression are consequences of change in depressive symptoms rather than its primary drivers. These insights could guide researchers and clinicians in future investigations towards precision psychotherapy, directing attention not only to what interventions are performed but also to when they are performed.
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5. Attachment Styles in Major Depressive Disorder: A Systematic Review and Meta-Analysis.
PMID:Major depressive disorder (MDD), a leading cause of disability, is associated with difficulties in close relationships. Attachment theory links early caregiving to internal working models shaping emotion regulation, interpersonal functioning and depression vulnerability. Attachment patterns in clinically diagnosed MDD have not been synthesised. Following PRISMA (PROSPERO: CRD42017068580), we searched for studies of adults with standardised diagnoses of MDD or postpartum depression (PPD) and attachment measures. Random-effects meta-analyses expressed categorical outcomes as odds ratios (ORs) and continuous outcomes as Hedges' g. As a result, 61 studies met inclusion criteria: 33 case-control and 28 depression-only, of which five provided qualitative data only. Categorically, MDD/PPD showed lower secure (OR = 0.20, 95% CI 0.15-0.26, p < 0.001) and higher anxious (OR = 2.46, 1.66-3.64, p < 0.001), avoidant (OR = 1.42, 1.04-1.95, p = 0.027) and fearful attachment (OR = 3.00, 1.97-4.54, p < 0.001) than healthy controls. On continuous measures, secure attachment was lower (g = -0.46, p = 0.003) and anxious (g = 0.63, p < 0.001) and avoidant (g = 0.41, p = 0.011) higher; fearful was not significant (g = 0.35, p = 0.062) until an outlier was removed. Single-arm prevalence meta-analyses found secure attachment in 24.1%, fearful in 26.9%, avoidant in 23.7% and anxious in 23.0%, with secure more prevalent in PPD than MDD (31.9% versus 21.3%, p = 0.009). In conclusion, MDD and PPD show lower secure and higher anxious, fearful and avoidant attachment than healthy controls. About three in four patients show insecure attachment, supporting attachment-informed assessment and treatment planning.
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6. Imagery Rescripting for Pathological Affective Dependence in Intimate Partner Violence (ImRs-PAD): An In-Person Proof-of-Concept Study.
PMID:This study evaluated the feasibility and preliminary effects of in-person Imagery Rescripting for Pathological Affective Dependence (ImRs-PAD), a trauma-focused and mechanism-based intervention for survivors of intimate partner violence (IPV). ImRs-PAD targets trauma-related relational dynamics-specifically Pathological Affective Dependence (PAD)-together with the related relational processes that may contribute to difficulties disengaging from abusive relationships. PAD is conceptualized as a relational constraint rooted in trauma, rather than individual pathology or responsibility. This study employed an exploratory single-arm repeated-measures proof-of-concept design conducted in Italy. Eighteen adult women survivors of IPV received a 13-session ImRs-PAD intervention, delivered within anti-violence services by supervised psychotherapy trainees. Primary outcomes included state and trait levels of PAD, relational commitment and intention to return to the abusive relationship, which were conceived as different, although potentially overlapping self-report indicators of relational entrapment. Secondary outcomes assessed complex trauma symptoms, psychological well-being and resilience. Participants were assessed at baseline/pre-treatment, mid-treatment, post-treatment and 1-month follow-up. Significant reductions were observed in PAD, relational commitment and intention to return over the course of the intervention. Improvements were also noted in trauma-related symptoms, psychological well-being and resilience from baseline to post-treatment. At 1-month follow-up, changes in the primary relational outcomes and resilience were largely maintained, whereas trauma-related symptoms showed slight attenuation but remained significantly improved relative to baseline. ImRs-PAD appears to be a feasible and promising intervention in real-world anti-violence centre settings, specifically targeting unmet relational needs implicated in IPV-related entrapment. Changes in the primary relational outcomes were more consistently maintained at follow-up than improvements in trauma-related symptoms after treatment termination, suggesting the potential importance of integrating such interventions within broader systems of psychosocial support. Trial Registration: ClinicalTrials.gov identifier: NCT06670326.
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7. Emotional Labour in Psychotherapy: A Scoping Review of How Therapists Regulate Emotions in Clinical Practice.
PMID:Emotional labour is an integral yet conceptually underexamined feature of psychotherapeutic work. This scoping review mapped how emotional labour has been conceptualized and operationalized among psychotherapists, along with the associated outcomes and factors linked to greater emotional burden, and potential protective resources. Following JBI and PRISMA-ScR guidance, PsycINFO, Web of Science and Scopus were searched in August 2025 and updated in April 2026 for peer-reviewed studies on emotional labour among professionals delivering psychotherapy published in English or Spanish. Two reviewers independently screened and charted records. Fourteen sources met inclusion criteria, comprising both quantitative and qualitative research. Emotional labour was most commonly conceptualized as the regulation of emotional experience and expression to meet professional expectations. Operationalizations ranged from surface and deep acting to multidimensional models incorporating emotional dissonance. Therapists described emotional labour as intrinsic, emotionally ambivalent and capable of extending beyond the therapy room. Surface acting and emotional dissonance were most consistently linked to exhaustion, burnout and secondary traumatic stress, whereas self-compassion, psychological flexibility and professional identity were associated with more favourable responses to emotional demands. Emotional labour thus appears structurally embedded in psychotherapeutic practice, although the predominantly cross-sectional evidence limits conclusions about temporal and causal relationships, underscoring the need for longitudinal and intervention research.
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8. Cross-Cultural Adaptation and Psychometric Evaluation of the Suicidal Intrusions Attributes Scale (SINAS) in Iranian Adolescents With Suicidal Ideation.
PMID:Suicidal intrusive thoughts are unwanted, recurrent mental images of suicide that carry considerable weight in suicide-risk evaluation. Yet, few brief screening instruments exist for assessing them in high-risk groups. This study examined the psychometric properties and cross-cultural adaptation of the Suicidal Intrusions Attributes Scale (SINAS) for evaluating the severity and characteristics of these thoughts in adolescents. The sample comprised 623 Iranian adolescents (aged 14-19 years) with current suicidal ideation, drawn from 12,000 students in Lorestan Province who were first screened with the Suicide Probability Scale and then selected through random cluster and purposive sampling. Instruments included the 10-item SINAS, the Suicide Probability Scale, the Beck Hopelessness Scale, the Hospital Anxiety and Depression Scale, a brooding-rumination measure, and a fearlessness-about-death measure. We examined age and gender as grouping variables to evaluate measurement invariance. Data were analysed in SPSS 26/27 and JASP 0.19.1. Exploratory factor analysis (n = 323) identified a single-factor structure explaining 50.48% of the variance; confirmatory factor analysis (n = 300) supported this one-factor structure with good fit. Internal consistency was satisfactory (Cronbach's α = 0.91; McDonald's ω = 0.89) and convergent and discriminant validity were acceptable. SINAS also discriminated well between adolescents with suicidal ideation and those with a history of a suicide attempt (AUC = 0.876). Convergent validity was supported by significant positive correlations between SINAS scores and suicide probability (r = 0.724), hopelessness (r = 0.698), anxiety (r = 0.663), rumination (r = 0.578), depression (r = 0.569) and fearlessness about death (r = 0.167; all p < 0.001). CFA confirmed a unidimensional structure, with measurement invariance across gender and age. These findings indicate that the SINAS demonstrates acceptable reliability and validity among Iranian adolescents with suicidal ideation and represents a suitable instrument for screening suicidal intrusive thoughts in research and clinical settings.
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9. Undoing Self-Contempt in Borderline Personality Disorder: A Controlled Test of Change in Emotion Processing in Psychotherapy.
PMID:Emotion processing has been discussed as a mechanism of change in several forms of psychotherapy for a broad range of psychological disorders. The general conclusions of the field do not allow for a step-by-step granularity of relevant emotional experiences in clients. This is particularly important for personality disorders, especially borderline personality disorder (BPD). Using a controlled out-of-therapy assessment, we assume that the lessening of expressed self-contempt by clients gives way to proportionally more expressions of self-compassion and assertive anger after a brief psychiatric intervention. The present secondary analysis of a randomized controlled trial includes N = 79 participants (n = 27 clients with BPD in the active treatment following the principles of good psychiatric management [GPM]; n = 23 clients with BPD in the treatment as usual [TAU]; n = 29 healthy controls). Both treatments-GPM and TAU-lasted 4 months. All participants underwent out-of-therapy experiential two-chair dialogues focusing on self-criticism at two time points. The participants' emotional expressions were assessed using the video-rated Classification of Affective Meaning States and the Self-Contempt Rating Scale. The results indicated that the intensity of out-of-session observed self-contempt as part of a person-relevant self-criticism decreased in clients with BPD undergoing GPM, with a large effect, similar to healthy controls. A medium-sized effect was found for reduction in self-contempt in clients undergoing TAU. The results also indicated that the proportion of individuals with BPD undergoing GPM accessing self-compassion and assertive anger increased, which was not the case for healthy controls nor clients in TAU. Undoing self-contempt may be an elusive, yet central task in psychotherapy for clients with BPD. The present study explored the client process of change of undoing self-contempt and moving towards self-compassion and assertive anger. These conclusions bear important clinical and research implications.
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10. Positive Schemas and Symptom Severity in Depressive and Anxiety Disorders: The Mediating Role of Schema Modes.
PMID:This study aimed to examine patients diagnosed with depressive disorder and anxiety disorder from a transdiagnostic perspective, compare them with healthy controls with respect to positive schemas and schema modes and investigate the parallel mediating role of schema modes in the effect of positive schemas on symptom severity. A total of 164 participants were included, comprising 110 patients diagnosed with depressive or anxiety disorder and 54 healthy volunteers. Psychiatric diagnoses were confirmed using the Structured Clinical Interview for DSM-5 Disorders-Clinician Version (SCID-5-CV). Participants completed the Young Positive Schema Questionnaire (YPSQ), the Schema Mode Inventory-Short Form (SMI-SF) and the Depression Anxiety Stress Scale (DASS-21). The simultaneous mediating role of four schema mode factors (dysfunctional child modes, dysfunctional parent modes, coping modes and healthy modes) in the effect of positive schemas on DASS total scores was tested using path analysis and bootstrap methodology. Positive schema and healthy mode scores were significantly lower in the clinical group compared with controls, whereas dysfunctional child, dysfunctional parent and coping mode scores were significantly elevated (all p < 0.001; Cohen's d = 1.10-2.12). In the parallel mediation model constructed for the clinical group, the direct effect of positive schemas on DASS total scores was non-significant (β = -0.055, p = 0.634), whereas indirect effects operating through dysfunctional child modes (IE = -0.310), dysfunctional parent modes (IE = -0.117) and healthy modes (IE = -0.199) remained significant, indicating a full mediation pattern (R = 0.520). In the control group, this four-path mediation mechanism was largely inoperative. The association between positive schemas and lower symptom severity appears to be mediated not through a direct pathway but through schema modes, suggesting that this mechanism may act as a protective factor in the presence of a psychopathological substrate. These findings support the view that positive schemas warrant consideration as independent and functional components in clinical assessment and treatment planning.