In-person therapy vs. computer-mediated therapy for college students: Single session outcomes and implications for the patient-therapist relationship

OBJECTIVE

This study focused on college students to examine if the communication channel of their most recent therapy session influenced the strength of their relationship with their therapist, post-session symptoms of anxiety and depression, and their intentions to adhere to therapist recommendations.

PARTICIPANTS

688 college students from a large Californian university.

METHODS

The online survey took place on the Qualtrics survey platform and the proposed model was tested using structural equation modeling.

RESULTS

College students' emotional self-disclosure was higher in mediated compared to in-person therapy sessions. Their perceived social presence from the therapist was greater in mediated compared to in-person sessions. Emotional self-disclosure and social presence were positive predictors of the patient-therapist relational bond strength, which subsequently predicted adherence and was associated with reduced post-session depression and anxiety levels.

CONCLUSIONS

A strong relational bond between patient and therapist is possible in both online and offline environments for college students.

Secret-keeping in therapy by clients who are sexually attracted to children

Objective This study investigated the reasons why pedohebephilic clients disclose their sexual attraction to children in therapy and the experiences associated with this decision among English-speaking samples. Method: The pre-registered online survey combined (1) quantitative correlational data of self-reported improvement, alliance, therapist reaction to disclosure, and the belief that mandatory reporting laws were in place, and (2) qualitative data about reasons for disclosure or no disclosure as well as perceived consequences. The sample consisted of pedohebephilic people who have been clients in therapy and have disclosed (n = 96) or not disclosed (n = 40). Results: While the disclosure and no disclosure groups did not differ in improvement or beliefs about mandatory reporting, those who had disclosed reported a stronger alliance. Clients who did not perceive the therapist's reaction as supportive reported less improvement than the no disclosure group. Thematic analysis of qualitative data identified three themes concerning motives for disclosing or not disclosing and a fourth regarding differential impacts of disclosure. Discussion: This study indicates that disclosing pedohebephilia does not in and of itself lead to improvement but is contingent on a therapist's reaction.

An examination of nonsuicidal self-injury disclosures in a high-risk university sample

Objective: There is a lack of research examining factors that promote the disclosure of nonsuicidal self-injury (NSSI) among post-secondary students. However, elucidating which factors facilitate disclosures among students - particularly students with high risk NSSI - is important given that disclosure may facilitate access to care. Methods: Participants included 149 post-secondary students with recent NSSI (81% women, Mage = 19.96) who reported on their disclosures, as well as several potential correlates of disclosure. Results: Eighty-seven percent of respondents had disclosed NSSI, often to several informal sources. Students with higher willingness to disclose personally distressing information, perceived levels of social support, stressful experiences, and frequency of NSSI engagement were more likely to disclose NSSI to more types of sources and more unique individuals. Conclusion: Results suggest that disclosure is an ongoing process rather than a single event, and underscore the importance of teaching effective NSSI disclosure responses to campus community members.

Trait rumination in post-stress growth among Chinese college students: the chain mediating effect of distress disclosure and perceived social support

Background

Rumination has emerged as a significant factor contributing to personal growth following periods of stress or trauma. The present study aimed to investigate the relationship between trait rumination and post-stress growth (PSG) within the context of Chinese college students who encounter mild stressors in their daily lives. Moreover, we aim to evaluate the potential mediating roles played by both distress disclosure and perceived social support in this dynamic relationship.

Method

All participants completed assessments using the Adolescent Self-Rating Life Events Checklist, Rumination Response Scale, Post-Stress Growth Inventory, Distress Disclosure Index, and Perceived Social Support Scale. Correlation and mediation analyses were conducted using SPSS PROCESS 4 MACRO.

Results

All students reported experiencing mild psychological impacts as a result of negative life events in the past year and displayed moderate levels of PSG. There was no significant correlation observed between the effects of negative life events and PSG. Significant negative correlations were found between trait rumination and distress disclosure, perceived social support, and PSG. Distress disclosure and perceived social support jointly operated as sequential mediators in the relationship between trait rumination and PSG among all the participants. Qualitative analyses revealed different correlation patterns of high- versus low-ruminator.

Conclusion

Trait rumination affects PSG both directly and indirectly, through its influence on distress disclosure and perceived social support. Our results emphasize the significance of actively participating in distress disclosure and nurturing a robust sense of social support to counteract the detrimental effects of rumination on post-stress growth among Chinese college students.

Social support from friends predicts changes in memory specificity following a stressful life event

Exposure to negative life stress has been associated with difficulty retrieving memories for specific autobiographical events, with important consequences for the emergence of emotional disorders. We examined whether social support can protect against the effects of negative events on memory specificity. University students (N = 143) were assigned to groups based on whether or not they experienced a negative stressor, operationalised as whether or not their recent exam performance was in line with their expectations. After receiving their exam results (T1), and one month later (T2), participants completed measures of memory specificity, their attitudes towards themselves and the occurrence of other stress-related events. Participants also completed a general measure of perceived social support from friends, family, and significant others, and an equivalent measure for social support related to performance. For participants who experienced an exam-related stressor, reduced performance-specific social support from friends was associated with reduced memory specificity at T2, even when accounting for T1 memory specificity, individual differences in attitudes towards self, the experience of additional stressors, and gender. No such relation was present for participants who did not experience a stressor. These findings provide new understanding of the influence of social variables on autobiographical memory specificity.

The Role of Distress Disclosure Tendencies in the Experience and Expression of Laboratory-Induced Sadness

Abstract. The benefits of talking with others about unpleasant emotions have been thoroughly investigated, but individual differences in distress disclosure tendencies have not been adequately integrated within theoretical models of emotion. The purpose of this laboratory research was to determine whether distress disclosure tendencies stem from differences in emotional reactivity or differences in emotion regulation. After completing measures of distress disclosure tendencies, social desirability, and positive and negative affect, 84 participants (74% women) were video recorded while viewing a sadness-inducing film clip. Participants completed post-film measures of affect and were then interviewed about their reactions to the film; these interviews were audio recorded for later coding and computerized text analysis. Distress disclosure tendencies were not predictive of the subjective experience of emotion, but they were positively related to facial expressions of sadness and happiness. Distress disclosure tendencies also predicted judges’ ratings of the verbal disclosure of emotion during the interview, but self-reported disclosure and use of positive and negative emotion words were not associated with distress disclosure tendencies. The authors present implications of this research for integrating individual differences in distress disclosure with models of emotion.

Beyond Cohesiveness

Despite a general consensus that cohesiveness promotes positive outcomes in group psychotherapy, the empirical evidence for this notion is limited. In this article the literature on group cohesiveness and its relation to clinical outcomes is reviewed. Three interrelated problems with this literature are highlighted: A lack of consensus as to how to conceptualize cohesiveness, inconsistent measurements of cohesiveness, and lack of attention to possible mediators of the cohesiveness-outcome relationship. The authors argue that the term cohesiveness is too vague and amorphous to be useful as a unitary construct and that the field could benefit by identifying more specific group processes that facilitate—or impede—clinical outcomes. They review social psychological research on group processes, and discuss how three constructs— group identification, independence, and homogeneity—might be applied to the clinical literature. Furthermore, in an attempt to stimulate a closer examination of mediational paths in the literature on group psychotherapy, they discuss possible mechanisms through which group processes affect clinical outcomes.

Client disclosure and therapist response in psychotherapy with women with a history of childhood sexual abuse

This study investigated the perceptions of adult clients (N=98; M age=32) with a history of childhood sexual abuse (CSA) of the costs and benefits of disclosure of this material. Significant benefits of disclosing included a sense of relief from sharing bottled-up emotions, and feeling more accepted and understood by one's therapist; significant negative consequences included feeling emotionally overwhelmed, and feeling uncomfortably vulnerable and exposed. Linear regressions indicated that CSA patients who generally disclose more have a greater tendency to experience both positive and negative effects of disclosure about abuse. In addition, a hierarchical regression analysis indicated that higher levels of symptomatology were predictive of higher levels of anxiety related to disclosure in therapy, suggesting that clinicians need to be cautious in encouraging disclosure about CSA with patients with severe pathology.

Psychological Predictors of Attitude towards Seeking Professional Psychological Help in a Nigerian University Student Population

Although research on the relationship between psychological factors and attitude towards seeking professional psychological help has been conducted in a wide range of settings, some psychological factors remained unexplored, especially among Nigerian university students. Therefore this study investigated predictive powers of psychological factors (health locus of control, mindfulness, openness to experience, personal growth initiative, and sense of coherence) on atitude towards seeking professional psychological help among 452 students in a Nigerian university. The study was comprised of 234 (51.77%) males and 218 (48.23%) females with mean age of 22 years ( SD = 2.16). Participants completed measures of health locus of control, mindfulness, openness to experience, personal growth initiative, sense of coherence, and attitude towards seeking professional psychological help. Results reveal significant independent and joint influence of health locus of control, mindfulness, openness to experience, personal growth initiative, and sense of coherence on attitude towards seeking professional psychological help. Findings from this study suggest that professionals in the areas of mental health and psychological well-being might improve students' engagement in psychological counseling through changing their attitudes toward seeking professional help by modifying their unfulfilled psychological, emotional, and social needs.

The relationship of non-disclosure in therapy to shame and depression

OBJECTIVE

This study aimed to explore the relationship between shame-proneness, depression, and non-disclosure in therapy in 85 men and women who had received treatment for depression.

METHOD

Data were collected by means of a questionnaire, which assessed depressive symptoms, shame-proneness, non-disclosure in therapy, and reasons for non-disclosure.

RESULTS

In total, 54% of the respondents reported concealing depression-related symptoms and behaviours or other distressing experiences from their therapist. Shame was the most frequently reported reason for non-disclosure overall, but was a more frequent reason for non-disclosure of symptoms than experiences. Similarly, shame-proneness was significantly related to non-disclosure of symptoms but not to non-disclosure of experiences. For participants no longer in therapy, non-disclosure of symptoms made a significant independent contribution to current level of depressive symptoms after controlling for demographic variables, worst depression, and shame-proneness.

CONCLUSIONS

The hypothetical model put forward in this study predicting a significant relationship between shame, non-disclosure in therapy, and current depressive symptomatology was supported. The findings suggest that encouraging and facilitating the disclosure of shameful symptoms and related behaviours has positive implications for the effectiveness of treatment.

Is Keeping a Secret or Being a Secretive Person Linked to Psychological Symptoms?

This prospective study explored whether keeping a major secret, self-concealment (i.e., the predisposition to keep secrets), and social support at Time 1 predicted symptomatology levels 9 weeks later (Time 2) among a sample of 86 undergraduates. The results showed that the process of keeping a secret actually predicted fewer symptoms, whereas the personality variable of self-concealment predicted more symptoms at Time 2, even when the analyses controlled for social support. However, the predictive effects of both secret keeping and self-concealment were wiped out when the analyses statistically controlled for initial symptomatology, which was positively linked to self-concealment from the outset. These findings challenge conventional wisdom about the dangers of keeping a major secret and suggest that, instead, the kind of person who is secretive simply might be more vulnerable to symptoms.