Erkki Heinonen

1. Taubner, S., Ioannou, Y., Saliba, A., Sales, C. M., Volkert, J., Protić, S., ... & Heinonen, E. (2023). Mediators of outcome in adolescent psychotherapy and their implications for theories and mechanisms of change: a systematic review. European Child & Adolescent psychiatry, 1-38.
2. Orlinsky, D. E., Messina, I., Hartmann, A., Willutzki, U., Heinonen, E., Rønnestad, M. H., ... & Schröder, T. (2023). Ninety psychotherapy training programmes across the globe: Variations and commonalities in an international context. Counselling and Psychotherapy Research.
3. Kuzminskaite, E., Gathier, A. W., Cuijpers, P., Penninx, B. W., Ammerman, R. T., Brakemeier, E. L., ... & Vinkers, C. H. (2022). Treatment efficacy and effectiveness in adults with major depressive disorder and childhood trauma history: a systematic review and meta-analysis. The Lancet Psychiatry.
4. Heinonen, E., Knekt, P., & Lindfors, O. (2022). What works for whom: Patients' psychological resources and vulnerabilities as common and specific predictors of working alliance in different psychotherapies. Frontiers in Psychiatry, 13, 848408.
5. Stenius, J., Heinonen, E., Lindfors, O., Holma, J., & Knekt, P. (2022). Ego Impairment Index (EII‐2) as a predictor of outcome in short‐and long‐term psychotherapy during a 5‐year follow‐up. Journal of Clinical Psychology, 78(9), 1739-1751.
6. Mestre, J. M., Taubner, S., Mota, C. P., Rangel Henriques, M., Saliba, A., Heinonen, E., ... & Protić, S. (2022). Theories of change and mediators of psychotherapy effectiveness in adolescents with externalising behaviours: a systematic review. Frontiers in Psychiatry, 12, 730921.
7. Heinonen, E., Orlinsky, D. E., Willutzki, U., Rønnestad, M. H., Schröder, T., Messina, I., ... & Hartmann, A. (2022). Psychotherapist trainees’ quality of life: Patterns and correlates. Frontiers in Psychology, 13, 864691.
8. Volkert, J., Taubner, S., Barkauskiene, R., Mestre, J. M., Sales, C. M., Thiele, V., ... & Heinonen, E. (2021). Mediators and theories of change in psychotherapy for young people with personality disorders: a systematic review protocol. Frontiers in Psychology, 12, 703095.
9. Alanne, C., Heinonen, E., Knekt, P., Rissanen, J., Virtala, E., & Lindfors, O. (2021). Predicting improvement of work ability in modalities of short‐and long‐term psychotherapy: The differential impact of reflective ability and other aspects of patient suitability. Journal of Clinical Psychology, 77(9), 1905-1920.
10. Conejo-Cerón, S., Taubner, S., Heinonen, E., Adler, A., Barkauskiene, R., Di Giacomo, D., ... & Moreno-Peral, P. (2021). Mediators in psychological treatments for anxiety and depression in adolescents and young people: a protocol of a systematic review. Frontiers in Psychology, 12, 708436.
11. Stenius, J., Knekt, P., Heinonen, E., Holma, J., Antikainen, R., & Lindfors, O. (2021). Predicting the working alliance over the course of long-term psychodynamic psychotherapy with the Rorschach Ego Impairment Index, self-reported defense style, and performance-based intelligence: An evaluation of three methodological approaches. Psychoanalytic Psychology, 38(1), 58.
12. Oddli, H. W., Heinonen, E., Hau, S., Nielsen, J., Esterhazy, R., Hoff, C. H., & Strømme, H. (2021). Learning Processes and Acquisition of Knowledge and Skills in Training and Supervision of Psychotherapy and Counselling: A Study Protocol for a Scoping Review. Frontiers in Psychology, 12, 718314.
13. Taubner, S., Saliba, A., Heinonen, E., Protić, S., Volkert, J., Adler, A., ... & Sales, C. M. (2021). Mediators and theories of change in psychotherapy with adolescents: a systematic review protocol. BMJ Open, 11(3), e042411.
14. Gómez Penedo, J. M., Babl, A., Krieger, T., Heinonen, E., & Flückiger, C. (2020). Interpersonal agency as predictor of the within-patient alliance effects on depression severity. Journal of Consulting and Clinical Psychology, 88(4), 338-
15. Orlinsky, D. E., Ronnestad, M. H., Hartmann, A., Heinonen, E., & Willutzki, U. (2020). The personal self of psychotherapists: Dimensions, correlates, and relations with clients. Journal of Clinical Psychology, 76, 461-475.
16. Heinonen, E. & Pos, A. E. (2020) The role of pre-treatment interpersonal problems for in-session emotional processing and long-term outcome in emotion-focused psychotherapy. Psychotherapy Research. DOI: 10.1080/10503307.2019.163077
17. Heinonen, E. & Nissen-Lie, H. A. (2020) The professional and personal characteristics of effective psychotherapists: a systematic review. Psychotherapy Research. DOI: 10.1080/10503307.2019.162036
18. Savander, E. È., Weiste, E., Hintikka, J., Leiman, M., Valkeapää, T., Heinonen, E. O., & Peräkylä, A. (in press). Offering patients opportunities to reveal their subjective experiences in psychiatric assessment interviews. Patient Education and Counseling.
19. Knekt, P., Lindfors, O., Heinonen, E., Maljanen, T., Virtala, E., & Härkänen, T. (in press). The effectiveness of three psychotherapies of different type and length in the treatment of patients suffering from anxiety disorder. In M. Ochs, M., Borcsa, J. Scheitzer (eds.), Linking Systemic Research and Practice – Innovations in Paradigms, Strategies and Methods. Cham: Springer International.
20. Lindfors, O., & Heinonen, E. (2019). Psykodynaamisen psykoterapian vaikuttavuus. [The effectiveness of psychodynamic psychotherapy: a review.] Finnish Medical Journal, 74, 739-745.
21. Heinonen, E., Knekt, P., Härkänen, T., Virtala, E., & Lindfors, O. (2018a). Association of early childhood adversities with mental disorders, psychological functioning, and suitability for psychotherapy in adulthood. Psychiatry Research, 264, 366-373.
22. Heinonen, E., Knekt, P., Härkänen, T., Virtala, E., & Lindfors, O. (2018b). Childhood adversities as predictors of improvement in psychiatric symptoms and global functioning in solution-focused and short- and long-term psychodynamic psychotherapy during a 5-year follow-up. Journal of Affective Disorders, 235, 525-534.
23. Knekt, P., Heinonen, E., & Lindfors, O. (2018). Effectiveness of long-term psychodynamic psychotherapy and psychoanalysis 5 years after ending psychoanalysis: minor differences in psychiatric symptoms and work ability. Neurology, Psychiatry and Brain Research, 30, 163-166.
24. Heinonen, E., Heiskanen, T., Lindfors, O., Härkäpää, K., & Knekt, P. (2017). Dispositional optimism as predictor of outcome in short- and long-term psychotherapy. Psychology & Psychotherapy: Theory, Research, and Practice, 90, 279-298.
25. Knekt, P., Lindfors, O., Keinänen, M., Heinonen, E., Virtala, E., & Härkänen, T. (2017). The prediction of the level of personality organization on reduction of psychiatric symptoms and improvement of work ability in short- versus long-term psychotherapies during a 5-year follow-up. Psychology & Psychotherapy: Theory, Research, and Practice, 90, 353-376.
26. Heinonen, E., Selinheimo, S., Pesonen, A.-K., Paunio, T., Lipsanen, J., Melartin, T., Lindblom-Ylänne, S., & Lindfors, O. (2017). Psykoterapeuttikoulutuksia tutkimalla vaikuttavampaa opetusta ja hoitoa? [Enhancing the development and outcomes of psychotherapy via studying psychotherapy trainees]. Duodecim [publication of the Finnish Medical Association], 133, 1790-7.
27. Heinonen, E., Kurri, K., & Melartin, T. (2016). Soveltuuko psykoterapia potilaalleni? [Is psychotherapy suitable for my patient?]. Finnish Medical Journal, 71, 1172-1176.
28. Ollila, P., Lindfors, O., Heinonen, E., & Knekt, P. (2016). Patients' interpersonal problems as predictors of working alliance in long-term psychotherapies. Psychiatry Research, 30, 110-117.
29. Knekt, P., Heinonen, E., Härkäpää, K., Järvikoski, A., Virtala, E., Rissanen, J., Lindfors, O., & the Helsinki Psychotherapy Study Group (2015). Randomized trial on the effectiveness of long- and short-term psychotherapy on psychosocial functioning and quality of life during a 5-year follow-up. Psychiatry Research, 229, 381-388.
30. Orlinsky, D. E., Heinonen, E., & Hartmann, A. (2015). Psychotherapy process research. In J. D. Wright (ed.), International Encyclopedia of Social and Behavioral Sciences (pp. 515-520) (2nd ed.). Oxford: Elsevier.
31. Heinonen, E., Knekt, P., Jääskeläinen, T., & Lindfors, O. (2014). Therapists’ professional and personal characteristics as predictors of outcome in long-term psychodynamic psychotherapy and psychoanalysis. European Psychiatry, 29, 265-274.
32. Heinonen, E., Lindfors, O., Härkänen, T., Virtala, E., Jääskeläinen, T., & Knekt, P. (2014). Therapists’ professional and personal characteristics as predictors of working alliance in short-term and long-term psychotherapies. Clinical Psychology & Psychotherapy, 21, 475-494.
33. Lindfors, O., Knekt, P., Heinonen, E., Härkänen, T., Virtala, E. & the Helsinki Psychotherapy Study Group (2014). The effectiveness of short- and long-term psychotherapy on personality functioning during a 5-year follow-up. Journal of Affective Disorders, 152, 202-211.
34. Heinonen, E., & Orlinsky, D. E. (2013). Psychotherapists' personal identities, theoretical orientations, and professional relationships: Elective affinity and role adjustment as modes of congruence. Psychotherapy Research, 23, 718-731.
35. Rosenström, T., Jokela, M., Hintsanen, M., Josefsson, K., Juonala, M., Kivimäki, M., Pulkki-Råback, L., Viikari, J. S. A., Hutri-Kähönen, N., Heinonen, E., Raitakari, O. T. & Keltikangas-Järvinen, L. (2013).  Body-image dissatisfaction is strongly associated with chronic dysphoria. Journal of Affective Disorders, 150, 253-260.
36. Lindfors, O., Knekt, P., Heinonen, E., & Virtala, E. (2013). Self-concept and quality of object relations as predictors of outcome in short- and long-term psychotherapy. Journal of Affective Disorders, 152, 202-211.
37. Heinonen, E., Lindfors, O., Laaksonen, M. & Knekt, P. (2012). Therapists’ professional and personal characteristics as predictors of outcome in short- and long-term psychotherapy. Journal of Affective Disorders, 138, 301-312.
38. Knekt, P., Laaksonen, M.A., Härkänen, T., Maljanen, T., Heinonen, E., Virtala, E. & Lindfors, O. (2012). The Helsinki Psychotherapy Study: effectiveness, sufficiency, and suitability of short- and long-term psychotherapy. In R. Levy, H. Kächele, S. Ablon (eds.), Psychodynamic Psychotherapy Research: Evidence-Based Practice and Practice-Based Evidence (pp. 71-94). New York: Humana Press.
39. Mizobuchi, S., Terasaki, S., Häkkinen, J., Heinonen, E., Bergquist, J. & Chignell, M. (2008). The effect of stereoscopic viewing in a word-search task with a layered background. Journal of the Society for Information Display, 16, 1105-1113.

• Martikainen, Silja; Karhunen, Oona; Mankki, Iiris; Gergov, Vera; Berg, Päivi & Venäläinen, Satu [Vis alle 17 forfattere av denne artikkelen] (2026). Interventions for Students’ Well-Being at the University of Helsinki (INSIGHT): Protocol and Preliminary Descriptive Results for a Quasi-Experimental Controlled Trial of a Social Identity Intervention and Two Active Comparators. JMIR Research Protocols. 15, s. 1–19. doi: 10.2196/79319.
• Høstmælingen, Andreas Teisner; Nissen-Lie, Helene, Amundsen; Monsen, Jon Trygve; Heinonen, Erkki; Wampold, Bruce E. & Czajkowski, Nikolai Olavi [Vis alle 9 forfattere av denne artikkelen] (2025). Use of antidepressant medication is associated with slower response to open-ended psychotherapy for depressed patients. Frontiers in Psychiatry. 16. doi: 10.3389/fpsyt.2025.1503848. Fulltekst i vitenarkiv Vis sammendrag

  Objective Depressed patients often experience both symptomatic distress and interpersonal problems. Comorbid personality disorder (PD) has been shown to attenuate the benefits of psychotherapy. Also, antidepressant medication (ADM) may affect the response to psychotherapy. The objective of this study was to investigate changes in depressive symptoms and interpersonal problems for ADM users and non-medicated depressed patients during psychotherapy and follow-up, controlling for comorbid PD. Method Depressive symptoms (SCL-90-R), and interpersonal problems (IIP-64) were assessed on 11 occasions for 166 depressed patients. ADM was used by 50.6% of the sample while 49.4% were unmedicated. Change during treatment and follow-up was assessed with multilevel modeling. We assessed whether ADM and PD predicted differences in symptom development. Results Depressive symptoms significantly reduced at a rate of.05 per month in treatment ( p <.001), corresponding to an effect size of 1.35. Interpersonal problems significantly reduced at a rate of.02 per month during treatment ( p <.001), corresponding to an effect size of.47. There was no significant difference between ADM users and nonmedicated patients at baseline. ADM users had nearly twice as long treatment duration than nonmedicated patients, and ADM users had lower rate of symptom reduction than nonmedicated patients for depressive symptoms and interpersonal problems. There were no differences in rates of change between patients with and without comorbid PD. Conclusion Medicated patients may experience less response to psychotherapy in terms of depressive symptoms and interpersonal problems compared to nonmedicated patients.

• Lehtovuori, Pirjo; Lindfors, Olavi; Tolvanen, Asko & Heinonen, Erkki (2024). Development of the Psychotherapist Character Virtues (PCV) Interview. Psychotherapy Research. ISSN 1050-3307. doi: 10.1080/10503307.2024.2352735. Fulltekst i vitenarkiv Vis sammendrag

  Objective: To develop an interview-based rating method for assessing therapists’ beneficial character traits and evaluate its reliability and validity. Method: The semi-structured Psychotherapist Character Virtues (PCV) interview and evaluation method, based on Erik Erikson’s and Heinz Kohut’s writings on 16 virtues or abilities and achievements of an adult self, was administered to 68 psychodynamic and solution-focused therapists. Inter-rater reliability was assessed based on 20 videorecorded interviews, rated by two evaluators. In a mixed-methods design, validity was investigated against (i) therapist’s questionnaire-based self-reported professional and personal background characteristics and (ii) a qualitative content analysis of emotional atmosphere in the interview. Results: Interrater reliability for individual 16 virtues was acceptable (median correlation .72). From individual virtues, three principal components (Creative Will, Empathy, and Love/Care) emerged with good/excellent internal consistency (component determinacies .95, .85, and .90, respectively) and criterion validity with self-reported professional and personal characteristics. Cluster analysis of therapists’ component scores yielded six different therapist character profiles. In qualitative analysis, character profiles meaningfully differed in their impact on the interview’s emotional atmosphere. Conclusion: PCV appears promising for evaluating therapists’ character virtues, posited to undergird therapists’ sensitive attunement and responsiveness. Further research is needed on PCV’s predictive validity for therapeutic relationships and outcomes.

• Laurila, Matias; Lindfors, Olavi; Knekt, Paul & Heinonen, Erkki (2024). The effect of individual short- and long-term psychotherapy on perceived social support: analysis of secondary outcomes of a randomized clinical trial. Nordic Journal of Psychiatry. ISSN 0803-9488. doi: 10.1080/08039488.2024.2306229. Fulltekst i vitenarkiv Vis sammendrag

  Purpose Social support is important for maintaining and restoring psychological well-being but the effects of individual psychotherapies on perceived social support are not well known. In this analysis of secondary outcomes from a randomized clinical study, we compared the effects of long-term psychotherapy and two short-term psychotherapies on social support during a 5-year follow-up. Materials and methods Altogether 326 adult outpatients suffering from depressive and/or anxiety disorders were randomly assigned to long-term psychodynamic psychotherapy (LPP, n = 126), short-term psychodynamic psychotherapy (SPP, n = 101) and solution-focused therapy (SFT, n = 97). Outcome was measured by the global index and six subscores of the self-reported Brief Inventory of Social Support and Integration scale (BISSI) at baseline and at 1, 2, 3, 4 and 5 years after the beginning of the therapy. Results Social support improved in all therapy groups and the improvement was relatively stable, lasting several years after the end of therapy. Little difference in improvement was observed either between therapy orientations or durations. Conclusions While no major differences were observed between treatment groups, the slight differences call for further research to verify these findings and to better understand how different therapies may improve perceived social support.

• Orlinsky, D.E.; Rønnestad, Michael Helge; Willutzki, U.; Schröder, T.A.; Heinonen, Erkki & Löffler-Stastka, H. [Vis alle 9 forfattere av denne artikkelen] (2024). Healing involvement and stressful involvement experienced by psychotherapy trainees: Patterns, correlates and perceived development. Counselling and Psychotherapy Research. ISSN 1473-3145. doi: 10.1002/capr.12788. Fulltekst i vitenarkiv Vis sammendrag

  Background and Method The experiences of 454 psychotherapy trainees when providing therapy to patients were surveyed in a multinational sample largely from European countries, as part of the collaborative SPRISTAD study, using established measures of trainees' Healing Involvement (HI) and Stressful Involvement (SI). Results The results of cross-sectional analyses included the delineation of four differential patterns of therapeutic work involvement showing approximately half the trainees experienced an Effective Practice (high HI, low SI) while the other half experienced either a Challenging Practice (high HI, high SI), a Disengaged Practice (low HI, low SI) or a Distressing Practice (low HI, high SI). Discussion Strong-to-moderate correlations were found between involvement styles and trainees' individual personal and professional characteristics, and among training programme and workplace situational conditions, and their possible applications to candidate selection and training practices were discussed. A strong association was seen between HI and SI qualities of trainees' therapeutic work and their positive or negative experiences of current professional development. Implications for training and hypotheses for future longitudinal studies were proposed based on the results.

• Protić, Sonja; Wittmann, Lutz; Taubner, Svenja; Conejo-Cerón, Sonia; Ioannou, Yianna & Heinonen, Erkki [Vis alle 22 forfattere av denne artikkelen] (2024). Mediators of Outcome in Trauma-Focused Psychotherapy with Youth: A Systematic Review. Trauma, Violence, & Abuse. ISSN 1524-8380. doi: 10.1177/15248380231223264. Fulltekst i vitenarkiv
• Hartmann, Armin; Orlinsky, David E.; Rønnestad, Michael Helge; Willutzki, Ulrike; Schröder, Thomas A. & Heinonen, Erkki (2024). Measuring psychotherapist functioning with the Therapist Work Involvement Scales (TWIS): reliability, factor structure, and measurement invariance. Psychotherapy Research. ISSN 1050-3307. doi: 10.1080/10503307.2024.2389857. Fulltekst i vitenarkiv Vis sammendrag

  Objectives The Therapist Work Involvement Scales (TWIS) is a self-report research instrument that enables a multilayered description of psychotherapists’ experiences when treating clients. The TWIS was created in a comprehensive study of close to 5,000 psychotherapists, and has been used in multiple studies. The aim of the current paper is to clarify the organization and statistical characteristics of the TWIS, and to present an updated version for longitudinal and cross-sectional research. Methods Collection of a large sample of psychotherapy trainees made possible the use of confirmatory factor analysis (CFA) to evaluate the dimensions and structure of therapists’ process experiences, assessing reliabilities, measurement invariance over gender, item statistics, and correlations with other measures to show concurrent and predictive validity. Results The CFAs largely confirmed the factor structure of four of the five facets, and of the global super-factors. The global factors of Healing Involvement and Stressful Involvement each showed substantial correlations with therapists’ attachment style and professional growth, and were used to describe four practice patterns that typify the experiences of therapists. Conclusion The results have shown the TWIS to be a statistically sound, multidimensional research instrument enabling therapists to describe their experience in current therapeutic work.

• Nissen-Lie, Helene, Amundsen; Oddli, Hanne Berit Weie & Heinonen, Erkki (2024). Do therapists differ in their general effectiveness? Therapist effects and their determinants. I Leong, Frederick; Callahan, Jennifer L; Zimmerman, Jeffrey; Constantino, Michael J. & Eubanks, Catherine F. (Red.), APA handbook of psychotherapy: Evidence-based practice, practice-based evidence, and contextual participant-driven practice, Vol. 2. American Psychological Association (APA). ISSN 9781433836749. s. 213–226. doi: 10.1037/0000354-014. Fulltekst i vitenarkiv
• Orlinsky, David E.; Messina, Irene; Hartmann, Armin; Willutzki, Ulrike; Heinonen, Erkki & Rønnestad, Michael Helge [Vis alle 8 forfattere av denne artikkelen] (2023). Ninety psychotherapy training programmes across the globe: Variations and commonalities in an international context. Counselling and Psychotherapy Research. ISSN 1473-3145. doi: 10.1002/capr.12690. Fulltekst i vitenarkiv
• Taubner, Svenja; Ioannou, Yianna; Saliba, Andrea; Sales, Célia M. D.; Volkert, Jana & Protić, Sonja [Vis alle 21 forfattere av denne artikkelen] (2023). Mediators of outcome in adolescent psychotherapy and their implications for theories and mechanisms of change: a systematic review. European Child and Adolescent Psychiatry. ISSN 1018-8827. doi: 10.1007/s00787-023-02186-9. Fulltekst i vitenarkiv Vis sammendrag

  Abstract Psychotherapeutic treatment of adolescents requires age-specific approaches and thus plausibly also involves different change mechanisms than adult psychotherapy. To guide further research and improve therapeutic outcomes for adolescents, we reviewed all RCTs investigating mechanisms of change in the psychological treatment of adolescents to identify the most promising age-, disorder- or treatment-specific mediators. Following the preferred reporting items for systematic reviews (PRISMA), 106 studies were included that reported 252 statistical mediation tests assessed with 181 different measures. Most often studied and significant mediators were cognitive, followed by family-related, and behavioral variables. Several mediators were identified to be promising for future investigations: changes in negative thoughts, dysfunctional beliefs and metacognitive skills; family functioning and parenting skills; as well as successful engagement in therapy activities and increased impulse control. Symptom change during therapy was least often a mediator for other therapeutic changes. Relational and emotional mediators were largely understudied, whereas peer-influence appeared a promising mediator for intervention outcomes. Adolescence-specific mediators were most commonly investigated. Majority of studied mediators were not disorder-specific. There was a tendency to mainly test change mechanisms of specific theoretical models without considering other possible change theories. Further, virtually no studies fulfilled all criteria for rigorously investigating mediation and only nine were classified with an overall good study quality. While bearing in mind the current limitations in study designs, methodological rigor and reporting, there appears to be substantial evidence for transdiagnostic age-specific change models in the psychological treatment of adolescents. For future research, need for consensus on a core set of transdiagnostic and transtheoretical mediators and measures is highlighted. These should address likely core mechanisms of change, as well as take into account age-relevant developmental challenges and biological markers.

• Nissen-Lie, Helene, Amundsen; Heinonen, Erkki & Delgadillo, Jaime (2023). Therapist factors. I Miller, Scott D.; Chow, Daryl; Malins, Sam & Hubble, Mark A. (Red.), The Field Guide to Better Results: Evidence-Based Exercises to Improve Therapeutic Effectiveness. American Psychological Association (APA). ISSN 9781433837593. s. 79–107. doi: 10.1037/0000358-005. Fulltekst i vitenarkiv
• Heinonen, Erkki; Orlinsky, David E.; Willutzki, Ulrike; Rønnestad, Michael Helge; Schröder, Thomas & Messina, Irene [Vis alle 8 forfattere av denne artikkelen] (2022). Psychotherapist Trainees’ Quality of Life: Patterns and Correlates. Frontiers in Psychology. 13. doi: 10.3389/fpsyg.2022.864691. Fulltekst i vitenarkiv Vis sammendrag

  While psychotherapists are trained to improve their clients’ quality of life, little work has examined the quality of life experienced by psychotherapist trainees themselves. Yet their life satisfactions and stresses would plausibly affect both their ability to learn new skills and conduct psychotherapy. Therefore, in the Society for Psychotherapy Research Interest Section on Psychotherapist Development and Training study, we investigated the patterns of self-reported life quality and their correlates in a multinational sample of 1,214 psychotherapist trainees. A comprehensive questionnaire was used at the outset of trainings to assess trainees’ professional background, current life situation, personal characteristics, family background, and social and national origin. The findings indicated 54.3% of trainees’ lives could be characterized as fortunate or happy (i.e., experiencing great life satisfaction and not much stress), whereas 14.3% could be characterized as clearly distressed or troubled (i.e., experiencing great life stress and not much satisfaction). The strongest correlates of high life stress, a contributor to poor life quality, were economic insecurity, self-protectiveness, and attachment-related anxiety in relationships, and economic or psychological hardship in childhood. In turn, greater wellbeing was most strongly associated with a warm and open interpersonal style, being married, having sufficient economic means, and material and emotional security in childhood. While the results indicate the majority of therapists experience a relatively good quality of life, the findings also suggest potential targets for increasing trainees’ life quality when it may be deficient, such as those on a societal level (e.g., availability of low-cost student loans), training program level (e.g., promoting supportive supervision, positive between-trainee relationships and group collaboration), and individual level (e.g., personal therapy and learning self-care), in order to promote effective learning and therapy practice.

• Stenius, Jaakko; Heinonen, Erkki; Lindfors, Olavi; Holma, Juha & Knekt, Paul (2022). Ego Impairment Index (EII-2) as a predictor of outcome in short- and long-term psychotherapy during a 5-year follow-up. Journal of Clinical Psychology. ISSN 0021-9762. s. 1–13. doi: 10.1002/jclp.23332. Fulltekst i vitenarkiv Vis sammendrag

  Objective This study examined the predictive ability of the Rorschach-based Ego Impairment Index (EII-2) on outcome of psychotherapy in different types and durations of therapy. Method A total of 326 outpatients suffering from depressive or anxiety disorders were randomized into receiving solution-focused (n = 97), short-term psychodynamic (n = 101), or long-term psychodynamic psychotherapy (n = 128). Psychotherapy outcome assessments during the 5-year follow-up period covered psychiatric symptoms, social functioning, and work ability. Results Lower EII-2 values, which indicate less problematic ego functioning, were found to predict faster improvement in both short-term therapies as compared to long-term psychotherapy. Conclusion The results provide preliminary support for the utility of EII-2 as a complementary measure to interview-based methods for selecting between short- and long-term therapies.

• Kuzminskaite, Erika; Gathier, Anouk; Cuijpers, Pim; Penninx, Brenda; Ammerman, Robert & Brakemeier, Eva-Lotta [Vis alle 31 forfattere av denne artikkelen] (2022). Treatment efficacy and effectiveness in adults with major depressive disorder and childhood trauma history: a systematic review and meta-analysis. The Lancet Psychiatry. ISSN 2215-0374. doi: 10.1016/S2215-0366(22)00227-9. Fulltekst i vitenarkiv Vis sammendrag

  Background Childhood trauma is a common and potent risk factor for developing major depressive disorder in adulthood, associated with earlier onset, more chronic or recurrent symptoms, and greater probability of having comorbidities. Some studies indicate that evidence-based pharmacotherapies and psychotherapies for adult depression might be less efficacious in patients with a history of childhood trauma than patients without childhood trauma, but findings are inconsistent. Therefore, we examined whether individuals with major depressive disorder, including chronic forms of depression, and a reported history of childhood trauma, had more severe depressive symptoms before treatment, had more unfavourable treatment outcomes following active treatments, and were less likely to benefit from active treatments relative to a control condition, compared with individuals with depression without childhood trauma. Methods We did a comprehensive meta-analysis (PROSPERO CRD42020220139). Study selection combined the search of bibliographical databases (PubMed, PsycINFO, and Embase) from Nov 21, 2013, to March 16, 2020, and full-text randomised clinical trials (RCTs) identified from several sources (1966 up to 2016–19) to identify articles in English. RCTs and open trials comparing the efficacy or effectiveness of evidence-based pharmacotherapy, psychotherapy, or combination intervention for adult patients with depressive disorders and the presence or absence of childhood trauma were included. Two independent researchers extracted study characteristics. Group data for effect-size calculations were requested from study authors. The primary outcome was depression severity change from baseline to the end of the acute treatment phase, expressed as standardised effect size (Hedges' g). Meta-analyses were done using random-effects models. Findings From 10 505 publications, 54 trials met the inclusion criteria, of which 29 (20 RCTs and nine open trials) contributed data of a maximum of 6830 participants (age range 18–85 years, male and female individuals and specific ethnicity data unavailable). More than half (4268 [62%] of 6830) of patients with major depressive disorder reported a history of childhood trauma. Despite having more severe depression at baseline (g=0·202, 95% CI 0·145 to 0·258, I2=0%), patients with childhood trauma benefitted from active treatment similarly to patients without childhood trauma history (treatment effect difference between groups g=0·016, –0·094 to 0·125, I2=44·3%), with no significant difference in active treatment effects (vs control condition) between individuals with and without childhood trauma (childhood trauma g=0·605, 0·294 to 0·916, I2=58·0%; no childhood trauma g=0·178, –0·195 to 0·552, I2=67·5%; between-group difference p=0·051), and similar dropout rates (risk ratio 1·063, 0·945 to 1·195, I2=0%). Findings did not significantly differ by childhood trauma type, study design, depression diagnosis, assessment method of childhood trauma, study quality, year, or treatment type or length, but differed by country (North American studies showed larger treatment effects for patients with childhood trauma; false discovery rate corrected p=0·0080). Most studies had a moderate to high risk of bias (21 [72%] of 29), but the sensitivity analysis in low-bias studies yielded similar findings to when all studies were included. Interpretation Contrary to previous studies, we found evidence that the symptoms of patients with major depressive disorder and childhood trauma significantly improve after pharmacological and psychotherapeutic treatments, notwithstanding their higher severity of depressive symptoms. Evidence-based psychotherapy and pharmacotherapy should be offered to patients with major depressive disorder regardless of childhood trauma status. Funding None.

• Heinonen, Erkki; Knekt, Paul & Lindfors, Olavi (2022). What Works for Whom: Patients' Psychological Resources and Vulnerabilities as Common and Specific Predictors of Working Alliance in Different Psychotherapies. Frontiers in Psychiatry. 13. doi: 10.3389/fpsyt.2022.848408. Fulltekst i vitenarkiv Vis sammendrag

  Background Across different types of psychotherapy, one of the most robust predictors of better therapeutic outcomes is a good working alliance between patient and therapist. Yet there is little comparative research on whether particular patients more likely achieve a better alliance in certain treatments which represent particular therapeutic approaches or durations. Methods 326 patients suffering from depressive and/or anxiety disorder were randomized into two short-term (solution-focused or psychodynamic) and one long-term (psychodynamic) therapy models. Treatments lasted ~7 and 36 months, respectively. Before randomization, patients were assessed with the interview-based Suitability for Psychotherapy Scale and filled Childhood Family Atmosphere and Life Orientation Test questionnaires. Patients filled Working Alliance Inventory after 3rd therapy session and at end of treatment; the long-term therapy patients, additionally, at 7 months' time point. Linear regression models were used. Results Greater psychological resources (e.g., capacity for self-reflection, affect regulation, flexible interaction) had little effect on alliance during the course of the short-term therapies. However, they did predict better working alliances at end of long-term as opposed to short-term therapy. Childhood adversities impacted alliances already at 7 months. Conclusions Although patients with certain qualities achieve better alliances in long-term as opposed to short-term therapies, apparently the theoretical orientation of therapy makes little difference. For patients with childhood adversities, differences between long-term (psychodynamic) treatment vs. various brief therapy models may be particularly salient.

• Orlinsky, David E.; Rønnestad, Michael Helge; Hartmann, Armin; Heinonen, Erkki & Willutzki, Ulrike (2022). Personal self. I Orlinsky, David E. (Red.), How Psychotherapists Live. The Personal Self and Private Life of Professional Healers. Routledge. ISSN 9781032108797. s. 33–55. Fulltekst i vitenarkiv
• Orlinsky, David E.; Rønnestad, Michael Helge; Willutzki, Ulrike; Schröder, Thomas; Heinonen, Erkki & Schofield, Margot J. (2022). Professional psychotherapists. I Orlinsky, David E. (Red.), How Psychotherapists Live. The Personal Self and Private Life of Professional Healers. Routledge. ISSN 9781032108797. s. 14–33. Fulltekst i vitenarkiv
• Alanne, Carita; Heinonen, Erkki; Knekt, Paul; Rissanen, Julius; Virtala, Esa & Lindfors, Olavi (2021). Predicting improvement of work ability in modalities of short- and long-term psychotherapy: The differential impact of reflective ability and other aspects of patient suitability. Journal of Clinical Psychology. ISSN 0021-9762. 77(9), s. 1905–1920. doi: 10.1002/jclp.23128. Fulltekst i vitenarkiv
• Mestre, Jose M.; Taubner, Svenja; Mota, Catarina Pinheiro; Henriques, Margarida Rangel; Saliba, Andrea & Heinonen, Erkki [Vis alle 21 forfattere av denne artikkelen] (2021). Theories of Change and Mediators of Psychotherapy Effectiveness in Adolescents With Externalising Behaviours: A Systematic Review. Frontiers in Psychiatry. 12. doi: 10.3389/fpsyt.2021.730921. Fulltekst i vitenarkiv Vis sammendrag

  Background Externalising behaviours are becoming a remarkably prevalent problem during adolescence, often precipitating both externalising and internalising disorders in later adulthood. Psychological treatments aim to increase the social functioning of adolescents in order for them to live a more balanced life and prevent these negative trajectories. However, little is known of the intervening variables and mediators involved in these treatments' change mechanisms. We conducted a systematic review, exploring the available evidence on mediators of psychological treatments for externalising behaviours and symptoms amongst adolescents (10 to 19 years old). Methods A systematic search was performed on Medline and PsycINFO databases, which identified studies from inception to February 23, 2020. Eligible studies included randomised controlled trials that enrolled adolescents with externalising symptoms and behaviours as, at least, one of the primary outcomes. A group of 20 reviewers from the COST-Action TREATme (CA16102) were divided into 10 pairs. Each pair independently screened studies for inclusion, extracted information from the included studies, and assessed the methodological quality of the included studies and the requirements for mediators, following Kazdin's criteria. Risk of bias of RCTs was assessed by the Mixed Methods Appraisal Tool. Extracted data from the included studies were reported using a narrative synthesis. Results Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA), after removing duplicates, 3,660 articles were screened. Disagreements were resolved by consensus. In a second stage, 965 full-text articles were assessed for eligibility. A total of 14 studies fulfilled all inclusion criteria. The majority were related to systemic psychological treatment approaches. Two types of mediators were identified as potentially being involved in the mechanisms of change for better social improvements of adolescents: to increase healthier parent–adolescent relationships and parental discipline. However, there were significant and non-significant results amongst the same mediators, which led to discussing the results tentatively. Conclusions Family variables were found to be the largest group of investigated mediators, followed by relational, behavioural, and emotional variables. No cognitive or treatment-specific mediators were identified. Both adequate behavioural control of adolescents' peer behaviour and a better positive balance in their relationships with their parents seemed to buffer the effects of externalising behaviours in adolescents. Several methodological limitations concerning mediation testing design, outcome measures, and mediator selection have been identified. Ethics and Dissemination Ethical approval was not required. PROSPERO registration number: CRD42021231835.

• Volkert, Jana; Taubner, Svenja; Barkauskiene, Rasa; Mestre, Jose M.; Sales, Célia M. D. & Thiele, Vanessa [Vis alle 22 forfattere av denne artikkelen] (2021). Mediators and Theories of Change in Psychotherapy for Young People With Personality Disorders: A Systematic Review Protocol. Frontiers in Psychology. 12, s. 1–7. doi: 10.3389/fpsyg.2021.703095. Fulltekst i vitenarkiv Vis sammendrag

  Background: Personality disorders (PDs) are a severe health issue already prevalent among adolescents and young adults. Early detection and intervention offer the opportunity to reduce disease burden and chronicity of symptoms and to enhance long-term functional outcomes. While psychological treatments for PDs have been shown to be effective for young people, the mediators and specific change mechanisms of treatment are still unclear. Aim: As part of the “European Network of Individualized Psychotherapy Treatment of Young People with Mental Disorders” (TREATme), funded by the European Cooperation in Science and Technology (COST), we will conduct a systematic review to summarize the existing knowledge on mediators of treatment outcome and theories of change in psychotherapy for young people with personality disorders. In particular, we will evaluate whether mediators appear to be common or specific to particular age groups, treatment models, or outcome domains (e.g., psychosocial functioning, life quality, and adverse treatment effects). Method: We will follow the reporting guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement recommendations. Electronic databases (PubMed and PsycINFO) have been systematically searched for prospective, longitudinal, and case–control designs of psychological treatment studies, which examine mediators published in English. Participants will be young people between 10 and 30years of age who suffer from subclinical personality symptoms or have a personality disorder diagnosis and receive an intervention that aims at preventing, ameliorating, and/or treating psychological problems. Results: The results will be published in a peer-reviewed journal and at conference presentations and will be shared with relevant stakeholder groups. The data set will be made available to other research groups following recommendations of the open science initiative. Databases with the systematic search will be made openly available following open science initiatives. The review has been registered in PROSPERO (evaluation is pending, registration number ID 248959). Implications: This review will deliver a comprehensive overview on the empirical basis to contribute to the further development of psychological treatments for young people with personality disorders.

• Taubner, Svenja; Saliba, Andrea; Heinonen, Erkki; Protić, Sonja; Volkert, Jana & Adler, Asta [Vis alle 21 forfattere av denne artikkelen] (2021). Mediators and theories of change in psychotherapy with adolescents: a systematic review protocol. BMJ Open. 11(3). doi: 10.1136/bmjopen-2020-042411. Fulltekst i vitenarkiv Vis sammendrag

  Introduction Approximately 75% of mental disorders emerge before the age of 25 years but less than half receive appropriate treatment. Little is known about the mechanisms underlying the therapeutic change of adolescents in psychotherapy. The ‘European Network of Individualised Psychotherapy Treatment of Young People with Mental Disorders’, funded by the European Cooperation in Science and Technology, will conduct the first systematic review to summarise the existing knowledge on mediators and theories of change in psychotherapy for adolescents. Method A systematic review will be conducted, conforming to the reporting guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement recommendations. Electronic databases (PubMed and PsycINFO) have been systematically searched on 23 February 2020, for prospective, longitudinal and case-control designs which examine mediators of change. Participants will be adolescents between 10 and 19 years of age who suffer from a mental disorder or psychological difficulties and receive an intervention that aims at preventing, ameliorating and/or treating psychological problems. Ethics and dissemination Ethical approval is not required for this systematic review as no primary data will be collected. The results will be published in a peer-reviewed journals and at conference presentations and will be shared with stakeholder groups. The whole data set will be offered to other research groups following recommendations of the open science initiative. Databases with the systematic search will be made openly available following open science initiatives. PROSPERO registration number CRD42020177535.

• Oddli, Hanne Berit Weie; Heinonen, Erkki; Hau, Stephan; Nielsen, Jan; Esterhazy, Rachelle & Hoff, Cecilie Hillestad [Vis alle 7 forfattere av denne artikkelen] (2021). Learning Processes and Acquisition of Knowledge and Skills in Training and Supervision of Psychotherapy and Counselling: A Study Protocol for a Scoping Review. Frontiers in Psychology. 12, s. 1–6. doi: 10.3389/fpsyg.2021.718314. Fulltekst i vitenarkiv Vis sammendrag

  Background: Increased awareness of the individual therapist’s vital contribution to treatment processes and outcome, and the potential role of training and supervision in this respect, warrants a close look at the empirical and theoretical literature on teaching and learning of therapists and counselors. Methods: A scoping review of the literature will be conducted based on an overarching research question: when authors have reported on learning processes and acquisition of knowledge and skills in psychotherapy/counseling and supervision/training literature over the past 30 years (since 1990), what evidence, concepts, theories, and models have they reported? A comprehensive search strategy is carried out to identify publications indexed in Scopus, PsycINFO, and Cochrane Central Register of Controlled Trials. Publications will be sorted according to four categories: (1) conceptual/theoretical; (2) empirical (quantitative, qualitative, mixed methods); (3) review, meta-synthesis or -analysis; (4) training program/model description. Procedures for the upcoming scoping review of conceptual/theoretical, empirical, and training program/model description publications will be outlined. Conclusion: Besides clarifying existing perspectives, practices, and evidence, and documenting the shifting trends of the field during the past three decades, this scoping review identifies knowledge gaps that point to vital future directions for research and theory development. Moreover, the comprehensive scoping lays the foundation for subsequent, more focused systematic reviews that address identified key research topics more specifically.

• Heinonen, Erkki & Pos, Alberta (2020). The role of pre-treatment interpersonal problems for in-session emotional processing and long-term outcome in emotion-focused psychotherapy. Psychotherapy Research. ISSN 1050-3307. 30, s. 635–649. doi: 10.1080/10503307.2019.1630778. Fulltekst i vitenarkiv Vis sammendrag

  Objective: Interpersonal problems may lead to, uphold, or follow from depression. However, we know little of how depressed patients’ different interpersonal problems are associated with patients’ emotional processing during psychotherapy and whether distinct processes are helpful for their long-term reduction. Method: 23 adult outpatients who received emotion-focused therapies lasting 16–20 sessions filled the Inventory of Interpersonal Problems at pre- and post-treatment and 18-month follow-up. These problems were related to emotional processing in two mid-therapy sessions, rated by observers with the Classification of Affective-Meaning States. Results: All pre-treatment interpersonal problems were clearly associated with patients’ negative evaluations of themselves during therapy. Self-experiences of vindictiveness were most pronouncedly linked to in-session emotional expressions of rejecting anger, and self-experiences of social inhibition to expressions of fear and shame, following a circumplex model. In the long-term reduction of interpersonal problems, especially reaching emotional states of hurt and grief seemed beneficial for patients who experienced themselves as socially inhibited, non-assertive, self-sacrificing, or overly accommodating. Conclusions: For clients suffering from particular interpersonal problems, accessing particularly beneficial emotional processes, such as hurt and grief, may form specific therapeutic process goals. Further studies should verify these findings, which link interpersonal theory with research on emotional processing in psychotherapy.

• Stenius, Jaakko; Knekt, Paul; Heinonen, Erkki; Holma, Juha; Antikainen, Risto & Lindfors, Olavi (2020). Predicting the working alliance over the course of long-term psychodynamic psychotherapy with the Rorschach Ego Impairment Index, self-reported defense style, and performance-based intelligence: An evaluation of three methodological approaches. Psychoanalytic psychology. ISSN 0736-9735. 38, s. 58–67. doi: 10.1037/pap0000318. Fulltekst i vitenarkiv Vis sammendrag

  Better therapeutic alliances are known to predict better treatment outcomes, but little knowledge still exists on the patient characteristics that lead to better alliances. In a sample of 128 outpatients assigned to long-term psychodynamic psychotherapy and suffering from mood and/or anxiety disorder, this study evaluated how the alliance, measured using the Working Alliance Inventory (WAI), is predicted by three different measures for assessing psychological resources and vulnerabilities: the Wechsler Adult Intelligence Scale—Revised (WAIS–R), the Defense Style Questionnaire (DSQ), and the Rorschach-based Ego Impairment Index (EII-2). All the three measures showed some ability to predict the development of the alliance during long-term therapy. The WAIS–R was found to be the strongest independent predictor, with higher intelligence scores predicting favorable development of both the patient- and therapist-rated alliance. Lower DSQ values, indicating less use of immature defenses, predicted greater improvement in the patient- but not the therapist-rated alliance. Higher EII-2 values, indicating more problematic ego functioning, predicted likewise greater patient-rated alliance improvement over the course of treatment. These findings support the value of pretreatment multimethod psychological assessment when tailoring treatment to the individual needs of patients.

• Orlinsky, David E.; Rønnestad, Michael Helge; Hartmann, Armin; Heinonen, Erkki & Willutzki, Ulrike (2019). The personal self of psychotherapists: Dimensions, correlates, and relations with clients. Journal of Clinical Psychology. ISSN 0021-9762. doi: 10.1002/jclp.22876. Fulltekst i vitenarkiv Vis sammendrag

  Objective The personal self of psychotherapists, that is, experiences of self in close personal relationships and its association with therapists' individual and professional attributes is explored. The study aimed to: (a) describe therapists' self‐ratings on specific self‐attributes; (b) determine their dimensionality; (c) explore demographic, psychological, and professional correlates; and (d) assess the convergence with professional self. Method Data from the Development of Psychotherapists Common Core Questionnaire were available for > 10,000 psychotherapists of various professions, theoretical orientations, career levels, and nations. Results Most psychotherapists described themselves in close relationships in affirming terms (e.g., warm/friendly), although a substantial minority also described themselves in negative terms. Factor analyses yielded four dimensions: Genial/Caring, Forceful/Exacting, Reclusive/Remote, and Ardent/Expressive. Being Genial/Caring was associated with life satisfaction. Among professional attributes, personal self‐experiences, and parallel dimensions of relationship with clients correlated strongly. Conclusions Analyses of > 10,000 psychotherapists revealed meaningful variations in personal self relevant to personal and professional life.

• Heinonen, Erkki & Nissen-Lie, Helene A (2019). The professional and personal characteristics of effective psychotherapists: a systematic review. Psychotherapy Research. ISSN 1050-3307. 30, s. 417–432. doi: 10.1080/10503307.2019.1620366. Fulltekst i vitenarkiv Vis sammendrag

  Objective: Psychotherapists differ notably in the outcomes their patients achieve, and the characteristics that may explain these differences have attracted increasing interest. We systematically review studies on therapist pre-treatment characteristics predicting patient outcomes. Method: Systematic searches on databases for psychotherapy research, clinical psychology, and medical science for the years 2000–2018 identified published research examining therapist characteristics and psychotherapy outcomes. Of 2041 studies, 31 met inclusion criteria. Results: Findings show a few direct effects of therapist intrapersonal variables (e.g., self-relatedness, attachment) and several interaction effects with other constructs (e.g., patient pathology) on outcome. There is little support for the relevance of self-rated social skills. However, more consistent evidence has recently emerged for performance-based measurements of professional interpersonal skills, especially when elicited in challenging situations. Patient outcomes were also predicted by therapists’ self-rated professional characteristics, such as their experienced difficulties in practice, coping mechanisms, and attitudes towards therapeutic work, indicating that therapist self-perception also matters, although not always in the direction expected. Conclusions: More effective therapists seem characterized by professionally cultivated interpersonal capacities, which are likely rooted in their personal lives and attachment history. Research guidelines are proposed for moving this field forward (including larger samples, multilevel modeling, and in-depth qualitative work).

Se alle arbeider i NVA

• Høstmælingen, Andreas Teisner; Nissen-Lie, Helene, Amundsen; Monsen, Jon Trygve; Heinonen, Erkki; Wampold, Bruce E. & Czajkowski, Nikolai Olavi [Vis alle 8 forfattere av denne artikkelen] (2026). The Potential Impact of Antidepressant Medication on Psychotherapy Outcome for Depressed Patients. Fulltekst i vitenarkiv Vis sammendrag

  Aim: Many depressed patients are already being treated with antidepressant medication (ADM) when presenting for psychotherapy. However, the potential impact of ADM on psychotherapy processes and outcome remains an unresolved issue. A large body of research indicates a combination of ADM and psychotherapy is superior to either monotherapy, but there are also indications that especially long-term use of ADM may be associated with negative consequences such as tolerance, negative side effects and iatrogenic comorbidity. The aim of this study was to investigate changes in depressive symptoms and interpersonal problems for ADM users and non-medicated depressed patients during psychotherapy and follow-up. Methods: Depressive symptoms (SCL-90-R) were assessed on 11 occasions for 166 depressed patients. ADM was used by 50.6% of the sample while 49.4% were unmedicated. Change during treatment and follow-up was assessed with multilevel modeling. We assessed whether ADM predicted differences in symptom development. Results: Depressive symptoms significantly reduced at a rate of .05 per month in treatment (p <.001), corresponding to an effect size of 1.35. There was no significant difference between ADM users and nonmedicated patients at baseline. ADM users had nearly twice as long treatment duration than nonmedicated patients, and ADM users had lower rate of symptom reduction than nonmedicated patients for depressive symptoms. Conclusions: Our results indicate medicated patients experience less response to psychotherapy than non medicated. Patients on ADM may believe that depression is primarily a biochemical condition and thus have less confidence in the potential for psychotherapy to treat depression. Also, it is possible that patients not using ADM have better access to emotions that need to be accessed and processed in psychotherapy. Iatrogenic comorbidity may thus have contributed to slower improvement for ADM users.

• Conejo-Cerón, Sonia; Taubner, Svenja; Heinonen, Erkki; Adler, Asta; Barkauskiene, Rasa & Giacomo, Dina Di [Vis alle 21 forfattere av denne artikkelen] (2021). Mediators in Psychological Treatments for Anxiety and Depression in Adolescents and Young People: A Protocol of a Systematic Review. Frontiers in Psychology. 12, s. 1–7. doi: 10.3389/fpsyg.2021.708436. Fulltekst i vitenarkiv Vis sammendrag

  Introduction Anxiety and depressive disorders are a significant problem that starts in childhood or adolescence and should be addressed early to avoid chronic mental conditions. There is strong evidence to demonstrate that psychological treatments are effective for these disorders, however, little is known on mediators and mechanisms of change of psychological treatment in adolescents and young adults. Understanding the pathways through which psychological treatments operate will facilitate more effective treatments. Aim We aim to conduct a systematic review, exploring the available evidence on mediators of psychological treatments for anxiety and depression in adolescents and young adults. Methods A systematic search has been performed on PubMed and PsycINFO databases to identify studies from inception to 23rd February 2020. Eligible studies include randomized controlled trials and trials (quasi-experimental) designs that have enrolled adolescents and young adults presenting with depression and/or anxiety and that have examined mediators of psychological treatments. A group of 20 reviewers from the COST-Action TREATme (CA16102) divided into 10 pairs independently screen studies for inclusion, extract information from the included studies, and assess the methodological quality of the included studies and the requirements for mediators. The methodological quality will be assessed by The Mixed Methods Appraisal Tool. Extracted data from the included studies will be collected and presented using a narrative approach. Discussion This systematic review will summarize and provide a comprehensive overview of the current evidence on mediators of psychological treatments for anxiety and depression for adolescents and young adults. Results will allow the identification of strategies to optimize intervention to enhance clinical outcomes. Ethics and dissemination Ethics approval is not required. Findings from this systematic review will be published in a peer-reviewed journal and disseminated at conferences and meetings. PROSPERO registration number: CRD42021234641.

Se alle arbeider i NVA