Meditation, mindfulness, and acceptance methods in psychotherapy: A systematic review.

OBJECTIVE: : Meditation, mindfulness, and acceptance (MMA) methods have gained popularity among psychotherapists and the public. The impact of these strategies as implemented in treatment packages (e.g., mindfulness-based interventions) has been studied extensively. However, the impact of integrating MMA strategies into individual psychotherapy has not been established. METHODS: : To address this gap in the literature, we conducted a systematic review of empirical (quantitative or qualitative) studies investigating the use of MMA methods during individual psychotherapy in adult samples. RESULTS: : After reviewing 4671 references, only three studies (one quantitative, two qualitative) met our inclusion criteria. The one experimental study (n = 162) provided no evidence that including mindfulness meditation improved outcomes beyond other active interventions (ds = 0.00-0.12 for effects on general clinical symptoms vs. progressive muscle relaxation and treatment-as-usual, respectively). Two qualitative studies (n = 5 therapist-patient dyads in one study, n = 9 adults in one study) provided preliminary evidence that patients may find MMA methods helpful. CONCLUSIONS: : We highlight future directions for work in this area, including clarifying optimal dosage and timing, identifying patient characteristics associated with beneficial or adverse effects, investigating cultural adaptations, and clarifying how MMA constructs can be measured within individual psychotherapy. We conclude by highlighting training recommendations and therapeutic practices.

The relationship between clients' expectation of therapist support and challenge and treatment outcome: A response surface analysis.

Clients' expectations of treatment have long been posited as an important therapeutic factor in treatment success. Decades of research and meta-analytic findings have supported the notion that client expectations about what will happen over the course of therapy and how beneficial therapy will be are directly related to treatment factors, such as the working alliance and treatment outcome. Client expectations can be categorized into two broad categories, outcome expectations (i.e., how beneficial treatment will be) and treatment expectations (i.e., what will happen in treatment). This study sought to examine clients' treatment expectations, specifically, their role expectations, which represent their beliefs of how their therapists will act in session. Data for this study included 1,233 clients participating in individual counseling with 49 therapists at a university counseling center. Multilevel polynomial regression and response surface analysis were used to test congruent and discrepant effects of clients' pretreatment support and challenge expectancy on reductions in their psychological distress over the course of treatment. Results indicated that reductions in clients' psychological distress were the greatest when their support and challenge expectancy scores were congruent and high. In other words, clients who expected both high challenge and high support from their therapist, prior to the start of counseling, reported the greatest improvement in counseling. Clients similarly reported reductions in their psychological distress when their support and challenge expectations were congruent and low, although this effect was smaller than when they expected high levels of both support and challenge. Together, these findings suggest that when clients' expectations of support and challenge are similar, they fare better in treatment, as opposed to when they expect a greater amount of support than challenge or vice versa. (PsycInfo Database Record (c) 2022 APA, all rights reserved).