University counseling services are increasingly recognized as effective interventions for promoting students' psychological well-being, yet the psychological mechanisms underlying their effectiveness are still poorly understood. The present study examined the role of epistemic stances (epistemic trust, mistrust, and credulity) and therapeutic alliance in predicting changes in psychological distress among students undergoing a brief psychodynamic counseling intervention. The sample included 93 university students who participated in a brief psychodynamic counseling intervention consisting of four sessions and a 3-month follow-up. Data were analyzed using hierarchical linear mixed-effects models. Psychological distress was assessed using the Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) at pre-treatment (T1), post-intervention (T2), and follow-up (T3). Epistemic stances were measured with the Epistemic Trust, Mistrust, and Credulity Questionnaire (ETMCQ) at T1, and therapeutic alliance was assessed at T2 with the Working Alliance Inventory - Short Form Revised (WAI-SR). Psychological distress significantly decreased from pretreatment to post-intervention and remained stable at follow-up. Higher baseline epistemic trust predicted lower levels of distress, whereas higher epistemic mistrust and credulity were associated with poorer outcomes. A stronger therapeutic alliance was associated with lower distress levels. Moreover, the therapeutic alliance moderated the relationship between epistemic mistrust and psychological distress, such that higher alliance was associated with lower distress. Findings suggest that both epistemic stances and the therapeutic alliance contribute to counseling effectiveness. A strong alliance may partially buffer the negative impact of epistemic mistrust, highlighting the importance of fostering a mentalizing environment in brief counseling interventions.
Relational skills and self-awareness are important aspects of psychotherapy training, shaping how trainees relate to clients, reflect on their experiences, and develop professionally. Despite their importance, little research has examined how these aspects are related during training. This cross-sectional study investigated the associations between relational skills and self-awareness outcomes in psychotherapy trainees and explored whether these variables differed according to stages of training, age, engagement in personal therapy, and self-reported mental health difficulties. The sample included 105 trainees (75.2% female, M age=29.71 years, SD=10.77), of whom 46% were in the beginning stage and 54% in the advanced stage of training. Relational styles were identified using exploratory factor analysis, and associations were examined using Pearson correlations and analyses of variance. Self-awareness outcomes were assessed with the Self-Awareness Outcomes Questionnaire (SAOQ). Exploratory factor analysis identified four relational styles: Warm, Guarded, Directive, and Intense. Warm, Directive, and Intense styles were positively associated with several self-awareness outcomes, whereas Guarded was associated with higher emotional costs of self-awareness. Older trainees (43+) reported greater emotional engagement, lower emotional strain, and higher scores on the Intense style than trainees aged 18-24. Trainees engaged in personal therapy tended to report lower emotional costs of self-awareness. Self-reported mental health difficulties were associated with higher emotional costs and more guarded, less warm relational styles. The results contribute to an understanding of how relational styles, self-awareness outcomes, and personal factors are interconnected in psychotherapy trainees and may help inform psychotherapy training by emphasizing individual differences in relational functioning.
Inflammatory bowel disease (IBD), encompassing Crohn’s disease (CD) and ulcerative colitis (UC), is a chronic immune-mediated gastrointestinal condition in which long-term care increasingly involves patient-reported health, emotional functioning, and psychological adaptation. Because psychological adaptation may not parallel clinical remission, this 5-year longitudinal study examined changes in psychopathological symptoms, alexithymia, coping strategies, and health-related quality of life (HR-QoL) in 73 outpatients receiving maintenance medical treatment. We expected no uniform mean-level improvement or deterioration and hypothesised that increases in depressive and anxiety symptoms, alexithymia, and avoidance coping would be associated with poorer HR-QoL outcomes and that increases in positive attitude coping would be associated with better outcomes. Participants were reassessed during clinical remission using validated measures, and psychological changes were analysed in relation to follow-up quality of life outcomes, adjusting for baseline levels and disease duration. Mean-level changes were limited across depressive symptoms, overall anxiety, alexithymia, most coping dimensions, and HR-QoL indices. Somatic anxiety increased over time (p=.03), whereas social support coping decreased consistently in the overall sample and within both diagnostic subgroups (p<.01). Increases in depressive symptoms were associated with poorer mental health and lower disease-specific HR-QoL (both p<.001), while increases in alexithymia were associated only with poorer disease-specific HR-QoL (p<.05). In the multivariate model, depressive change independently predicted follow-up physical health (p=.02), mental health (p<.001), and disease-specific HR-QoL (p<.001). These findings suggest that psychological vulnerability may remain clinically relevant even during remission and identify depressive symptoms as a key correlate of long-term patient-reported functioning. The results support the integration of psychological assessment and multidisciplinary care within routine gastroenterological follow-up and highlight the potential value of psychologically informed interventions aimed at preserving HR-QoL and long-term adaptation.
Research on university staff mental health and intervention evaluation remains limited, especially in Italy. Brief psychodynamic counseling appears promising for reducing distress and improving emotion regulation. The present study aimed to explore the socio-demographic, occupational, and psychological characteristics of university staff members seeking support at a brief psychodynamic counseling service and to examine changes in psychological functioning and distress, symptomatology, and mentalized affectivity following the intervention. Forty-eight participants (mean age=46.16 years, SD=9.57) completed the counseling program, consisting of four weekly clinical sessions followed by a one-month follow-up session. Measures included: the Outcome Questionnaire-45 (OQ-45), the Depression Anxiety Stress Scales (DASS-21), the Brief Mentalized Affectivity Scale (BMAS), and the Defense Mechanism Rating Scales - Self-Report 30 (DMRS-SR-30). Higher use of the counseling service among female staff (69%), with a fairly balanced distribution across employment stages, emerged. The main reason for seeking support was psychological difficulties (46%), while others reported work- or family-related issues. At baseline, 68% showed psychological functioning above the OQ-45 clinical cut-off. Paired-samples t-tests revealed significant reductions in overall psychological functioning, distress, and symptomatology, alongside improvements in the processing dimension of mentalized affectivity. Participants also exhibited a moderate-to-good level of defensive functioning at baseline, indicating relatively adaptive capacities. Preliminary findings suggest that brief psychodynamic counseling may support improvements in functioning and symptomatology among university staff members, together with changes in emotional processing. Integrating defensive functioning and mentalized affectivity may contribute to clarifying the mechanisms of change, although further controlled longitudinal research is needed.
This study examined client-therapist alliance congruence as a predictor of psychological well-being among 104 Filipino psychotherapy dyads. Descriptive analysis showed that although most dyads had non-identical ratings, 55.8% fell within the conservative broad agreement band; among dyads outside this band, therapist-higher discrepancies were more common. Client- and therapist-rated alliances were analyzed using polynomial regression with response surface analysis (RSA) to model both congruent and incongruent alliance effects on client psychological well-being. Treatment length, treatment interval, therapist professional maturity, and client symptom severity were included as covariates. Results indicated a significant positive linear effect along the line of alliance congruence, such that a mutually perceived alliance was associated with greater psychological well-being. In contrast, significant curvature along the line of incongruence (LOIC) showed that discrepancies between therapist and client alliance ratings were associated with lower well-being, with increasing mismatch predicting progressively poorer outcomes. The findings suggest that therapist and client alliance perceptions should not be treated as interchangeable and that their dyadic alignment provides clinically meaningful information beyond either perspective alone. These results are discussed in relation to alliance monitoring, client feedback, and culturally responsive psychotherapy practice in the Filipino context.
