Paradoxical intention (PI) is a psychotherapeutic technique that is intended to help clients become more flexible, or at least more open to thinking about their problems, such as anxiety, from a new perspective. In line with this I have developed an approach that involves a “Panic Attack Time Line” (PATL). This PATL (a) helps the client visualize and understand what is happening during the panic attack, and (b) encourages them to understand why, when they start to have panicky feelings in their body, it will be paradoxically helpful to make these feelings worse, for example, if the attack makes their heart beat faster, they might be instructed to do jumping jacks. One of the important advantages of this PATL approach is that it can typically shorten therapy for treating anxiety disorders to just three sessions in comparison with traditional CBT protocols that typically require 6–20 sessions for achieving clinically meaningful change. Two, 3-session adult individual cases, “Fran” and “Emily,” are presented to illustrate the different ways that the PATL-grounded, PI approach can be combined with hypnosis to produce successful therapeutic outcomes. In Fran’s case, the PATL was used explicitly by itself with her and was sufficient to address her agoraphobia/panic disorder. Hypnosis was then used to extend the gains produced by PI. In the case of Emily's aviophobia, the PATL was not used explicitly with her. Rather, the paradoxical logic it embodies was used to create a paradoxical directive that was conveyed via hypnotic suggestion.

The Hogrefe Publishing series "Advances in Psychotherapy - Evidence-Based Practice" provides readers with practical evidence-based guidance on the diagnosis and treatment of the most common disorders seen in clinical practice in a compact, reader-friendly manner. Books in this series can be purchased through Hogrefe's website.

The Hogrefe Publishing series "Advances in Psychotherapy - Evidence-Based Practice" provides readers with practical evidence-based guidance on the diagnosis and treatment of the most common disorders seen in clinical practice in a compact, reader-friendly manner. Books in this series can be purchased through Hogrefe's website.

The U.S. Supreme Court’s 2024–2025 Term was remarkable. It was an unusual “Tale of Two Terms.” The regular Term, starting in October 2024, proceeded as expected, with extensive briefing, oral arguments, and full opinions. For mental health professionals, several cases stood out: the Court upheld state laws restricting gender-transition care for minors, recognized parents’ rights to exclude their children from certain LGBTQ+ classroom materials, and ruled on cases involving disabilities, the death penalty, gun rights, and pornography. The American Psychological Association (APA) filed amicus briefs in the gender-transition and LGBTQ+ instruction cases. Meanwhile, a Second (“Shadow”) Term was dominated by a flood of emergency requests, many of them tied to Trump administration policies. These disputes, including issues related to federal grants, immigration, and executive power, were often decided without complete briefing or oral arguments. The Court generally did not provide full written opinions, leaving some ambiguities about the decisions. This article analyzes both Terms, examines public trust in the Court, and previews a consequential year ahead, with cases involving conversion therapy, transgender athletes, and pregnancy center regulations.

Immigration-related discrimination is a unique stressor that many Latine youth and families face. Youth may experience discrimination from peers, teachers, adults in their communities, and health service providers. The ubiquitous nature of these experiences can influence how Latine youth engage with their healthcare providers, which may affect the therapeutic alliance and disclosure of suicide risk. We discuss the ethical and clinical considerations when working with undocumented youth and youth from mixed-status families who might minimize their mental health concerns as a means of preventing negative ramifications to their family. Using anti-racist frameworks, the authors provide recommendations for working sensitively and responsively with immigrant Latine youth and their families. Clinicians have a responsibility to protect vulnerable communities, manage personal biases, and increase their competence to provide quality services to immigrant families. Addressing the structural and cultural stressors are necessary steps to provide culturally responsive care.

Racial trauma is often not addressed within trauma informed training, leaving lived experiences overlooked and untreated in many therapy settings. This article introduces the adaptation of Dr. Yosso’s Community Cultural Wealth (CCW) model to guide the professional development of therapists as they integrate racial trauma support into their clinical practice. The cultural capitals that make up this model (aspirational, linguistic, familial, social, navigational, and resistance), when considered through a clinical lens, can be used to conceptualize salient questions and discussion points to process a client’s experiences and honor their unique strengths and stressors. This article explores how the CCW model can be used to gather information, conceptualize treatment, and intentionally create space in the therapy room for racialized experiences to be appropriately validated and addressed.

Gambling disorder (GD) poses hidden yet significant challenges for families and partners, often leaving concerned significant others (CSOs) in states of confusion, distress, and uncertainty. This article details the case of Mary, whose discovery of her partner’s concealed sports betting triggered acute emotional turmoil and relational disruption. The case illustrates how factors inherent to problem gambling such as secrecy, financial instability, and cultural normalization complicate coping and help-seeking among CSOs. Intervention emphasized comprehensive and ongoing assessment, integrative psychotherapy techniques, psychoeducation, and skills-based strategies to increase emotional processing and foster relational repair. Clinical reflections highlight the ethical dilemmas of disclosure, the balance of empathy with accountability, and the corrective impact of the therapeutic alliance as tailored to the unique relational experiences of CSOs.

Research has demonstrated that psychedelic-assisted therapy (PAT) can reduce anxiety, depression, and demoralization in patients with life-threatening illness. Although PAT routinely produces experiences that are spiritually or existentially meaningful, psychotherapeutic modalities that address spiritual, existential, religious, and theological (SERT) concerns remain underexplored in PAT. In this article, we introduce a novel, manualized approach to psychosocial support in PAT, Meaning and Purpose Therapy Modified for Psilocybin (P-MaP), which was adapted from the original Meaning and Purpose therapy for a multicenter clinical trial for demoralized adults near the end of life. Through the discussion of an amalgamated clinical vignette derived from experiences in this trial, we explore how principles of professional spiritual care can expand and advance psychosocial support in PAT for patients with serious and life-threatening medical illness.

The new edition of this concise and popular guide delivers up-to-date, hands-on guidance on the assessment and treatment of obsessive-compulsive disorder (OCD), offering a framework for understanding and helping people with this complex and challenging condition. Written by leading experts in the field, this book unpacks the intricacies of diagnosing OCD and explores models that explain the onset, development, and persistence of the disorder as well as its various manifestations.

Older adults are often underdiagnosed and undertreated for substance use disorders due to difficulty recognizing signs of substance use disorders in this population, as well as difficulty applying the DSM criteria to older adults. The current paper focuses on the prevalence of alcohol and cannabis use among older adults, as well as best practices for assessment and intervention. Through the integration of a case presentation, the current paper highlights common signs of substance use among older adults, clinical and ethical challenges in substance use disorder diagnosis and treatment among older adults, appropriate substance use assessments for older adults, and a variety of evidence-based treatment approaches that can be used with this population.

Measurement-Based Care (MBC) holds significant potential to enhance the effectiveness of the Primary Care Behavioral Health (PCBH) model, yet it remains inconsistently applied. This article positions MBC not as a procedural task, but as a core clinical competency that fosters therapeutic alliance, clarifies treatment goals, and promotes equitable care. Drawing from contrasting clinical vignettes, we demonstrate how tools inform clinical decision-making and enhance collaboration when applied skillfully by Behavioral Health Consultants. Finally, this article identifies cultural, structural, and operational barriers to implementation and offers pragmatic strategies to integrate MBC into routine care. By reframing MBC as a clinical competency, we advocate for its broader adoption as a standard of care within integrated behavioral health and PCBH specifically.

This article offers an overarching review of the literature on pregnancy loss including key terminology, standard medical treatments, patients’ reactions to pregnancy loss, and empirically supported psychological interventions for supporting loss patients. The remainder of the article delves into specific applications of therapeutic approaches for health service psychologists working with pregnancy loss patients. The vignette of a patient’s story highlights challenges that pregnancy loss patients often face and demonstrates how the health service psychologist can ultimately facilitate healing. We conclude with a list of practical “Do’s and Don’ts” for the health service psychologist working with pregnancy loss patients.

Teaching parents effective parenting strategies has several challenges for therapists, often stemming from family dynamics and ineffective discipline. Harsh punishment, inconsistency, and permissiveness can worsen behaviors, highlighting the need for structured, supportive parenting. Authoritative parenting, with warmth and consistency, fosters positive development. Therapists play a key role in helping parents regulate emotions, avoid disciplinary hypocrisy, and adapt strategies across developmental stages. By equipping parents with practical tools, therapy can strengthen parent-child relationships, reduce opposition, and promote long-term behavioral resilience.

Driven by the rapid progression of generative AI and other technological advancements, interactive virtual conversational agents are transforming the therapeutic relationship and how clients participate in behavioral health care. This article explores a case example of adopting an AI-powered conversational agent into a psychologist’s practice workflow, addressing key ethical, legal, and practical considerations. It emphasizes the importance of a client-centered approach and safety and calls for active involvement from psychologists and the broader behavioral health community in shaping the future of AI in mental health care.

Obsessive-compulsive disorder (OCD) is a chronic incapacitating mental health condition that is underrepresented in clinical treatment settings. The worldwide treatment gap for OCD is estimated at 60% (Kohn et al., 2004), a figure that reflects a shortage of specialized services, delayed help-seeking in suffers, and a mounting cost to society. The treatment of choice for OCD is a combination of cognitive-behavioral therapy (CBT) and pharmacotherapy (SSRIs), which has been proven efficacious in measurably reducing symptoms to below the clinical threshold (McKay et al., 2015). Nevertheless, when evaluated holistically, the success rate of the first-line treatment is limited. This study provides a literature review of the various psychodynamic models of obsessive-compulsive pathology and their attendant approaches to treatment. At present, empirical evidence for psychodynamic therapies for OCD is lacking (Leichsenring et al., 2015). To fill this gap in the research, this pragmatic case study (PCS; Fishman, 1999) aims to demonstrate the viability of short-term psychodynamic psychotherapy (STPP) as an effective treatment for OCD. Specifically, this pilot case study examines the theoretical implementation of Leichsenring and Steinert’s (2017) empirically-derived, manual-guided STPP treatment for OCD, rendered as a treatment for “Serena,” a 28-year-old female patient presenting with mild-to-moderate symptoms of OCD. Serena is a hybrid case, which is an aggregate of actual, de-identified psychotherapy cases and clinical examples from the relevant psychological literature. Through a disciplined inquiry approach, Serena’s treatment process is systematically described. Treatment outcomes are analyzed both qualitatively and quantitatively. This case study attempts to illustrate the interplay between symptom expression and the not-always-linear progress toward structural change. I conclude with a discussion of the applications and limitations of the hybrid case study and STPP for OCD, as well as implications for psychotherapy integration.