Loneliness and COVID-19: How online counselling may be part of the puzzle

Check This article was edited and approved for accuracy By Adam Szmerling on April 1, 2020

The COVID-19 pandemic has transformed life as we know it across many regions of the world in just a few short months. I could not have fathomed how quickly my life and that of everyone impacted by COVID-19 could be upended.

We are all adjusting to new terminology such as “social distancing”, “essential and non-essential services”, “self isolation” and “flattening the curve”. While these are vital public health measures required to curb the rate of COVID-19 spread, the social and economic consequences are enormous.

One of the social consequences that has been highlighted following lock-down processes in Wuhan, Italy, Spain, and other places has been an inescapable sense of loneliness. The process of social distancing has involved limiting gatherings of people in public and our own homes, shutting down of environments that facilitated social encounters (cafes, restaurants, bars) and invoked fear of others. It has also led to the closing of workplaces which for many people is a large component of how they meet their need for social interactions. Older individuals (those over age 60) who are more vulnerable to the severe and life threatening aspects of COVID-19 have been encouraged to self-isolate at home and nursing homes have banned visitors from entering their facilities.

Humans are neurologically wired for social interactions. We evolved to live in packs and groups as a way to enhance survival and ensure continuation of our species. The directive to socially distance is at odds with what we are hard wired to orient towards. Yet this is exactly what we are being asked to override during these strange and unprecedented times.

What can I do to manage feelings of loneliness

Firstly it is important to notice that this is how you are feeling and that it is valid and makes sense in the current context. If you are a person who relishes weekly coffee catch ups, hosting dinner parties, hanging out with big groups of friends or seeing extended family regularly this has the potential to be a very difficult and disorienting time. It is ok to feel lonely.

It can be helpful to re-phrase the term “social distancing” to “physical distancing”. To protect those vulnerable members of the community, we need to keep our physical distance from each other. But it does not mean we need to be socially or emotionally distant. In fact this pandemic calls for the ongoing building and preservation of social bonds as we navigate the coming weeks and months. Remind yourself that physically you can’t socialise or hang out with family the same way as you could before but you can remain connected.

Embrace technology for it will be your friend and social lifeline for the next little while. Organise group video catch ups on Facetime or Zoom. Call your buddies on the phone. Set up a WhatsApp group to share messages of support and goof around on. For those with elderly parents and grandparents who are isolating and not confident using more modern technology, connections can be maintained through regular phone contact, writing letters and cards and sending surprise packages and gifts.

I’m doing all these things and I still feel lonely. What now?

Not all experiences of loneliness will be ameliorated using the above strategies. For those who have been struggling to build friendships or meet a suitable partner, the social distancing measures may limit your ability to build these relationships. You might also find yourself feeling distressed and that nothing you try helps with your feeling of loneliness. If this is happening to you, please consider making an appointment with one of our clinicians for online counselling. The services are confidential and continue to concur with ethical standards established by various organisations including PACFA, the AASW and the APS.

COVID-19 and cabin fever

COVID-19 has led to a massive overhaul in how we live our lives. Across Australia at the moment, most schools are either closed for school holidays or on a hiatus to try and prevent a rapid escalation of COVID-19 in our community to avoid the tragic images that have emerged from Asia, Europe and the USA over the past few weeks and months. Along with school being out, many workplaces have either shut down completely or are redesigning the way they operate so their staff can work from home. As such, you might find yourself spending a lot more time with your housemates, partner or children than you (and them) are used to. Without the routine breaks in contact with those we live with due to work, school or other commitments, our ability to stay patient can wear thin very rapidly. It can be especially trying when these relationships were already under strain even with the structure of daily life and accompanying times apart.

How to manage cabin fever

We have all been in a situation where someone close to us is causing frequent irritation. It might be screeching or squabbling children, housemates who have different standards of cleanliness for common areas, a partner who leaves their belongings in a mess or someone being overly critical of our preferences and styles. When we are living in close proximity to these triggers with little opportunity for respite, frustrations rise, sometimes without one being aware of why. When these resentments are not directly addressed they can build up and lead to an explosion causing tears, conflict and emotional distancing.

If tempers are running high in your home at the moment, it can be helpful to try the following before considering online counselling.

Pause now

Stop and take a breath, then another and another. Once you are feeling calm, spend some time thinking about what is going on. Who is saying what? Who is doing what? What is the impact of this on you? Can you speak to the person about it calmly?

Call a meeting

We are traversing unprecedented times. As we begin to spend much more time with those we live with, it is important that you work together as a team to get through the next few months as best you can. Schedule a meeting to discuss how you can structure your daily life and routine (accounting for child care or entertainment, work responsibilities and household chores) to try and take account for everybody’s needs, differences and abilities. We can’t expect small kids to understand that screeching while mum or dad are on a work call is disruptive. We can expect our partner or housemate to not disturb us when we are doing critical work and we can expect them to contribute to the functioning and running of the household. The golden rule is don’t expect and don’t assume – ask people what they need, ask them what they think, ask them what works for them. If you are uncertain about how to communicate effectively and listen well, make an appointment with us for online counselling. We can help you with that.

Ease off a little bit

Being at home with the same people for months on end and limited options to get out of the house will be a huge test. Consider relaxing some of your standards – if your partner leaves their socks on the floor, a gentle and friendly reminder will work better than berating them. If you forget to water the plants or pick something up at the supermarket, let it go. If your kids are watching more TV, iPad or screens at the moment, don’t beat yourself up.

Have time for yourself

It can be vital to carve out time for solitude and connecting with those who don’t live with you. With the limits on reasons we can leave our home rapidly dwindling, it can be more challenging to figure out how to get our own space. It may be getting up a little earlier before the rest of the house and enjoying a mindful cup of tea or coffee or a short yoga or pilates session helps. It could be that while you cook dinner, your partner takes the children out for a walk or bike ride (and then you trade the next day). Alternatively taking the time to have a shower or bubble bath alone can help you unwind as can a brisk walk or bike ride – this is a great opportunity to chat with a friend on the phone or listen to some music to help you feel recharged.

If you are living in a house where there is frequent conflict, disharmony or chaos and it’s getting to you, online counselling is a service to consider. The clinicians at Bayside Psychotherapy are experienced and all are now offering online counselling services in light of the COVID 19 pandemic. In fact, our online counselling services predated the corona virus pandemic. We are ensuring that our sessions continue to maintain your privacy and adhere to the ethical standards set out by organisations such as PACFA, the AASW and the APS.

Adam Szmerling

Bayside Psychotherapy was founded by Adam Szmerling in Melbourne, offering counselling and psychotherapy for individuals and couples. Adam's experience with psychotherapy inspired him to help others improve their self-understanding, mental health and wellbeing.

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Cognitive Behavioural Therapy (CBT)


Cognitive Behavioral Therapy (CBT) is a short-term, goal-oriented psychotherapy treatment that aims to change negative patterns of thinking or behaviour. It is based on the idea that our thoughts, feelings, and actions are interconnected and that changing negative thought patterns can lead to changes in feelings and behaviours. CBT helps individuals identify and challenge distorted or unhelpful thinking patterns and beliefs, teaching them to respond to challenging situations more effectively. It is commonly used to treat a wide range of disorders, including depression, anxiety, and phobias. The therapy involves working with a therapist in a structured setting, and the skills learned can be applied to everyday life. With its evidence-based approach, CBT has proven effective for many individuals in managing their psychological challenges.

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Psychodynamic Therapy


Psychodynamic therapy, rooted in the theories of psychoanalysis developed by Sigmund Freud, focuses on the unconscious processes as they manifest in a person's present behaviour. The goal is to increase self-awareness and understanding of how past experiences influence current behaviour. It explores unresolved conflicts and traumatic experiences from the past, which may be impacting present-day behaviours and emotions. Therapists often delve into childhood events, dreams, and the relationship between the therapist and client to uncover hidden patterns. By bringing these unconscious feelings and drives to consciousness, individuals can gain insights into their lives, leading to healing and personal growth. While traditionally long-term, many contemporary forms of psychodynamic therapy are shorter-term. It is used to treat a broad range of conditions, including depression, anxiety, and personality disorders.

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Person-Centred Therapy (or Rogerian Therapy)


Person-centred therapy, developed by Carl Rogers, is a humanistic approach that emphasises the individual's inherent drive towards self-actualization and growth. The therapist provides an environment of unconditional positive regard, empathy, and genuineness, allowing clients to freely express themselves without fear of judgement. This nurturing atmosphere facilitates self-exploration and self-acceptance. Central to the approach is the belief that individuals possess an innate ability to find their solutions when given the right conditions. The therapist's role is not to direct or advise, but rather to act as a facilitative companion on the client's journey. The focus is on the here and now, with the aim to enhance the individual's self-awareness, self-worth, and capacity to create positive changes in their lives.

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Hypnotherapy


Hypnotherapy is a therapeutic technique that uses guided relaxation, intense concentration, and focused attention to achieve a heightened state of consciousness or trance. Conducted by certified hypnotherapists, it taps into the subconscious mind, allowing clients to explore suppressed memories, emotions, or negative patterns. The process can facilitate behaviour change by introducing positive affirmations or suggestions. Hypnotherapy is often employed to treat anxieties, phobias, substance addictions, unwanted behaviours, and pain management. It can also be used to uncover and address deeper traumas or past experiences. While many report positive results from hypnotherapy, it requires the individual's willingness and trust in the process. It is crucial to approach it with an open mind and under the guidance of a trained professional.

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Interpersonal Therapy (IPT)


Interpersonal therapy (IPT) is a time-limited, evidence-based treatment that focuses on interpersonal issues, aiming to improve communication patterns and relational dynamics. Developed primarily for depression, IPT operates on the premise that psychological symptoms are often linked to interpersonal problems. It concentrates on four main areas: unresolved grief, role disputes (conflicts with significant others), role transitions (major life changes), and interpersonal deficits (long-standing difficulties in forming and maintaining healthy relationships). Therapists help clients identify and address current interpersonal issues that may contribute to their emotional distress. By enhancing communication and relational skills, IPT seeks to alleviate symptoms and improve interpersonal functioning. Emphasising the here and now, it offers practical strategies and insights for individuals to better navigate their social environments.

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Dialectical Behaviour Therapy (DBT)


Dialectical Behaviour Therapy (DBT) is a cognitive-behavioural treatment developed by Dr. Marsha Linehan, primarily for individuals with borderline personality disorder and chronic suicidality. DBT combines standard cognitive-behavioural techniques with concepts from Buddhist meditation, emphasising both acceptance and change. The therapy addresses emotional dysregulation by teaching patients skills in four key areas: mindfulness (staying present in the moment), distress tolerance (managing crises and accepting situations without change), emotion regulation (understanding and managing intense emotions), and interpersonal effectiveness (communicating and setting boundaries). DBT incorporates both individual therapy and group skills training. Its efficacy has expanded beyond its initial focus, showing promise in treating other disorders like eating disorders, substance use disorders, and mood disorders. It aims to balance self-acceptance with the need for change, fostering both emotional stability and interpersonal effectiveness.

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Integrative or Eclectic Therapy


Integrative or Eclectic therapy combines elements from various therapeutic approaches based on a client's individual needs. Instead of adhering to a single therapy model, integrative therapists are flexible, drawing from multiple theories and techniques to create a personalised treatment. This approach recognizes the value of diverse therapeutic methods and believes no one size fits all. By blending elements from different therapies, integrative practitioners aim to enhance treatment efficacy, tailoring it to the specific issues, preferences, and cultural backgrounds of each client. The underlying principle is that different individuals may benefit from different approaches at different times. Thus, an integrative or eclectic approach is holistic, adaptable, and client-centred, aiming to achieve optimal therapeutic outcomes by using a wider range of tools and insights.

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Narrative Therapy


Narrative therapy is a therapeutic approach that centres on the stories people construct and hold about their lives. Developed by Michael White and David Epston, it posits that individuals give meaning to their experiences through narrative, often influenced by societal norms and beliefs. In this therapy, problems are externalised, allowing clients to view issues as separate from themselves. Therapists help clients "re-author" these narratives, emphasising strengths, achievements, and overlooked potential. By dissecting and reframing these stories, individuals can perceive challenges differently, identify alternative narratives, and construct more empowered versions of their lives. The approach is non-pathologizing, viewing people as experts of their own lives, with the therapist acting as a collaborative partner in the exploration and rewriting process. Narrative therapy fosters resilience, agency, and personal transformation.

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Solution-Focused Brief Therapy (SFBT)


Solution-focused brief therapy (SFBT) is a goal-oriented approach that emphasises solutions rather than problems. Developed by Steve de Shazer and Insoo Kim Berg in the 1980s, SFBT operates on the belief that clients possess inherent strengths and resources to manage difficulties and create desired changes. Instead of delving into the origins of problems, the therapy focuses on envisioning a preferred future and identifying practical steps to achieve it. Sessions often involve questions that help clients recognize successes, however small, and build on them. Questions might explore exceptions (times when the problem was not present) or elicit positive feedback, reinforcing progress. SFBT is typically shorter in duration than other modalities and is applicable across various settings and populations, emphasising resilience, competence, and actionable solutions.

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Gestalt Therapy


Gestalt therapy, developed by Fritz Perls in the mid-20th century, is an experiential and holistic approach focusing on self-awareness and the "here and now." It emphasises personal responsibility and the individual's experience in the present moment, the environment, and the context. The therapy seeks to help clients integrate fragmented aspects of the self, leading to a more unified, authentic whole. Gestalt therapists use creative techniques, including role-playing, dialogue, and experiential exercises, to heighten awareness and resolve unfinished business or "gestalts." Central to the approach is the belief in the innate human capacity for self-regulation and growth when individuals fully experience their feelings and perceptions. Gestalt therapy underscores the importance of the therapist-client relationship, direct engagement, and mutual influence, aiming to foster self-acceptance and personal growth.

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Schema Therapy


Schema therapy, developed by Dr. Jeffrey Young, integrates elements of cognitive-behavioural, psychodynamic, attachment, and gestalt approaches to treat complex disorders, particularly borderline personality disorder. It posits that maladaptive "schemas" or core beliefs form in childhood due to unmet emotional needs. These schemas persist into adulthood, leading to unhealthy life patterns or coping styles. The therapy identifies and addresses these deep-rooted schemas, aiming to replace them with healthier coping mechanisms. Schema therapy uses various techniques like cognitive restructuring, experiential exercises, and behavioural pattern-breaking. Therapists also emphasise a therapeutic relationship marked by "limited reparenting," wherein they provide the support and guidance that clients might have missed in their childhood. By addressing these core beliefs and their origins, schema therapy seeks long-lasting change and healing for individuals with chronic psychological challenges.

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Acceptance and Commitment Therapy (ACT)


Acceptance and Commitment Therapy (ACT) is a therapeutic approach that blends traditional behaviour therapy with mindfulness principles. Developed by Steven C. Hayes in the 1980s, ACT's primary objective is to increase psychological flexibility. It encourages individuals to embrace their thoughts and feelings rather than resisting or feeling guilty for them. The therapy focuses on six core processes: cognitive defusion (distancing from unhelpful thoughts), acceptance (embracing feelings without judgement), present-moment awareness (mindfulness), self-as-context (recognizing a consistent self beyond thoughts), values clarification (identifying what truly matters), and committed action (taking steps aligned with values). ACT posits that pain is a normal part of life and aims to help clients pursue meaningful lives in the presence of pain, rather than avoiding or being dominated by internal distress.

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Mindfulness-based cognitive therapy (MBCT)


Mindfulness-Based Cognitive Therapy (MBCT) is an integrative therapy that combines traditional cognitive behavioural therapy (CBT) with mindfulness strategies. Developed to prevent the recurrence of depression, MBCT teaches individuals to become more aware of their thoughts and feelings, fostering a different relationship with them rather than trying to eliminate them. This approach aids in recognizing and disrupting automatic cognitive processes, often preventing depressive relapses. Through meditation exercises and awareness techniques, clients learn to focus on the present moment, reducing rumination and negative thought patterns. Research has shown MBCT to be effective in reducing the recurrence of depression, especially for those with a history of recurrent episodes. Beyond depression, it is also applied to various conditions, promoting mental well-being by cultivating mindfulness and a more adaptive relationship with thoughts and emotions.

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Family Systems Therapy


Family systems therapy, rooted in the work of Murray Bowen, views individuals in the context of their family unit, considering familial relationships, dynamics, and patterns. It posits that an individual's behaviours and emotional well-being are inseparable from the family system they belong to. Distress or dysfunction in one member often reflects broader family dynamics. The therapy seeks to identify and address unhealthy patterns within the family, aiming to foster understanding, improve communication, and resolve conflicts. Therapists observe interactions, facilitate dialogues, and guide family members towards healthier ways of relating. They consider generational patterns, roles, and boundaries. The goal is not just to address the concerns of one member but to enhance the well-being and functionality of the entire family system, recognizing its interconnected nature.

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Cognitive Behavioural Therapy (CBT) References


  • Hofmann, S. G., Asnaani, A., Vonk, I. J., Sawyer, A. T., & Fang, A. (2012). The efficacy of cognitive behavioral therapy: A review of meta-analyses. Cognitive Therapy and Research, 36(5), 427-440.
  • Cuijpers, P., Karyotaki, E., Weitz, E., Andersson, G., Hollon, S. D., & van Straten, A. (2017). The effects of psychotherapies for major depression in adults on remission, recovery, and improvement: a meta-analysis. Journal of Affective Disorders, 202, 511-517.
  • Wiles, N., Thomas, L., Abel, A., Ridgway, N., Turner, N., Campbell, J., ... & Hollinghurst, S. (2013). Cognitive behavioural therapy as an adjunct to pharmacotherapy for primary care based patients with treatment-resistant depression: results of the CoBalT randomised controlled trial. The Lancet, 381(9864), 375-384.
  • Johnsen, T. J., & Friborg, O. (2015). The effects of cognitive behavioral therapy as an anti-depressive treatment is falling: A meta-analysis. Psychological Bulletin, 141(4), 747.
  • Driessen, E., Van, H. L., Don, F. J., Peen, J., Kool, S., Westra, D., ... & Dekker, J. J. (2013). The efficacy of cognitive-behavioral therapy and psychodynamic therapy in the outpatient treatment of major depression: a randomized clinical trial. American Journal of Psychiatry, 170(9), 1041-1050.
  • Cuijpers, P., Cristea, I. A., Karyotaki, E., Reijnders, M., & Huibers, M. J. (2016). How effective are cognitive behavior therapies for major depression and anxiety disorders? A meta-analytic update of the evidence. World Psychiatry, 15(3), 245-258.

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Psychodynamic Therapy References


  • Leichsenring, F., & Rabung, S. (2011). Long-term psychodynamic psychotherapy in complex mental disorders: update of a meta-analysis. The British Journal of Psychiatry, 199(1), 15-22.
  • Abbass, A., Kisely, S., & Kroenke, K. (2014). Short-term psychodynamic psychotherapy for somatic disorders: Systematic review and meta-analysis of clinical trials. Psychotherapy and Psychosomatics, 83(5), 265-274.
  • Luyten, P., & Fonagy, P. (2015). The neurobiology of mentalizing. Personality Disorders: Theory, Research, and Treatment, 6(4), 366.
  • Gerber, A. J., Kocsis, J. H., Milrod, B. L., Roose, S. P., Barber, J. P., Thase, M. E., ... & Schneier, F. R. (2011). A quality-based review of randomized controlled trials of psychodynamic psychotherapy. American Journal of Psychiatry, 168(1), 19-28.
  • Munder, T., Wilmers, F., Leonhart, R., Linster, H. W., & Barth, J. (2010). Working Alliance Inventory-Short Revised (WAI-SR): psychometric properties in outpatients and inpatients. Clinical Psychology & Psychotherapy, 17(3), 231-239.
  • Town, J. M., Diener, M. J., Abbass, A., Leichsenring, F., Driessen, E., & Rabung, S. (2012). A meta-analysis of psychodynamic psychotherapy outcomes: Evaluating the effects of research-specific procedures. Psychotherapy, 49(3), 276.

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Person-Centred Therapy (or Rogerian Therapy) References


  • Elliott, R., Greenberg, L. S., Watson, J., Timulak, L., & Freire, E. (2013). Research on humanistic-experiential psychotherapies. Bergin and Garfield's Handbook of Psychotherapy and Behavior Change, 495-538.
  • Cooper, M., O'Hara, M., Schmid, P. F., & Wyatt, G. (2016). The Handbook of Person-Centred Psychotherapy and Counselling. Palgrave Macmillan.
  • Prochaska, J. O., & Norcross, J. C. (2018). Systems of Psychotherapy: A Transtheoretical Analysis. Oxford University Press.
  • Watson, J. C. (2017). Constructing the therapeutic relationship in person-centered therapy. Journal of Psychotherapy Integration, 27(4), 475.
  • Cepeda, L. M., & Davenport, D. S. (2016). Person-centered therapy and solution-focused brief therapy: An integration of present and future awareness. Psychotherapy, 53(1), 27.
  • Murphy, R., & Hutton, P. (2018). Practitioner review: Therapist variability, patient-reported therapeutic alliance, and clinical outcomes in adolescents undergoing mental health treatment–A systematic review and meta-analysis. Journal of Child Psychology and Psychiatry, 59(1), 5-19.

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Hypnotherapy References


  • Alladin, A. (2012). Cognitive hypnotherapy: An integrated approach to the treatment of emotional disorders. Journal of Cognitive Psychotherapy, 26(4), 272-284.
  • Elkins, G., Barabasz, A., Council, J., & Spiegel, D. (2015). Advancing research and practice: The revised APA Division 30 definition of hypnosis. American Journal of Clinical Hypnosis, 57(4), 378-385.
  • Jensen, M. P., Jamieson, G. A., Lutz, A., Mazzoni, G., McGeown, W. J., Santarcangelo, E. L., ... & Terhune, D. B. (2015). New directions in hypnosis research: Strategies for advancing the cognitive and clinical neuroscience of hypnosis. Neuroscience of Consciousness, 2015(1), niv012.
  • Elkins, G., Barabasz, A., Council, J., & Spiegel, D. (2015). Advancing Research and Practice: The Revised APA Division 30 Definition of Hypnosis. International Journal of Clinical and Experimental Hypnosis, 63(1), 1-9.
  • Lynn, S. J., Rhue, J. W., & Kirsch, I. (2010). Handbook of clinical hypnosis (2nd ed.). Washington, DC: American Psychological Association.
  • Alladin, A. (2012). Cognitive hypnotherapy: An integrated approach to the treatment of emotional disorders. John Wiley & Sons.

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Interpersonal Therapy (IPT) References


  • Cuijpers, P., Karyotaki, E., Weitz, E., Andersson, G., Hollon, S. D., & van Straten, A. (2016). The effects of psychotherapies for major depression in adults on remission, recovery, and improvement: A meta-analysis. Journal of Consulting and Clinical Psychology, 84(3), 262.
  • Markowitz, J. C., & Weissman, M. M. (2012). Interpersonal psychotherapy: Past, present and future. Clinical Psychology & Psychotherapy, 19(2), 99-105.
  • Mufson, L., Dorta, K. P., Wickramaratne, P., Nomura, Y., Olfson, M., & Weissman, M. M. (2017). A randomized effectiveness trial of interpersonal psychotherapy for depressed adolescents. Archives of General Psychiatry, 64(6), 577-584.
  • Cuijpers, P., Geraedts, A. S., van Oppen, P., Andersson, G., Markowitz, J. C., & van Straten, A. (2011). Interpersonal psychotherapy for depression: A meta-analysis. The American Journal of Psychiatry, 168(6), 581-592.
  • Belsher, B. E., Beevers, C. G., & Neimeyer, R. A. (2012). Differential treatment response for depressed patients high in anxiety or anger. Journal of Consulting and Clinical Psychology, 80(5), 852.
  • Lemmens, L. H., Galindo-Garre, F., Arntz, A., Peeters, F., Hollon, S. D., Derubeis, R. J., & Huibers, M. J. (2017). Exploring mechanisms of change in cognitive therapy and interpersonal psychotherapy for adult depression. Behaviour Research and Therapy, 94, 81-92.

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Dialectical Behaviour Therapy (DBT) References


  • Kliem, S., Kröger, C., & Kosfelder, J. (2010). Dialectical behavior therapy for borderline personality disorder: A meta-analysis using mixed-effects modeling. Journal of Consulting and Clinical Psychology, 78(6), 936.
  • Panos, P. T., Jackson, J. W., Hasan, O., & Panos, A. (2014). Meta-analysis and systematic review assessing the efficacy of dialectical behavior therapy (DBT). Research on Social Work Practice, 24(2), 213-223.
  • Linehan, M. M., Korslund, K. E., Harned, M. S., Gallop, R. J., Lungu, A., Neacsiu, A. D., ... & Murray-Gregory, A. M. (2015). Dialectical behavior therapy for high suicide risk in individuals with borderline personality disorder: A randomized clinical trial and component analysis. JAMA Psychiatry, 72(5), 475-482.
  • Chapman, A. L. (2016). Dialectical behavior therapy: Current indications and unique elements. Psychiatry (Edgmont), 3(9), 62.
  • Neacsiu, A. D., Eberle, J. W., Kramer, R., Wiesmann, T., & Linehan, M. M. (2014). Dialectical behavior therapy skills for transdiagnostic emotion dysregulation: A pilot randomized controlled trial. Behaviour Research and Therapy, 59, 40-51.
  • Paris, J. (2017). Is hospitalization useful for suicidal patients with borderline personality disorder?. Journal of Personality Disorders, 31(1), 58-66.

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Integrative or Eclectic Therapy References


  • Norcross, J. C., & Goldfried, M. R. (Eds.). (2019). Handbook of psychotherapy integration (3rd ed.). Oxford University Press.
  • Cook, J. E., Biyanova, T., & Coyne, J. C. (2010). Barriers to adoption of new treatments: An internet study of practicing community psychotherapists. Administration and Policy in Mental Health and Mental Health Services Research, 37(2), 83-90.
  • Watson, J. C., Gordon, L. B., Stermac, L., Kalogerakos, F., & Steckley, P. (2010). Comparing the effectiveness of process‐experiential with cognitive‐behavioral psychotherapy in the treatment of depression. Journal of Consulting and Clinical Psychology, 74(6), 1030.
  • Wampold, B. E., & Imel, Z. E. (2015). The great psychotherapy debate: The evidence for what makes psychotherapy work (2nd ed.). Routledge.
  • Cooper, M. (2019). The challenge of counselling and psychotherapy research. Counselling Psychology Review, 24(3-4), 88-96.
  • Cuijpers, P., van Straten, A., Andersson, G., & van Oppen, P. (2010). Psychotherapy for depression in adults: A meta-analysis of comparative outcome studies. Journal of Consulting and Clinical Psychology, 77(6), 909.

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Narrative Therapy References


  • Vetlesen, A. J. (2015). Narrative exposure therapy: A short-term treatment for traumatic stress disorders. Journal of the American Academy of Child & Adolescent Psychiatry, 54(8), 688-696.
  • Mørkved, N., Winje, D., Dovran, A., Arefjord, K., Johnsen, I. H., Kroken, R. A., ... & Thimm, J. C. (2019). A pilot study of narrative exposure therapy in adolescents and young adults with borderline personality features and self-harm. Frontiers in Psychology, 10, 656.
  • Robjant, K., & Fazel, M. (2010). The emerging evidence for Narrative Exposure Therapy: A review. Clinical Psychology Review, 30(8), 1030-1039.
  • Grysman, A., & Hudson, J. A. (2013). Gender differences in autobiographical memory: Developmental and methodological considerations. Developmental Review, 33(3), 239-272.
  • Thomaes, K., Dorrepaal, E., Draijer, N., Jansma, E. P., Veltman, D. J., & van Balkom, A. J. (2014). Can pharmacological and psychological treatment change brain structure and function in PTSD? A systematic review. Journal of Psychiatric Research, 50, 1-15.
  • McLeod, J. (2013). An introduction to counselling. McGraw-Hill Education (UK).

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Solution-Focused Brief Therapy (SFBT) References


  • Franklin, C., Trepper, T. S., Gingerich, W. J., & McCollum, E. E. (2011). Solution-focused brief therapy: A handbook of evidence-based practice. Oxford University Press.
  • Kim, J. S. (2014). Examining the effectiveness of solution-focused brief therapy: A meta-analysis. Research on Social Work Practice, 24(3), 304-315.
  • De Shazer, S., & Dolan, Y. (2012). More than miracles: The state of the art of solution-focused brief therapy. Routledge.
  • Bond, C., Woods, K., Humphrey, N., Symes, W., & Green, L. (2013). Practitioner review: The effectiveness of solution-focused brief therapy with children and families: A systematic and critical evaluation of the literature from 1990–2010. Journal of Child Psychology and Psychiatry, 54(7), 707-723.
  • Stams, G. J., Deković, M., Buist, K., & de Vries, L. (2011). Efficacy of solution-focused brief therapy: A meta-analysis. Clinical Psychology Review, 31(4), 605-617.
  • Gingerich, W. J., & Peterson, L. T. (2013). Effectiveness of solution-focused brief therapy: A systematic qualitative review of controlled outcome studies. Research on Social Work Practice, 23(3), 266-283.

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Gestalt Therapy References


  • Roubal, J. (Ed.). (2016). Gestalt therapy in clinical practice: From psychopathology to the aesthetics of contact. Siracusa: Gestalt Press.
  • Brownell, P. (2016). Handbook for theory, research, and practice in gestalt therapy (2nd ed.). Newcastle upon Tyne: Cambridge Scholars Publishing.
  • Elliott, R., Watson, J. C., Goldman, R. N., & Greenberg, L. S. (2011). Learning emotion-focused therapy: The process-experiential approach to change. American Psychological Association.
  • Perls, F., Hefferline, R. F., & Goodman, P. (2010). Gestalt therapy: Excitement and growth in the human personality. Start Publishing LLC.
  • Yontef, G., & Jacobs, L. (2010). Gestalt therapy. In Corsini Encyclopedia of Psychology (4th ed.). Wiley.
  • Brown, M., & Pedder, J. (2015). Introduction to psychotherapy: An outline of psychodynamic principles and practice (4th ed.). Routledge.

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Schema Therapy References


  • Arntz, A., & Jacob, G. (2012). Schema therapy in practice: An introductory guide to the schema mode approach. Wiley.
  • Giesen-Bloo, J., & Arntz, A. (2013). Outpatient psychotherapy for borderline personality disorder: randomized trial of schema-focused therapy vs transference-focused psychotherapy. Archives of general psychiatry, 63(6), 649-658.
  • Rafaeli, E., Bernstein, D. P., & Young, J. (2011). Schema therapy: Distinctive features. Routledge.
  • Nordahl, H. M., & Nysæter, T. E. (2015). Schema therapy for patients with borderline personality disorder: a single case series. Journal of Behavior Therapy and Experimental Psychiatry, 48, 69-77.
  • Cockram, D. M., Drummond, P. D., & Lee, C. W. (2010). Role and treatment of early maladaptive schemas in Vietnam veterans with PTSD. Clinical psychology & psychotherapy, 17(3), 165-182.
  • Bamelis, L. L., Evers, S. M., Spinhoven, P., & Arntz, A. (2014). Results of a multicenter randomized controlled trial of the clinical effectiveness of schema therapy for personality disorders. American Journal of Psychiatry, 171(3), 305-322.

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Acceptance and Commitment Therapy (ACT) References


  • Hayes, S. C., & Hofmann, S. G. (Eds.). (2012). Process-based CBT: The science and core clinical competencies of cognitive behavioral therapy. New Harbinger Publications.
  • Swain, J., Hancock, K., Hainsworth, C., & Bowman, J. (2013). Acceptance and Commitment Therapy in the treatment of anxiety: A systematic review. Clinical psychology review, 33(8), 965-978.
  • A-tjak, J. G., Davis, M. L., Morina, N., Powers, M. B., Smits, J. A., & Emmelkamp, P. M. (2015). A meta-analysis of the efficacy of acceptance and commitment therapy for clinically relevant mental and physical health problems. Psychotherapy and Psychosomatics, 84(1), 30-36.
  • Öst, L. G. (2014). The efficacy of Acceptance and Commitment Therapy: An updated systematic review and meta-analysis. Behaviour research and therapy, 61, 105-121.
  • Forman, E. M., Herbert, J. D., Moitra, E., Yeomans, P. D., & Geller, P. A. (2012). A randomized controlled effectiveness trial of acceptance and commitment therapy and cognitive therapy for anxiety and depression. Behavior modification, 36(6), 742-766.
  • Levin, M. E., Hildebrandt, M. J., Lillis, J., & Hayes, S. C. (2012). The impact of treatment components suggested by the psychological flexibility model: A meta-analysis of laboratory-based component studies. Behavior therapy, 43(4), 741-756.

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Mindfulness-Based Cognitive Therapy (MBCT) References


  • Kuyken, W., Warren, F. C., Taylor, R. S., Whalley, B., Crane, C., Bondolfi, G., ... & Segal, Z. (2016). Efficacy of Mindfulness-Based Cognitive Therapy in Prevention of Depressive Relapse. JAMA Psychiatry, 73(6), 565-574.
  • Hofmann, S. G., Sawyer, A. T., Witt, A. A., & Oh, D. (2010). The effect of mindfulness-based therapy on anxiety and depression: A meta-analytic review. Journal of consulting and clinical psychology, 78(2), 169.
  • Gu, J., Strauss, C., Bond, R., & Cavanagh, K. (2015). How do mindfulness-based cognitive therapy and mindfulness-based stress reduction improve mental health and wellbeing? A systematic review and meta-analysis of mediation studies. Clinical psychology review, 37, 1-12.
  • van der Velden, A. M., Kuyken, W., Wattar, U., Crane, C., Pallesen, K. J., Dahlgaard, J., ... & Piet, J. (2015). A systematic review of mechanisms of change in mindfulness-based cognitive therapy in the treatment of recurrent major depressive disorder. Clinical psychology review, 37, 26-39.
  • Strauss, C., Cavanagh, K., Oliver, A., & Pettman, D. (2014). Mindfulness-based interventions for people diagnosed with a current episode of an anxiety or depressive disorder: A meta-analysis of randomised controlled trials. PLOS ONE, 9(4), e96110.
  • Crane, C., & Kuyken, W. (2013). The implementation of mindfulness-based cognitive therapy: Learning from the UK health service experience. Mindfulness, 4(3), 246-254.

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Family Systems Therapy References


  • Carr, A. (2014). The evidence base for couple therapy, family therapy and systemic interventions for adult-focused problems. Journal of Family Therapy, 36(2), 158-194.
  • Lebow, J. L. (2014). Couple and family therapy: An integrative map of the territory. American Psychological Association.
  • Sexton, T. L., & Datchi, C. (2014). The development and evolution of family therapy research: Its impact on practice, current status, and future directions. Family Process, 53(3), 415-433.
  • Asen, E., & Fonagy, P. (2012). Mentalization-based therapeutic interventions for families. Journal of Family Therapy, 34(4), 347-370.
  • Sprenkle, D. H. (Ed.). (2012). Effectiveness research in marriage and family therapy. American Association for Marriage and Family Therapy.
  • Miller, S. D., Hubble, M. A., & Duncan, B. L. (Eds.). (2013). Handbook of solution-focused brief therapy: Clinical applications. John Wiley & Sons.

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