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Background Children with mental health difficulties are at increased risk of many adverse psychological, academic, and social outcomes. Emotion regulation is a key transdiagnostic factor in the development and maintenance of mental health challenges. Parents and the family system (e.g., parental functioning, parenting, parent-child relationship) play a central role in children’s development of emotion regulation and, in turn, their mental health. Therefore, continued efforts are needed to understand the effectiveness of emotion-focused treatments for child mental health difficulties, particularly those that include a family-based approach. Emotion Focused Family Therapy (EFFT) is an intervention for parents of children with mental health difficulties that teaches parents advanced skills to support their child’s emotional development, potentially leading to improvements in the psychological functioning of the affected child as well as the family. Despite this, EFFT’s efficacy has yet to be tested empirically via a randomized controlled trial. Methods A six-week group modality of EFFT was developed based on the standard manualized version of a two-day group modality of EFFT. Efficacy of the six-week group modality of EFFT will be tested in a randomized controlled trial among parents of children aged 7 to 15 with anxiety, depression, or behavioral challenges. Parents will be randomized to the intervention condition or waitlist control condition. Online questionnaires and in-lab assessments will be conducted at pre-treatment, post-treatment, 4-month follow-up and 1-year follow-up. Intervention effects on primary (parent psychological symptoms, child psychological symptoms, parent emotion regulation, child emotion regulation, parent-child co-regulation) and secondary (parental emotion socialization, parent emotion blocks, parental self-efficacy, perceived parental stress, treatment satisfaction, treatment fidelity) outcomes will be analyzed by linear mixed models. Discussion The study protocol describes the randomized controlled trial of EFFT, a parent group intervention for parents of children with anxiety, depression, and behavioral challenges. Findings contribute to the understanding of the efficacy of EFFT as a time-limited, transdiagnostic intervention for the treatment of child mental health challenges with potential positive impacts on parent and family functioning. Trial registration [2a] ClinicalTrials.gov: NCT05603000. Prospectively registered October 13, 2022. Protocol version [3] Version 1.1 November 2023.

Background Premenstrual dysphoric disorder (PMDD) is a debilitating condition, affecting women of reproductive age. It is characterized by severe periodic physical and psychological symptoms, which end after the onset of menstruation. This study aimed to evaluate the effectiveness of emotion-focused therapy (EFT) for PMDD patients. Methods A total of 48 PMDD women, in the age range of 18–44 years, were randomly assigned to two intervention and control groups. The intervention group participated in 16 weeks of EFT treatment, while the control group was selected based on the waiting list (waitlist control group) and followed-up after three months. Forty-four patients finally completed this study. The participants completed the Premenstrual Syndrome Screening Tool (PSST), Difficulties in Emotion Regulation Scale (DERS), and Depression Anxiety Stress Scale-21 (DASS-21) in the first premenstrual period before treatment, the first premenstrual period after treatment, and the premenstrual period three months after treatment. Results Based on the repeated measure analysis of variances, the total score of DERS and the total score of PSST decreased significantly ( P  < 0.05). Also, in DASS-21, the scores of depression and stress subscales reduced significantly ( P  < 0.05), while there was no significant decrease in the score of anxiety subscale ( P  > 0.05). Conclusion Based on the present results, EFT can be an effective treatment for alleviating the symptoms of PMDD. This treatment can reduce the emotion regulation difficulties of women with PMDD and alleviate the symptoms of depression and stress. Trial registration Iranian Registry of Clinical Trials, IRCT ID: IRCT20220920055998N1, Registered on: 12/2/2023.

Objectives Intimate relationships can enhance quality of life and reduce the risk of psychological disorders. Self-disclosure, a fundamental component of intimacy, occurs only when vulnerability is met with acceptance rather than rejection. However, shame disrupts this process by inhibiting vulnerability and promoting defensive strategies, thereby undermining intimacy and relational security. This study aimed to address shame within an Emotionally Focused Couple Therapy framework to enhance intimacy. Method A randomized controlled design was employed. Twenty-six married couples were randomly assigned to either an experimental group or a control group. The Experience of Shame Scale and the Personal Assessment of Intimacy in Relationships were used as assessment tools. Results Compared with the control, EFCT significantly increased intimacy and reduced shame in the experimental group ( p  < 0.05). Conclusion Shame may disrupt both intimacy and the therapeutic relationship and should be addressed during treatment. The discussion outlines possible mechanisms of change. Trial registration This paper has been registered with the Clinical Trial ID (71773). It was registered on 2024/10/04. (Clinical Trial Number IRCT20230801058994N1)

Background Anxiety disorders are common psychological pregnancy problems that can lead to adverse pregnancy outcomes. The study aimed to compare the improvement of psychological distress between Internet-Based Emotion-Focused Cognitive Behavioral Therapy (iECBT) with and without husbands’ participation in pregnant women with anxiety disorders. Method In a randomized controlled trial, 84 pregnant women diagnosed with anxiety disorders were randomly assigned to two groups: iECBT alone ( n  = 42) and iECBT with their husband’s participation ( n  = 42). In a group of iECBT alone, women received eight sessions of iECBT (with a duration of 50 min) once a week. In the iECBT group with the husband’s participation, women received psychotherapy as same as iECBT alone, and their husbands received eight sessions (with a duration of 20 min) once a week. The outcomes were the Spielberger State-Trait Anxiety Inventory (STAI), the Brief Symptom Inventory 18, the pregnancy-specific stress, and Garnefski’s cognitive emotion regulation in the four-time series. Results The mean age of participants was about 30 years. Both iECBTs, with and without the husband’s participation, were effective in improving state anxiety, psychological distress, pregnancy-specific stress, and emotion regulation in pregnant women. iECBTs with and without the husband’s participation were not superior to each other regarding improving the outcomes. Conclusion As iECBT with the husband’s participation was not superior to iECBT alone, further studies should evaluate proper strategies to increase men’s effective role in the treatment of their pregnant partners with psychological disorders. Trial registration IRCT20110228005931N10.

Background Testicular cancer diagnosis and treatment, especially given its threat to sexuality and reproductive health, can be distressing in the formative period of young adulthood and the majority of young survivors experience impairing, distressing, and modifiable adverse outcomes that can persist long after medical treatment. These include psychological distress, impairment in pursuit of life goals, persistent physical side effects, elevated risk of secondary malignancies and chronic illness, and biobehavioral burden (e.g., enhanced inflammation, dysregulated diurnal stress hormones). However, few targeted interventions exist to assist young survivors in renegotiating life goals and regulating cancer-related emotions, and none focus on reducing the burden of morbidity via biobehavioral mechanisms. This paper describes the methodology of a randomized controlled biobehavioral trial designed to investigate the feasibility and preliminary impact of a novel intervention, Goal-focused Emotion-Regulation Therapy (GET), aimed at improving distress symptoms, emotion regulation, goal navigation skills, and stress-sensitive biomarkers in young adult testicular cancer patients. Methods Participants will be randomized to receive six sessions of GET or Individual Supportive Therapy (ISP) delivered over 8 weeks. In addition to indicators of intervention feasibility, we will measure primary (depressive and anxiety symptoms) and secondary (emotion regulation and goal navigation skills, career confusion) psychological outcomes prior to (T 0 ), immediately after (T 1 ), and 12 weeks after (T 2 ) intervention. Additionally, identified biomarkers will be measured at baseline and at T 2 . Discussion GET may have the potential to improve self-regulation across biobehavioral domains, improve overall cancer adjustment, and address the need for targeted supportive care interventions for young adult cancer survivors. Trial registration Clinicaltrials.gov , NCT04150848 . Registered on 28 October 2019.

Background Generalised anxiety disorder (GAD) is a chronic and debilitating condition characterised by high co-morbidity. Alongside pharmacological treatment, cognitive behavioural therapy (CBT) is an established psychological therapy for GAD. Its effectiveness is limited, however, with only an estimated 50% of clients presenting in the non-clinical range after a course of treatment. Furthermore, not all clients prefer CBT as a psychological therapy. Recently, emotion-focused therapy (EFT) was developed for GAD and was tested in an open trial with promising results. Methods/design The present research project is a feasibility testing randomised controlled trial (RCT) that compares the efficacy of EFT with an established treatment for GAD, CBT. Sixty clients presenting in a primary care psychology/counselling service will be randomly assigned to one of two conditions: EFT or CBT. Outcomes will be assessed using several measures (Generalised Anxiety Disorder-7, Generalised Anxiety Disorder Severity Scale, Patient Health Questionnaire-9, and Clinical Outcome in Routine Evaluation – Outcome Measure). Clients will be assessed prior to and at the end of therapy, as well as at 6-month follow-up. On the basis of findings from the initial open EFT trial with regard to the optimal length of therapy, it is proposed that therapy last between 16 and 20 sessions. Discussion This study aims to test the feasibility of a full comparison RCT. It will test subject recruitment, therapist adherence to manualised treatment, and client retention rates. It will also provide estimates of comparative outcomes that can inform power calculations for a definitive trial. Trial registration ISRCTN Registry, ISRCTN52689081 . Registered on 24 October 2017.

Purpose Young adult Latino testicular cancer survivors experience adverse impacts after treatment. We developed Goal-focused Emotion regulation Therapy (GET) to improve distress symptoms, goal navigation skills, and emotion regulation. This open pilot trial extended GET to Latino young adult survivors of testicular cancer and assessed feasibility and tolerability as well as changes in anxiety and depressive symptoms. Secondary outcomes included goal navigation, emotion regulation, and components of hope-related goal processes (i.e., agency and pathway mapping). To assess the extent to which GET is culturally congruent or in need of adaptation, the influence of simpatía and acculturative stress were also examined. Methods Thirty-five eligible young adult (age 18–39) survivors treated with chemotherapy were enrolled and assessed at baseline. Study acceptability, tolerability, and therapeutic alliance were examined. Preliminary efficacy was evaluated for changes in anxiety and depressive symptoms as well as psychological processes (goal navigation, agency, goal pathway skill, and emotion regulation) from baseline to immediate post- and 3-month post-intervention. Results Among the 35 men assessed at baseline, 54% initiated intervention sessions. Among these, 94.7% completed all study procedures. Helpfulness ratings of intervention components and therapeutic alliance scores were strong. Repeated measures ANOVA revealed significant reductions in anxiety and depressive symptoms from pre- to post-intervention with sustained change at the 3-month follow-up. Favorable patterns of change were also observed in GET-related psychological processes. Simpatía was associated with less depressive symptoms at post-intervention, but not change in anxiety. Acculturative stress was associated with increased anxiety and depressive symptoms over time. Conclusion GET is a feasible and acceptable intervention for reducing adverse outcomes after testicular cancer for young adult Latino men. Results should be considered preliminary but suggest meaningful changes in emotional and psychological outcomes.

This study investigates the effect of an emotion-focused group counseling program (EFGCP) on the emotional awareness and psychological well-being of divorced women. It also investigates their opinions regarding its effectiveness. This mixed-method study used a real experimental design with a 2 × 3 pretest–post-test control group with follow-up tests. It administered 16 EFGCP sessions to the experimental group and collected quantitative data from the Levels of Emotional Awareness Scale and Psychological Well-being Scale and qualitative data from client and group leader diaries and focus group interview forms. The quantitative data were analyzed using a mixed 2 × 3 repeated-measure analysis of variance, while the qualitative data were examined using content analysis. Quantitative findings showed that EFGCP increased the emotional awareness levels of divorced women in the experimental group compared with those in the control group. This effect continued for 3 months, and while it improved their psychological well-being, the improvement was not significant. Meanwhile, qualitative results were grouped under two categories: “contribution” and “emotion-focused group counseling.” The contribution category included four themes, namely, emotional awareness, psychological well-being, adaptation after divorce, and metaphors. However, the emotion-focused group counseling category included techniques, group leader, and recommendations for group structure themes. Implications for further research and practice are discussed in light of the literature.

Background: Although there are effective treatments for posttraumatic stress disorder (PTSD), there is little research on treatments with non-cognitive-behavioural backgrounds, such as gestalt therapy. We tested an integrative gestalt-derived intervention, dialogical exposure therapy (DET), against an established cognitive-behavioural treatment (cognitive processing therapy, CPT) for possible differential effects in terms of symptomatic outcome and drop-out rates. Methods: We randomized 141 treatment-seeking individuals with a diagnosis of PTSD to receive either DET or CPT. Therapy length in both treatments was flexible with a maximum duration of 24 sessions. Results: Dropout rates were 12.2% in DET and 14.9% in CPT. Patients in both conditions achieved significant and large reductions in PTSD symptoms (Impact of Event Scale - Revised; Hedges' g = 1.14 for DET and d = 1.57 for CPT) which were largely stable at the 6-month follow-up. At the posttreatment assessment, CPT performed statistically better than DET on symptom and cognition measures. For several outcome measures, younger patients profited better from CPT than older ones, while there was no age effect for DET. Conclusions: Our results indicate that DET merits further research and may be an alternative to established treatments for PTSD. It remains to be seen whether DET confers advantages in areas of functioning beyond PTSD symptoms.