#therapyoutcomes — Public Fediverse posts
Live and recent posts from across the Fediverse tagged #therapyoutcomes, aggregated by home.social.
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DATE: July 28, 2026 at 11:00AM
SOURCE: PSYPOST.ORG** Research quality varies widely from fantastic to small exploratory studies. Please check research methods when conclusions are very important to you. **
-------------------------------------------------TITLE: Better personality functioning at the end of therapy is linked to long-term mental health
A recent study published in Comprehensive Psychiatry provides evidence that improving an individual’s underlying personality functioning during therapy helps sustain mental health gains long after the formal treatment ends. The research suggests that when patients experience improvements in their core ability to regulate emotions and relate to others, they are less likely to see a return of depression, anxiety, and physical symptoms a year later.
Personality functioning is a psychological concept that acts as a structural framework for mental health. “Clinicians in psychodynamic settings work on the assumption that symptoms often rest on something more basic, namely a person’s capacity to perceive themselves realistically, regulate emotion, and maintain contact with others, which is usually summarized as personality structure or, more commonly now, personality functioning,” said Jürgen Fuchshuber, a researcher at the Department of Psychoanalysis and Psychotherapy at the Medical University of Vienna.
When a person has impairments in this area, they often struggle to handle stress. These difficulties are frequently associated with a variety of psychiatric issues, including depression and anxiety.
In the context of psychotherapy, mental health professionals seek to understand how changes in these deep-seated personality traits influence more noticeable symptoms over time. Past research indicates that therapy can improve personality functioning. “Generally, I have been interested in applying quantitative empirical methods to psychodynamic theories for some time,” Fuchshuber said. “The data from the sample investigated in this study gave us the opportunity to take a real in depth look at some very interesting questions in this regard.”
Past studies have attempted to measure these changes, but they often struggled to pinpoint exact individual progress. “Earlier work with these data had shown that personality functioning and symptoms change together during treatment,” Fuchshuber noted. “While those results are valid and answer different questions from the ones we asked here, the methods used did not separate stable differences between patients from fluctuations within one patient over time, as the random intercept cross lagged panel model does.”
This advanced statistical approach allowed the team to isolate temporary, dynamic changes from a person’s general baseline traits. The scientists were specifically interested in the transition out of care.
“We were also curious about what happens after discharge, when the supporting effect of the therapeutic relationship falls away and patients have to rely on their own regulatory capacities,” Fuchshuber explained. It is relatively easy for a patient to feel better while they are in a highly supportive hospital environment. The real test often comes after discharge, when the patient must rely on their own internal coping skills.
To explore these dynamics, the scientists analyzed data from an existing large project known as the Multicenter Effectiveness Study of Inpatient Psychosomatic Psychotherapeutic Treatment. The study included 2,094 participants receiving mental health care at 19 different university hospitals in Germany. The sample was 68 percent female, with an average age of nearly 40 years. The patients received either day hospital or full inpatient care. Treatment included various approaches like cognitive-behavioral therapy and psychodynamic therapy.
The researchers tracked the participants across three distinct time points. The first measurement took place at baseline, when the patients were admitted to the hospital. The second measurement occurred at discharge, after an average of about 50 days of treatment. Finally, the third measurement was taken at a one-year follow-up point.
At each time point, the participants filled out a series of standardized questionnaires. To measure personality functioning, the researchers used a 12-item self-report survey that assesses impairments in self-perception and relationship models. Higher scores on this survey indicated more severe impairments.
The team also measured three specific categories of psychopathology. They used a widely recognized nine-item questionnaire to gauge the severity of depressive symptoms. A similar seven-item survey was used to assess generalized anxiety. Finally, they measured somatic symptoms using a 15-item questionnaire. Somatic symptoms are physical issues, such as pain or fatigue, that cause significant distress and can be linked to psychological stress.
The researchers applied their complex statistical model to see how fluctuations in these variables influenced one another over time. They controlled for factors like age, sex, and the duration of the hospital stay. During the active treatment phase, from admission to discharge, the scientists did not find that changes in personality functioning predicted changes in symptoms.
“The treatment context turned out to matter a lot,” Fuchshuber told PsyPost. “During the inpatient or day clinic treatment itself, a patient’s personality functioning did not predict how their symptoms developed. Symptom change in that phase was instead strongly tied to depressive symptoms at admission.”
Patients with higher initial depression scores tended to show less improvement in personality functioning. High baseline depression also predicted worse physical symptoms and higher anxiety at the time of discharge.
The therapeutic environment itself seemed to provide the necessary support for the patients, reducing the immediate need for internal coping skills. “A plausible reading is that the clinic itself provides a good deal of external structure and regulation, so individual differences in self regulation matter less while the patient is in it, and considerably more once they are on their own,” Fuchshuber explained.
The most prominent pattern emerged in the period after treatment ended, from hospital discharge to the one-year follow-up. “After discharge, this changed,” Fuchshuber said. “In that period, where a patient’s personality functioning stood at the end of treatment predicted their depressive, anxious and physical symptoms a year later.”
If a patient’s personality functioning at discharge remained poorer than their personal average, they were significantly more likely to experience increased depression, anxiety, and physical symptoms a year later. On the other hand, patients who achieved better-than-average improvements in their personality functioning by the end of their hospital stay tended to maintain their symptom relief.
In addition, depression at the time of discharge strongly predicted an increase in both anxiety and somatic symptoms at the one-year mark. This indicates that lingering depressive symptoms can have a broad, negative impact on a person’s overall physical and mental health long after therapy concludes. Interestingly, higher anxiety at admission predicted a slight decrease in depression and physical symptoms by discharge. The authors suggest this might be a statistical anomaly caused by the overlapping nature of anxiety and depression, where a temporary spike in anxiety triggers compensatory coping mechanisms.
These interconnected findings provide specific guidance for mental health professionals. “For treatment that would suggest depressive symptoms deserve early attention, while personality functioning is more relevant to whether gains hold up over the following year,” Fuchshuber noted. “But of course, these are statistical patterns within a large clinical sample, not a guarantee about any individual course of therapy.”
Some limitations should be considered when interpreting these findings. A notable issue is the amount of missing data at the one-year follow-up mark. Nearly 40 percent of the original patients did not complete the final set of questionnaires. It is possible that patients whose mental health deteriorated after leaving the hospital were less likely to respond to the follow-up surveys, which could skew the long-term estimates.
The complex statistical models used in this research estimate many variables at once. Because of this complexity, some of the observed pathways were relatively modest in size. The authors suggest that these specific long-term predictions need to be replicated in independent studies before clinical guidelines are officially changed.
Future research might explore exactly which types of therapeutic interventions are most effective at improving personality functioning. Understanding these mechanisms could help mental health professionals tailor their treatments to build deeper, more enduring coping skills in their patients. Monitoring personality functioning throughout therapy could help clinicians identify individuals who might need more intensive aftercare.
The study, “How personality functioning shapes symptom development during and after treatment: A random intercept cross lagged panel analysis,” was authored by Jürgen Fuchshuber, Henrik Kessler, Aram Kehyayan, Magdalena Pape, Tobias Hofmann, Matthias Rose, Katrin Imbierowicz, Franziska Geiser, Ilona Croy, Kerstin Weidner, Jörg Rademacher, Silke Michalek, Eva Morawa, Yesim Erim, Martin Teufel, Alexander Bäuerle, Stanislav Heinzmann, Claas Lahmann, Eva Milena Johanne Peters, Johannes Kruse, Dirk von Boetticher, Christoph Herrmann-Lingen, Mariel Nöhre, Martina de Zwaan, Ulrike Dinger, Hans-Christoph Friederich, Alexander Niecke, Christian Albus, Rüdiger Zwerenz, Manfred Beutel, Casper Roenneberg, Peter Henningsen, Barbara Stein, Christiane Waller, Karsten Hake, Carsten Spitzer, Andreas Stengel, Stephan Zipfel, Katja Weimer, Harald Gündel, Stephan Herpertz, and Stephan Doering.
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Private, vetted email list for mental health professionals: https://www.clinicians-exchange.org
Unofficial Psychology Today Xitter to toot feed at Psych Today Unofficial Bot @PTUnofficialBot
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#psychology #counseling #socialwork #psychotherapy @psychotherapist @psychotherapists @psychology @socialpsych @socialwork @psychiatry #mentalhealth #psychiatry #healthcare #depression #psychotherapist #personalityfunctioning #therapyoutcomes #mentalhealth #depression #anxiety #psychotherapy #longtermhealth #psychodynamictherapy #inpatientcare #posttreatmentcare
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DATE: July 28, 2026 at 11:00AM
SOURCE: PSYPOST.ORG** Research quality varies widely from fantastic to small exploratory studies. Please check research methods when conclusions are very important to you. **
-------------------------------------------------TITLE: Better personality functioning at the end of therapy is linked to long-term mental health
A recent study published in Comprehensive Psychiatry provides evidence that improving an individual’s underlying personality functioning during therapy helps sustain mental health gains long after the formal treatment ends. The research suggests that when patients experience improvements in their core ability to regulate emotions and relate to others, they are less likely to see a return of depression, anxiety, and physical symptoms a year later.
Personality functioning is a psychological concept that acts as a structural framework for mental health. “Clinicians in psychodynamic settings work on the assumption that symptoms often rest on something more basic, namely a person’s capacity to perceive themselves realistically, regulate emotion, and maintain contact with others, which is usually summarized as personality structure or, more commonly now, personality functioning,” said Jürgen Fuchshuber, a researcher at the Department of Psychoanalysis and Psychotherapy at the Medical University of Vienna.
When a person has impairments in this area, they often struggle to handle stress. These difficulties are frequently associated with a variety of psychiatric issues, including depression and anxiety.
In the context of psychotherapy, mental health professionals seek to understand how changes in these deep-seated personality traits influence more noticeable symptoms over time. Past research indicates that therapy can improve personality functioning. “Generally, I have been interested in applying quantitative empirical methods to psychodynamic theories for some time,” Fuchshuber said. “The data from the sample investigated in this study gave us the opportunity to take a real in depth look at some very interesting questions in this regard.”
Past studies have attempted to measure these changes, but they often struggled to pinpoint exact individual progress. “Earlier work with these data had shown that personality functioning and symptoms change together during treatment,” Fuchshuber noted. “While those results are valid and answer different questions from the ones we asked here, the methods used did not separate stable differences between patients from fluctuations within one patient over time, as the random intercept cross lagged panel model does.”
This advanced statistical approach allowed the team to isolate temporary, dynamic changes from a person’s general baseline traits. The scientists were specifically interested in the transition out of care.
“We were also curious about what happens after discharge, when the supporting effect of the therapeutic relationship falls away and patients have to rely on their own regulatory capacities,” Fuchshuber explained. It is relatively easy for a patient to feel better while they are in a highly supportive hospital environment. The real test often comes after discharge, when the patient must rely on their own internal coping skills.
To explore these dynamics, the scientists analyzed data from an existing large project known as the Multicenter Effectiveness Study of Inpatient Psychosomatic Psychotherapeutic Treatment. The study included 2,094 participants receiving mental health care at 19 different university hospitals in Germany. The sample was 68 percent female, with an average age of nearly 40 years. The patients received either day hospital or full inpatient care. Treatment included various approaches like cognitive-behavioral therapy and psychodynamic therapy.
The researchers tracked the participants across three distinct time points. The first measurement took place at baseline, when the patients were admitted to the hospital. The second measurement occurred at discharge, after an average of about 50 days of treatment. Finally, the third measurement was taken at a one-year follow-up point.
At each time point, the participants filled out a series of standardized questionnaires. To measure personality functioning, the researchers used a 12-item self-report survey that assesses impairments in self-perception and relationship models. Higher scores on this survey indicated more severe impairments.
The team also measured three specific categories of psychopathology. They used a widely recognized nine-item questionnaire to gauge the severity of depressive symptoms. A similar seven-item survey was used to assess generalized anxiety. Finally, they measured somatic symptoms using a 15-item questionnaire. Somatic symptoms are physical issues, such as pain or fatigue, that cause significant distress and can be linked to psychological stress.
The researchers applied their complex statistical model to see how fluctuations in these variables influenced one another over time. They controlled for factors like age, sex, and the duration of the hospital stay. During the active treatment phase, from admission to discharge, the scientists did not find that changes in personality functioning predicted changes in symptoms.
“The treatment context turned out to matter a lot,” Fuchshuber told PsyPost. “During the inpatient or day clinic treatment itself, a patient’s personality functioning did not predict how their symptoms developed. Symptom change in that phase was instead strongly tied to depressive symptoms at admission.”
Patients with higher initial depression scores tended to show less improvement in personality functioning. High baseline depression also predicted worse physical symptoms and higher anxiety at the time of discharge.
The therapeutic environment itself seemed to provide the necessary support for the patients, reducing the immediate need for internal coping skills. “A plausible reading is that the clinic itself provides a good deal of external structure and regulation, so individual differences in self regulation matter less while the patient is in it, and considerably more once they are on their own,” Fuchshuber explained.
The most prominent pattern emerged in the period after treatment ended, from hospital discharge to the one-year follow-up. “After discharge, this changed,” Fuchshuber said. “In that period, where a patient’s personality functioning stood at the end of treatment predicted their depressive, anxious and physical symptoms a year later.”
If a patient’s personality functioning at discharge remained poorer than their personal average, they were significantly more likely to experience increased depression, anxiety, and physical symptoms a year later. On the other hand, patients who achieved better-than-average improvements in their personality functioning by the end of their hospital stay tended to maintain their symptom relief.
In addition, depression at the time of discharge strongly predicted an increase in both anxiety and somatic symptoms at the one-year mark. This indicates that lingering depressive symptoms can have a broad, negative impact on a person’s overall physical and mental health long after therapy concludes. Interestingly, higher anxiety at admission predicted a slight decrease in depression and physical symptoms by discharge. The authors suggest this might be a statistical anomaly caused by the overlapping nature of anxiety and depression, where a temporary spike in anxiety triggers compensatory coping mechanisms.
These interconnected findings provide specific guidance for mental health professionals. “For treatment that would suggest depressive symptoms deserve early attention, while personality functioning is more relevant to whether gains hold up over the following year,” Fuchshuber noted. “But of course, these are statistical patterns within a large clinical sample, not a guarantee about any individual course of therapy.”
Some limitations should be considered when interpreting these findings. A notable issue is the amount of missing data at the one-year follow-up mark. Nearly 40 percent of the original patients did not complete the final set of questionnaires. It is possible that patients whose mental health deteriorated after leaving the hospital were less likely to respond to the follow-up surveys, which could skew the long-term estimates.
The complex statistical models used in this research estimate many variables at once. Because of this complexity, some of the observed pathways were relatively modest in size. The authors suggest that these specific long-term predictions need to be replicated in independent studies before clinical guidelines are officially changed.
Future research might explore exactly which types of therapeutic interventions are most effective at improving personality functioning. Understanding these mechanisms could help mental health professionals tailor their treatments to build deeper, more enduring coping skills in their patients. Monitoring personality functioning throughout therapy could help clinicians identify individuals who might need more intensive aftercare.
The study, “How personality functioning shapes symptom development during and after treatment: A random intercept cross lagged panel analysis,” was authored by Jürgen Fuchshuber, Henrik Kessler, Aram Kehyayan, Magdalena Pape, Tobias Hofmann, Matthias Rose, Katrin Imbierowicz, Franziska Geiser, Ilona Croy, Kerstin Weidner, Jörg Rademacher, Silke Michalek, Eva Morawa, Yesim Erim, Martin Teufel, Alexander Bäuerle, Stanislav Heinzmann, Claas Lahmann, Eva Milena Johanne Peters, Johannes Kruse, Dirk von Boetticher, Christoph Herrmann-Lingen, Mariel Nöhre, Martina de Zwaan, Ulrike Dinger, Hans-Christoph Friederich, Alexander Niecke, Christian Albus, Rüdiger Zwerenz, Manfred Beutel, Casper Roenneberg, Peter Henningsen, Barbara Stein, Christiane Waller, Karsten Hake, Carsten Spitzer, Andreas Stengel, Stephan Zipfel, Katja Weimer, Harald Gündel, Stephan Herpertz, and Stephan Doering.
-------------------------------------------------
Private, vetted email list for mental health professionals: https://www.clinicians-exchange.org
Unofficial Psychology Today Xitter to toot feed at Psych Today Unofficial Bot @PTUnofficialBot
-------------------------------------------------
#psychology #counseling #socialwork #psychotherapy @psychotherapist @psychotherapists @psychology @socialpsych @socialwork @psychiatry #mentalhealth #psychiatry #healthcare #depression #psychotherapist #personalityfunctioning #therapyoutcomes #mentalhealth #depression #anxiety #psychotherapy #longtermhealth #psychodynamictherapy #inpatientcare #posttreatmentcare
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Beyond Willpower in Addiction: 4 Powerful Lessons
Originally Published on November 11th, 2025 at 08:00 amWe often think of addiction as a private, grueling battle of willpower.
Whether it’s a dependency on a substance, a behavior like gambling, or even an unhealthy pattern in a relationship, the prevailing narrative suggests that breaking free is a matter of pure, individual strength.
If you just try hard enough, you can overcome it. If you fail, it’s a personal failing.
But what if this framework is fundamentally flawed? A recent, year-long study offers a more structured, hopeful, and evidence-based path to recovery.
Researchers applied a specific form of therapy, Cognitive Behavioral Therapy (CBT), to individuals struggling with a range of addictions and discovered that the right tools can do more than just help people cope; they can fundamentally transform their lives.
It’s about building a life so full and satisfying that the addiction no longer has room to thrive.
This year-long study is particularly significant because it was conducted in Kazakhstan, a region where evidence-based psychotherapy is still emerging and social stigma can be a major barrier to recovery.
This article distills the four most impactful takeaways from this groundbreaking research. It reveals how a systematic therapeutic approach can lead to profound, measurable life changes, challenging the myth that recovery is simply a matter of gritting your teeth and pushing through.
Lesson 1: The Change to Isn’t Small, It’s Transformative
While we might expect therapy to offer some benefit, the sheer magnitude of improvement seen in this study was extraordinary.
Participants who received Cognitive Behavioral Therapy didn’t just get slightly better; they experienced a dramatic and measurable enhancement in their overall well-being.
The study used the World Health Organization’s Quality of Life scale (WHOQOL-BREF), which measures well-being across four key areas. The results were staggering.
On average, the experimental groups saw their quality of life scores jump from the low 40s to the mid-70s on a 100-point scale. To put that in concrete terms, participants with alcohol use disorder went from an average score of 42.31 before therapy to 74.47 after one year.
This isn’t just a number on a chart; it represents a profound shift from a life constrained by addiction to one filled with new possibilities and well-being.
Meanwhile, the control groups, those who did not receive CBT, saw no meaningful improvement in their quality of life, with their average scores remaining essentially unchanged.
This powerful contrast repositions recovery as a genuine opportunity to build a measurably better and more satisfying life.
It’s about building a life so full and satisfying that the addiction no longer has room to thrive.
Are you exploring your trauma? Do you feel your childhood experiences were detrimental to your current mental or physical health? Utilize this free, validated, self-report questionnaire to find out.
Take the Adverse Childhood Experience (ACE) Questionnaire
Beyond Willpower Lesson 2: The Same Tools Can Fix Different Problems
One of the most compelling aspects of the study was its breadth.
Researchers applied the same core therapeutic model, CBT, to four very different challenges:
- Alcohol use disorder
- Drug addiction
- Gambling disorder
- Codependency
The key finding was that CBT was highly effective across the board.
For every single group that received therapy, there was a statistically significant reduction in the severity of their addiction. The data paints a clear picture of this versatility:
- For drug addiction, the experimental group’s average severity score dropped from 7.96 (signifying harmful use) down to 3.14 (representing low-risk or minimal use).
- For gambling disorder, the average severity score plummeted from a “severe” 39.55 to a “mild or moderate” 14.36.
This suggests that no matter the substance or behavior, the underlying challenge is often the same: learning to recognize triggers, challenge automatic negative thoughts, and develop new, healthier coping strategies.
CBT provides a toolkit for rewiring these exact processes, effectively helping people move from a place of denial or ambivalence into decisive action and long-term maintenance.
Do you have enough hours for your LPC renewal? Are you in need of continuing education, but bored with the current offerings? Check out Dr. Weeks’ course on Cannabis Use Disorder, and other unique courses on her practice website.
Sexual Addiction Treatment Services has been approved by NBCC as an Approved Continuing Education Provider, ACEP No. 7250. Programs that do not qualify for NBCC credit are clearly identified. Sexual Addiction Treatment Services is solely responsible for all aspects of the programs.
Lesson 3: Codependency Isn’t Just a “Relationship Problem.” It’s Treatable.
The study took the significant step of including codependency, an excessive emotional or psychological dependence on a partner, often linked to that partner’s addiction, alongside clinical addictions. While codependency is not formally classified as a standalone diagnosis in major manuals like the DSM-5-TR, the researchers recognized it as a clinically significant phenomenon that is actively addressed in rehabilitation.
The results were a powerful validation of this approach.
The experimental group for codependency saw their average severity scores drop from a “high level” of 69.12 to a “moderate or low level” of 31.44. The control group, in stark contrast, showed no significant change.
For anyone who has felt trapped in a dynamic of supporting someone else’s addiction at the expense of their own well-being, this finding is a beacon of hope.
This is a crucial takeaway.
It frames the struggle of codependency not as a character flaw or an intractable relationship dynamic, but as a treatable condition. It offers empowerment and a clear path toward building greater independence, self-esteem, and healthier relationship dynamics.
Beyond Willpower Lesson 4: Recovery Isn’t Just Stopping, It’s a Total Life Upgrade
The study’s design was brilliant in its simplicity: it measured success in two ways. It tracked the reduction of the negative (addiction severity) and the increase of the positive (overall quality of life). The results showed that these two things are deeply intertwined.
The “quality of life” assessment wasn’t a vague feeling of happiness; it was a concrete evaluation of four essential domains of life:
- Physical Health: Including energy and fatigue, quality of sleep, and even physical mobility.
- Psychological Health: Covering everything from positive feelings and self-esteem to the ability to concentrate and learn new things.
- Social Relationships: Examining the quality of personal relationships, the strength of social support networks, and even sexual activity.
- Environment: Looking at practical, real-world factors like financial security, physical safety, the comfort of one’s home, and access to healthcare.
The participants who underwent CBT saw significant improvements across all of these areas. This demonstrates that effective treatment doesn’t just happen in a therapist’s office. It radiates outward, improving every facet of a person’s existence.
True recovery, as this study shows, is about building a life that is so robust and fulfilling that the old addictive behaviors no longer hold the same power or appeal.
Conclusion: A New Framework for Change
The findings from this study in Kazakhstan provide a powerful, evidence-based roadmap for recovery that moves far beyond the limited concept of willpower.
It shows that addiction, in its many forms, is not a moral failing but a condition that responds remarkably well to structured, compassionate, and science-backed intervention.
By focusing on cognitive and behavioral strategies, individuals can achieve not just abstinence, but a transformative and holistic improvement in their lives. The tools exist, the evidence is clear, and the potential for change is immense.
This research leaves us with a vital question to consider:
If we can treat these complex issues so effectively, what does that change about how we should approach mental health and personal growth in our own lives?
Are you a professional looking to stay up-to-date with the latest information on, sex addiction, trauma, and mental health news and research? Or maybe you’re looking for continuing education courses? Then you should stay up-to-date with all of Dr. Jen’s work through her practice’s newsletter!
Do you feel your sexual behavior, or that of someone you love, is out of control? Then you should consult with a professional.
Are you looking for more reputable data-backed information on sexual addiction? The Mitigation Aide Research Archive is an excellent source for executive summaries of research studies.
#addiction #addictionRecovery #addictionTreatment #alcoholAbuse #alcoholRecovery #alcoholUse #alcoholUseDisorder #cbt #cognitiveBehavioralTherapy #drugAbuse #drugAddiction #drugAddictionRecovery #drugUse #evidenceBasedTherapy #gambling #gamblingAddiction #kazakhstan #therapyOutcomes #willpower