BackgroundThe course of depression is poorer in clinical settings than in the general population. Several predictors have been studied and there is growing evidence that a history of childhood maltreatment consistently predicts a poorer course of depression.MethodsBetween 2008 and 2012, we assessed 238 individuals suffering from a current episode of major depression. Fifty percent of these (N = 119) participated in a follow-up study conducted between 2012 and 2014 that assessed sociodemographic and clinical variables, the history of childhood abuse and neglect (using the Adverse Childhood Experience questionnaire), and the course of depression between baseline and follow-up interview (using the Life Chart method). The Structured Clinical Interview for DSM-IV-TR was used to assess diagnosis at baseline and follow-up interview. Statistical analyses used the life table survival method and Cox proportional hazard regression tests.ResultsAmong 119 participants, 45.4% did not recover or remit during the follow-up period. The median time to remission or recovery was 28.9 months and the median time to the first recurrence was 25.7 months. Not being married, a chronic index depressive episode, comorbidity with an anxiety disorder, and a childhood history of physical neglect independently predicted a slower time to remission or recovery. The presence of three or more previous depression episodes and a childhood history of emotional neglect were independent predictors of depressive recurrences.ConclusionsChildhood emotional and physical neglect predict a less favorable course of depression. The effect of childhood neglect on the course of depression was independent of sociodemographic and clinical variables.

Ten judges applied a twelvefold category system of good and very good moments of client movement, progress, improvement, process, or change to two consecutive middle sessions of experiential psychotherapy. The findings indicated a) a large proportion of good and very good moments in both sessions; b) the distribution of good and very good moments into a distinctive subset of the 12 categories; c) the occurrence of bursts or series of good moments rather than discrete events; d) in-session stages or phases of good moments; e) distinctive clusters of good and very good moments; andf) data-generated hypotheses of therapist methods effective in the occurrence and maintenance of very good moments.Many researchers have called for the study of good moments of welcomed and desirable client movement, progress, improvement, process, or change (

The purpose of this study was to examine the concept of microstrategies, i.e., organized patterns of sequential statements by therapists over a single session. The data consisted of the sequences of actual verbatim statements of prominent behavioral, clientcentered, and Gestalt therapists in eight sessions with six clients. Results indicated that each of the three therapists used an organized pattern of sequential statements, that each followed a distinctive microstrategy, that the same microstrategy tends to be used across different clients, and that predominantly the same microstrategy was used over a series of sessions with a single client. The concept of microstrategies is discussed as a useful investigative tool in psychotherapy process research.In describing the sequential process of what therapists do, the units are almost exclusively at the macro level, and typically refer to steps or phases over a series of sessions. These include macro units such as sequential aims and goals, phases or stages of psychotherapy, therapeutic programs and plans, therapeutic strategies, therapist

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