Research Department of Clinical, Educational and Health Psychology.
J Couns Psychol. 2022 Oct;69(5):678-690. doi: 10.1037/cou0000625. Epub 2022 Jun 23.
Although the theory of epistemic trust has started informing research in clinical populations and psychotherapy, no study has yet explored the phenomenon of epistemic trust and mistrust in depressed adolescents receiving psychotherapy. The present study aims to address this gap by creating a typology of depressed adolescents' experiences regarding their different journeys through the course of psychotherapy in relation to issues of epistemic trust and mistrust over a 2-year period. This study is based on a post hoc analysis of interview data collected for a broader purpose. A total of 45 semistructured interviews at three time points were conducted with 15 adolescents (80% female; age = 15.28, = 1.79) who entered treatment with indications of epistemic mistrust or hypervigilance. These interviews were qualitatively analyzed using ideal type analysis. Three distinct journeys of adolescents' experiences were identified. Some experienced a shift from epistemic mistrust to epistemic trust which seemed to be associated with the experience of therapy; other adolescents also showed a shift but did not consider it as an outcome of therapy; and finally, some adolescents reported continued mistrust over the 2-year period. An interpersonal component within or beyond therapy may be the key to breaking the vicious cycle of epistemic mistrust and generating epistemic trust; but not all depressed adolescents in therapy achieve this. Particular attention should be drawn to depressed adolescents who have difficulty making use of therapy and/or their broader social environment. Psychological interventions may need to openly address their issues of mistrust in early sessions as epistemic mistrust or hypervigilance may hinder paths to learning both within and beyond therapy. Treatments that intervene at the level of the wider social system are encouraged. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
虽然认知信任理论已经开始为临床人群和心理治疗的研究提供信息，但尚无研究探讨接受心理治疗的抑郁青少年的认知信任和不信任现象。本研究旨在通过在 2 年的时间内，针对认知信任和不信任问题，为抑郁青少年在心理治疗过程中的不同经历创建一个类型学，从而填补这一空白。本研究基于更广泛目的收集的访谈数据的事后分析。在三个时间点共对 15 名青少年（80%为女性；年龄=15.28，=1.79）进行了 45 次半结构化访谈，他们进入治疗时表现出认知不信任或过度警惕的迹象。这些访谈使用理想类型分析进行了定性分析。确定了青少年经历的三种不同的旅程。一些人经历了从认知不信任到认知信任的转变，这似乎与治疗体验有关；其他青少年也经历了转变，但不认为这是治疗的结果；最后，一些青少年在 2 年内报告持续存在不信任。治疗过程中或之外的人际成分可能是打破认知不信任的恶性循环并产生认知信任的关键；但并非所有接受治疗的抑郁青少年都能做到这一点。应特别关注那些在治疗中难以利用治疗和/或更广泛的社会环境的抑郁青少年。心理干预可能需要在早期阶段公开解决他们的不信任问题，因为认知不信任或过度警惕可能会阻碍治疗内外的学习途径。鼓励采取干预更广泛社会系统层面的治疗方法。（PsycInfo 数据库记录（c）2022 APA，保留所有权利）。
