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tasks, not affected by the direction. (d) However, for therapists with high client-specific self-efficacy, their underestimations were more associated with the less severe next-session symptoms of their clients than their overestimations. This association was not found among clients whose therapists' self-efficacies for them were low. The findings provide a deeper insight into the congruence of the working alliance. (PsycInfo Database Record (c) 2020 APA, all rights reserved).The "good-enough level" (GEL) model proposes that people respond differentially to psychotherapy, and that the typical curvilinear "dose-response" shape of change may be an artifact of aggregation. We conducted a systematic review and meta-analysis of the GEL literature to examine (a) whether different subgroups of adults accessing psychotherapy respond to therapy at different rates and (b) whether the shape of change is linear or nonlinear. This review was preregistered on PROSPERO. Fifteen studies were synthesized (n = 114,123), with 10 included across two meta-analyses (n = 46,921; n = 41,515). Systematic searches took place using Medline, PsycINFO and Scopus databases. A key inclusion criterion was that cases must be stratified by treatment length to examine the GEL. In support of the GEL, there was no overall association between treatment duration and outcomes (r = -0.24, 95% confidence interval [CI -0.70, 0.36], p = .27). Longer treatments were associated with higher baseline symptom scores (r = 0.15, 95% CI [0.08, 0.22], p less then .001) and slower rates of change. Different shapes of change were also evidenced Curvilinear responses were more often found in shorter treatments, while linear shapes were more often found in longer treatments. However, findings varied depending on methodological criteria used. Although rates of change varied in line with the GEL, most people nonetheless responded within defined boundaries as described in the dose-response literature. We therefore refer to the notion of "boundaried responsive regulation" to describe the relationship between treatment duration and outcomes. (PsycInfo Database Record (c) 2020 APA, all rights reserved).Psychotherapy clients often hold multiple and varied cultural identities, and it is important for therapists to attend to the intersectionality of clients' cultural identities, as well as the saliency of these identities. However, to date, few studies have considered the saliency of clients' multiple identities and how this may impact clients' perceptions of cultural processes in therapy. Therefore, this study utilized polynomial regression and response surface analysis to operationalize and examine congruent and discrepant effects between the saliency of clients' multiple identities and their perceptions of their therapists' cultural humility and cultural missed opportunities. Data for this study consisted of 87 clients who received individual counseling services at either a university counseling center or training clinic at two large universities in the United States. As hypothesized, results indicated significant discrepant effects between the saliency of clients' first and second most important cultural identities and perceptions of their therapists' cultural humility and cultural missed opportunities. Specifically, clients' ratings of their therapist's cultural missed opportunities were lowest when they reported either a) high saliency of cultural identity one and low saliency of cultural identity two, or b) low saliency of cultural identity one and high saliency of cultural identity two. buy MK-4827 Similarly, clients' ratings of their therapist's cultural humility were highest when they reported either a) high saliency of cultural identity one and low saliency of cultural identity two, or b) low saliency of cultural identity one and high saliency of cultural identity two. (PsycInfo Database Record (c) 2020 APA, all rights reserved).Microaggressions have been found to occur at high rates within individual therapeutic dyads, and negatively impact therapeutic processes and outcomes for clients. However, there has been limited attention to the occurrence and impact of racial microaggressions in a group therapy context. Therefore, this study sought to examine the occurrence and impact of racial microaggressions on clients' perceptions of group cohesion and improvement in group therapy, as well as the buffering role of members' perceptions of their group's multicultural orientation (MCO) on the impact of racial microaggressions. Data for this study consisted of 71 racial/ethnic minority (REM) clients across 38 interpersonal process therapy groups. Results indicated that 72% of participants reported experiencing at least 1 racial microaggression over the course of their group therapy experience. Contrary to our hypothesis, racial microaggressions were not associated with member's perceptions of group cohesion or improvement. However, results indicated that REM members' experiences of racial microaggressions had a stronger negative effect on their perceptions of group cohesion in groups with perceived low cultural comfort. This study documents the high prevalence of racial microaggressions in group therapy and the effect of the group's MCO on the relationship between racial microaggressions and REM members' perceptions of group cohesion. (PsycInfo Database Record (c) 2020 APA, all rights reserved).Most measures of psychotherapy outcome focus on symptomatic change. However, clients often report other changes through therapy, such as increased self-acceptance. This study reports on the development and validation of the Complementary Measure of Psychotherapy Outcome (COMPO) that assesses different areas of psychological functioning deemed important by clients and therapists. Items were written based on a literature review of client-reported change and feedback from experienced therapists. Exploratory factor analysis was conducted on the initial 42-item COMPO administered to 264 psychotherapy clients. Iterative item reduction resulted in the final 12-item, four-factor solution, with factors named self-acceptance, self-knowledge, relationship quality, and consideration of others. This factor structure, along with a bifactor model that contains a general factor and the four domain-specific factors, was replicated on a sample of 571 adults in the community. The 12-item COMPO exhibits convergent validity with measures of self-esteem, insight, social support, and empathy; demonstrates 2-week test-retest reliability; and predicts life satisfaction.