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Holmqvist, Rolf, ProfessorORCID iD iconorcid.org/0000-0003-2093-2510
Alternative names
Publications (10 of 72) Show all publications
Alexandersson, K., Wågberg, M., Ekeblad, A., Holmqvist, R. & Falkenström, F. (2023). Session-to-session effects of therapist adherence and facilitative conditions on symptom change in CBT and IPT for depression. Psychotherapy Research, 33(1: special sektion part 2), 57-69
Open this publication in new window or tab >>Session-to-session effects of therapist adherence and facilitative conditions on symptom change in CBT and IPT for depression
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2023 (English)In: Psychotherapy Research, ISSN 1050-3307, E-ISSN 1468-4381, Vol. 33, no 1: special sektion part 2, p. 57-69Article in journal (Refereed) Published
Abstract [en]

Objective: The objective of this study was to analyze the effect of adherence to both specific technique factors and facilitative condition variables (e.g., therapists involvement, understanding and support) in Cognitive Behavior Therapy (CBT) and Interpersonal Psychotherapy (IPT). In addition, we were interested in whether the effect of therapist adherence would depend on the level of the working alliance. Method: Three sessions each from 74 patients diagnosed with Major Depressive Disorder who were randomized to 14 sessions of IPT or CBT were rated for adherence using a modified version of The Collaborative Study Psychotherapy Rating Scale-6 (CSPRS-6). Data was analyzed using Multilevel Modeling. Results: No effects of adherence to specific factors on outcome were found in neither CBT nor IPT. Facilitative conditions were associated with better outcome in CBT but not in IPT, even after adjustment for the quality of the working alliance. No interaction effects were found. Conclusions: Our findings highlight the importance of relational factors in CBT, but do not support the need for specific adherence to any of the two treatments. Possible explanations of the findings and directions for future research are discussed.

Place, publisher, year, edition, pages
Routledge; Taylor & Francis, 2023
Keywords
cognitive behavior therapy; interpersonal psychotherapy; depression; psychotherapy process; within-patient effects; adherence; facilitative conditions; alliance; psychotherapy outcome
National Category
Applied Psychology
Identifiers
urn:nbn:se:liu:diva-182622 (URN)10.1080/10503307.2022.2025626 (DOI)000745876600001 ()35068364 (PubMedID)
Available from: 2022-02-01 Created: 2022-02-01 Last updated: 2023-11-16
Åkerman, A., Holmqvist, R. & Falkenström, F. (2023). What changes during specialized foster care? A study on adaptive functioning and emotional and social problems. Child & Family Social Work, 28(2), 405-416
Open this publication in new window or tab >>What changes during specialized foster care? A study on adaptive functioning and emotional and social problems
2023 (English)In: Child & Family Social Work, ISSN 1356-7500, E-ISSN 1365-2206, Vol. 28, no 2, p. 405-416Article in journal (Refereed) Published
Abstract [en]

Various models of specialized foster care have been developed, but research on them is limited. This longitudinal, exploratory study analysed data on adaptive functioning, emotional and social problems and self-concept in a specialized foster care service in Sweden. The focus of the study was on the development of the children and young people in placement. The Adaptive Behaviour Assessment System (ABAS-II) was used to measure adaptive functioning, and the Beck Youth Inventories of Emotional and Social Impairment (BYI) was used to measure self-rated emotional and social problems and self-concept. Self-ratings showed significant improvements in disruptive behaviour, anger, anxiety and depression. Adaptive functioning as rated by foster parents improved but not enough to catch up with the non-clinical norm group. The average adaptive functioning among the participants at baseline was considerably below the Swedish norm group. Similar to the results of a previous study of the same treatment model, children and young people rated improvement while their foster parents did not do so to the same extent. Possible explanations for this are discussed in the paper. The study is limited by the lack of a control group and by data attrition.

Place, publisher, year, edition, pages
John Wiley & Sons, 2023
Keywords
adaptive functioning; emotional problems; outcome; self-concept; social problems; specialized Foster Care
National Category
Social Work
Identifiers
urn:nbn:se:liu:diva-188765 (URN)10.1111/cfs.12972 (DOI)000855610400001 ()2-s2.0-85138299342 (Scopus ID)
Available from: 2022-09-26 Created: 2022-09-26 Last updated: 2024-01-10
Kullgard, N., Holmqvist, R. & Andersson, G. (2022). Premature Dropout From Psychotherapy: Prevalence, Perceived Reasons and Consequences as Rated by Clinicians. Clinical Psychology in Europe, 42(2), Article ID e6695.
Open this publication in new window or tab >>Premature Dropout From Psychotherapy: Prevalence, Perceived Reasons and Consequences as Rated by Clinicians
2022 (English)In: Clinical Psychology in Europe, E-ISSN 2625-3410, Vol. 42, no 2, article id e6695Article in journal (Refereed) Published
Abstract [en]

Background: Why clients discontinue their psychotherapies has attracted more attention recently as it is a major problem for many healthcare services. Studies suggest that dropout rates may be affected by the mode of therapy, low-quality therapeutic alliance, low SES, and by conditions such personality disorders or substance abuse. The aims of the study were to investigate what happens in therapies which end in a dropout, and to estimate how common dropout is as reported by practicing clinicians. Method: An online questionnaire was developed and completed by 116 therapists working in clinical settings. They were recruited via social media (Facebook and different online psychotherapy groups) in Sweden and worked with Cognitive Behavioural Therapy (CBT), Psychodynamic Therapy (PDT), Interpersonal Psychotherapy (IPT) and Integrative Psychotherapy (IP). Results: Psychotherapists rated the frequency of premature dropout in psychotherapy to be on average 8.89% (MD = 5, SD = 8.34, Range = 0-50%). The most common reasons for a dropout, as stated by the therapists, were that clients were not satisfied with the type of intervention offered, or that clients did not benefit from the treatment as they had expected. The most common feeling following a dropout was self-doubt. Conclusion: In conclusion, premature dropout is common in clinical practice and has negative emotional consequences for therapists. Premature dropout may lead to feelings of self-doubt and powerlessness among therapists. The therapeutic alliance was mostly rated as good in dropout therapies. Further research is needed to validate the findings with data on the prevalence and subjective reasons behind a dropout from point of view of clients. © Lublin Studies in Modern Languages and Literature.All rights reserved.

Place, publisher, year, edition, pages
PsychOpen, 2022
Keywords
premature dropout; psychotherapy; psychotherapy dropout; therapeutic alliance
National Category
Applied Psychology
Identifiers
urn:nbn:se:liu:diva-193317 (URN)10.32872/cpe.6695 (DOI)36397946 (PubMedID)2-s2.0-85133615285 (Scopus ID)
Note

Funding Agencies|Linköpings Universitet, LiU

Available from: 2023-05-01 Created: 2023-05-01 Last updated: 2023-08-21
Holmqvist, R. (2021). Principles and practices of relational psychotherapy (1ed.). Abingdon: Routledge
Open this publication in new window or tab >>Principles and practices of relational psychotherapy
2021 (English)Book (Other academic)
Place, publisher, year, edition, pages
Abingdon: Routledge, 2021. p. 252 Edition: 1
Keywords
Psykoterapi
National Category
Psychiatry
Identifiers
urn:nbn:se:liu:diva-188475 (URN)9780367461027 (ISBN)
Available from: 2022-09-13 Created: 2022-09-13 Last updated: 2022-12-21Bibliographically approved
Nilsson, D., Lejonclou, A. & Holmqvist, R. (2020). Psychoform and somatoform dissociation among individuals with eating disorders. Nordic Journal of Psychiatry, 74(1), 1-8
Open this publication in new window or tab >>Psychoform and somatoform dissociation among individuals with eating disorders
2020 (English)In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 74, no 1, p. 1-8Article in journal (Refereed) Published
Abstract [en]

Objective: This study analyzed the prevalence of psychoform and somatoform dissociation among individuals with the whole spectrum of eating disorder diagnoses and compared it with ratings from a non-clinical group. The relationship between dissociation and severity of eating disturbance was examined as well as differences between the eating disorder diagnosis groups in extent of dissociation. The validity of a new structural dissociation interview suitable for eating disorder patients was analyzed.

Method: Sixty individuals with eating disorder completed three self-report questionnaires: Dissociation Questionnaire Sweden, Somatoform Dissociation Questionnaire and Eating Disorder Examination Questionnaire. The ratings were compared with the scores in a female non-clinical group (N = 245). Twenty patients with eating disorder diagnoses were interviewed with the Interview for Dissociative Disorders and Trauma Related Symptoms. The validity of the interview was tested by comparing the ratings on the interview subscales with the scores on the Dissociation questionnaires and the Somatoform Dissociation Questionnaire.

Results: Participants with eating disorders reported a higher extent of both psychoform and somatoform dissociation compared with the non-clinical individuals. Analyses also showed a correlation between degree of dissociation and severity of eating disorder symptoms. No differences in dissociation were found between the ED subgroups. Participants reporting more dissociation got higher ratings on the interview, indicating convergent validity.

Discussion: Eating disorders seem to be associated with presence and severity of dissociative symptoms. The extent of dissociation needs to be assessed for these individuals as treatment may benefit from a focus on such symptoms in order to increase its effect.

Place, publisher, year, edition, pages
Taylor & Francis, 2020
Keywords
Dissociation; psychoform; somatoform; eating, disorder; young adults
National Category
Psychiatry
Identifiers
urn:nbn:se:liu:diva-160526 (URN)10.1080/08039488.2019.1664631 (DOI)000485377100001 ()31509059 (PubMedID)
Note

Funding agencies: Department of Research and Development, Region Ostergotland; Gyllenstiernska Krapperup stiftelsen

Available from: 2019-09-25 Created: 2019-09-25 Last updated: 2021-04-29Bibliographically approved
Andersson, Y., Holmqvist, R. & Nilsson, D. (2019). Child Evacuations During World War II: This ShouldNot Happen Again. Journal of Loss and Trauma, 24(3), 213-225
Open this publication in new window or tab >>Child Evacuations During World War II: This ShouldNot Happen Again
2019 (English)In: Journal of Loss and Trauma, ISSN 1532-5024, Vol. 24, no 3, p. 213-225Article in journal (Refereed) Published
Abstract [en]

There is little research about the long-term effects on childrenthat were separated from their parents and moved fromFinland to Sweden during World War II. The aim of this studywas to capture these now-lifelong reflections, and so questionnaireswere sent to 14 potential participants. Ten personsaged 7381 responded. The themes that emerged concernedpride over professional achievements, the pain of separation,and feelings of alienation and loneliness. The informantsemphasized the importance of sibling relationships. The conclusionwas that the participants, despite the hardships connectedwith the migration, had successfully lived a good lifein Sweden.ARTICLE HISTORYReceived 16 July 2018Accepted 11 May 2018KEYWORDSFinnish war children; childseparations; childevacuation; importance ofsibling relationsAt

Place, publisher, year, edition, pages
UK: Routledge, 2019
Keywords
Finish warchildren, child separations, childevacuation, imprtance of siblingrelations
National Category
Nursing
Identifiers
urn:nbn:se:liu:diva-155074 (URN)10.1080/15325024.2018.1549198 (DOI)000465767700001 ()
Available from: 2019-03-13 Created: 2019-03-13 Last updated: 2020-04-08Bibliographically approved
Holmqvist, R. & Herlofson, J. (2019). Fokus på individen – framtidens melodi inom psykiatrisk behandling. Läkartidningen, 16(14)
Open this publication in new window or tab >>Fokus på individen – framtidens melodi inom psykiatrisk behandling
2019 (Swedish)In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 16, no 14Article in journal (Other (popular science, discussion, etc.)) Published
Abstract [sv]

Definitionen av psykisk sjukdom har avgörande betydelse för vårdens organisation och utformningen av behandlings-utbudet. Personcentrerad vårdideologi är en väg vidare för psykiatrin, anser författarna till denna artikel om skilda förhållningssätt till psykopatologin.

Place, publisher, year, edition, pages
Stockholm, Sweden: Läkartidningen Förlag AB, 2019
National Category
Psychiatry
Identifiers
urn:nbn:se:liu:diva-165419 (URN)
Available from: 2020-05-01 Created: 2020-05-01 Last updated: 2020-05-05Bibliographically approved
Holmqvist Larsson, M., Björkman, K., Nilsson, K., Falkenström, F. & Holmqvist, R. (2019). The Alliance and Rupture Observation Scale (AROS): Development and validation of an alliance and rupture measure for repeated observations within psychotherapy sessions. Journal of Clinical Psychology, 75(3), 404-417
Open this publication in new window or tab >>The Alliance and Rupture Observation Scale (AROS): Development and validation of an alliance and rupture measure for repeated observations within psychotherapy sessions
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2019 (English)In: Journal of Clinical Psychology, ISSN 0021-9762, E-ISSN 1097-4679, Vol. 75, no 3, p. 404-417Article in journal (Refereed) Published
Abstract [en]

Objective: The aim of this study was to test a new observer-rated instrument, the Alliance and Rupture Observation Scale (AROS). It was designed for repeated measurements of the alliance within sessions and to detect alliance ruptures.

Method: Videotaped therapy sessions with depressed adults were analyzed. Reliability was mainly assessed as inter-rater reliability. Convergent, predictive, and discriminant validity of the AROS was assessed by comparing the instrument with both observer-rated and patient-rated measures.

Results: The AROS exhibited excellent inter-rater reliability. Alliance levels measured with the AROS predicted patients’ ratings of the alliance in the same session and were highly correlated with another observer-rated alliance measure. Alliance patterns (rupture; repair; and no-rupture) based on AROS scores were significantly correlated with patients’ ratings of the alliance.

Conclusions: Preliminary support for convergent and predictive validity was found. It is yet to be determined whether AROS scores are related to psychotherapy outcomes.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
alliance ruptures and repairs, measurement, observer-based alliance measure, psychotherapy process, test development, therapeutic alliance, therapeutic relationship
National Category
Psychology
Identifiers
urn:nbn:se:liu:diva-154932 (URN)10.1002/jclp.22704 (DOI)000459626300006 ()30431649 (PubMedID)2-s2.0-85056660476 (Scopus ID)
Available from: 2019-03-06 Created: 2019-03-06 Last updated: 2019-06-27Bibliographically approved
Holmqvist Larsson, M., Falkenström, F., Andersson, G. & Holmqvist, R. (2018). Alliance ruptures and repairs in psychotherapy in primary care. Psychotherapy Research, 28(1), 123-136
Open this publication in new window or tab >>Alliance ruptures and repairs in psychotherapy in primary care
2018 (English)In: Psychotherapy Research, ISSN 1050-3307, E-ISSN 1468-4381, Vol. 28, no 1, p. 123-136Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: The association between alliance level and outcome in psychotherapy has been extensively studied. One way to expand this knowledge is to study alliance patterns. The main aims of this study were to examine how frequent alliance patterns with ruptures or rupture-repair episodes were in a naturalistic sample of psychotherapies in primary care, and if three alliance patterns (a Rupture pattern, a Repair pattern, and a No Rupture pattern) were differentially associated with treatment outcome.

METHOD: The psychotherapies (N = 605) included a wide range of different treatment orientations and patient diagnoses. Alliance patterns were studied at session-to-session level, using patient-rated alliance scores. Outcome data were analyzed using longitudinal multilevel modeling with a slopes-as-outcomes model.

RESULTS: The Repair pattern accounted for 14.7% (n = 89) of the treatments, 10.7% (n = 65) exhibited a Rupture pattern, and 74.5% (n = 451) contained no ruptures. The Rupture pattern was associated with inferior treatment outcomes. The Repair pattern was, in longer treatments, associated with better outcomes than the No Rupture pattern.

CONCLUSIONS: The results support theory about the importance of ruptures in the therapeutic alliance and suggest that identification of alliance ruptures is important in alliance-outcome research, for feedback purposes in clinical practice, and in training of therapists.

Place, publisher, year, edition, pages
Routledge, 2018
Keywords
alliance, alliance patterns, alliance ruptures, longitudinal multilevel modeling, naturalistic process and outcome research
National Category
Applied Psychology
Identifiers
urn:nbn:se:liu:diva-143855 (URN)10.1080/10503307.2016.1174345 (DOI)000418942800011 ()27139816 (PubMedID)2-s2.0-84965032354 (Scopus ID)
Available from: 2017-12-21 Created: 2017-12-21 Last updated: 2019-06-27Bibliographically approved
Gidhagen, Y., Holmqvist, R. & Philips, B. (2018). Attachment style among outpatients with substance use disorders in psychological treatment. Psychology and Psychotherapy: Theory, Research and Practice, 91(4), 490-508
Open this publication in new window or tab >>Attachment style among outpatients with substance use disorders in psychological treatment
2018 (English)In: Psychology and Psychotherapy: Theory, Research and Practice, ISSN 1476-0835, E-ISSN 2044-8341, Vol. 91, no 4, p. 490-508Article in journal (Refereed) Published
Abstract [en]

Objectives

To explore the associations between self-rated attachment style, psychological distress and substance use among substance use disorder (SUD) outpatients in psychological treatment.

Design and Methods

In this practice-based study, 108 outpatients were asked to fill in the Experiences in Close Relationships – Short form, the Clinical Outcomes in Routine Evaluation – Outcome Measure (CORE-OM), the Alcohol Use Disorders Identification Test (AUDIT), and the Drug Use Disorders Identification Test (DUDIT) at treatment start and end. Patients were given psychological treatments with a directive, reflective or supportive orientation.

Results

An insecure attachment style was more common among the SUD outpatients, compared to non-clinical groups. Patients with a fearful attachment style scored higher on psychological distress than patients with a secure attachment style. The associations between the attachment dimensions and psychological distress were stronger than those between attachment and SUD. Significantly more patients had a secure attachment style at treatment end.

Conclusions

This study shows significant relations between patients’ attachment style and their initial psychological distress. The causal relationship between attachment style and psychological distress is, however, not clear and can likely go in both directions. The psychological treatment of patients with SUD contributed significantly to changes from insecure to secure attachment style.

Practitioner Points

We found among patients with SUD a strong relation between patients’ attachment style and their psychological distress. Knowledge of the patient’s attachment style may help the therapist to tailor the treatment to the patient’s needs. A change from insecure to secure attachment style can be an important goal for a SUD treatment, as it may prevent the patient from using defence strategies involving substance use for regulating emotions and interpersonal relationships.

Place, publisher, year, edition, pages
John Wiley & Sons, 2018
Keywords
attachment, CORE-OM, ECR-S, practice-based study, psychological distress, substance use disorder
National Category
Psychology
Identifiers
urn:nbn:se:liu:diva-152442 (URN)10.1111/papt.12172 (DOI)000451783900004 ()
Note

Funding agencies: Region Council in Ostergotland, Sweden [LIO-279451]; Department of Dependency Disorders, Vrinnevi Hospital, Norrkoping, Sweden

Available from: 2018-10-31 Created: 2018-10-31 Last updated: 2018-12-20Bibliographically approved
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ORCID iD: ORCID iD iconorcid.org/0000-0003-2093-2510

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