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Mapping the journey from epistemic mistrust in depressed adolescents receiving psychotherapy.
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= 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).
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Failed treatment attempts lead to disappointment in and distrust of mental health services, which may undermine future care-seeking or treatment success.
“failed treatment attempts lead to disappointment in and distrust of mental health services [18], which may undermine future care-seeking or treatment success.”
From The (cost-)effectiveness of early intervention (MBT-early) versus standard protocolized treatment (CBT) for emerging borderline personality disorder in adolescents (the EARLY study): a study protocol for a randomized controlled trial (2024) · cites this paper as [18]
In “Optimal case: Nathan” (page unavailable), the paper describes an adolescent who was disappointed by his therapist and says the experience might have worsened his mistrust. The “Significant variations” section (page unavailable) also describes adolescents who dropped out because therapy felt unhelpful. These accounts support the gist, but do not establish that failed treatment attempts generally cause distrust of mental health services; the paper frames the effect on Nathan’s mistrust as possible. (LLM, conf=0.82)
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Self-citation
Metadata
- Authors
- Li, E. T., Midgley, N., Luyten, P., Sprecher, E. A., & Campbell, C.
- Venue
- Journal of Counseling Psychology
- Published
- 2022-10
- Volume
- 69
- Issue
- 5
- Pages
- 678-690
- ISSN
- 0022-0167 (ISSN-L)
- 1939-2168
- OpenAlex
- W4283381367
- Cited by
- 32
- References
- 0
- Citations by year
- 2026: 6 · 2025: 5 · 2024: 12 · 2023: 9
- FWCI
- 5.93
- Type
- journal article
- Language
- en
- Open access
- green
- discovery.ucl.ac.uk
- Locations
- Journal of Counseling Psychology (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- epistemic mistrust, epistemic trust, adolescent depression, psychotherapy, hypervigilance, therapeutic relationship, interpersonal factors, social environment, treatment engagement
- MeSH terms
- Adolescent, Female, Humans, Male, Psychotherapy, Social Environment, Trust
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