Critical aspects of the therapeutic alliance appear to be established as early as the first session. Specifically, the affective bond between the therapeutic dyad appears to develop early in treatment and tends to remain stable over time, while agreements on goals and tasks tend to fluctuate over the course of treatment. Are there distinguishable early signs of a strong therapeutic alliance? In this study, we examined how some linguistic measures indicative of joint emotional elaboration correlated with a measure of the therapeutic alliance assessed within a single session. Initial intake sessions with 40 patients with varying diagnoses were videotaped, transcribed, and analyzed using linguistic measures of referential process and then scored with the Segmented Working Alliance Inventory-Observer form. Results showed that patients who were rated as more emotionally engaged in relating their experiences and then reflecting on them by mid-session also had higher scores in the therapeutic alliance by the final part of that same session. An implication of this study is that the interpersonal factors facilitating elaboration of inner experience, including elements of warmth, safety, and analytic trust, are related to the development of early therapeutic alliance. These findings did not appear to be dependent on the patient’s psychopathology. This study is one in a growing line of research exploring how patients speak rather than just the content of what they say.

The biopsychosocial paradigm is a model of care that has been proposed in order to improve the effectiveness of health care by promoting collaboration between different professions and disciplines. However, its application still faces several issues. A quantitative-qualitative survey was conducted on a sample of general practitioners (GPs) from Milan, Italy, to investigate their attitudes and beliefs regarding the role of the psychologist, the approach adopted to manage psychological diseases, and their experiences of collaboration with psychologists. The results show a partial view of the psychologist’s profession that limits the potential of integration between medicine and psychology in primary care. GPs recognized that many patients (66%) would often benefit from psychological intervention, but only in a few cases (9%) were these patients regularly referred to a psychologist. Furthermore, the referral represents an almost exclusive form of collaboration present in the opinions of GPs. Only 8% of GPs would consider the joint and integrated work of the psychologist and doctor useful within the primary health care setting. This vision of the role of psychologists among GPs represents a constraint in implementing a comprehensive primary health care approach, as advocated by the World Health Organization.

Background: The network analysis (NA) approach has predominantly relied on cross-sectional data, to characterize the relationships between symptoms across individuals at a single time point. In contrast, fully idiographic network analysis (FINA) allows for a more personalized perspective by estimating symptom networks at the individual level using intensive data collection. The aim of this scoping review is to map current practices in FINA in mental health research, identify methodological trends and gaps, and offer recommendations to support future studies in planning, data collection, analysis, and reporting. Methods: We searched MEDLINE, PsycINFO, Scopus, and Web of Science for peer-reviewed journal articles (published until January 2025). The initial search identified 12,586 articles, of which 43 were included in the review. Information was extracted on study and sample characteristics, data collection methods, and data analytic techniques. Results: We observed high heterogeneity between the studies. Commonly employed data collection methods included experience sampling and ecological momentary assessment, and the FINA model most frequently employed was graphical vector auto-regressive. Most studies estimated both contemporaneous and temporal networks, and fewer than half shared their data following open science practices. Conclusions: FINA is a promising tool for mental health research, but future studies need to adopt greater scientific rigor. To support this goal, we provide a set of recommendations and a structured checklist to guide researchers in conducting FINA studies.

Social anxiety disorder (SAD) is a common and disabling mental disorder that follows a chronic course unless it is treated with effective treatments. This systematic review examines randomized controlled trials (RCTs) of pharmacological treatments for adults with SAD published since 2015. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Search was conducted on PubMed, Scopus, Web of Science, and PsycINFO. Risk of bias of the included studies was assessed using the Cochrane risk of bias tool for randomized trials. Eighteen RCTs were included. Selective serotonin reuptake inhibitors (SSRIs) were the most investigated pharmacological intervention, either as monotherapy or in combination with cognitive behavioral therapy (CBT). More recent drugs show promising results include cannabidiol and d-cycloserine. When CBT is unavailable, SSRIs are the first-line pharmacological treatment for SAD based on current evidence. However, response rates vary substantially. We recommend a personalized approach that includes patient preference and treatment accessibility.

Many children are affected by social anxiety disorder (SAD). Pharmacotherapy, such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), may be indicated, but a clear understanding of the risks and benefits associated with these pharmacological treatments is needed. This expert review explores the risks and benefits of pharmacotherapy for treating SAD in children. Pharmacotherapy may be considered as a treatment when symptoms are complex or severe or when effective psychotherapy, such as cognitive behavioral therapy (CBT), is not accessible. We recommend that clinicians collaborate closely with parents, pediatricians, and psychiatrists in the treatment planning process, while monitoring the effects of pharmacotherapy. Future research should prioritize the personalization of treatments.