{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T10:14:59Z","timestamp":1788516899911,"version":"build-2803163510"},"reference-count":63,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T00:00:00Z","timestamp":1788480000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T00:00:00Z","timestamp":1788480000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100005416","name":"Norges Forskningsr\u00e5d","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005416","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Clin Psychol"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Social connection predicts health, but remains largely underexplored as an outcome of psychotherapy. A friendly relationship to oneself is linked to positive relationships to others, but it is not clear how they influence each other across time during and after treatment. This study evaluates change in a measure of social connection and support, the Quantity and Quality of Social Relations (QQSR), and investigates its longitudinal associations with the Structural Analysis of Social Behavior Introject self\u2010affiliation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>370 adult outpatients in Norway with various presenting problems were assessed before and after open\u2010ended psychotherapy, with up to 2.5 years follow\u2010up. We fitted latent growth curves and structured residual models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>There was significant growth in QQSR across long\u2010term follow\u2010up, particularly in support and non\u2010family relationships. There was no change from pre\u2010 to posttreatment, and significant between\u2010patient variation in both intercepts and growth rates. Improved QQSR after treatment predicted improved self\u2010affiliation in the next follow\u2010up, which in turn predicted improved QQSR. These effects were robust to detrending and controlling for pretreatment personality disorder. Pretreatment QQSR correlated with self\u2010affiliation growth.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>On average over a long timespan, patients' social connection shows gradual positive growth, and reciprocal lagged associations with self\u2010affiliation. The QQSR might measure relatively stable characteristics and between\u2010patient differences relevant to self\u2010affiliation change. Clinicians might screen for social and self\u2010relationships throughout therapy, both as outcomes and resources.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jclp.70220","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T09:37:46Z","timestamp":1788514666000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Connected to Others and Kind to Self: Social Connection and Self\u2010Affiliation Change in Open\u2010Ended Psychotherapy"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-2810-8582","authenticated-orcid":false,"given":"Andreas","family":"Voldstad","sequence":"first","affiliation":[{"name":"Department of Psychiatry University of Oxford Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8341-0560","authenticated-orcid":false,"given":"Ole Andr\u00e9","family":"Solbakken","sequence":"additional","affiliation":[{"name":"Department of Psychology Faculty of Social Sciences, University of Oslo Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5677-1662","authenticated-orcid":false,"given":"Jes\u00fas","family":"Montero\u2010Mar\u00edn","sequence":"additional","affiliation":[{"name":"Teaching, Research &amp; Innovation Unit, Parc Sanitari Sant Joan de D\u00e9u Sant Boi de Llobregat, Barcelona Spain"},{"name":"Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiology and Public Health\u2014CIBERESP) Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0879-8902","authenticated-orcid":false,"given":"Jon Trygve","family":"Monsen","sequence":"additional","affiliation":[{"name":"Department of Psychology Faculty of Social Sciences, University of Oslo Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8846-8983","authenticated-orcid":false,"given":"Erkki","family":"Heinonen","sequence":"additional","affiliation":[{"name":"Department of Psychology Faculty of Social Sciences, University of Oslo Oslo Norway"},{"name":"Finnish Institute for Health and Welfare Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,4]]},"reference":[{"issue":"1","key":"e_1_2_11_2_1","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-024-63528-4","article-title":"The Impact of Social Isolation and Loneliness on Cardiovascular Disease Risk Factors: A Systematic Review, Meta\u2010Analysis, and Bibliometric Investigation","volume":"14","author":"Albasheer O.","year":"2024","journal-title":"Scientific Reports"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ssmmh.2021.100042"},{"issue":"3","key":"e_1_2_11_4_1","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1037\/0033-2909.117.3.497","article-title":"The Need to Belong","volume":"117","author":"Baumeister R. 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