Mental pain intensity and tolerance as predictors of psychotherapy process and outcome

Ariella Grossman-Giron, Gideon Becker, Yogev Kivity, Shani Shalev, Dana Tzur Bitan

Research output: Contribution to journalArticlepeer-review


Background: The extensive reliance on symptoms for the study of psychotherapy is often criticized. In this study we examined whether the subjective sense of mental pain predicts psychotherapy process and outcome, above and beyond the effect of symptomatic distress. Methods: Outpatients (n = 53) treated in a psychiatric hospital completed measures of mental pain intensity and tolerance, symptomatic distress, and session climate at pretreatment and posttreatment. Multilevel modeling was utilized to assess the predictive effect of mental pain, while controlling baseline symptomatic distress. Results: Patients with high mental pain at baseline showed significant reductions in distress, while patients with low mental pain showed no significant improvement. Moreover, low mental pain and high mental pain tolerance predicted decreases in session smoothness. Conclusions: Mental pain can serve as a predictive marker for psychotherapy process and outcome, and complement the reliance on symptomatic distress in psychotherapy research.

Original languageEnglish
Pages (from-to)1296-1306
Number of pages11
JournalJournal of Clinical Psychology
Issue number6
StatePublished - Jun 2021
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2020 Wiley Periodicals LLC


  • mental pain intensity
  • mental pain tolerance
  • psychotherapy outcome
  • psychotherapy process
  • psychotherapy research

ASJC Scopus subject areas

  • Clinical Psychology
  • Arts and Humanities (miscellaneous)


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