Volume III, Issue 3, 2025
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Clients in high-acuity psychological states, marked by developmental neglect, trauma, or existential dislocation, often retreat into internally constructed psychic worlds. This paper explores the phenomenon of “Inner Architecture” as a self-protective and narrative-engineering strategy, drawing from autoethnographic accounts and composite client narratives. It proposes a model of sovereign inner governance, detailing how rites, roles, and symbolic maps are constructed by those for whom the external world offered no safe harbour.
© The Author(s) 2025. Published by RITHA Publishing. This article is distributed under the terms of the license CC-BY 4.0., which permits any further distribution in any medium, provided the original work is properly cited maintaining attribution to the author(s) and the title of the work, journal citation and DOI.
Article’s history: Received: 27th of May, 2025; Revised: 7th of July, 2025; Accepted: 24th of July, 2025; Available online: 31st of July, 2025; Published as research article in Volume III, Issue 3, 2025.
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This article advances a conceptual dialogue between Attachment Theory and Polyvagal Theory, positioning co-regulation as their central point of convergence. While Attachment Theory explains how early relational experiences shape emotional regulation and internal working models, Polyvagal Theory provides a neurophysiological framework for understanding how states of safety and threat organize affective and relational functioning. Integrating these perspectives, the paper examines how the experience of feeling safe with another constitutes a foundational condition for emotional regulation and psychotherapeutic change.
Rather than proposing a unified model, the article offers an integrative conceptual framework that preserves the specificity of each theory while highlighting their shared clinical focus on embodied relational safety. The analysis demonstrates how attachment patterns and autonomic states interact through co-regulation within therapeutic encounters, fostering emotional tolerance, relational trust, and narrative integration. This perspective contributes a refined clinical lens for understanding affective dysregulation, relational trauma, and attachment-based difficulties in contemporary psychotherapy.
© The Author(s) 2025. Published by RITHA Publishing. This article is distributed under the terms of the license CC-BY 4.0., which permits any further distribution in any medium, provided the original work is properly cited maintaining attribution to the author(s) and the title of the work, journal citation and DOI.
Article’s history: Received: 27th of August, 2025; Revised: 4th of October, 2025; Accepted: 22nd of October, 2025; Available online: 27th of October, 2025; Published as research article in Volume III, Issue 3, 2025.
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Substance use disorders (SUDs) are chronic, relapse-prone conditions requiring longitudinal and adaptive models of care. Although face-to-face interventions remain effective, structural barriers, service fragmentation, and fluctuating relapse risk limit sustained engagement. The expansion of telemedicine has accelerated the development of online and hybrid treatment architectures in addiction care.
This paper examines telemedicine in SUD treatment from a mechanism-centered and implementation-science perspective. Evidence indicates that telehealth-delivered interventions can achieve outcomes comparable to in-person care when core therapeutic processes are preserved. The Hybrid Mechanism Model conceptualizes treatment as a dynamic system in which relapse-risk fluctuation, ecological monitoring, modality allocation, and therapeutic processes interact across phases of care. The STANDUP® framework is presented as an applied example of this architecture.
Telemedicine does not simplify addiction treatment but restructures its delivery environment. Clarifying optimal hybrid configurations, long-term outcomes, and population-specific benefit remains a priority for future research.
© The Author(s) 2025. Published by RITHA Publishing. This article is distributed under the terms of the license CC-BY 4.0., which permits any further distribution in any medium, provided the original work is properly cited maintaining attribution to the author(s) and the title of the work, journal citation and DOI.
Article’s History: Received: 17th of September, 2025; Revised: 4th of October, 2025; Accepted: 22nd of October, 2025; Available online: 27th of October, 2025; Published as research article in Volume III, Issue 3, 2025.
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Cardiovascular surgery is often accompanied by significant psychological distress, which can adversely affect postoperative recovery. This study investigates the role of psychological interventions in supporting emotional adjustment and enhancing recovery outcomes in patients undergoing cardiovascular surgery. Employing an applied clinical design, adult patients received structured psychological support both pre- and postoperatively and were assessed using validated measures of anxiety, emotional distress, pain perception, and well-being. Central to the assessment protocol is the introduction of a specialised 10-item "Cardiac Anxiety Questionnaire" (CAQ), designed to capture the specific neurophysiological and cognitive concerns of cardiac patients.
The findings indicate that psychological interventions are associated with reduced postoperative anxiety, improved emotional regulation, enhanced coping strategies, and a more favourable recovery trajectory. These results underscore the importance of integrating psychological support into multidisciplinary cardiovascular care. From a psychotherapeutic standpoint, early emotional assessment, facilitated by targeted tools like the CAQ, and structured interventions may foster psychological resilience and contribute to better clinical outcomes.
© The Author(s) 2025. Published by RITHA Publishing. This article is distributed under the terms of the license CC-BY 4.0., which permits any further distribution in any medium, provided the original work is properly cited maintaining attribution to the author(s) and the title of the work, journal citation and DOI.
Article’s history: Received: 24th of September, 2025; Revised: 27th of November, 2025; Accepted: 20th of December, 2025; Available online: 27th of December, 2025; Published as research article in Volume III, Issue 3, 2025.
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Eating and Feeding Disorders (ED/FD) are multi-level conditions arising from dynamic interactions among biological, psychological, relational, and nutritional processes. Despite advances in multidisciplinary and interdisciplinary care, treatment remains fragmented, with parallel interventions and limited mechanistic integration.
This paper proposes a trans-disciplinary, mechanism-based framework that reorganises ED/FD care around shared constructs, coordinated mechanisms of change, unified outcome systems, and joint clinical decision-making. The model targets core transdiagnostic processes, including interoceptive dysregulation, avoidance, cognitive–affective rigidity, and relational dynamics, enabling synchronised intervention across domains and enhancing clinical coherence and continuity of care. Moving beyond role coordination, the framework shifts integration toward mechanism alignment, conceptualising treatment as a unified therapeutic system rather than a set of parallel inputs. To support real-world implementation, the model incorporates CFIR and RE-AIM frameworks, providing a structured approach to evaluating feasibility, fidelity, and sustainability.
This approach offers both a conceptual and operational advancement, with implications for service design, professional training, and outcome standardisation. Beyond ED/FD, it provides a scalable model for complex psychiatric conditions characterised by multi-level maintaining mechanisms.
© The Author(s) 2025. Published by RITHA Publishing. This article is distributed under the terms of the license CC-BY 4.0., which permits any further distribution in any medium, provided the original work is properly cited maintaining attribution to the author(s) and the title of the work, journal citation and DOI.
Article’s history: Received: 17th of October, 2025; Revised: 20th of November, 2025; Accepted: 20th of December, 2025; Available online: 27th of December, 2025; Published as research article in Volume III, Issue 3, 2025.
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Effective risk and safety management in contemporary organisations depends on complex interactions among human, organisational, and environmental factors. This study examines the psychological determinants of safety management in Romanian public institutions by analysing the interrelationships among executor (worker), means of production, work environment, and workload. Data from 512 managers were analysed using Spearman’s rho correlation coefficients. Results reveal strong positive associations among all components, particularly between worker characteristics and workload (ρ = 0.92, p < .001) and between work environment and workload (ρ = 0.95, p < .001). These findings support a systems-based psychological model of organisational safety, emphasising the importance of integrated managerial strategies for accident prevention, safety culture development, and sustainable organisational performance.
© The Author(s) 2025. Published by RITHA Publishing. This article is distributed under the terms of the license CC-BY 4.0., which permits any further distribution in any medium, provided the original work is properly cited maintaining attribution to the author(s) and the title of the work, journal citation and DOI.
Article’s history: Received 27th of November, 2025; Revised 21st of December, 2025; Accepted: 27th of December, 2025; Available online: 30th of December, 2025; Published as research article in Volume III, Issue 3, 2025.
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This study critically examines the predictive factors influencing language recovery, integrating lesion-related variables (location, size, stroke subtype) with non-lesion factors (age, education, cognitive reserve, and socio-economic status). Emphasis is placed on the role of neuroplasticity and early intervention in facilitating functional reorganisation of language networks. The paper further explores the limitations of current prognostic models, highlighting the substantial inter-individual variability that constrains predictive accuracy. In addition, the emotional and psychological impact of aphasia is considered, underscoring the importance of integrating psychological support within rehabilitation frameworks. The findings contribute to a more nuanced understanding of recovery mechanisms and support the development of personalised, network-informed therapeutic strategies aimed at optimising both linguistic and psychosocial outcomes.
© The Author(s) 2025. Published by RITHA Publishing. This article is distributed under the terms of the license CC-BY 4.0., which permits any further distribution in any medium, provided the original work is properly cited maintaining attribution to the author(s) and the title of the work, journal citation and DOI.
Article’s history: Received 4th of November, 2025; Revised 16th of December, 2025; Accepted 27th of December, 2025; Available online: 30th of December, 2025; Published as research article in Volume III, Issue 3, 2025.
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Attachment-related difficulties present in diverse ways, including relational instability, emotional flattening, and cognitive-emotional disconnection, and may arise from shared underlying mechanisms rather than distinct symptom categories. A proposed mechanism is emotional memory reconsolidation, in which previously encoded emotional learning can be updated when reactivated under specific conditions.
This study examines whether these presentations can be understood and treated through a shared process involving the modulation of autonomic activation, conceptualized here as autonomic charge. A multiple-case analysis (N = 3) was conducted using the Somatic Attachment Protocol (SAP), a process-based framework integrating somatic observation, neural interruption, and relational co-regulation, with cases selected to represent relational instability, emotional flattening, and cognitive-emotional disconnection. Across all cases, therapeutic change followed a similar sequence of activation, sustained somatic observation, reduction in autonomic activation, and subsequent reorganization of emotional and behavioural responses (AORR). Despite differences in presentation, all cases converged toward increased emotional regulation and adaptive relational functioning.
These findings support a process-based view of psychotherapy, in which diverse attachment difficulties may reflect variations in a shared underlying mechanism. SAP is presented as a flexible clinical framework for engaging this process, with limitations and implications for future research discussed.
© The Author(s) 2025. Published by RITHA Publishing. This article is distributed under the terms of the license CC-BY 4.0., which permits any further distribution in any medium, provided the original work is properly cited maintaining attribution to the author(s) and the title of the work, journal citation and DOI.
Article’s history: Received 1st November, 2025; Revised 9th of December, 2025; Accepted: 27th of December, 2025; Available online: 30th of December, 2025; Published as research article in Volume III, Issue 3, 2025.
