Psychological treatment of late-life anxiety: An empirical review.

This study provides a meta-analytic review of nonpharmacological interventions for late-life anxiety, focusing on treatment efficacy. Included in the analysis are studies in which a comparison was made either to a control condition or to another treatment. A total of 15 outcome studies, published or reported between January 1975 and January 2002, were identified involving 495 participants (mean age exceeding 55.0 years and a grand mean of 69.5 years) and providing 20 separate treatment interventions. The analysis indicated that psychological interventions were reliably more effective than no treatment on self-rated and clinician-rated measures of anxiety, yielding an effect size of .55. Maintenance of treatment gains (a minimum of 6 months follow-up) was insufficiently reported across studies to allow for a reliable demonstration of an overall estimate of long-term efficacy. It is concluded that psychological interventions produce significant improvements, but the analyses must be qualified by data limitations in the research synthesis. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The causal generalization paradox: The case of treatment outcome research.

Data from psychological experiments pose a causal generalization paradox. Unless the experimental results have some generality, they contribute little to scientific knowledge. Yet, because most experiments use convenience samples rather than probability-based samples, there is almost never a formal justification, or set of rigorous guidelines, for generalizing the study's findings to other populations. This article discusses the causal generalization paradox in the context of outcome findings from experimental evaluations of psychological treatment programs and services. In grappling with the generalization paradox, researchers often make misleading (or at least oversimplified) assumptions. The article analyzes 10 such assumptions, including the belief that a significant experimental treatment effect is likely to be causally generalizable and the belief that the magnitude of a significant experimental effect provides a sound effect size estimate for causal generalization. The article then outlines 10 constructive strategies for assessing and enhancing causal generality. They include strategies involving the scaling level of outcome measures, variable treatment dosages, effectiveness designs, multiple measures, corroboration from observational designs, and the synthesis of multiple studies. Finally, the article's discussion section reviews the conditions under which causal generalizations are justified. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Bridging the gap between alcoholism treatment research and practice: Identifying what works and why.

Despite the proliferation of alcoholism treatment research over the past 2 decades, there is a continued gap between what has been shown to be promising in the extant literature and what is commonly practiced by clinicians in the alcohol treatment field. The present article is an effort to bridge this gap by examining findings from the broad body of alcoholism treatment outcome research to determine how these findings may optimally be used by treatment providers. To this end, the authors provide clinicians with a succinct review of the current alcoholism treatment outcome literature and identify hallmarks of the most empirically supported treatments. Clinical implications of this literature for practitioners working with client with alcohol use disorders are discussed, with a focus on factors underlying effective treatments and on how these factors can be transferred from research to practice. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The comparative validities of the Rorschach and MMPI: A meta-analysis.

A meta-analysis comparing "undirected" and "conceptual" MMPI studies, and conceptual Rorschach and MMPI studies, indicated the following conclusions, (a) Conceptual work more successfully validates an assessment instrument than does undirected investigation, (b) The validatory success of the "average" conceptual Rorschach study is comparable to that of similar MMPI work. This finding suggests that the former's questionable status may be based on sociocultural factors, rather than scientific ones, (c) The "average" conceptual Rorschach or MMPI study has only modest explanatory power, (d) Investigators' misuse of X2 has resulted in exaggerated effect size in many instances where the statistic was employed. It is suggested that future research be judged on the coherence of its inference processes, the specificity of its predictions, and the amount of variance it explains. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Patient-focused research: Using patient outcome data to enhance treatment effects.

A program of research aimed at improving the quality of psychological interventions is described. Data from over 10,000 patients were analyzed to understand the association between number of treatment sessions and clinically significant improvement. In addition to a potential dose-response relationship, typical recovery curves were generated for patients at varying levels of disturbance and were used to identify patients whose progress was less than expected ("signal" cases). The consequences of passing this information along to therapists were reported. Analyses of dose-response data showed that 50% of patients required 21 sessions of treatment before they met criteria for clinically significant improvement. Seventy-five percent of patients were predicted to improve only after receiving more than 40 treatment sessions in conjunction with other routine contacts, including medication in some cases. Identification of signal cases (potential treatment failures) shows promise as a decision support tool, although further research is needed to elucidate the nature of helpful feedback. Outgrowths of this research include its possible contribution to social policy decisions, reductions in the need for case management, use in supervision, and possible effects on theories of change. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Treatment adherence in rehabilitation: The role of treatment accommodation.

Poor adherence to treatment in rehabilitation has historically been a costly and far-reaching problem. This article summarizes factors thought to affect adherence, including patient, treatment provider, environmental, and treatment characteristics. A model of adherence is proposed that emphasizes treatment characteristics. The concepts of treatment accommodation and research acceptability are introduced. Finally, steps are proposed to help clinicians design and implement treatment plans that facilitate treatment adherence in rehabilitation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Assessment of Chronic Pain in Rehabilitation: Outcomes Measures in Clinical Trials and Clinical Practice.

Objective: Chronic pain, or pain that lasts for months or even years, is prevalent among patients in rehabilitation settings, and treatment is costly. People with chronic pain often suffer physical limitations and emotional distress. As new treatments become available and clinical trials are initiated, it is important to measure outcomes in an effort to determine the efficacy of treatment interventions. This article provides a review of the core domains of outcomes assessment among people with chronic pain, including recommendations for outcome measures to be used in clinical trials and clinical practice settings. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Some properties of requivalent: A simple effect size indicator.

One version of requivalent, calculated from Fisher's exact test p values and recommended for small samples, is considered "a more realistic . . . [and] a more accurate estimate of the population correlation than . . . the sample correlation, rsample" (R. Rosenthal & D. B. Rubin, 2003, p. 494). Small sample properties of rsample and of two effect size estimators (requivalent* and rhybrid) that use requivalent were examined: rsample is preferable to requivalent* (defined as requivalent used without restrictions) in terms of bias and mean squared error (MSE); rhybrid (defined as requivalent only when rsample = 1.0) is generally preferable to requivalent*, and preferable to rsample in terms of MSEs, except when population correlations are very large. Conditions favoring rsample over requivalent* and rhybrid in meta-analyses are noted. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The role of physical exercise in alcoholism treatment and recovery.

A growing body of literature has demonstrated that physical exercise is associated with favorable mental health outcomes. Exercise has the potential to be an accessible and affordable adjunct treatment option for persons with alcohol use disorders (AUD); however, exercise-based interventions have rarely been applied to this population. The authors examine the potential role of physical exercise in the process of recovery from AUD. Possible physiological, psychological, and social mechanisms whereby exercise may exert influence on alcohol use outcomes are outlined. Studies examining the effects of physical exercise on alcohol and other addictive behaviors are reviewed, and the viability of structured, exercise-based adjunct interventions for AUD populations is discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Challenges to engaging Black male victims of community violence in healthcare research: Lessons learned from two studies.

A dearth of literature exists on barriers to conducting research with Black male victims of community violence, despite the need for evidence-based postinjury interventions. This study used qualitative data from a cross-sectional interview study (n = 16) and a pilot intervention study (n = 11) conducted in Boston, MA to identify challenges and facilitators to conducting research with Black male victims of community violence, particularly with regard to recruitment and maintenance of a study sample. Qualitative methods, including Grounded Theory and ethnography, were used to analyze the data. Challenges included a fear of police involvement, an impression of “snitching” when disclosing personal information, mistrust of research motives, suspicion of the informed consent process, the emotional impact of the trauma itself, and logistical issues. Facilitators to research included monetary incentives and motivation to help oneself and others. Participant recommendations on recruitment methods relating to approach and timing are provided. Findings from this study may assist in the planning of research studies for Black male victims of community violence. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The role of readiness to change in response to treatment of adolescent depression.

The effect of readiness to change on treatment outcome was examined among 332 adolescents (46% male, 74% Caucasian), ages 12 through 17 years (M = 14.6, SD = 1.5), with major depressive disorder who were participating in the Treatment for Adolescents With Depression Study (TADS). TADS is a randomized clinical trial comparing the effectiveness of fluoxetine (an antidepressant medication), cognitive–behavioral therapy, their combination, and a pill placebo. An abbreviated Stages of Change Questionnaire was used to obtain 4 readiness to change scores: precontemplation, contemplation, action, and maintenance. The association between each readiness score and depression severity across 12 weeks of acute treatment for depression, as measured by the Children’s Depression Rating Scale—Revised, was examined. Although treatment response was not moderated by any of the readiness scores, baseline action scores predicted outcome: Higher action scores were associated with better outcome regardless of treatment modality. Furthermore, treatment effects were mediated by change in action scores during the first 6 weeks of treatment, with increases in action scores related to greater improvement in depression. Assessing readiness to change may have implications for tailoring treatments for depressed adolescents. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Consumer participation in disability research: The golden rule as a guide for ethical practice.

This article explores the value of the disability research process and outcomes, as viewed by those to whom the research is often directed-the research participants and their peers. The author discusses the "golden rule" for conducting research with people with disabilities and cites literature on participatory action research to assess research outcomes--especially the relevance of such research for those to whom it purports to benefit. The author also discusses guidelines to make disability research more participatory and empowering to those who are identified as beneficiaries of the research outcomes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Examining psychokinesis: The interaction of human intention with random number generators--A meta-analysis.

Séance-room and other large-scale psychokinetic phenomena have fascinated humankind for decades. Experimental research has reduced these phenomena to attempts to influence (a) the fall of dice and, later, (b) the output of random number generators (RNGs). The meta-analysis combined 380 studies that assessed whether RNG output correlated with human intention and found a significant but very small overall effect size. The study effect sizes were strongly and inversely related to sample size and were extremely heterogeneous. A Monte Carlo simulation revealed that the small effect size, the relation between sample size and effect size, and the extreme effect size heterogeneity found could in principle be a result of publication bias. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The client-counselor match and the corrective emotional experience: Evidence from interpersonal and attachment research.

Models of brief psychodynamic therapy posit the corrective emotional experience as a key factor in therapeutic change. Although widely taught and used, these models do not have strong empirical support. This article proposes the client-counselor match as a facilitating condition for a corrective emotional experience and reviews the relevant evidence from attachment and interpersonal research. Overall, the notion of the corrective emotional experience has received some support from attachment research, which looks at complementarity of styles at the personality level. Interpersonal research, rather, considers complementarity of actual exchanges in therapy and has yielded mixed results. It thus appears that the validity of the corrective experience has yet to be established, notably through the use of a more fine-grained approach. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A Comment on Sampling Error in the Standardized Mean Difference With Unequal Sample Sizes: Avoiding Potential Errors in Meta-Analytic and Primary Research.

The authors discuss potential confusion in conducting primary studies and meta-analyses on the basis of differences between groups. First, the authors show that a formula for the sampling error of the standardized mean difference (d) that is based on equal group sample sizes can produce substantially biased results if applied with markedly unequal group sizes. Second, the authors show that the same concerns are present when primary analyses or meta-analyses are conducted with point-biserial correlations, as the point-biserial correlation (r) is a transformation of d. Third, the authors examine the practice of correcting a point-biserial r for unequal sample sizes and note that such correction would also increase the sampling error of the corrected r. Correcting rs for unequal sample sizes, but using the standard formula for sampling error in uncorrected r, can result in bias. The authors offer a set of recommendations for conducting meta-analyses of group differences. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Moving beyond efficacy and effectiveness in child and adolescent intervention research.

This Special Section of the Journal of Consulting and Clinical Psychology focuses on research that extends beyond documenting the efficacy and effectiveness of specific psychological treatments or preventive interventions for children and youths. In the past 30 years, there have been remarkable advances in the development and evaluation of psychological treatments and preventive interventions for a wide range of child and adolescent problems. At the same time, only a small percentage of youths who suffer from emotional and behavioral problems receive psychological services, and many of these services are not evidence-based. This article discusses key features of the Special Section studies, which examine important issues related to (a) disseminating treatments in diverse community settings (i.e., investigating the transportability of treatment), (b) personalizing mental health care (i.e., investigating predictors and moderators of treatment outcome), and (c) developing evidence-based explanations of treatment (i.e., investigating mediators of treatment). Key issues that are raised in the specific studies are discussed, and important considerations for future research are highlighted. Moving the field forward requires innovation, complex research designs, and a willingness to develop treatment models that reach beyond the current body of treatment outcome and prevention research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Common method biases in behavioral research: A critical review of the literature and recommended remedies.

Interest in the problem of method biases has a long history in the behavioral sciences. Despite this, a comprehensive summary of the potential sources of method biases and how to control for them does not exist. Therefore, the purpose of this article is to examine the extent to which method biases influence behavioral research results, identify potential sources of method biases, discuss the cognitive processes through which method biases influence responses to measures, evaluate the many different procedural and statistical techniques that can be used to control method biases, and provide recommendations for how to select appropriate procedural and statistical remedies for different types of research settings. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The future of play therapy: Elevating credibility through play therapy research.

Elevating credibility in play therapy through research has been a difficult task. This difficulty is represented well in the Myth of Sisyphus (wherein Sisyphus is cursed with the mandate of rolling a large boulder up a hill, only to have it roll back down every time he approaches the top of the hill). Play therapy, in some form, has been in mental health clinics, clinician’s offices, and in journals for more than a century—yet empirical research on play therapy has consistently lagged behind practice. Also, we have several decades of research supporting the use of play therapy in addressing many common childhood problems, yet there is little recognition of play therapy as an “empirically supported treatment.” To stretch the Myth of Sisyphus just a bit, if we are to see the effort to develop empirical support for play therapy as our task, we need to look carefully at who is pushing the boulder, what strategies are being used to get the boulder up the hill, and how we will we know when we’ve reached the top of the hill. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effectiveness of psychodramatic techniques: A meta-analysis.

Questions concerning the scientific basis of the clinical application of psychodramatic techniques have been raised primarily because of the infrequency of research publications that validate the clinical observations. A meta-analysis conducted on the basis of 25 experimentally designed studies showed an overall effect size that points to a large size improvement effect similar to or better than that commonly reported for group psychotherapy in general. The techniques of role reversal and doubling emerged as the most effective interventions. Of the 4 techniques investigated, 3 were significantly different from each other. There was no difference between the techniques' effectiveness when used with clinical versus student populations or between their use in single versus multiple sessions. The meaning of the findings is discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)