Reframing and restraining directives in the treatment of clinical depression.

We tested the effects of reframing and restraining directives on depression of high- and low-reactant clients. Reframing was more effective than restraining or control, and level of reactance had no effect. Restraining did not differ from control. Subjects were 74 moderately to severely depressed outpatients. Results are discussed in light of the compliance–defiance model of paradoxical interventions and psychological reactance theory. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Three sessions of brief couples therapy: A clinical trial.

The effects of positive reframing and restraining in the context of time limited brief couples therapy were investigated. Forty couples were randomly assigned to either an immediate treatment group or to a waiting-list control group that received delayed treatment. The interventions had a positive impact on dyadic adjustment target complaints and conflict resolution of treated couples compared to couples in the waiting-list control group. There were no significant differences observed in the relationship belief and spousal attributions between the treated and untreated couples. Thirty-nine percent of couples met L. Christensen and J. Mendoza's (1986) definition of clinically meaningful improvement. Treatment gains observed at the termination of the 3-session treatments appear to have been maintained at 6-weeks follow-up. A positive relation was observed between couples improvement and compliance with treatment directives. Implications for time-limited brief therapy are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Compliance-based and defiance-based intervention strategies and psychological reactance in the treatment of free and unfree behavior.

These studies investigated the use of restraining paradoxical interventions with high- and low-reactant subjects in the treatment of either procrastination or test anxiety. Study 1 compared a restraining intervention with a nonparadoxical-intervention group and a control group in the treatment of procrastination. Subjects received two 30-min interviews in which either a restraining directive or a nonparadoxical directive was given. All subjects improved their procrastination behavior. High-reactant subjects were less satisfied with their procrastination and had less expectation for change. Subjects who received the nonparadoxical treatment showed a greater expectation for change than those who received the paradoxical treatment. Study 2 compared a restraining intervention with a reframing intervention for either procrastination or test anxiety. Results showed no significant main effects for treatment for either procrastination or anxiety. All subjects decreased their anxiety. Low-reactant subjects exhibited less anxiety after treatment than high-reactant subjects. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of reframing and self-control directives on loneliness, depression, and controllability.

57 female undergraduates who scored at least 1 standard deviation above the mean (47 or above) on the UCLA Loneliness Scale and who scored as moderately depressed (8–26) on the Beck Depression Inventory also completed the Causal Dimension Scale and were randomly assigned to 1 of 3 groups: reframing, self-control directives, and a waiting-list control. Treatment groups met for 2 weekly ?-hr interviews. Interviewer responses in the reframing group focused on ways to experience loneliness more positively, whereas self-control responses involved encouraging Ss to overcome loneliness. All 3 groups were again administered the 3 measures posttreatment and 2-wk follow-up. Results indicate that Ss in the reframing group experienced a more significant reduction in depression than Ss in the self-control or control groups. All Ss became less lonely over time, but no treatment was more effective than another in reducing loneliness. No differences were found for controllability. (15 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Ironic effects of emotion suppression when recounting distressing memories.

Theories of ironic mental control posit that under conditions in which effortful control is compromised, for example, in laboratory manipulations of mental load or in those suffering from clinical levels of negative affect, attempts to suppress negative emotions can lead to a paradoxical increase in such feelings, relative to conditions in which no suppression is attempted. In line with this, we showed that high negative affect participants, when asked to suppress (downregulate) their negative feelings while writing about a distressing personal memory, exhibited an ironically greater increase in negative emotions compared with a no-instruction condition, in contrast to low negative affect controls who were able to suppress their emotions. Comparable ironic effects were not associated with instructions to experience emotions. This first demonstration of ironic effects of emotion suppression in response to personal material in those with emotional problems sheds light into how certain emotion regulation strategies may maintain and exacerbate such conditions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Acceptability of paradoxical interventions: Some paradoxes of psychotherapy research.

The opportunity to respond to Cavell, Frentz, and Kelley's (1986) empirical evaluation of the components of our previously reported paradoxical intervention (Kolko & Milan, 1983) provides a forum for discussion of issues pertaining to both paradoxical techniques and alternative psychotherapeutic procedures. Specifically, we elaborate on the conceptualization of paradoxical interventions, significance of client resistance to therapeutic directives, and use and content of reframing in the administration of paradoxical instructions. Clinical and empirical issues are discussed in regard to the process of obtaining informed consent, impact of methodological differences in the interpretation of findings, and pertinence and assessment of social validity in the evaluation of treatment efficacy and acceptability. We hope that such considerations will stimulate thorough examination of the rationale, characteristics, and utility of paradoxical strategies as well as refinement in the practices used to evaluate emerging psychotherapeutic techniques. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effect of paradoxical and nonparadoxical self-disclosure on counselor social influence.

Examined the effects of counselor self-disclosure and paradoxical homework directives on Ss' ratings on a 5-item homework directive rating scale and on perceived counselor social influence. It was hypothesized that counselor self-disclosure would reduce potentially negative perceptions of paradoxical directives. 49 female and 40 male undergraduates experiencing problems with test anxiety rated 1 of 4 videotapes of actual counselor–client interaction when a female counselor interviewed a client reporting problems with test anxiety. Results show that paradoxical homework directives were perceived as more tricky, manipulative, and confusing than were nonparadoxical directives but that these perceptions did not affect Ss' perceptions of the counselor's willingness or ability to help or increase feelings of anger toward the counselor. Results also indicate that paradoxical directives were not damaging to perceptions of counselor social influence and the counselor self-disclosure did not affect perceptions of counselor social influence. (17 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A comparison of paradoxical and nonparadoxical interpretations and directives.

Explored the effects of consistent and inconsistent combinations of paradoxical and nonparadoxical interpretations and directives in brief counseling with 49 moderately depressed undergraduates. It was hypothesized that a consistent paradoxical intervention would be more effective than inconsistent interventions, which in turn would be more effective than a consistent nonparadoxical intervention. Ss who wanted to change were randomly assigned to 4 interview intervention conditions and a no-treatment control condition. In the intervention conditions, Ss received 2 interviews with counselors who gave 6 interpretations and 2 directives over the course of the interviews. Ss in the intervention conditions decreased their depression more than did Ss in the control condition. Paradoxical interpretations were associated with more symptom remission than were nonparadoxical interpretations, whereas the nature of the directives students received made little difference. Whether the interventions were consistent or inconsistent made little difference on changes in depression, but Ss had more favorable impressions of their counselors when interpretations and directives were consistent. The impact of the interventions on Ss' attributions of the cause of therapeutic change was also explored. (12 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mood and the formation of attitudes.

Conducted 2 studies to examine how mood influences the attitudes formed by 72 undergraduates (Study 1) and 45 undergraduates (Study 2). After reading the Velten mood induction cards, Ss were presented with positive and negative belief statements about an unfamiliar attitude object. Measures of attitudes, statements recalled, and evaluations of statements were taken. In both studies, mood was shown to influence attitudes. Moreover, in Study 1, Ss evaluated both positive and negative statements in line with their mood. These results are consistent with the research of D. M. Mackie and L. T. Worth (see record 1989-31851-001) on the effects of positive mood on persuasion and suggest that negative mood may also operate to encourage the use of heuristic processing of information. No evidence was found for a mood-congruity effect in either study. (French abstract) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The causal effects of emotion on couples' cognition and behavior.

The authors conducted 2 translational studies that assessed the causal effects of emotion on maladaptive cognitions and behaviors in couples. Specifically, the authors examined whether negative emotions increased and positive emotions decreased partner attributions and demand-withdraw behaviors. Study 1 (N=164) used video clips to assess the effects of emotion on individuals' attributions. Study 2 (N=47 couples) was a therapy analogue study intended to assess whether emotion generated from couples' conversations would influence subsequent attributions and behaviors. Results indicate that participants in the negative emotion conditions tended to attribute more blame to their partners and were more likely to engage in demand-withdraw patterns and other negative behaviors than were those in the positive emotion conditions. Implications for research and practice are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychotherapy in two-plus-one sessions: Outcomes of a randomized controlled trial of cognitive–behavioral and psychodynamic–interpersonal therapy for subsyndromal depression.

A total of 116 clients with a range of subsyndromal depression received 3 therapy sessions: 2 sessions 1 week apart followed by a 3rd session 3 months later (the 2?+?1 model). Clients were stratified for severity on the Beck Depression Inventory (BDI) as stressed, subclinical, or low-level clinically depressed. In a 2?×?2 design, they received either cognitive–behavioral (CB) or psychodynamic–interpersonal (PI) therapy, either immediately or after a 4-week delay. An initial advantage for the immediate condition disappeared once the delayed-condition clients received treatment. Improvement rates at the end of treatment were 67% (stressed), 72% (subclinical), and 65% (low-level clinically depressed). There were no significant differences between CB and PI treatment methods, with the exception at 1-year follow-up, when the BDI showed a significant advantage for CB. Implications for designing very brief planned interventions are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of paradoxical and self-control directives in counseling.

32 students who reported having a serious and recurring procrastination problem were randomly assigned to either of 2 directive interview conditions (paradoxical or self-control) or to a no-interview control condition. Dependent measures included weekly S ratings of problem frequency, perceptions of problem controllability, expectation to change, and satisfaction with behavior, as well as a measure of Ss' perceptions of the interviewer. Results after 4 wks indicate that both directive groups exhibited generally greater improvement over time than controls and that the opposing forms of direction promoted different change patterns on self-report measures of problem frequency and controllability. Specifically, Ss exposed to paradoxical directives reported a sharper rate of change in their procrastination without viewing their problem behavior as significantly more controllable. (27 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The impact of paradoxical interventions on perceptions of the therapist and ratings of treatment acceptability.

Addressed ethical questions about the manipulative, deceptive nature of paradoxical interventions. Perceptions of the therapist and of the acceptability of paradoxical vs nonparadoxical directives were examined using simulation methodology. Participants (97 undergraduates) took part in a semester-long family simulation of excessive family arguing associated with a rebellious adolescent daughter. Before experimental manipulation, the "families" participated in 4 role-playing exercises and attended a family therapy session. They then received a letter from their therapist containing 1 of the 2 types of directives and, subsequently, responded to the dependent measures. Results indicated (1) paradoxical directives did not negatively influence perceptions of therapist attractiveness, expertness, or trustworthiness; (2) they were judged less acceptable than nonparadoxical directives, although neither was deemed unacceptable. Implications for clinical practice and future research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Daily stress, coping, and well-being in parents of children with autism: A multilevel modeling approach.

This study used a repeated daily measurement design to examine the direct and moderating effects of coping on daily psychological distress and well-being in parents of children with Autism Spectrum Disorders (ASD). Twice weekly over a 12-week period, 93 parents provided reports of their daily stress, coping responses, and end-of-day mood. Multilevel modeling analyses identified 5 coping responses (e.g., seeking support, positive reframing) that predicted increased daily positive mood and 4 (e.g., escape, withdrawal) that were associated with decreased positive mood. Similarly, 2 coping responses were associated with decreased daily negative mood and 5 predicted increased negative mood. The moderating effects of gender and the 11 coping responses were also examined. Gender did not moderate the daily coping?mood relationship, however 3 coping responses (emotional regulation, social support, and worrying) were found to moderate the daily stress?mood relationship. Additionally, ASD symptomatology, and time since an ASD diagnosis were not found to predict daily parental mood. This study is perhaps the first to identify coping responses that enhance daily well-being and mitigate daily distress in parents of children with ASD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The relationship between personality pathology and dysfunctional cognitions in previously depressed adults.

Multivariate and univariate regression models were used to examine the relationship between Axis II personality pathology and dysfunctional cognitions in a follow-up study of 40 formerly depressed inpatients. A dimensionalized measure of overall Axis II pathology was significantly and positively related to dysfunctional attitudes (Dysfunctional Attitudes Scale [DAS]) and maladaptive negative event attributions (Attributional Style Questionnaire–Negative Composite [ASQ-N]); the Axis II measure accounted for approximately 29% of the variance in DAS and 14% of the variance in ASQ-N, after controlling statistically for subsyndromal depressive symptoms (Beck Depression Inventory [BDI]). Axis II pathology was not significantly associated with positive event attributions, and no significant Axis II?×?BDI interaction effects were observed. A secondary canonical analysis of Axis II clusters was largely consistent with a hypothesized general personality pathology factor associated with dysfunctional cognitions, though a more specific association between Axis II Cluster C pathology and dysfunctional attitudes was also observed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Personal versus professional evaluations of self-disclosing and self-involving counselors.

The concept of counselor disclosure was separated into 2 types of counselor responses: self-disclosing statements and self-involving statements. These types were also varied along a positive–negative dimension. 80 female undergraduates listened to taped segments and rated the counselor using self-involving statements as more professional than the counselor using self-disclosing statements. Positive vs negative disclosures produced no significant differences. Self-disclosing statements directed Ss' attention toward the counselor, whereas self-involving statements kept the focus of counseling on the client. (20 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)