Moving targets: Patients' changing complaints during psychotherapy.

Used standardized assessment procedure recommended by J. Mintz (1977) to follow up 44 22–58 yr old patients in time-limited marital or family therapy in an investigation of Ss' changing complaints during psychotherapy. Ss were divided into 2 groups: those who were contacted for target-complaint assessment twice (Weeks 1 and 10) and those who were contacted 4 times (Weeks 1, 4, 7, and 10). At termination of treatment, Ss completed global outcome ratings on their success, satisfaction, and improvement with regard to target complaints. It was hyothesized that (1) S-rated improvement on new target complaints would significantly raise the multiple correlation with outcome criteria compared with initial complaints only and (2) the 2 interim measurements of target complaints would not constitute a therapeutic intervention (although previous researchers have contended that defining target symptoms is therapeutic in itself). Results support the hypotheses. ANOVA revealed that membership in either the 2- or 4-contact assessment group was unrelated to the pooled global outcome rating. Across treatment, 56% of Ss listed new target complaints in addition to those mentioned at Week 1. S-rated improvement on these new issues accounted for a significant increment in outcome variance and was the single best predictor of therapy outcome. Findings are discussed in terms of implications for comparative-competitive psychotherapy studies and process and outcome research. (29 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Acceptance, values, and therapeutic change.

Studied the role of therapist acceptance of patient values, patient acceptance of therapist values, and value persuasion on outcome among 13 psychotherapy dyads. Therapists consisted of 13 graduate students in clinical psychology, all of whom had been trained in relationship/insight-oriented therapy. The 13 17–25 yr old patients were randomly selected, 1 from each therapist's caseload. Before beginning therapy all therapists completed a series of value questionnaires; patients completed the same scales after the 1st and 12th therapy sessions. A priori assessment of value acceptance was related to patients' perceptions of their therapists and ratings of improvement, with outcome being enhanced by selective value rejection as well as acceptance. A significant relationship was found between the patients' acquisition of their therapists' values and their ratings of improvement. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Client improvement on higher and lower intensity problems as a function of group cohesiveness.

16 graduate students (mean age 28.5 yrs) met in 2 separate therapy groups for 10 wks. S-selected outside raters evaluated Ss' improvement or deterioration in problem resolution. Ratings were performed on both disclosed problems and on nondisclosed control problems that Ss had indicated as of higher or lower intensity. It was determined that the order of problem improvement was: (1) disclosed higher-intensity problems, (2) disclosed lower-intensity problems, (3) nondisclosed lower-intensity problems, and (4) nondisclosed higher-intensity problems; all differences were significant. More problems were disclosed in higher-cohesive sessions, and external raters' S improvement on problems disclosed in higher-cohesive sessions was significantly greater than those disclosed in lower-cohesive sessions. Results are discussed in relation to group therapy. (9 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Exploring minors' reluctance and dissatisfaction with psychotherapy.

Among 42 10–19 yr olds with learning and associated behavioral or emotional problems who had been referred for counseling, 79% manifested some form of reluctance or dissatisfaction, as demonstrated by refusal to participate, expressions of ambivalence, avoidance, or premature termination. The most frequent reasons for negative attitudes toward psychotherapy were perceived negative attributes of therapy, Ss' feeling that they did not need therapy, and lack of choice in the decision. Ss' mothers and therapists tended to attribute their resistance to therapy to defensiveness, rebellion, or other negative attributes of the Ss. Ss who were reluctant to enter therapy rated it as less important and were rated by their therapists as less committed than Ss who were not reluctant to begin therapy. A 1-yr follow-up of 25 Ss showed a high degree of consistency in Ss' attitudes toward and decisions regarding psychotherapy. (15 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Parent and therapist evaluation of behavior therapy in a child psychological clinic.

Obtained evaluations from the parents of 70 children who were treated by psychological interns being trained in behavior therapy. Therapist ratings of specific problem improvement were obtained at close of therapy. Improvement ratings of the same specific problems were obtained from parents approximately 6 mo later. Classification of an S as improved or unimproved depended on the averages of both the therapist and parent ratings of the presenting problems. This procedure indicated overall improvement in 87 and 90% of the cases, based on therapist and parent averages, respectively. Therapists rated 80% of all specific problems improved at termination, as compared to 77% of problems improved as rated by parents at follow-up. Correlation between the improvement ratings of each problem by parent and therapist was highly significant (r = .51). 96% of the parents liked their therapists, and personal characteristics most frequently noted by the parents were warmth, understanding, and sincere interest in the S. The high improvement rates reported by therapists and parents are discussed in regard to previous therapy outcome studies with children. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Contingency and control beliefs as predictors of psychotherapy outcomes among children and adolescents.

Suggests that control-related beliefs may predict problem-solving behavior in psychotherapy if 2 conditions are met. First, distinction must be made among beliefs about outcome contingency, personal competence, and control (defined as the capacity to cause intended outcomes). Second, beliefs must be assessed for the specific behavioral domain that is the object of prediction (rather than global locus of control). This was tested among 78 8–17 yr olds referred for outpatient therapy. At the outset, Ss answered probes assessing contingency, competence, and control beliefs about solving problems at home and at school. At the outset and again 6 mo later when therapy had ended, parents reported the Ss' problems at home and at school, using the Child Behavior Checklist. Perceived contingency and perceived control accounted for 29% of the variance in total problem reduction, indicating that the 2 beliefs were related to problem solving during therapy. This suggests that the effects of child psychotherapy may be enhanced by targeting children's contingency and control beliefs for intervention. (39 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Individual decision processes in an assessment center.

Analyzed individual ratings made by 46 assessors working in an assessment center for the selection of entry-level managers. 10 Ss' ratings (each of whom had rated more than 200 assessees) were individually subjected to confirmatory factor analyses (using linear structural relations) and examined within a lens model framework. Support was found for both a formal and informal method of arriving at an overall assessment rating. Subgroup analyses suggest that there was little effect of assessee sex on the way Ss arrived at a rating. (18 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognition and psychopathology: An analysis of social introversion and self-statements.

Administered the MMPI and the Social Interaction Self-Statement Test (SISST) to 92 18–49 yr old mental health center clients as part of the intake process. Ss' self-ratings and clinicians' ratings on the degree to which shyness had been a problem for S were also obtained. Results show that the Social Introversion scale of the MMPI was the most efficient predictor of the SISST scales. Both measures were equally efficient in predicting clinicians' ratings of shyness. Findings support the notion that cognitive assessment methods may complement information obtained by traditional assessment methods. (2 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perceptions of client needs and counseling center staff roles and functions.

Used a national sample of 205 university and college counseling center staff members to obtain ratings of Ss' perceptions of changes in client presenting problems, changes in agency expectations with regard to 9 service-related tasks, and their comfort and skill in performing these tasks. Ratings were obtained from past and present time perspectives to aid in assessing perceived changes in these areas. Results indicate that Ss perceived client problems to be changing from more informational/educational to more serious emotional/behavioral problem areas. At the same time, staff members across all experience levels reported an increased pressure to perform in 7 of the 9 tasks listed. Staff members generally rated themselves as able to meet current service demands. Implications for counseling training programs indicate that an emphasis on acquiring traditional therapy and assessment skills may become increasingly important and that opportunities for specialty training should be expanded. (9 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Measuring the outcomes of psychotherapy: Findings of the Penn Psychotherapy Project.

Reports analyses of outcome measures obtained from patients, therapists, and clinical observers in the Penn Psychotherapy Project, a 5-yr study of factors that predict outcome in outpatient psychotherapy. The data from the "method factors" study by D. S. Cartwright et al (see record 1963-06833-001) were also reanalyzed. Results in both studies were very similar. Substantial agreement was found among viewpoints about broadly defined treatment outcomes, although distinct viewpoints did clearly exist. Contrary to a common opinion, consensus measures of psychotherapy outcome could be meaningfully defined. Relationships among posttreatment ratings of benefits from therapy and measures of adjustment obtained before and after treatment were explored. A strong relationship was found between the residual gain score and ratings of benefits, suggesting that posttreatment ratings of outcome take account of the fact that the amount of change to be expected depends on the initial level of functioning. (31 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Personality traits as seen by patients, therapists and other group members: The Big Five in personality disorder groups.

Interactional group psychotherapy is based on the assumption that patients bring their problematic personality problems into the group, and that feedback and the ability to test new behaviors leads to change. A corollary of this assumption is that there should be consensual validation among therapists and other group members (OGMs) regarding a patient's personality. The present study tested this corollary. 35 group patients with personality disorders were rated by themselves, their therapists, and OGMs on a measure of the Big Five personality factors. Substantial agreement was found between the therapists and OGMs regarding a target patient's personality, with lesser agreement with the target patient's self ratings. Furthermore, the degree of agreement between self and others was positively related to the number of personality disorder symptoms prior to beginning the group. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Patient and therapy process variables relating to dropout and change in psychotherapy.

Investigated the relationship between pretherapy patients and process variables and change in 91 19–54 yr old adults who received psychotherapy from 26 trainees at a university teaching hospital. Pretherapy measures included Rotter's Internal–External Locus of Control Scale, the Eysenck Personality Inventory, and the SCL-90 (Revised). Upon termination of therapy, Ss completed the SCL-90, the Barrett-Lennard Relationship Inventory—Form OS64, and a personal evaluation form; therapists completed a psychotherapy process inventory and a discharge summary. Results indicate that process variables rather than preexisting S traits were the best predictors of outcome. Therapist ratings of Ss' involvement in therapy were the best single predictor of symptomatic change. Variables differentiating dropouts from remainers were also investigated. Few outcome differences were observed between Ss who remained in and Ss who dropped out of therapy. (27 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

College students as companions to long-term mental hospital patients: Some considerations.

51 student volunteers for a companionship program each visited a mental hospital patient 1 hr/wk, for an average of 18 wk. Ss' ratings of certain aspects of patients' appearance and behavior correlated with psychiatric aides' ratings of patients' contact. But only the behavior ratings (rather than appearance ratings) correlated significantly with Ss' liking for the relationship. Patients' sex, education, years of hospitalization, and age were the best predictors of Ss' interest in future companionship. Some implications are that the Ss' apparent discouragement in relating to chronic patients might be lessened if experienced students were assigned to long-term patients and if the period of companionship were shortened. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effect of audiorecording and videorecording on client satisfaction and self-expression.

Examined the effects of audiorecording and videorecording for the purpose of counselor supervision on 60 undergraduates with personal or education-vocational problems. Videorecording inhibited the self-exploration of Ss with personal problems and resulted in less satisfaction with counseling. Both recording methods inhibited self-exploration in Ss with educational-vocational problems, but neither method affected their satisfaction. Recording methods also affected Ss' self-reports of the extent to which they felt inhibited by these methods, and the effect was equal across problem types. The effects of recording did not decrease from the 1st-2nd interview. Recording did not affect Ss' responses to, or counselors' ratings of the Ss on, an excitation-inhibition scale. (19 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Teacher judgments concerning the acceptability of school-based interventions.

Investigated the influence of behavior problem severity, interventionist, and modality of case presentation on teacher's judgments of school-based interventions. 54 regular and special education teachers attending a university summer course used an intervention scale and the Semantic Differential to rate all possible combinations of 2 interventions (principal or teacher implemented) applied to 2 behavior problems (daydreaming and destruction of others' property). Ss read about or viewed a videotape of a 5th-grade boy engaging in 1 of the 2 problem behaviors. An ANOVA of Ss' ratings of intervention acceptability showed that behavior problem severity and interventionist significantly affected Ss' judgments of intervention acceptability. Findings show that interventions that could be implemented by the teacher were more acceptable. In addition, Ss rated interventions as more acceptable when applied to behavior problems of greater severity. (16 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social competence promotion with inner-city and suburban young adolescents: Effects on social adjustment and alcohol use.

Assessed the impact of school-based social competence training on skills, social adjustment, and self-reported substance use of 282 6th and 7th graders. Training emphasized broad-based competence promotion in conjunction with domain-specific application to substance abuse prevention. The 20-session program comprised 6 units: stress management, self-esteem, problem solving, substances and health information, assertiveness, and social networks. Findings indicated positive training effects on Ss' skills in handling interpersonal problems and coping with anxiety. Teacher ratings revealed improvements in Ss' constructive conflict resolution with peers, impulse control, and popularity. Self-report ratings indicated gains in problem-solving efficacy. Results suggest some preventive impact on self-reported substance use intentions and excessive alcohol use. In general, the program was found to be beneficial for both inner-city and suburban students. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Therapists' liking of their psychotherapy patients: Some issues related to severity of disorder and treatability.

57 American and Israeli psychotherapists completed the MMPI and questionnaires on professional background and personal experience in psychotherapy. Ss each nominated 1 "easy" and 1 "difficult" patient, and MMPIs and personal information were obtained from these patients. Several factors appeared to differentiate easy from difficult psychotherapy patients. The general characteristics of easy as compared to difficult patients indicated significantly less pathology on the MMPI, a more favorable psychotherapy prognosis, greater physical attractiveness if female, and less of a tendency to be labeled "personality disorder." The positive "liking" ratings of therapists toward their easy patients appeared to override all ideological differences in therapeutic orientation. The impact of the therapist's affective response is discussed in terms of "nonspecific" treatment factors that may affect the outcome of therapy. (21 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Lack of synchronized seasonal variation in the intensity of psychological problems.

Temporal variation in the subjective intensity of psychological problems identified by 40 psychotherapy clients (most diagnosed as depressed) was investigated longitudinally. Each client rated the intensity of 10 individualized problems 3 times per week (on Tuesdays, Thursdays, and Sundays) for an average of 6 mo. Ratings from all clients were spread over 3 yrs. When scores were statistically adjusted for client differences and average rate of improvement, no significant variation among months was found, regardless of problem content or client gender. Standard assessment measures administered 4 times to each client also failed to show systematic seasonal variation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The prediction of child psychotherapy outcome: Factors specific to treatment.

Examined the prediction of child psychotherapy outcome from client, parent, and process factors specific to the therapeutic relationship. 31 children (mean age 11 yrs) were assessed by some independent and therapist ratings, as were parental behaviors, at admission and at discharge from a community mental health center. The primary diagnoses were adjustment disorder (89%) and functional enuresis (11%). Process was evaluated by therapist ratings on the Psychotherapy Process Inventory by P. E. Baer et al (see record 1981-11629-001). Results support the importance of treatment dosage and client participation to global change in impairment and are consistent with findings of B. Gomes-Schwartz (see record 1979-26509-001). Change (decrease) in the severity of Ss' primary problem through treatment was predicted by less frequent parental psychological punishment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)