Outcomes of couples with infidelity in a community-based sample of couple therapy.

Infidelity is an often cited problem for couples seeking therapy, but the research literature to date is very limited on couple therapy outcomes when infidelity is a problem. The current study is a secondary analysis of a community-based sample of couple therapy in Germany and Austria. Outcomes for 145 couples who reported infidelity as a problem in their relationship were compared with 385 couples who sought therapy for other reasons. Analyses based on hierarchical linear modeling revealed that infidelity couples were significantly more distressed and reported more depressive symptoms at the start of therapy but continued improving through the end of therapy and to 6 months posttherapy. At the follow-up assessment, infidelity couples were not statistically distinguishable from non-infidelity couples, replicating previous research. Sexual dissatisfaction did not depend on infidelity status. Although there was substantial missing data, sensitivity analyses suggested that the primary findings were not due to missing data. The current findings based on a large community sample replicated previous work from an efficacy trial and show generally optimistic results for couples in which there has been an affair. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effectiveness of play therapy: Responding to the critics.

Notes that play therapy has long been criticized for a lack of adequate research base to prove its efficacy. For 6 decades, while play therapists conducted small research studies, critics challenged the utility and efficacy of play therapy as a viable psychotherapy intervention. The purpose of this study was to conduct a meta-analysis of 94 research studies focusing on the efficacy of play therapy, filial therapy, and combined play therapy and filial therapy. The following electronic databases were used in the authors 3-yr search for studies on play therapy: PsycLit, PsycINFO, ERIC, FirstSearch, and Dissertation Abstracts. Meta-analysis revealed a large positive effect on treatment outcomes with children. Play therapy appeared effective across modality, age, gender, clinical vs nonclinical populations, setting, and theoretical schools of thought. Additionally, positive play therapy effects were found to be greatest when there was parent involvement in treatment and an optimal number of sessions provided. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Cognitive therapy of anxiety disorders: Science and practice.

Reviews the book, Cognitive therapy of anxiety disorders: Science and practice edited by David A. Clark and Aaron T. Beck (2009). Drs. Clark and Beck’s book Cognitive therapy of anxiety disorders: Science and practise is a comprehensive review of cognitive therapy for anxiety from its empirical theoretical foundation to its clinical application to disorders. Although the focus of the text is ultimately on the cognitive treatment of anxiety, the rich theoretical background that is interwoven throughout makes this book of interest to academics and graduate students as well as clinicians. The book is divided into three parts, each with several chapters: 1) cognitive theory and research on anxiety; 2) assessment and intervention techniques used in cognitive therapy for anxiety; and 3) the application of cognitive therapy to specific anxiety disorders (e.g., panic disorder, obsessive– compulsive disorder [OCD]). Overall, this book is an excellent resource for researchers and clinicians working in the field of anxiety disorders. The reference section alone makes it a valuable addition to one’s bookshelf, and the authors have done an excellent job of organising a vast, and at time disparate, body of research into a cohesive review of cognitive theory as it applies to anxiety. Although the treatment chapters may be a bit overly ambitious in attempting to review both the research and the application of the cognitive model to the treatment of specific disorders, the book in its entirety is clearly an essential text for those interested in obtaining a comprehensive understanding of cognitive therapy and anxiety. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Evaluating the generality of findings in analogue therapy research.

Analog research in psychotherapy and behavior therapy has proliferated in recent years. The major source of controversy about the value of analog studies is their external validity, i.e., the extent to which the results can be generalized to the clinical situation. Much of the controversy stems from conceptualizing therapy investigations discretely as either analog or clinical research. All treatment research, however, is an analog of the situation to which an investigator wishes to generalize, and the main question is the extent to which an investigation is an analog of the clinical situation. An investigation can vary from the clinical situation along several dimensions, such as the target problem, the clients studied, the manner of client recruitment, and others. It is often assumed that the greater the similarity of an intervention to the clinical situation, the more likely the findings will be generalizable to the clinical situation. The present article questions this assumption and suggests an empirical method for evaluating the generality of therapy research to the clinical situation. (45 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A critique of the application of sensory integration therapy to children with learning disabilities

Sensory integration (SI) therapy is a controversial--though popular--treatment for the remediation of motor and academic problems. It has been applied primarily to children with learning disabilities, under the assumption that such children (or at least a subgroup of them) have problems in sensory integration to which some or all of their learning difficulties can be ascribed. The present article critically examines the related issues of whether children with learning disabilities differentially exhibit concomitant problems in sensory integration, and whether such children are helped in any way by means specific to SI therapy. An overview of theoretical contentions and empirical findings pertaining to the first issue is presented, followed by a detailed review of recent studies in the SI therapy research literature, in an effort to resolve the second issue. Results of this critique raise serious doubts as to the validity or utility of SI therapy as an appropriate, indicated treatment for the clinical population in question--and, by extension, for any other groups diagnosed as having "sensory integrative dysfunction." It is concluded that the current fund of research findings may well be sufficient to declare SI therapy not merely an unproven, but a demonstrably ineffective, primary or adjunctive remedial treatment for learning disabilities and other disorders.     

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)     

From the Editor.

The research in social sciences has continued to evolve in order to strengthen fields of study that are not typically associated with "hard science." Play therapy is one such field in which research explores variables that are difficult to identify, label, control, and measure. However, emerging professional standards dictate that mental health research will be encouraged to follow stricter guidelines. The field of play therapy is being called on to conduct and provide research that meets prevailing mental health investigation criteria set in the last decade. The "International Journal of Play Therapy," (IJPT) has responded to the field by strengthening requirements for the reporting of play therapy research. The journal seeks to integrate two goals offer research that will ensure the continuation of play therapy as an accepted mental health practice, and offer explanation of play therapy practices to ensure the continued education of our play therapy practitioners. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Evaluating the effectiveness of family therapies: An integrative review and analysis.

A number of previous reviews of studies evaluating the effectiveness of family therapy have varied in their conclusions. This review is the first attempt at an integrated statistical analysis of family therapy effectiveness research. Family therapy was found to have positive effects compared with both no-treatment and alternative treatment controls, as measured by family interactions and behavior ratings. Follow-up data demonstrated that family therapy continued to show positive effects over time, but the effects were diminished and more variable than at posttreatment assessment. Future research should concentrate on comparative outcome studies with specific populations and with both legitimate alternative treatments and placebo controls. In addition, researchers need to describe in greater detail the family therapy procedures that are used. Outcome measures should represent multiple vantage points and should include measures of family interactions, preferably using both self-report and observational methods. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Analytic complexities associated with group therapy in substance abuse treatment research: Problems, recommendations, and future directions.

In community-based alcoholism and drug abuse treatment programs, the vast majority of interventions are delivered in a group therapy context. In turn, treatment providers and funding agencies have called for more research on interventions delivered in groups in an effort to make the emerging empirical literature on the treatment of substance abuse more ecologically valid. Unfortunately, the complexity of data structures derived from therapy groups (because of member interdependence and changing membership over time) and the present lack of statistically valid and generally accepted approaches to analyzing these data have had a significant stifling effect on group therapy research. This article (a) describes the analytic challenges inherent in data generated from therapy groups, (b) outlines common (but flawed) analytic and design approaches investigators often use to address these issues (e.g., ignoring group-level nesting, treating data from therapy groups with changing membership as fully hierarchical), and (c) provides recommendations for handling data from therapy groups using presently available methods. In addition, promising data-analytic frameworks that may eventually serve as foundations for the development of more appropriate analytic methods for data from group therapy research (i.e., nonhierarchical data modeling, pattern-mixture approaches) are also briefly described. Although there are other substantial obstacles that impede rigorous research on therapy groups (e.g., evaluation and measurement of group process, limited control over treatment delivery ingredients), addressing data-analytic problems is critical for improving the accuracy of statistical inferences made from research on ecologically valid group-based substance abuse interventions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perceived effectiveness of filial therapy for a Jamaican mother: A qualitative case study.

Although filial therapy has traditionally been viewed as suitable for children of diverse cultures, there is limited research to support this perspective. This qualitative case study examined the perceived effectiveness of filial therapy for a Jamaican mother and the perceived effect on the mother-child relationship. Findings indicate that some aspects of filial therapy are congruent with the parenting practices and values of this Jamaican mother. The mother reported an increase in empathy, a heightened awareness of her child's needs, and a stronger relationship with her child. She expressed some difficulty with limit setting and tracking skills taught as part of the model. Future research directions include further examination of the compatibility of filial therapy with other Jamaican parents and the effectiveness of group filial therapy with Jamaican parents or other parents of Caribbean descent. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Building a firm foundation in play therapy research: Response to Phillips (2010).

This article is a response to Phillips’s (see record 2010-01037-002) article titled “How Firm Is Our Foundation? Current Play Therapy Research.” Strengths of Phillips’s article are identified as (a) recognition of evidence-based standards in scientific literature, (b) challenge for methodologically sound studies, and (c) clear recommendations for future research. Responses to his concerns were addressed by (a) identifying credible scientific evidence of recent play therapy research studies, (b) providing a balanced interpretation of Bratton, Ray, Rhine, and Jones’s (2005) meta-analysis, and (c) replying to metaquestions in play therapy research. The authors conclude that play therapy researchers have made steady progress in building a firm foundation of play therapy research and continue to do so. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

What the research shows about play therapy.

The results of a comprehensive literature review of 82 play therapy research studies from 1942–2000 are summarized with an emphasis on the effectiveness of play therapy with specific presenting issues and populations. Studies are organized by research topic in chart form to allow play therapists to readily utilize the information to educate parents, schools, judicial systems, managed care systems, other mental health professionals, and other populations with whom they work. Although positive outcomes were noted with each of the research areas, self-concept, behavioral adjustment, social skills, emotional adjustment, intelligence, and anxiety/fear are topics demonstrating the most significance regarding the efficacy of play therapy. Although not all outcomes have supported the use of play therapy as viable intervention, the authors focus primarily on significant findings regarding play therapy effectiveness. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Assessing the effects of clinic-based psychotherapy with children and adolescents.

Recent meta-analyses suggest that psychotherapy is quite effective with children and adolescents. However, most research in those analyses involved controlled laboratory interventions that may not represent typical therapy in clinics. We studied more representative treatment as it routinely occurs, in 9 clinics. We compared 93 youngsters who completed a course of therapy with 60 who dropped out after intake. At intake, the groups did not differ on demographic, family, or clinical measures, including Child Behavior Checklist (CBCL) scores. Six months later (when therapy had ended for 98% of the treated children) and again 1 year later, the 2 groups were compared on CBCL scores, parent ratings of each child's major referral problem, and (for a subsample) teacher reports. No comparison showed significant main effects of therapy. The findings (a) raise questions about the generalizability of findings from research-oriented therapy and (b) suggest that the control and precision of research therapy may be needed in clinical practice. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Time-limited brief therapy has gone too far: The result is invisible rationing.

Proponents of managed care endorse time-limited brief treatment on the belief that time limits result in little or no harm to psychotherapy outcome. However, the research findings cited as favorable to time limits are based on erroneously classified research, and the related research is incorrectly interpreted. Properly classified and interpreted, the research indicates that time-limited therapy is in fact inferior to clinically determined treatment. Both research and reason indicate that time-limited therapy is not an equally effective alternative treatment but merely a form of rationing. Although rationing may be necessary, when time-limited therapy is promoted as equivalent to clinically determined treatment, the consumer is often unaware of the rationing. The result is the ethically questionable practice of invisible rationing. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Group psychotherapy: Studies in methodology of research and therapy. Report of a group psychotherapy research project of the U. S. Veterans Administration.

Reviews the book, Group Psychotherapy: Studies in Methodology of Research and Therapy. Report of a group psychotherapy research project of the U. S. Veterans Administration by Jerome D. Frank and Florence B. Powdermaker (see record 1954-02756-000). According to the reviewer, the project described in this volume was probably the first large-scale formal research into the process of group psychotherapy. The two major objectives of the investigation were to develop methods for studying the process of therapy and the specific problems faced by therapists, and to develop methods which could provide solutions to the problems isolated by the analysis of the treatment process. The book, like the project, has two main divisions, the research with neurotic clinic patients and a controlled study of group therapy with hospitalized schizophrenics. According to the reviewer, whatever its failings as pure research, there can be no question that this is an important and useful book. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clinical supervision from the standpoint of cognitive-behavior therapy.

This article presents an approach to supervising cognitive-behavior therapists that is closely related to the process and content of cognitive-behavior therapy (CBT). The goal of CBT is to help therapists adopt the philosophy of CBT as the basic approach for changing clients' cognitions, emotions, and behaviors. A secondary goal is to teach therapists specific techniques. The seven major features of CBT and their implications for supervision are described: therapy as a meaning-making process; systematic and goal directed therapy; practicing and experiencing; therapy as a collaborative effort; person-focused therapy; the therapists as a facilitator of change and development; and empowerment of the client with self-change skills. Some of the major dilemmas and constraints in CBT supervision that are derived from adapting the principles of therapy to supervision are discussed as well as the need for supervision outcome research and recommendations for its implementation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Whistling in the dark? A review of play therapy research.

Reviews the empirical research on process and outcome in play therapy. Attempts to measure the play therapy process and more specific process findings are considered. Outcome research is examined within particular clinical populations or problems. Play therapy with cognitive–behavioral components is noted as a promising direction, based on the work conducted so far. (65 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Comprehensive process analysis of insight events in cognitive-behavioral and psychodynamic-interpersonal psychotherapies.

Comprehensive Process Analysis (CPA) is an interpretive, qualitative research method for analyzing significant therapy events. CPA was used to analyze 6 client-identified significant insight events in 2 treatments. Two events are presented in depth. The psychodynamic-interpersonal therapy event documented the existence of 2-part significant events and the value of key words. The cognitive-behavioral therapy event illustrated the role of context in transforming small therapy events into significant events. Events in both therapies involved therapist interpretations of recent difficult life events that were delivered in a firm but interactive style. Interpersonal therapy events were distinguished by links to themes from previous sessions and led to awareness of painful emotions. Cognitive therapy events were externalizing reattributions given to more clinically distressed clients. A revised 5-stage microprocess model of the insight is presented. (PsycINFO Database Record (c) 2010 APA, all rights reserved)