Group therapy of phobic disorders by systematic desensitization.

Phobic patients were placed in groups receiving either insight or desensitization (Wolpe, 1958) therapy. In approximately 20 sessions, 13 of 18 Ss treated by Wolpe's method were able to tolerate the fantasy of their phobic situation as well as to live through the experience outside of therapy without experiencing anxiety. Only 2 patients were symptom free in a comparable number of hours of insight-oriented group therapy. The 15 non-symtom-free Ss in the latter group were then placed in densensitization groups: 10 improved in 10 sessions. The implication of the results were discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Treatment of anxiety through systematic desensitization in therapy groups.

The effects of short-term treatment by modified systematic desensitization in time-limited intensive therapy groups were evaluated in a matched groups design. 10 chronically anxious college males, treated by the group method, were evaluated on the basis of personality and anxiety scales against an "own-control" period, and 4 equated groups of 10 Ss each. 1 group served as an untreated control for evaluating extra-treatment effects on college grade-point average, as an objective, public criterion. Ss in the remaining groups received 1 of the following individual treatments: systematic desensitization, insight-oriented psychotherapy, or an attention-placebo treatment. The group method produced several significant improvements, suggesting that combined group desensitization offers an efficient and effective treatment for social-evaluative anxiety. (27 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Treatment of insomnia using a variant of systematic desensitization.

Describes the treatment of a case of severe insomnia. The treatment, a variant of systematic desensitization, was short and apparently quite successful. The primary difference between usual desensitization procedures and those employed in this case was the absence of a fear hierarchy. A trainee-O was present during several training and early therapy sessions. He observed 2 therapy sessions and then became the therapist. He was directly supervised for 2 more therapy sessions and then continued treatment singly. The case illustrates the flexibility of behavior therapy in both procedural variations and in training of therapists. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Experimental desensitization of phobia.

24 snake phobic Ss participated in an experimental investigation of systematic desensitization therapy. Ss who experience desensitization showed a greater reduction in phobic behavior (as measured by avoidance behavior in the presence of the phobic object and self-ratings) than did nonparticipating controls. Ss tended to hold or increase therapy gains at a 6-month follow-up evaluation, and gave no evidence of symtom substitution. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A psychoanalytic reinterpretation of the effectiveness of systematic desensitization: Experimental data bearing on the role of merging fantasies.

Subjected 10 women with insect phobias to a variant of systematic desensitization in which a procedure aimed at stimulating a fantasy of "merging with mother" was substituted for muscle relaxation. The procedure consisted of the tachistoscopic subliminal exposure of the verbal stimulus MOMMY AND I ARE ONE during the visualization part of desensitization, whenever the S's anxiety rose above a specified level. A control group of 10 other women with insect phobias underwent the same procedure except that the subliminally exposed message was the neutral stimulus PEOPLE WALKING. On measures of both phobic behavior and anxiety, the experimental group manifested significantly more improvement than the controls. This supports the proposition that (part of) the effectiveness of systematic desensitization resides in its activating unconscious merging fantasies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Brief successful psychotherapy of a chronic phobic reaction.

A report demonstrating the use of hypnosis in the therapy of a phobic reaction. Hypnotic and posthypnotic suggestions were used to help uncover the affectively-laden but forgotten experiences which elucidated the meaning of the phobia, as well as to help the patient relive, work through, and accept the insights gleaned therefrom, both during the therapeutic hour, between therapeutic hours, and after termination. It was felt the use of hypnosis in this case helped shorten the duration of the therapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A comparison of completers and noncompleters of exposure-based cognitive and behavioral treatment for phobic and anxiety disorders in youth.

This article examined sociodemographic and clinical characteristics of child treatment completers, and noncompleters who received exposure-based cognitive-behavioral treatment. A total of 137 children (46% girls) and their parents (predominantly Euro-American and Hispanic/Latino) participated in this study (106 completers, 31 noncompleters). The majority of noncompleters, received an average of 5 sessions. Findings were generally consistent with past research in terms of lack of differences between completers; and noncompleters. Results are discussed in the context of previous child attrition research and directions for future research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The treatment of two phobic patients on the basis of learning principles.

"The treatment of two phobic patients has been described. Case 1 manifested an excessive fear of going out on her own; Case 2 displayed disabling symptoms in the form of an excessive fear of going into enclosed and crowded places. Both cases had blackouts of unknown nature. The treatment program for both cases was mainly based on the principle of primary stimulus generalization. Owing to the more "diffuse" nature of the anxiety displayed by Case 2, an additional simple conditioning technique was employed." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Affect-focused body psychotherapy in patients with generalized anxiety disorder: Evaluation of an integrative method.

The aim of this study was to explore the long-term effects of affect-focused body psychotherapy (ABP) for patients with generalized anxiety disorder (GAD). A group of 61 consecutive patients, 21–55 years old, were randomized to ABP and psychiatric treatment as usual (TAU). The patients were assessed before treatment and followed up 1 and 2 years after inclusion. The ABP patients received one session of treatment per week during 1 year. Three self-report questionnaires were administered; Symptom Checklist—90, Beck Anxiety Inventory, and the WHO (Ten) Well-Being Index. In both groups, there was a significant improvement. On termination, the ABP group had improved significantly more on the SCL-90 Global Symptom Index than the TAU group, whereas the differences were short of significance on the other two scales. The integration of bodily techniques with a focus on affects in a psychodynamically informed treatment seems to be a viable treatment alternative for patients with GAD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reflections on the "unknown" in psychotherapy.

Suggests that "darkness" (in contrast to and in alternation with "light") is useful as a metaphor for representing ever-recurring periods in dynamic psychotherapy during which the therapist does not and cannot know what is occurring in the work with his/her patient. Such unfathomable "dark" periods are a fertile matrix from which central meanings in a patient's life will emerge, provided the therapist does not interfere with their unfolding. However, these "dark" periods are anxiety provoking for the therapist and often result in anxiety-instigated, growth-deflecting efforts at prediction and control. Clinical vignettes are presented to illustrate the inevitable rhythm of alternation in therapy between "darkness" and "light," the imponderability of various key therapeutic events, and the therapist's struggles with these issues. (1 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Hypnosis versus systematic desensitization in the treatment of test anxiety.

Assessed the comparative effectiveness of systematic desensitization (SD) and the directed experience hypnotic technique (HT) in reducing self-reported test anxiety and increasing the academic performance of 36 test-anxious undergraduates. Ss were assigned randomly to either the HT or SD conditions or to 1 of 2 control groups. All Ss had previously scored above the 50th percentile on Sarason's Test Anxiety Questionnaire (TAQ) and below the 85th percentile on a midterm exam. Results indicate that only the SD treatment significantly reduced TAQ scores. No significant improvement in academic performance was observed for either treatment. An additional analysis of high- vs moderate-anxious subgroups failed to show differential treatment effects on either dependent measure. (18 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The future of psychotherapy.

This "article" contains two blank pages, as an indication of G. W. Albee's concerns about the future of psychotherapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Comparative psychotherapy: Rational-emotive therapy versus systematic desensitization in the treatment of stuttering.

15 male and 5 female patients (mean age, 28 yrs) at a speech and hearing center were given either no treatment or 8 45-min intensive rational-emotive (R-E) or systematic desensitization (SD) therapy sessions with or without in vivo tasks. In vivo behavioral tasks included 5 telephone calls to persons defined as significant acquaintances by Ss and 5 spontaneous discussions with relative strangers. Assessment measures (TAT, Institute for Personality and Ability Testing Anxiety Scale, and Iowa Scale of Attitudes Toward Stuttering) were administered before, immediately and 1 mo after treatment. R-E therapy was more efficacious than SD in reducing stuttering behavior as well as accompanying anxiety and negative attitudes toward stuttering. SD, however, did fare better than no treatment (control) in reducing speech disfluencies. The inclusion of in vivo tasks did not have consistent effects across all criterion measures but did add to both therapies in influencing attitudes toward problem speech in the desired directions. Results favor a cognitive-behavioral approach to stuttering over a traditional behavioral approach. (15 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Disturbances and silences in the patient's speech in psychotherapy.

"Linguistic measures of the patient's anxiety in therapeutic interviews can be useful in several areas of research… . On empirical and theoretical grounds, speech disturbance and silence seem to be expressive attributes that are useful as anxiety indices… . Data from 2 cases show that the 2 measures discriminate 'some thing' between-sessions and within-sessions for a given patient. Motivational phase judgments have been proposed as useful criteria for validating the Speech-Disturbance Ratio and Silence Quotient as anxiety measures. Detailed knowledge of the dynamic context of the interview is necessary to make such judgments of criteria since manifest content is of limited value in this regard… . Preliminary results of the proposed validation procedure indicate that the present approach is fruitful." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Comorbid anxiety disorders and treatment of depression in people with multiple sclerosis.

Objective: Anxiety is highly comorbid with depression, but little is known about the impact of anxiety disorders on the effectiveness of empirically supported psychotherapies for depression. We examined such outcomes for people with Multiple Sclerosis (MS) and depression, with versus without comorbid anxiety disorders. Design: Participants with MS (N = 102) received 16 weeks of telephone-administered psychotherapy for depression and were followed for one year post-treatment. Results: Participants with comorbid anxiety disorders improved to a similar degree during treatment as those without anxiety disorders. Outcomes during follow-up were mixed, and thus we divided the anxiety diagnoses into distress and fear disorders. The distress disorder (GAD) was associated with elevated anxiety symptoms during and after treatment. In contrast, fear disorders (i.e., panic disorder, agoraphobia, social phobia, specific phobia) were linked to depression, specifically during follow-up, across 3 different measures. Conclusions: People with GAD receiving treatment for depression may benefit from additional services targeting anxiety more specifically, while those with comorbid fear disorders may benefit from services targeting maintenance of gains after treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Frequency of treatment and change in psychotherapy.

To test the hypothesis that frequency of weekly interview has a selective effect on psychological changes in patients in individual psychotherapy, 133 VA outpatients were randomly assigned to 3 schedules: twice, once, and bi-weekly. Changes were measured by tests based on objective evaluation of personality characteristics and assessed after 4 mo., 8 mo., and 12 mo. of therapy. The results failed to confirm that there was any major support for the hypothesis that frequency of contact produced differences in personality changes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Comparison of relaxation as self-control and systematic desensitization in the treatment of test anxiety.

Relaxation as self-control and desensitization were compared to a waiting-list control in the reduction of test and other anxieties in 43 undergraduates. Neither active treatment differed significantly from the other, but they did differ significantly from the control treatment on several variables. Ss in both treatments reported less debilitating test anxiety, whereas desensitization Ss showed greater facilitating test anxiety. Under stressful conditions, treated Ss were less worried and anxious, found the situation less aversive, and perceived themselves and their abilities more favorably than controls. Significant reductions in nontargeted anxieties suggested transfer of anxiety-management skills to areas other than test anxiety. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Adult attachment and history of psychotherapy in a normative sample.

The willingness to trust and self-disclose to others, key aspects in the decision to seek psychotherapy, is expected to vary across attachment classifications. The current study examined the association between internal working models of attachment and history of psychotherapy in a middle-class sample of 120 women, who were administered the Adult Attachment Interview (C. George, N. Kaplan, & M. Main, 1985/1996) and the Mental Health Survey (S. A. Riggs & D. Jacobvitz, 2002). Findings supported predictions that security of attachment is linked to history of psychotherapy. Specifically, adults classified as Dismissing were less likely than other adults to report a history of psychotherapy, whereas Secure adults reported the highest rates of couples therapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The efficacy of psychodynamic psychotherapy.

Empirical evidence supports the efficacy of psychodynamic therapy. Effect sizes for psychodynamic therapy are as large as those reported for other therapies that have been actively promoted as “empirically supported” and “evidence based.” In addition, patients who receive psychodynamic therapy maintain therapeutic gains and appear to continue to improve after treatment ends. Finally, nonpsychodynamic therapies may be effective in part because the more skilled practitioners utilize techniques that have long been central to psychodynamic theory and practice. The perception that psychodynamic approaches lack empirical support does not accord with available scientific evidence and may reflect selective dissemination of research findings. (PsycINFO Database Record (c) 2010 APA, all rights reserved)