Adolescent and parent therapeutic alliances as predictors of dropout in multidimensional family therapy.

The authors examined the relations between adolescent-therapist and mother-therapist therapeutic alliances and dropout in multidimensional family therapy for adolescents who abuse drugs. The authors rated videotapes of family therapy sessions using observational methods to identify therapist-adolescent and therapist-mother alliances in the first 2 therapy sessions. Differences in adolescent and mother alliances in families that dropped out of therapy and families that completed therapy were compared. Results indicate that both adolescent and mother alliances with the therapist discriminated between dropout and completer families. Although no differences were observed between the 2 groups in Session 1, adolescents and mothers in the dropout group demonstrated statistically significantly lower alliance scores in Session 2 than adolescents and parents in the completer group. These findings are consistent with other research that has established a relationship between therapeutic alliance and treatment response. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The efficacy of cognitive behavior therapies: A quantitative review of the research evidence.

Assessed the effectiveness of cognitive behavior therapies in a review of 48 studies of adolescents and adults that compared cognitive behavioral therapy with some form of control group. Analyses indicated that cognitive behavior therapies were superior to no treatment; however, there was no firm evidence that these therapies were superior to other psychotherapies. Analyses failed to find cognitive behavior therapies emphasizing behavioral techniques to be more effective than primarily cognitive approaches. Also, the efficacy of cognitive behavior therapies appeared relatively uniform across diagnostic categories and equally effective when administered in a group or individual format. There was no evidence that sex or age of patient, experience of therapist or even duration of therapy were related to treatment effects. (54 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Comparison of women who enter feminist therapy and women who enter traditional therapy.

A sample of 201 women in feminist therapy and 207 women in traditional therapy was drawn from a national survey of women in consciousness-raising groups. Comparisons were made on political views at the time of entering therapy and on demographic characteristics and evaluations of therapy. There were no differences between clients of feminist and traditional therapy on demographic characteristics, symptom levels (Hopkins Sympton Checklist), and overall levels of life stress (Life-Events Stress Index). Clients of feminist therapists were more likely to describe their political views as radical and to identify themselves as members of the women's movement than were clients of traditional therapists. Clients of feminist therapists rated therapy as more helpful than clients of traditional therapy did. Clients who identified themselves as members of the women's movement evaluated feminist therapy as more helpful than traditional therapy; nonmembers evaluated feminist and traditional therapies as equally helpful. (26 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Identification in group therapy.

"The Ss of this study were male and female adolescents (12-15 years of age) who were asked to volunteer to participate in groups that 'would discuss adolescent problems.' Those who volunteered were rated by their teachers on emotional adjustment. Ss rated as most poorly adjusted were eliminated from the study. Three therapy groups were organized, each composed of five boys and five girls, each in the charge of a different therapist. The members of the group were given a special questionnaire, designed to assess needs, and a group form of the Rorschach before therapy began. At the conclusion of therapy, all Ss again took the questionnaire… . The hypotheses that both rigidity and lability were inversely related to identification were tested by correlational methods. Results were positive in both instances." From Psyc Abstracts 36:01:1IG95B. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Enhancing substance abuse treatment engagement in incarcerated adolescents.

The purpose of this study was to determine whether motivational interviewing (MI), compared with an attention control condition (relaxation training [RT]) enhances substance abuse treatment engagement in incarcerated adolescents. At the start of incarceration, adolescents were randomly assigned to individually administered MI or RT. Subsequently, therapists and adolescents (N = 130) rated degree of adolescent participation in the facility's standard care group-based treatments targeting crime and substance use. All adolescents received the facility standard care treatment after their individual MI or RT session. MI statistically significantly mitigated negative substance abuse treatment engagement. Other indicators of treatment engagement were in the expected direction; however, effect sizes were small and nonsignificant. These findings are significant, given concerns regarding the deleterious effects of treating delinquent adolescents in groups and the potential for adolescents to reinforce each other's negative behavior, which in turn may lead to escalated substance use and other delinquent behaviors after release. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Adolescent prosocial behavior: Peer-group and situational factors associated with helping.

90 8th graders were rated by peers on sociometric dimensions of helpful and popular (and their converses) and were each observed or rated on 6 helping tasks in the school setting that differed in terms of perceived demand characteristics. In general, sociometric nominations were accurate in predicting who was not behaviorally helpful—those Ss rated as the unpopular and unhelpful. Sociometric status of Ss rated more positively by peers did not predict well the level of behavioral performance. To examine the interaction between peer-group status and helping behavior, the most helpful Ss were divided into 2 groups on the basis of peer status. There were significant differences in the types of situations in which these 2 groups performed: More popular helpers scored higher on peer-related helping tasks, whereas less popular helpers were more facilitative in non-peer-related helping tasks. Implications for individual socialization and future research in helping behavior are discussed in relation to peer-group status. (25 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Group treatment of preorgasmic women: Evaluation of partner involvement and spacing of sessions.

Assessed the effects of couples vs women group treatment for primary orgasmic dysfunction and massed vs distributed spacing of sessions. 22 women and their partners were blocked and randomly assigned to 1 of 4 treatment groups: couples massed, couples distributed, women massed, and women distributed. All participants served as their own waiting list controls. Results support the expectation that the couples and women groups would not differ on the self-activities measures. Contrary to the hypothesis, the couples groups were not superior on multiple measures that assessed couple activities and frequency of orgasm via couple activities. Spacing was significant on one variable: Distributed groups rated their spacing more helpful than did massed groups. Analyses of combined-group data for females revealed significant improvements in both self-sexuality and couple sexuality. Data for males showed significant long-term improvements on the majority of couple-activities measures. (18 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Individual versus group therapy for obesity: Effects of matching participants to their treatment preferences.

This study examined the effects of matching participants to treatments on the basis of their preferences for either individual or group therapy for obesity. Seventy-five obese adults who expressed a clear preference for either individual or group therapy were randomly assigned to either their preferred or their nonpreferred treatment modality within a 2 (individual vs group therapy)?×?2(preferred vs nonpreferred modality) factorial design. At posttreatment, group therapy produced significantly greater reductions in weight and body mass than individual therapy, and no significant effects were observed for treatment preference or the interaction for treatment preference by type of therapy. All treatment conditions showed equivalent improvements in psychological functioning. These findings suggest that group therapy produces greater weight loss than individual therapy, even among those clients who express a preference for individual treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Individual and group psychotherapy of childhood aggression: A comparison of outcomes and processes.

The purpose of this study was to compare outcomes and processes of a therapeutic intervention to reduce children's aggressive behavior, delivered in individual and group formats. Children in 15 small groups (n?=?71) and 15 individual treatment children were compared in a pre–post experimental and control design. The Achenbach self-report behavior checklist and teachers' evaluations were used to measure outcomes. To assess outcome results further, the process of change was qualitatively analyzed. In addition, the therapeutic processes were compared using Hill's counselor and client verbal response modes system. Results concerning outcomes indicated reduced aggression of treated children compared with wait-list children, with no differential impact of the format of treatment. The analyses of stages of change supported the similarity in outcomes. Results concerning process variables indicated differences in both therapist and client verbal responses. In therapists' responses, directives were used more in groups and self-disclosure was used more in individual therapy. In clients' responses, most variables were more frequently used in individual therapy. Experiencing was more frequent in group therapy, and there was no difference in insight and simple responses… (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An investigation of systemic conceptualizations of parent-child coalitions and symptom change.

Two important theoretical assumptions of family therapy were examined: (a) Child behavior problems are associated with cross-generational coalitions, and (b) treatment of these coalitions using family therapy leads to decreases in individual symptomatology. Ss were 45 delinquent adolescents assigned to multisystemic therapy (MST) or individual therapy and 16 well-adjusted adolescents. Pretreatment and posttreatment assessments included measures of observed family relations and self-reported symptoms. Cross-generational coalitions were more evident in families of delinquents vs. families of well-adjusted adolescents. In addition, changes in adolescent and paternal symptoms in the MST group were linked with changes in marital relations. Implications for systemic conceptualizations of symptom maintenance and change are highlighted. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Parental criticism and treatment outcome in adolescents hospitalized for severe, chronic asthma

This pilot study investigated the relationship between parental criticism and medical treatment outcome across an inpatient hospitalization in 19 adolescents with severe, chronic asthma. Parental criticism toward their asthmatic adolescent was assessed using the Five Minute Speech Sample technique (FMSS) at the beginning of the adolescent's inpatient stay at a national asthma referral center. Those adolescents whose parents were rated as high in criticism on the FMSS were found to have greater improvement in their overall asthma severity, greater reduction in their steroid medication dose, and shorter lengths of stay in the hospital than those whose parents were rated as low in criticism. The adolescents whose parents were rated as high in criticism also showed lower compliance with their prescribed theophylline and oral steroid medication at admission than the low criticism group. These findings do not appear to be due to misdiagnosis secondary to the presence of vocal cord dysfunction or to the allergy status of the children. Clinical implications and possible causal mechanisms underlying these findings are discussed.     

Individual and family therapy in the treatment of children.

Surveyed 144 clinicians (mean age 42.7 yrs) who evaluate and treat child referral cases to examine whether Ss who define themselves primarily as individually vs family oriented actually differ significantly in their therapeutic practices. 18 Ss were identified as advocating the individual child-oriented approach over the family-oriented approach, 74 Ss advocated the use of both approaches, and 52 Ss advocated a family-oriented approach. It was found that Ss who preferred the individual and combined approaches showed a preference to approach evaluation by first seeing the parents and then shifting to the identified child. Family-oriented Ss preferred an approach that focused on seeing all family members conjointly throughout treatment. Also, individual-oriented Ss showed a greater use of tools that are more closely associated with psychodynamic theory and allow for individual play: projective testing, doll or puppet play, and craft projects. The family-oriented group used more action-oriented, interpersonally focused tools, such as behavioral contracting and assigning tasks. The individual-oriented group rated psychodynamic models as significantly more useful, while the family-oriented group rated family systems models as significantly more useful. (9 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Relationships Between Hope and Outcomes at the Pretreatment, Beginning, and Later Phases of Psychotherapy.

Individual differences in self-reported hope assessed before and during treatment were related to outcome markers of therapeutic improvement. Clients were assigned to either a motivational orientation group or a waiting list group. All clients thereafter received 12 weeks of individual therapy. As hypothesized, higher baseline hope was associated with greater client wellbeing, functioning and coping, and regulation of emotional distress and fewer symptoms. High- relative to low-hope clients also reported that the orientation group was significantly more helpful. As hypothesized, agency scores (tapping motivation) from baseline were associated with positive changes in outcome variables early in therapy, and pathways scores (tapping planfulness) from baseline were associated with positive changes in later therapy sessions. The implications of these findings are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A randomized controlled trial of online versus clinic-based CBT for adolescent anxiety.

Objective: The study examined the relative efficacy of online (NET) versus clinic (CLIN) delivery of cognitive behavior therapy (CBT) in the treatment of anxiety disorders in adolescents. Method: Participants included 115 clinically anxious adolescents aged 12 to 18 years and their parent(s). Adolescents were randomly assigned to NET, CLIN, or wait list control (WLC) conditions. The treatment groups received equivalent CBT content. Clinical diagnostic interviews and questionnaire assessments were completed 12 weeks after baseline and at 6- and 12-month follow-ups. Results: Assessment at 12 weeks post-baseline showed significantly greater reductions in anxiety diagnoses and anxiety symptoms for both NET and CLIN conditions compared with the WLC. These improvements were maintained or further enhanced for both conditions, with minimal differences between them, at 6- and 12-month follow-ups. Seventy-eight percent of adolescents in the NET group (completer sample) no longer met criteria for the principal anxiety diagnosis at 12-month follow-up compared with 80.6% in the CLIN group. Ratings of treatment credibility from both parents and adolescents were high for NET and equivalent to CLIN. Satisfaction ratings by adolescents were equivalent for NET and CLIN conditions, whereas parents indicated slightly higher satisfaction ratings for the CLIN format. Conclusions: Online delivery of CBT, with minimal therapist support, is equally efficacious as clinic-based, face-to-face therapy in the treatment of anxiety disorders among adolescents. This approach offers a credible alternative to clinic-based therapy, with benefits of reduced therapist time and greater accessibility for families who have difficulty accessing clinic-based CBT. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Group composition and group therapy for complicated grief.

This prospective study investigated the impact of group composition on the outcome of 2 forms of time-limited, short-term group therapy (interpretive, supportive) with 110 outpatients from 18 therapy groups, who presented with complicated grief. The composition variable was based on the patient's level of quality of object relations. The higher the percentage of patients in a therapy group who had a history of relatively mature relationships, the better the outcome for all patients in the group, regardless of the form of therapy or the individual patient's quality of object relations score. The findings have direct clinical implications for composing short-term therapy groups for outpatients with complicated grief and possibly for other types of group therapies and patient problems. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social competence and depression: The role of illusory self-perceptions.

Attempted to evaluate the role in clinical depression of 2 personal variables: social competencies (as perceived by others) and their encoding or self-perception by the individual. Both self-ratings and ratings from observers were obtained for 71 depressed, 59 psychiatric control, and 73 normal control individuals following a group interaction at different times in the course of treatment. As expected, the depressed Ss initially rated themselves and were rated by others as less socially competent than the 2 control groups, and their self-perceptions improved with treatment. Surprisingly, the depressed were more realistic in their self-perceptions than the controls. Specifically, the controls perceived themselves more positively than others saw them, whereas the depressed saw themselves as they were seen. This realism of the depressed tended to decrease in the course of treatment. The theoretical implications of a possibly illusory flow for appropriate affect and self-regulation are discussed. (20 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive-Behavioral and Humanistic Group Treatment for Children With Learning Disabilities: A Comparison of Outcomes and Process.

The authors of this study examined the outcomes and processes of 2 types of group treatment--cognitive-behavioral treatment groups (CBTG) and humanistic group therapy (HGT)--offered to 200 elementary schoolchildren in a center for students with learning disabilities in Israel. Results indicated that the addition of either type of group treatment to individual academic assistance was more effective than the latter alone on most measures. In fact, on the majority of measures, group treatment without academic assistance was more effective than just individual assistance. Finally, HGT was more effective than CBTG on most measures. Most of the outcomes were sustained at follow-up, and some even increased from termination to follow-up, although effect sizes were quite low. Process measures included the Client Behavior System and the therapist Helping Skills System, which were measured at 5 points in time. Differences between the 2 treatment types were revealed on both process measures, including differences in the growth curve of these behaviors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)