Is there utility for treatment utility?

Comments on the article by S. C. Hayes et al (see record 1988-11276-001) on the use of treatment utility as a criterion for evaluating assessment procedures. The present author argues that the treatment utility concept has several logical difficulties concerning which assessment practices have treatment utility and how they influence intervention outcomes. What kinds of change are associated with what kinds of practices, practitioners, patients, and problems in what contexts are at the center of these logical difficulties. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The treatment utility of assessment: A functional approach to evaluating assessment quality.

In practical terms, the sine qua non of the modes, methods, devices, strategies, and theories of clinical assessment is their contribution to treatment outcome. The importance of this contribution has often been noted, but under many different labels and rationales. The resultant conceptual confusion has considerably restricted the visibility and frequency of research in this critical area. In this article we propose a name for the impact of assessment on treatment outcome: the "treatment utility of assessment." Some of the questions that can be asked about the treatment utility of assessment are described, and methods appropriate for asking them are examined. Finally, the implications of this kind of utility for other approaches to evaluating assessment quality are analyzed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The utility of empirically supported treatments.

How does a psychotherapist decide what treatment approach is most appropriate for a client? This issue has been addressed by the Division 12 Task Force on Promotion and Dissemination of Psychological Procedures (1995) and has stimulated considerable debate among psychologists about the importance of identifying, teaching, and practicing empirically supported treatments (ESTs). This article examines recent literature supporting both sides of this issue in an attempt to identify and understand the arguments in favor of and against the movement to identify and implement ESTs and their treatment manuals. On the basis of current research related to ESTs, recommendations are offered pertaining to practice, research, and training. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The utility of hermeneutic interpretation in psychotherapy.

Examines how a hermeneutic psychotherapy might be possible by adapting interpretive theory arising in the human sciences and in response to the critiques that continue to question hermeneutics proper. Based on the work of several noted researchers, including M. Foucault (1972, 1976), M. Merleau-Ponty (1962, 1964), and H. Dreyfus and P. Rabinow (1983), such topics as the relationship of psychoanalysis and phenomenology, the distinction of hermeneutics and interpretive analytics, hermeneutics and the deep self, and hermeneutics and psychoanalysis are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Functional assessment in behavioral consultation: A treatment utility study.

The primary purpose of the study was to examine the utility of functional assessment in comparison to a technological approach to treatment. Specifically, we investigated the treatment utility of functional assessment within a behavioral consultation framework to determine the effect of different uses of assessment data on child treatment outcome. Participants consisted of 19 preschool children enrolled in a Head Start program who demonstrated social and/or behavioral problems in the classroom. Their classroom teachers participated in the study as consultees who received help from trained consultants in identifying target behaviors and implementing classroom-based interventions. Participants were randomly assigned to two conditions: a consultation approach utilizing functional assessment methods to develop individualized behavioral interventions, or a consultation approach that used nonfunctional analytic assessment methods and a standard treatment package of self-help materials. The outcomes of the individual consultation cases were analyzed with case study methodology to determine behavior change and, in general, consultation resulted in positive treatment outcomes that were moderate in magnitude. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The general applicability of a scale for rating research productivity.

"The RBD III, a forced-choice rating form to provide scores indicative of a person's productive research behavior in physical science research settings, was administered in a setting other than the one in which it was developed." 50 Ss were selected at random from 168 research engineers. Supervisory judgments of a person's creativity activity indicated its validity. The "RBD III can be used to provide criterion scores for research productivity in other physical science research settings." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The role of applicability in the emergence of the overattribution bias.

Study 1 assessed participants' theories regarding various issues previously used in overattribution bias studies. Results suggest that personality plays an important role in explaining positions on these issues. Studies 2, 3, and 4 indicated that the overattribution bias is contingent on the explanatory applicability of accessible concepts for a particular issue. Study 2 used an issue associated with personality; an overattribution bias emerged only when personality was stressed in the instructions. Study 3 used an issue associated with a sociological theory; this time, an overattribution bias appeared only when a socioeconomic concept was emphasized. Essays were not circulated in Studies 2 and 3, but were in Study 4. Again, the bias appeared only when an applicable (personality) concept was activated. These results, which extend the range of applicability, are discussed within the framework of the social judgability approach. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The utility of motivational interviewing as an adjunct to exposure therapy in the treatment of anxiety disorders.

Motivational interviewing (MI; W. R. Miller & S. Rollnick, 2002) was designed as a prelude to standard substance use treatment. Because of its purported capacity to resolve ambivalence about change, MI has been applied to many other behavioral and mental health problems. Ambivalence about engaging in exposure-based therapies is common among those with anxiety disorders, and systematic efforts (e.g., MI) to ameliorate such ambivalence may yield superior clinical outcomes. The use of MI as an adjunct intervention to standard exposure therapy in anxiety disorders is explored with a focus on treatment retention and adherence. Shared and disparate treatment difficulties among substance use and anxiety disorder populations suggest that MI may be especially effective with anxiety disorders. Empirical evidence supporting the use of MI with substance abuse and anxiety disorder populations is presented. Practical aspects of MI's clinical application as an adjunct intervention to standard exposure therapies for anxiety disorders are discussed. Last, a future research agenda is delineated. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The utility of measuring the skillfulness of therapeutic techniques.

Discusses the attempts made by researchers to measure the extent to which a given psychotherapeutic technique is carried out and applied skillfully in evaluating the efficacy of a given type of psychotherapy. Such measures are objective and are used in research designs that have generalizability. They also provide an opportunity to test theories of how psychotherapy helps patients. It is asserted that conceptualizing therapist behavior in terms of the specific factors has less of a tendency to perpetuate the therapist "uniformity myth" than conceptualizing therapist behavior in terms of nonspecific factors. (29 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Teaching ethics: The utility of the CPA code.

Teaching professional ethics can take 2 very different forms, reflecting different fundamental assumptions about ethical rules, and leading to different problem-solving strategies in professional life. In this article, the author outlines and contrasts the 2 approaches, which he calls the overriding principle approach and the moral dilemma approach. The first reifies ethical principles and underpins them with rationales drawn from moral philosophy. The second sees principles as templates of default options, which may or may not fit the facts of the case and the context in which a decision must be made. In the moral dilemma approach, for instance, there is always some circumstance in which following a particular moral rule would produce the wrong result. The Canadian Psychological Association Code of Ethics has different advantages and disadvantages for teaching professional ethics depending on one's fundamental approach. The author concludes that although he believes its rhetoric and its ordering of rules seems to reflect the overriding principle approach, the Code is actually more relevant to the moral dilemma approach. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Organizational commitment: The utility of an integrative definition.

Reports a series of 9 studies, with a total of 2,734 adults, in which the construct definition, measurement, and validation of organizational commitment (OC) were evaluated. An integrated examination of a wide range of antecedents of the various dimensions of OC was conducted. Results support the existence of 3 major OC dimensions (affective, continuance, and normative), with 2 subdimensions (personal sacrifice and lack of alternatives) for the continuance dimension. Results suggest that the widely used Organizational Commitment Questionnaire (L. Porter et al; see record 1975-06351-001) assesses primarily the affective dimension. Results provide various levels of support for the set of proposed antecedents. Implications for construct definition, measurement, and future research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The utility of open-ended measures to assess intergroup ambivalence.

Demonstrated the utility of open-ended measures for assessing intergroup ambivalence. 42 Canadian undergraduates completed open-ended measures of stereotypes (beliefs about characteristics of group members), symbolic beliefs (beliefs that group members promote or threaten cherished values), and emotions, in order to determine their degree of ambivalence toward Native Peoples, French Canadians, Oriental Immigrants, and Canadians. Ss also completed an attitude measure assessing their overall evaluations of the groups. Examination and comparison of these measures revealed findings consistent with the following theoretical expectations: (1) the positive and negative dimensions were not highly negatively correlated, (2) ambivalence toward the groups differed, and (3) ambivalence toward the groups was not highly correlated. Results support the open-ended measure of ambivalence. (French abstract) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The value and utility of the 1992 ethics code.

This article describes organizational and conceptual strengths of the current American Psychological Association's ethics code within the context of the diversity of activities in which psychologists are engaged and the constantly changing realities of professional and legal responsibilities. The article places into practical perspective (a) the revised format, choice of wording, and enforceability of the code; (b) protections for students, supervisees, research participants, and diverse groups; (c) requirements for informed consent to psychotherapy, continuity of care, and appropriate termination; (d) restrictions regarding multiple relations; and (e) standards particularly relevant to teaching, research, forensic, and managed care contexts. Discussion aims at assisting psychologists in using the ethical principles and standards to conduct their activities in morally responsible ways and avoid potential ethical violations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Lay persons' sensitivity to statistical information: The case of high perceived applicability.

Six experimental studies were conducted to test the notion that lay persons are insensitive to statistical information when they are in the presence of individuating information allowing judgment by representativeness. Ss were 174 Israeli undergraduates and 259 members of the Israel Defense Forces. Two experiments examined the effects of reliability information on the regressiveness of predictions and on judgmental confidence. Two additional experiments examined the effects on confidence of informational redundancy. The final 2 studies examined Ss' capacity to reason in accordance with the notion of statistical information when its situational applicability is made apparent. On the basis of this and previous evidence, it is concluded that statistical rules seem to be used in accordance with the same rules that govern the use of nonstatistical rules, such as the "representativeness" rule and other rules of various contents. (23 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

From leadership to parenthood: The applicability of leadership styles to parenting styles.

Lewin's (1948) three styles of leadership and group dynamics provided the basis for Dreikurs' (1995) formulation concerning parental styles. Baumrind's (1971) later parenting typology, also based on Lewin, focused on parent-child dyads, whereas Dreikurs referred to the total family patterning with parents as group leaders. The present article measured young adults' perceived parenting values that occurred in childhood and corresponded to Dreikurs' and Lewin's leadership styles: autocratic, democratic, and laissez-faire. This investigation was the foundation for a long-term program of research. Two large samples of college students in a midwestern university provided data that partially supported the Lewin-Dreikurs three-factor formulation for leadership styles and that, interestingly, also revealed an independent individualism factor described by Triandis (1995). Implications of the findings are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The clinical utility of magnetic resonance imaging in 3-dimensional treatment planning of brain neoplasms

Results of the clinical experience gained since 1986 in the treatment planning of patients with brain neoplasms through integration of magnetic resonance imaging (MRI) into computerized tomography (CT)-based, three-dimensional treatment planning are presented. Data from MRI can now be fully registered with CT data using appropriate three-dimensional coordinate transformations allowing: (a) display of MRI defined structures on CT images; (b) treatment planning of composite CT-MRI volumes; (c) dose display on either CT or MRI images. Treatment planning with non-coplanar beam arrangements is also facilitated by MRI because of direct acquisition of information in multiple, orthogonal planes. The advantages of this integration of information are especially evident in certain situations, for example, low grade astrocytomas with indistinct CT margins, tumors with margins obscured by bone artifact on CT scan. Target definitions have repeatedly been altered based on MRI detected abnormalities not visualized on CT scans. Regions of gadolinium enhancement on MRI T1-weighted scans can be compared to the contrast-enhancing CT tumor volumes, while abnormalities detected on MRI T2-weighted scans are the counterpart of CT-defined edema. Generally, MRI markedly increased the apparent macroscopic tumor volume from that seen on contrast-CT alone. However, CT tumor information was also necessary as it defined abnormalities not always perceptible with MRI (on average, 19% of composite CT-MRI volume seen on CT only). In all, the integration of MRI data with CT information has been found to be practical, and often necessary, for the three-dimensional treatment of brain neoplasms.     

The utility of theories in intuitive statistics: The robustness of theory-based judgments.

Research on human judgment demonstrates that people's theories often bias their evaluation of evidence and suggests that people might be more accurate if they were unbiased by prior beliefs. In 2 studies using the covariation estimation problem and the t-test problem, judgments made by Ss who had potentially biasing prior information about data were compared to those made by Ss who were not biased by prior information. 265 undergraduates served as Ss in Study 1; 201 undergraduates were Ss in Study 2. The quality of the data was varied to present Ss with data that were either well-behaved or contaminated with outliers. In both studies, Ss' judgments approximated robust statistical measures rather than the conventional measures typically used as normative criteria. The usual biasing effects of prior beliefs were found, along with an advantage for Ss who had prior theories—even incorrect ones—over Ss who were completely "objective." Potentially biasing beliefs both enhanced Ss' sensitivity to the bulk of the data and reduced the influence atypical scores had on their estimates. Evidence is provided that this robustness results from the fact that prior theories make judgment problems more meaningful. (40 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Preventing therapy dropout in the real world: The clinical utility of videotape preparation and client estimate of treatment duration.

Practicing clinicians realize that patients' dropping out of therapy is detrimental to treatment outcome and can prove costly to psychotherapists in terms of financial and personal consequences. Two procedures to prevent therapy dropout were tested in the "real-world," naturalistic environment of a health maintenance organization (HMO). Whereas video preparation significantly reduced dropout, opportunity to estimate treatment duration did not. Results were obtained from 125 randomly assigned adult outpatients. Findings suggest that psychologists in clinical and administrative positions may experience reduced dropout rates by providing new patients with videotaped instructional material about what they might expect in the psychotherapy process. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The predictive utility of hypnotizability: The change in suggestibility produced by hypnosis.

Objective: The predictive utility of hypnotizability, conceptualized as the change in suggestibility produced by a hypnotic induction, was investigated in the suggested reduction of experimental pain. Method: One hundred and seventy-three participants were assessed for nonhypnotic imaginative suggestibility. Thereafter, participants experienced hypnotic and nonhypnotic imaginative analgesia suggestions, counterbalanced for order. Hypnotic suggestibility was then assessed. Results: Hypnotizability, operationalized as hypnotic suggestibility with imaginative suggestibility statistically controlled (Braffman & Kirsch, 1999), predicted intraindividual differences in responding to the hypnotic and imaginative analgesia suggestions. Higher hypnotizability was associated with relatively greater response to the hypnotic analgesia suggestion than to the imaginative analgesia suggestion. Conclusions: Operationalized in this way, hypnotizability may be a useful predictor of the effect of adding a hypnotic induction to a specific imaginative suggestion. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The applicability and diagnostic effectiveness of transjugular liver biopsy

BACKGROUND: The aim of this study was to evaluate the applicability, the diagnostic profitability and the incidence of complications associated with tranjugular liver biopsy associated with the measurement of the hepatic venous pressure gradient (HVPG). PATIENTS AND METHODS: The clinical histories of 829 consecutive patients in whom transjugular liver biopsy was performed from 1982 to 1993 were reviewed. The diagnostic value of the sample obtained was evaluated in all the patients and the HVPG determined. Moreover, the size of the greatest fragment obtained during biopsy was also determined. RESULTS: Material for histologic study was obtained in 95% of the cases. In 70% the biopsy was diagnostic, in 11% it provided data contributing to diagnosis and in 19% it was not useful. Potentially severe complications were presented in 0.8% of cases being fatal in one (0.1%). The obtention of a fragment of small size was significantly associated with the presence of disease with marked fibrosis and high HVPG. A HVPG > 10 mmHg in patients with a suspicion of liver disease had a sensibility of 92% and a specificity of 63% for the diagnosis of hepatic cirrhosis. In 83% of patients with a GPVH > 10 mmHg in whom the biopsy was not useful, the diagnosis of hepatic cirrhosis was performed by other methods. CONCLUSIONS: Transjugular biopsy in a safe, effective diagnostic method in patients with severe coagulation disorders. The appearance of the material obtained and the HVPG provide useful information for diagnosis although the biopsy is not diagnostic.