A paradigm for single-case research: The time series study of a long-term psychotherapy for depression.

Articulates a paradigm for single-case research in psychotherapy. A patient diagnosed as having major depressive disorder was seen in an intensive, twice-weekly psychodynamic psychotherapy for 2.5 years. Each session was videotaped, and assessments of patient change were obtained at regular intervals. A time-series analysis was used to model fluctuations in the therapy process to take into account time and the effect of previous events on subsequent changes, thereby preserving the context-determined meaning for therapist and patient actions. A bidirectional analysis of causal effects shows that the influence processes between therapist and patient are mutual and reciprocal and suggests that the effect of the patient on the therapist and on the process has not been made sufficiently explicit in previous models of process and change. The potential of intensive single-case designs for uncovering causal effects in psychotherapy is demonstrated. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Some myths of psychotherapy research and the search for a paradigm.

3 myths prevalent in psychotherapy research are considered and refuted. These include the uniformity assumptions, spontaneous remission of psychoneurosis, and the belief that present theoretical formulations provide adequate paradigms. Several other confusions are listed and clarified including the process-outcome distinction, the classification problem, and the expectation of the definitive study in therapy research. Finally, an attempt is made to delineate the minimal requirements of any psychotherapy research paradigm by incorporating present empirical evidence as well as by specifying common sources of confounding vis-a-vis the therapy interaction. (2 p. ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Specific and nonspecific factors in the effectiveness of a treatment system.

The paradox of the placebo concept is used to evaluate both specific and nonspecific treatment components responsible for the effectiveness of North Carolina's statewide program for the Treatment and Education of Autistic and related Communication Handicapped Children (Division {teacch}). Empirical studies used to demonstrate specific treatment procedures of structured teaching and parent training are reviewed. The use of extended field trials to avoid negative side effects and short-lived fads characteristic of many specific treatment techniques is discussed. The enthusiastic response of the program's constituency, or the nonspecific effects of the {teacch} system, are evaluated from personal observation, to reduce their vagueness and potential for misunderstanding. Central program concepts and structures that generate and support this nonspecific response of enthusiasm are discussed. It is concluded that empirical research demonstrating specific treatment techniques must be evaluated in the broader context of nonspecific treatment effects. Implications for other service programs are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Nonspecific treatment factors in psychotherapy outcome research.

Discusses salient issues raised by W. Wilkins (see record 1980-01498-001). The term nonspecific treatment factors usually refers to several, often unspecified, variables that may influence therapy outcome. The word nonspecific denotes that these factors may extend to many different techniques. Recent research has demonstrated that treatment and control conditions differing from each other in overall efficacy may also differ in such factors as their credibility to the client and in the expectancies for improvement they generate. Relatively high levels of credibility and expectancies for improvement may be inherent in most, if not all, treatments. The task for therapy research is not to demonstrate that treatment operates free from such factors. Rather, the task is to demonstrate that specific treatment techniques considered to carry the burden of client change go beyond the results that can be obtained by implementing procedures that produce change merely because of their relatively high levels of credibility and treatment-generated expectancies. The present article briefly examines the conceptual and methodological issues raised by nonspecific treatment factors and the interpretive problems these factors pose for selected outcome questions. (27 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Assimilation of problematic experiences by clients in psychotherapy.

Presents an integrative model for a central aspect of change in psychotherapy. According to the assimilation model, clients in successful psychotherapy follow a regular sequence in processing their problematic experiences as these are assimilated into schemata developed in the therapeutic interaction. The model's principal concepts include schema, problematic experience, and assimilation and accommodation. Stages of assimilation are discussed, and case illustrations of a 37-yr-old man and a 37-yr-old woman illustrate this process. Advantages of the assimilation model for research, for clinicians, and for the therapeutic relationship are addressed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Placebos and common factors in two decades of psychotherapy research.

Two decades of psychotherapy research conceptualizing placebos as variables common across psychotherapies are reviewed. Placebo treatments and placebo controls have been thought to be composed of factors common across psychotherapies by definition. Little empirical support, however, was found for this view. The components of placebo controls are not necessarily common with but are often very different from the components of designated therapies. A review was also conducted of the more obvious as well as the more subtle sources of noncontrolled variables that may differentially enter therapeutic conditions. The types of placebo control groups most often used in the literature are not adequate to control the effects of various so-called nonspecific variables or to test the active elements of psychotherapies. Two types of placebo groups were found to be the most appropriate to control for confounding variables in the study of psychological and active therapeutic components. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social science research in law: A new paradigm.

The law is hampered in using social science research by the obsolete notion that research used to change a legal rule is "legislative fact" and research in which only the parties to a case have an interest is "adjudicative fact." In important ways, however, social research is more akin to law itself than to "fact." We suggest a paradigm in which law-changing research is "social authority," case-specific research is "social fact," and a newer hybrid combination of these two is "social framework." In each of these areas, we propose that judges treat aspects of empirical studies much as they treat legal precedents under the common law. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A primer for conducting child psychotherapy outcome research.

Presents basic principles for conducting child psychotherapy outcome research and suggests that a multivariate framework is needed to illuminate important mechanisms of change in effective child psychotherapy. Issues related to type of treatment, therapist variables, child problems, context, research design, and statistical concerns are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The ecological paradigm of mind and its implications for psychotherapy.

As the result of a tremendous cross-disciplinary effort, the past 20 years have witnessed huge advances in our understanding of the brain and of the brain's relationship to the mind. A new paradigm of the mind--an ecological paradigm, as Gregory Bateson called it in 1973--has fallen into place. The authors have begun to have a scientific, biologically grounded explanation of how the human brain-mind system works. Despite the likely relevance of this paradigm for psychotherapy, its uptake in the clinical literature has been uneven to date. Accordingly, this article aims to pique the interest of the psychotherapeutic community in the ecological paradigm as a whole, in hopes of stimulating wider discussion and research into its clinical aspects and consequences. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Concerns regarding the traditional paradigm for causal research: The unified paradigm and causal research in scientific psychology.

The traditional paradigm refers to the assumption held by most methodologists and researchers that causal research must be defined in terms of the causal powers evident in a closed system. The traditional paradigm does not concord, however, with the nature of scientific theories often cited in the methodological and research literature. The unified paradigm is introduced and causal research defined in terms of the causal powers evident in an open system. Notable implications of the unified paradigm are that experimental methods do not provide a better opportunity than modeling methods to conduct a causal analysis and that the nomenclature often used to describe the validity of causal conclusions must be amended. Additional implications of the unified paradigm are discussed and includes a comparison of the traditional paradigm and the unified paradigm when applied to treatment-outcome research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The social relations model: A tool for group psychotherapy research.

The social relations model presented in this article provides a solution to some of the problems that plague group psychotherapy research. The model was designed to analyze nonindependent data and can be used to study the ways in which group members interrelate and influence one another. The components of the social relations model are the constant (i.e., group effect), the perceiver effect, the target effect, the relationship effect, and error. By providing estimates of the magnitude of these 5 factors and by examining the relationships among these factors, the social relations model allows investigators to examine a host of research questions that have been inaccessible. Examples of applications of the social relations model to issues of group leadership, interpersonal feedback, and process and outcome research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Patients' representations of psychotherapy: A new focus for psychodynamic research.

Presents a psychodynamic framework and research methods for investigating the significance of patients' internal representations of therapy-with-their-therapists. In this article, 2 instruments developed for this purpose (Therapist Representation Inventory and Intersession Experience Questionnaire) are introduced, and their psychometric characteristics are described. Also, findings from a series of studies conducted with these instruments are summarized. Finally, the types of questions these instruments appear to be well suited to are proposed for addressing in future research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The evolving role of women in society: A fact for research and psychotherapy.

Argues that past psychologies of women are dated and are based on societal constructs of former eras, reflecting limited conceptualizations of the roles of women in society that are no longer valid. Psychotherapists are facing women clients presenting life choices and goals inadequately addressed by many personality theories of the past. Behavioral scientists and psychotherapists must adopt fresh attitudes, recognizing and appreciating the transitional and incomplete data on women in society. (17 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Assessment of assimilation in psychotherapy: A quantitative case study of problematic experiences with a significant other.

The development of a methodology for the evaluation of the assimilation model in which both experimental rigor and clinical sensitivity are priorities is described. The methodology was applied to a good-outcome case. The 3-phase methodology comprised (1) the identification of a problematic content domain, (2) the definition of a problematic experience within that domain, and (3) the rating of the experience's changing level of assimilation across randomly ordered passages from selected sessions. Independent sets of raters carried out the tasks of each phase. Results supported the assimilation model's hypothesized progression by which a problematic experience is successfully incorporated into a schema, and the ratings highlighted 1 session in which much of the clinical progress on 1 problem was achieved. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Exploratory in-session process research in individual psychotherapy: A review.

The goal of exploratory process research is to describe what occurs within psychotherapy sessions, eventually leading to the development of theories based on the accumulation of replicated results. Several areas in which exploratory methods are currently being used are described: therapist techniques, client behavior, covert processes, process models, interactions between therapist and client, and therapy events. Additionally, several areas in which exploratory methods would be useful for future research are described: the links between client personality characteristics, therapy process, and outcome; the timing and quality of therapist interventions; and client readiness for the therapist interventions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Observation and discrimination learning in the rat: Specific and nonspecific effects.

After watching the performance of a model rat (N = 10), 48 Os (naive male hooded rats) were trained on a visual pattern discrimination. Results show that the observational experience facilitated discrimination learning if the same cue pattern was positive for the model and the O; it retarded learning in Ss trained on the reversal of the observed discrimination. These results depend on the viewing of a model contiguous with the cue pattern. A 2nd type of facilitating effect followed visual exposure to the cue patterns presented without a model S. When such an observational condition involved stimulus change, discrimination learning was facilitated regardless of the cue to be approached. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A research paradigm for the study of interpersonal learning.

A research paradigm is introduced to investigate the process whereby 1 person learns to predict the behavior of another person. The paradigm is derived from Brunswik's probabilistic functionalism and his "lens model" of behavior. Methods of analysis are applied to data provided by an illustrative experiment. Results of the experiment show that interpersonal learning occurs; the results are also shown to have implications for problems inherited from studies of interpersonal perception. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Group psychotherapy with incarcerated offenders: A research synthesis.

The purpose of this study was to evaluate the efficacy of group psychotherapy with incarcerated offenders. Meta-analytic techniques were applied to 26 empirical studies that used a treatment group versus a control group. The outcome measures assessed in this study included institutional adjustment, anger, anxiety, depression, interpersonal relations, locus of control, and self-esteem. The results indicate that positive treatment effects were found for the use of group psychotherapy with incarcerated offenders across all outcomes. Supplemental analyses were also included to identify factors that contribute to the efficacy of group psychotherapy and indicate that the use of homework exercises resulted in significantly improved outcomes. Furthermore, participants mandated to treatment did not negatively influence the efficacy of group psychotherapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Helpful and hindering events in psychotherapy: A practice research network study.

This paper presents the findings of a psychotherapy process study conducted within the Pennsylvania Psychological Association Practice Research Network (PPA-PRN). The investigation was the product of a long-term collaborative effort, both in terms of the study design and implementation, between experienced clinicians of various theoretical orientations and full-time psychotherapy researchers. Based on a relatively large sample of clients seen in independent practice settings, close to 1,500 therapeutic events (described by clients and therapists as being particularly helpful or hindering) were collected. These events were coded by three independent observers using a therapy content analysis system. Among the findings, both clients and therapists perceived the fostering of self-awareness as being particularly helpful. The results also point to the importance of paying careful attention to the therapeutic alliance and other significant interpersonal relationships. The merits and difficulties of conducting scientifically rigorous and clinically relevant studies in naturalistic contexts are also discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)