Group cognitive-behavioral therapy and group interpersonal psychotherapy for the nonpurging bulimic individual: A controlled comparison.

Evaluated the effectiveness of group cognitive-behavioral treatment (CBT) and group interpersonal psychotherapy (IPT) for binge eating. 56 women with nonpurging bulimia were randomly assigned to 1 of 3 groups: CBT, IPT, or a wait-list control (WLC). Treatment was administered in small groups that met for 16 weekly sessions. At posttreatment, both group CBT and group IPT treatment conditions showed significant improvement in reducing binge eating, whereas the WLC condition did not. Binge eating remained significantly below baseline levels for both treatment conditions at 6-mo and 1-yr follow-ups. These data support the central role of both eating behavior and interpersonal factors in the understanding and treatment of bulimia. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Alliance in individual psychotherapy.

This article reports on a research synthesis of the relation between alliance and the outcomes of individual psychotherapy. Included were over 200 research reports based on 190 independent data sources, covering more than 14,000 treatments. Research involving 5 or more adult participants receiving genuine (as opposed to analogue) treatments, where the author(s) referred to one of the independent variables as “alliance,” “therapeutic alliance,” “helping alliance,” or “working alliance” were the inclusion criteria. All analyses were done using the assumptions of a random model. The overall aggregate relation between the alliance and treatment outcome (adjusted for sample size and non independence of outcome measures) was r = .275 (k = 190); the 95% confidence interval for this value was .25–.30. The statistical probability associated with the aggregated relation between alliance and outcome is p     

Strategic hope-focused relationship-enrichment counseling with individual couples.

Strategic hope-focused relationship enrichment is a brief, eclectic, research-based program to enhance couples' relationships. Couples (N?=?51; 16 married, 24 cohabiting, 11 engaged) completed 5 sessions of enrichment counseling (n?=?26) or 3 written assessments (n?=?25) from 1 of 12 counselors. Couples receiving enrichment counseling had higher relationship satisfaction and quality-of-couple skills at posttest and at the 3-week follow-up than did written-assessment-only (control) couples. Conditions did not differ in terms of quality of overall attraction or 2 measures of commitment. We concluded that relationship enrichment using this program was effective, powerful, and cost-effective. Future research should focus on testing the effectiveness of the program presented in a group format. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Conceptual complexity and obsessionality in bulimic college women.

Conceptual simplicity and high levels of obsessionality have been suggested as perpetuating factors in eating disorders, more specifically bulimia. Our study examined the relationship between bulimia, conceptual complexity, obsessional symptoms, and obsessional traits in 54 college women, ages 19–35. On the basis of a structured interview and an Eating Attitudes Test-26 score, participants were placed in one of four groups: (a) bulimic-anorexic vomiters (n?=?13), (b) normal-weight bulimic vomiters (n?=?13), (c) clinical controls (n?=?13), and (d) normal controls (n?=?15). The participants were given the Paragraph Completion Method (Hunt, Butler, Noy, & Rosser, 1978), a measure of levels of conceptual development, and the questionnaire form (Snowdon, 1980) of the Leyton Obsessional Inventory (Cooper, 1970), a measure of obsessional sysmptoms and traits. Our findings indicated that both bulimic groups, although similar to each other, exihibited significantly lower levels of conceptual functioning (p?p?p?     

Interactional group therapy for anorexic and bulimic women.

Describes interactional group therapy for anorexic and bulimic women, as it was used for 12 groups (with 4–8 Ss each) conducted over 4.5 yrs. Bulimics and anorexics were combined because it is believed that the 2 types of eating-disordered patients have much that they can learn from each other. Group themes particularly relevant to eating-disordered women are discussed, including confidentiality, sexuality, commonalities between the 2 types, and transference. Stages in the evolution of the group and strategies for facilitating group process are reviewed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Normal bone mass in bulimic women

The aim of this study was to examine the relationship among exercise, menstrual function, and bone mineral density (BMD) in different groups of age-matched patients with eating disorders. Dieting and eating disorder history, physical activity history, and menstrual history were assessed by clinical interview in 43 bulimic and 13 anorectic young women as well as in 17 healthy control subjects (18-29 yr). BMD was assessed by dual x-ray absorptiometry. All the anorectics but only 30% of the bulimics exercised regularly from the onset of their eating disorder (P < 0.01), mainly using aerobic dancing and running. All of the anorectics had been amenorrheic since the start of their symptoms, and 68% of the bulimics had a history of menstrual dysfunction. Within the exercise subgroups of bulimic patients, there was no significant relationship between BMD and current or previous menstrual function. Anorectic patients had lower BMD than bulimics and controls in all skeletal regions studied (P < 0.01). Bulimic patients who had exercised regularly during their illness had higher total body BMD than bulimics classified as sedentary (P < 0.01). Bulimics who had exercised regularly or intermittently since the onset of their eating disorder had higher BMD than sedentary bulimics in the lumbar vertebrae, femoral neck, and legs (P < 0.05). It appears that weight-bearing exercise can prevent or attenuate bone loss at specific skeletal sites in normal weight bulimic patients, but not in anorectics.     

Some ethical considerations in psychotherapy with religious women.

Contends that both religiously oriented and secular therapists should be sensitive to the basic philosophies of religious teaching and the effects of the women's movement on religious women patients. Ethical as well as practical considerations are discussed in terms of individual and group treatment. Black churchwomen, clergy wives, religious women professionals, religious feminists, and spiritual women are treated separately. (49 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Nausea in bulimic women in response to palatable food.

Nausea in response to an appetizing food stimulus was assessed in bulimic women and healthy control subjects. Nausea was assessed via subjects' self-report and changes in levels of plasma arginine vasopressin (AVP), a hormonal correlate of nausea. Converging evidence was obtained indicating that bulimic women experienced nausea in response to the sight, smell, or taste of the palatable food stimulus. The possibility that the observed nausea is a learned response that may contribute to the bulimic binge/purge pattern is discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Shame: Countertransference identifications in individual psychotherapy.

Shame is a universal experience felt by patients and therapists alike. Yet, the experience of shame, with its profound sense of inadequacy and worthlessness, is anathema to the competent and compassionate self-image of most therapists. In order to help therapists understand their own shame and their countertransference identifications to patient shame, this article first describes the nature of shame, its developmental progression within interpersonal relationships, and the defenses commonly employed to cope with shame. Because the experience of shame involves the activation of devalued and devaluing internal representations, therapists may develop concordant or complementary countertransference identifications. These countertransference identifications are influenced further by the patient's primary reaction to shame' which includes withdrawal, attacks on self, avoidance, and attacks on others. Each of these reflects a habitual reaction to shame that is displayed in the patient–therapist relationship. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Subtyping bulimic women along dietary restraint and negative affect dimensions.

Etiologic models of bulimia center on dieting and negative affect, yet no research has subtyped bulimic individuals according to whether they fit dietary versus negative affect profiles. This study subtyped 265 bulimic women along dieting and depressive dimensions and tested whether subtypes showed differences in eating pathology, clinical correlates, and treatment response. Cluster analysis revealed a pure dietary subtype (62%) and a mixed dietary–depressive subtype (38%). Whereas dietary and dietary–depressive bulimic women showed similar levels of bulimic behaviors, the latter reported more eating and weight obsessions; social maladjustment; higher rates of mood, anxiety, eating, impulse control, and personality disorders; and poorer treatment response. Results suggest dieting is a central feature of bulimia, but depressive affect occurs in only a subset of cases. However, the combination of dieting and depressive affect seems to signal a more severe variant of bulimia. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Couples' accounts of the effects of individual psychotherapy.

Describes 3 couples' experiences of one of the partners having been in psychotherapy, recounted during interviews conducted with each spouse individually. The information provided by the couples indicates that individual psychotherapy can have both positive and negative effects on the client's spouse and marital relationship. The importance of marital quality, couple adaptability, and shared problem perception in the adjustment to therapeutic changes is highlighted. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A comparison of computer-based versus traditional individual psychotherapy.

Professional psychologists are challenged to determine the appropriate use of interactive computer therapy programs. Although such programs have the potential of enhancing delivery of mental health services and reaching ever broader audiences, they raise serious clinical, legal, ethical, and practical concerns. This article reports on a controlled clinical trial comparing short-term traditional individual therapy with a computer-based intervention among 90 adults overseen by a therapist. Results were favorable and comparable in both conditions, with individual therapy outperforming computer-based therapy on some measures. The practitioner's use of computer-based psychotherapy interventions is discussed and some guidelines offered. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Patient suitability and outcome in short-term individual psychotherapy.

The effects of short-term (time-limited), dynamically oriented individual therapy and the patient characteristic quality of object relations (QOR) were studied in a controlled clinical trial involving 8 experienced therapists and 144 psychiatric outpatients. A comprehensive set of outcome scores was monitored at 5-month intervals including a follow-up assessment. A strong treatment effect that was maintained at follow-up was found. The effect was evident in terms of statistical significance, effect size, and clinical significance. Evidence for an additive effect of the combination of treatment and QOR was also found. The best results were attained by high QOR therapy patients, and the worst results were attained by low QOR control patients. The results were suggestive of an optimal match between type of patient and type of therapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Use of between-session homework in systems-oriented individual psychotherapy.

This article focuses on the use of between-session homework assignments in Unified Therapy, an individual psychotherapy approach that integrates psychodynamic, cognitive-behavioral, and family systems therapies. Unified therapy theory posits that, in clients with personality disturbances, ongoing and recurrent interpersonal behavior patterns within their family of origin serve as both behavioral triggers to and reinforcers of self-destructive or self-defeating behavior. Family behavior is believed to be the most powerful such environmental factor and is believed to have far more influence on patients than a therapist. Homework assignments are geared toward implementing strategies by which dysfunctional family patterns are altered. Strategies are designed by the patient and therapist, using role-playing techniques, which are described. A case example is presented to demonstrate the use of such homework throughout the arc of psychotherapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Pattern of alliance and outcome in short-term individual psychotherapy.

Pattern of change in the therapeutic alliance across time-limited, 20-session individual psychotherapy was investigated with the procedure of hierarchical linear modeling (HLM) in 2 samples of 32 psychiatric outpatients each (aged 21–53 yrs), those with low and those with high quality of object relations (QOR). Significant variation in the pattern of change in the therapeutic alliance was found within each sample. For low-QOR patients, a direct relationship was found between increasing therapist-rated alliance and favorable outcome. Pattern of change was more important than average level. For high-QOR patients, there was no evidence of a direct relationship between pattern of change and outcome. However, there was considerable evidence of a direct relationship between average level and favorable outcome. The use of HLM provided a new perspective to understanding alliance–outcome relationships. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Strategic eclecticism: A technical alternative for eclectic psychotherapy.

Proposes a technical eclecticism that extends the strategic model of the Mental Research Institute (R. Fisch et al, 1982) to include contributions of diverse psychotherapy approaches. Strategic eclecticism is conceptually based in systems theory and constructivism and attempts to (1) maximize common factor effects and (2) enable the selective application of diverse psychotherapy technique, language, and content. Three assumptions and 3 levels of intervention of strategic eclecticism are discussed. Case examples of 4 patients (aged 32–43 yrs) illustrate differing levels of intervention. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prediction of dropping out in time-limited, interpretive individual psychotherapy.

Predictors of dropping out were investigated for patients who participated in time-limited, interpretive individual psychotherapy in a randomized clinical trial. A sample of 22 dropouts was compared with a sample of 22 matched completers on pretherapy and therapy process variables. A modified Vanderbilt Psychotherapy Process Scale was used to assess patient hostility and patient and therapist exploration and focus on transference. Pretherapy predictors, which included demographic, diagnostic, and initial disturbance outcome variables, did not significantly differentiate the two groups. Therapeutic alliance, dynamic and supportive work, patient exploration, and focus on transference significantly differentiated dropouts from completers. For dropouts, there was a weaker alliance, less work, less exploration, and greater focus on transference. Examination of the last session of dropouts revealed a nonproductive pattern characterized by resistance and transference interpretation. Implications and limitations associated with the study are considered. (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)     

The evaluation of process and outcome in individual child psychotherapy.

The purpose of this study was to demonstrate the use of an objective method for the evaluation of therapy process and outcome in cases of individual child psychotherapy. Fourteen children ranging in age from 4 to 6 years were videotaped during the first and eighth sessions in interaction with their therapists. Approximately half the children received psychodynamic play therapy whereas the other half received client-centered play therapy. Using the Play Therapy Observational Instrument (PTOI) of Howe & Silvern (1981), videotapes were scored on 19 items. Data was reduced to 3 clusters: emotional discomfort, quality of interaction with the therapist, and beneficial fantasy play. No significant differences were obtained between therapeutic approaches. However, the PTOI was found to be sensitive to mean behavioral and verbal changes in the children from session one to session eight. Hence it appears that the PTOI scales offer clinicians a method of reviewing, tracking and assessing the process and outcome of their therapy work with children. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sex bias and sex-role stereotyping in psychotherapy with women: Survey results.

192 female former clients of 49 psychotherapists responded to a 70-item questionnaire developed around 4 themes of sex bias and sex-role stereotyping in psychotherapy. Results suggest that the majority of women were treated in a sex-fair manner. Women with the least amount of formal education and women with children experienced more sex bias in therapy. When bias was noted, it was often in acts of omission in the therapy; this was particularly true for victimized women. The most bias noted was in the areas of fostering traditional roles, lack of acceptance of anger, and lack of a sociocultural context in the therapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)