Predicting change for individual psychotherapy clients on the basis of their nearest neighbors.

This study extended client-focused research by using the nearest neighbor (NN) approach, a client-specific sampling and prediction strategy derived from research on alpine avalanches. Psychotherapy clients (N = 203) seen in routine practice settings in the United Kingdom completed a battery of intake measures and then completed symptom intensity ratings before each session. Forecasts of each client's rate of change and session-by-session variability were computed on the basis of that client's NNs (n = 10-50 in different comparisons). Alternative forecasts used linear or log-linear slopes and were compared with an alternative prediction strategy. Results showed that the NN approach was superior to the alternative model in predicting rate of change, though the advantage was less clear for predicting variability. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Acceleration of changes in session impact during contrasting time-limited psychotherapies.

Following the suggestion that therapeutic change is accelerated in time-limited psychotherapy, this study investigated the across-session patterns of session impact in the treatments of 117 depressed clients who were randomly allocated to 8 or 16 sessions of cognitive-behavioral (CB) or psychodynamic-interpersonal (PI) therapy. After each session, all clients completed the Session Evaluation Questionnaire and 75 of the clients completed the Session Impacts Scale. Session ratings indicated that sessions were perceived increasingly positively on most impact dimensions (e.g., session depth and smoothness, relationship with the therapist, feelings of understanding and problem solving, postsession positive mood) as treatment progressed. Early in treatment, PI therapy sessions were less smooth (i.e., more tense and uncomfortable) and less focused on problem solving, but PI sessions changed more rapidly than CB sessions on these dimensions, so that later in treatment, sessions of both treatments were equivalently positive. In both treatments, the trend toward more positive sessions was more rapid (i.e., the across-session slope was steeper) in 8-session treatments than in 16 session treatments. Such accelerated changes in session impact may reflect the suggested acceleration … (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Therapist responsiveness to client interpersonal styles during time-limited treatments for depression

A 4-kb DNA segment of Tenebrio molitor (Insecta, Coleoptera) genomic DNA containing two larval-pupal cuticular genes has been cloned and sequenced. These genes, transcribed in opposite directions, are related in DNA sequence and the proteins encoded are very similar. Each of them contains a single intron located inside the sequence encoding the signal peptide, and a conserved sequence at -200 bp from the mRNA start position. These similarities in sequence suggest that these genes have evolved by duplication followed by diversification and that they are members of a family of genes with a common ancestry. They are the first example of clustered genes in Tenebrio molitor.     

Sudden Gains in Cognitive Therapy for Depression: A Replication and Extension.

Of 76 clients receiving 8-20 sessions of cognitive therapy (CT) in a joint university and a national health service clinic, 31 experienced sudden gains that appeared very similar to those first reported in clinical trials of CT by T. Z. Tang and R. J. DeRubeis (1999) and subsequently replicated in other studies. The sudden gains appeared less stable in the present study's more routine clinical practice settings than they were in the clinical trials. Life events did not appear to account for sudden gains. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Convergent validity of the CORE measures with measures of depression for clients in cognitive therapy for depression.

Clients (N = 77) undergoing cognitive therapy for depression were assessed before treatment with the Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM), which encompasses domains of subjective well-being, problems, functioning, and risk of harming self or others, along with the Beck Depression Inventory-II (BDI-II), the Hamilton Rating Scale for Depression (HRSD), the Beck Hopelessness Scale (BHS), and a measure of avoidant (Cluster C) personality problems (Inventory of Interpersonal Problems-Avoidant [IIP-Av]). The CORE-OM and the BDI-II were strongly correlated with each other and showed coherent and similar patterns of correlations with the HRSD, the BHS, and the IIP-Av. Sixty-one of the clients were repeatedly assessed during treatment with alternating versions of the CORE Short Form and with the BDI-II. Results strongly supported the convergent validity of the CORE measures with the BDI-II in across-clients comparisons of means scores and rates of improvement and in across-sessions comparisons within clients. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relations of the alliance with psychotherapy outcome: findings in the Second Sheffield Psychotherapy Project

Clients (n = 79) and therapists (n = 5) rated their alliance using parallel forms of the Agnew Relationship Measure (ARM) after every session of their time-limited psychodynamic-interpersonal or cognitive-behavioral treatments for depression. The ARM assesses 5 dimensions of the alliance: Bond, Partnership, Confidence, Openness, and Client Initiative. Treatment outcome was assessed as residual gain from pretreatment assessment to end of treatment, 3-month follow-up, and 1-year follow-up on 6 standard measures. Some aspects of the alliance as measured by the ARM were correlated with clients' gains in treatment. The strength of the association varied across assessment measures, occasions of outcome assessment, ARM scales, and the session number when the alliance was measured.     

Therapist session intentions in cognitive–behavioral and psychodynamic–interpersonal psychotherapy.

Theories of psychotherapy are implemented by therapists' intentional actions within sessions. This study examined the structure and construct validity of the Therapist Session Intentions (TSI) form. Ten therapists rated their therapeutic intentions following each of 2,305 therapy sessions of cognitive–behavioral or psychodynamic–interpersonal therapy in the Second Sheffield Psychotherapy Project. Seven conceptually coherent clusters of intentions, or therapeutic foci, were identified: treatment context, session structure, affect, obstacles, encouraging change, behavior, and cognition-insight. Contrasting patterns of therapeutic focus across treatments and changes in focus across sessions within treatments appeared conceptually coherent. Correlations across a subsample of sessions confirmed correspondences of the TSI foci with dimensions found previously in observers' ratings. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Looking as strongly as we should in the right places: Reply to Norcross and Rossi (1994).

In response to J. C. Norcross and J. S. Rossi's (see record 1994-38252-001) comment on our article (D. A. Shapiro et al; see record 1994-38260-001), we note that research as reported does not fully represent the processes whereby it was designed and completed. The true statistical power of an investigation reflects all the analyses carried out, not just those that get reported. The power of our analyses was sufficient to address the substantive questions at issue. The importance of these questions does not depend on allegiance to equivalent outcomes of diverse therapies. The outcome phase of the Second Sheffield Psychotherapy Project is but part of its broad strategic approach to advancing our understanding of the mechanisms of change in the psychotherapies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)