Cognitive-behavioral therapy and relationship therapy in the treatment of children referred for antisocial behavior.

112 children (aged 7-13 yrs) were randomly assigned to one of three treatments: problem-solving skills training (PSST), problem-solving skills training with in vivo practice (PSST-P), which included therapeutically planned activities to extend training to settings outside of treatment, or client-centered relationship therapy (RT). PSST and PSST-P children showed significantly greater reductions in antisocial behavior and overall behavior problems, and greater increases in prosocial behavior than RT children. These effects were evident on measures obtained immediately after treatment and at a 1-year follow-up, and on measures of child performance at home and at school. PSST-P children showed greater changes than PSST children on measures of functioning at school at posttreatment, but these differences were no longer evident at follow-up. Children in both PSST conditions showed significant reductions in deviant behavior and improvements in prosocial behavior from pretreatment to follow-up, whereas RT children tended to remain at their pretreatment level of functioning. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Empirical and clinical focus of child and adolescent psychotherapy research.

The present study evaluated the characteristics of research on child and adolescent psychotherapy. Published studies (N?=?223) of psychotherapy from 1970 to 1988 were codified to characterize research, clinical, and methodological characteristics. The major results indicate that (1) treatment research focuses almost exclusively on the impact of treatment techniques with scant attention to influences (child/adolescent, parent, family, therapist) that may moderate outcome and (2) several characteristics of the children/adolescents and methods of treatment delivery and approaches depart markedly from those evident in the practice of treatment. Priorities for treatment research to place clinical practice on firmer empirical footing are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Drawing on clinical practice to inform research on child and adolescent psychotherapy: Survey of practitioners.

This study was designed to draw on clinical practice as a way of identifying priority areas for child and adolescent psychotherapy research. 1,162 psychologists and psychiatrists described several features of their clinical work and evaluated the effects of alternative treatment approaches, factors that influence therapeutic change, and the priority of alternative types of research. The majority agreed on (a) the importance of several specific child, parent, and therapist factors that contribute to outcome; (b) the utility and effectiveness of alternative treatment approaches; and (c) the high priority of research on therapeutic processes and matching cases to alternative types of treatments. In general, the factors, treatments, and types of studies identified have rarely been examined empirically. The use of practitioner views to identify lines of research may aid not only in reducing the hiatus between research and practice but also in placing clinical work on a stronger empirical footing. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Beyond clinical trials: Generalizing from research to practice.

Suggests that clinical trials, or evaluations of psychotherapy techniques in clinical settings with patient populations, play a pivotal role in treatment research. Well-controlled psychotherapy trials provide a test of what treatment can do under conditions in which procedures such as therapist training and monitoring and the integrity of treatment are optimal. Methods designed to reduce the hiatus in how treatments are implemented, monitored, and evaluated in clinical research and practice include developing standardized assessment and treatment packages that can be implemented by practitioners, altering the manner in which clinical training is implemented and evaluated, training clinicians in strategies to evaluate their own clinical work, and conducting clinical replication case studies as a way to evaluate treatment applications in clinical practice. These alternatives combine standardization, training, evaluation, and clinical practice to help increase the generality of research findings to clinical work and to help merge research and clinical priorities. (46 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Introduction to the special series.

The topic of violence spans multiple disciplines and areas of research. Even within a given discipline, violence is an arena in which several specialty areas can be enacted. Within our own field, theory and research from experimental, comparative, physiological, developmental, social, clinical, and other areas of psychology can be brought to bear on the topic in significant ways. The purpose of the present series is to highlight a segment of the larger topic by focusing on violence in the home. The goal is to draw general attention to the area and to convey the relevance to our clinical focus. The present articles illustrate significant areas of research rather than systematically represent the full set of ways in which violence in the home may be manifest. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Covert and overt rehearsal and homework practice in developing assertiveness.

Evaluated the effects of overt rehearsal and homework practice on covert modeling treatment of social skills. 79 18–73 yr old nonassertive clients received 1 of 4 variations of covert modeling that resulted from a 2?×?2 combination of overt rehearsal and homework practice. Ss who received overt rehearsal engaged in overt enactments (role playing) within the treatment sessions; Ss who received homework practice engaged in extra treatment activities to develop their social skills. A delayed-treatment control group was also included to serve as a no-treatment condition before Ss were randomly assigned to 1 of the 4 treatments. Findings indicate that treatments led to significant improvements on self-report inventories, global ratings, and behavioral measures of assertiveness (the Conflict Resolution Inventory and the Wolpe-Lazarus Assertiveness Questionnaire). Ss who engaged in homework practice and/or overt rehearsal of assertive behavior within the treatment sessions made consistently greater improvements at posttreatment and at an 8-mo follow-up than Ss who did not receive the procedures. Treatment effects extended to novel assessment situations and brought Ss to the level of 45 16–41 yr olds who regarded themselves as adept in social situations. (28 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Drawing valid inferences from case studies.

Although the case study is usually accorded an important heuristic role, its limitations as a basis for drawing valid conclusions about the efficacy of treatment are recognized. The major problem with a case study is the ambiguity related to the precise influences that are responsible for change. Threats to internal validity, normally ruled out in experimentation, make ambiguous the basis for therapeutic change. However, case studies may vary along several dimensions that dictate the extent to which specific threats to internal validity are addressed. The present article discusses the possibility of conceptualizing and conducting cases in such a way as to maximize the likelihood that internally valid conclusions can be drawn. Although case studies can never replace experimentation, the scientific yield from case reports might be improved in clinical practice where methodological alternatives are unavailable. (21 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Evidence-based treatment and practice: New opportunities to bridge clinical research and practice, enhance the knowledge base, and improve patient care.

The long-standing divide between research and practice in clinical psychology has received increased attention in view of the development of evidence-based interventions and practice and public interest, oversight, and management of psychological services. The gap has been reflected in concerns from those in practice about the applicability of findings from psychotherapy research as a guide to clinical work and concerns from those in research about how clinical work is conducted. Research and practice are united in their commitment to providing the best of psychological knowledge and methods to improve the quality of patient care. This article highlights issues in the research- practice debate as a backdrop for rapprochement. Suggestions are made for changes and shifts in emphases in psychotherapy research and clinical practice. The changes are designed to ensure that both research and practice contribute to our knowledge base and provide information that can be used more readily to improve patient care and, in the process, reduce the perceived and real hiatus between research and practice. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Measuring the potency of risk factors for clinical or policy significance.

For those in the prevention field who need to use risk factors to identify those at risk, mere statistical significance is not sufficient to establish clinical or policy significance. For that purpose, some measure of "potency" of risk factors is needed, that is, an effect size interpretable and meaningful in a clinical or policy context. The numerous possible candidate measures available often lead to contradictory conclusions. Which of the candidate measures is right or wrong for clinical and policy decision making depends on the fit between the trade-offs between false-positive and false-negative decisions implicit in the definition of the measure (and often unknown to the user) and those related to a specific context of application. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychotherapy for children and adolescents: Current progress and future research directions.

Psychotherapy research for children and adolescents has progressed considerably in the past decade. In this article, reviews of treatment outcome research, individual outcome studies, programmatic studies of specific interventions, and treatments for specific clinical dysfunctions are highlighted to convey progress. Current advances in treatment have been augmented greatly by psychological theory and research on the nature of child dysfunction as well as by improved methods for assessing children and specifying and evaluating treatments. In light of the current status of research, several priorities are identified that include expanding the range of research questions asked about treatment, evaluating a broader range of treatments, examining long-term treatment effects, bridging research and practice, extending treatment further to underserved and understudied populations, and integrating developmental theory and research into child treatment research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)