Therapist Satisfaction With Four Manual-Based Treatments on a National Multisite Trial: An Exploratory Study.

Ratings by 44 therapists in 4 modalities (cognitive, supportive-expressive, individual drug counseling, and group drug counseling) were obtained during one of the largest outcome trials ever conducted, the National Collaborative Cocaine Treatment Study. Views of the treatments, desired changes, and influences on implementation were studied. Therapists were highly positive about the treatments. However, their likelihood of using them in the future without modification was low, and they viewed them as too short. Supervision was perceived as more important than manuals and taping of sessions as more important than adherence scales. It took therapists an average of 8 months to feel comfortable with the treatments. New learning was therapists' primary motivation, more than extrinsic factors such as pay. Supportive-expressive therapists reported the most negative views, among modalities. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A clinical profile of women with posttraumatic stress disorder and substance dependence.

To assess the clinical characteristics of women with posttraumatic stress disorder (PTSD) and substance dependence, 28 women with both disorders were compared with 29 women with PTSD alone on a wide battery of lifetime and current clinical measures. The dual-diagnosis women consistently had a more severe clinical profile, including worse life conditions (e.g., physical appearance, opportunities in life), both as children and as adults; greater criminal behavior; a higher number of lifetime suicide attempts; a greater number having a sibling with a drug problem; and fewer outpatient psychiatric treatments. One discrepant finding, however, was their lower rate of major depression. Interestingly, the 2 groups did not differ in number or type of lifetime traumas, PTSD onset or severity, family history of substance use; coping style, functioning level, psychiatric symptoms, or sociodemographic characteristics. Treatment implications and methodological limitations are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Therapists' emotional reactions to substance abusers: A new questionnaire and initial findings.

Developed and tested the Ratings of Emotional Attitudes to Clients by Treaters (REACT) scale. The REACT was administered to 52 therapists and 140 cocaine-dependent outpatients, at sessions 2, 5, and 24 of psychotherapy. It was found to have high internal consistency at each time point, moderately high convergent validity with therapists' (but not patients') therapeutic alliance ratings, and a factor structure that appeared to meaningfully derive 4 factors: "therapist in conflict with self," "therapist focused on own needs," "positive connection," and "therapist in conflict with the patient." Therapists' emotional responses were found to become more negative over the course of treatment, and, when compared by theoretical orientation, were found more positive for 12-step drug counselors than for cognitive or supportive-expressive therapists. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Can Advertising Increase Awareness of Problem Gambling? A Statewide Survey of Impact.

With the rapid rise of state-sponsored gambling during the 1990s, the number of problem gamblers increased as well. In this study, 800 Indiana adult residents were randomly surveyed to evaluate the impact of a statewide advertising campaign designed to increase awareness of problem gambling. The pre- to postcampaign telephone survey (with 400 independent respondents at each time point) targeted (a) the impact of the advertising campaign and (b) general awareness of problem gambling issues. Results indicated, overall, little impact of the ad campaign and a low rate of exposure to it (8%). Billboards and slogans appeared to be the methods with strongest impact. The sample had a positive view of problem gambling awareness campaigns and appeared quite knowledgeable about problem gambling in general. Awareness of state resources to aid problem gamblers was lower. Results are discussed in relation to the study methodology, and suggestions to improve future advertising efforts are offered. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Training in cognitive, supportive-expressive, and drug counseling therapies for cocaine dependence.

This study assessed the effects of training on the performance of 65 therapists in delivering manual-guided therapies to 202 cocaine-dependent patients. Changes in ratings of therapists' adherence and competence was assessed in 3 treatment modalities: supportive-expressive dynamic therapy (SE), cognitive therapy (CT), and individual drug counseling. Effects of manual-guided training on the therapeutic alliance were also assessed. Training effects were examined through a hierarchical linear modeling approach that examined changes both within cases and across training cases. A large effect across cases was detected for training in CT. Supportive-expressive therapists and individual drug counselors demonstrated statistically significant learning trends over sessions but not over training cases. Training in SE and CT did not have a negative impact on the therapeutic alliance, although alliance scores for trainees in drug counseling initially decreased but then rebounded to initial levels. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Differences in the effectiveness of psychodynamic therapists: A process-outcome study.

Using data from a study (e.g., H. H. Strupp; see record 1993-38424-001) on the effect of therapist training on psychotherapy outcome, 16 therapists were identified as either more effective or less effective based on patients' outcome scores and length of stay (LOS) in treatment. Measures were completed by patients, therapists, independent observers, and therapists' supervisors. In-session behaviors were assessed at Sessions 3, 8, 16, and 22. More effective therapists displayed more positive behaviors (e.g., warmth), fewer negative behaviors (e.g., attacking), and more self-criticism than did less effective therapists. All therapists, however, showed some negative behavior. Significant results were almost entirely relationship-oriented. LOS was related to therapist behavior more often than were outcome scores. Only supervisors were largely unable to make the distinction between more or less effective therapists. (PsycINFO Database Record (c) 2010 APA, all rights reserved)