The Relationship Between Dropout and Outcome in Naturalistic Cognitive Behavior Therapy

Dropout from psychotherapy is frequent and limits the benefits patients can receive from treatment. The study of factors associated with dropout has the potential to yield strategies to reduce it. This study analyzed data from a large sample of adults (N = 1,092) receiving naturalistic cognitive behavioral therapy (CBT) to test the hypotheses that dropouts, as compared to completers, had (1) higher symptom severity at treatment termination, (2) a slower rate of symptom change during treatment, and (3) a higher odds that the therapist rated treatment as ending for reasons related to poor outcome. Results showed that although dropouts ended treatment with higher symptom severity than completers, dropouts and completers did not differ in their rate of symptom change during treatment, suggesting that dropouts had higher symptom severity at termination because they received fewer sessions of treatment, not because their symptoms changed at a slower rate. Dropout was also associated with a higher odds of having a therapist-rated termination reason indicating a poor outcome, suggesting that dropout is more likely if patients are dissatisfied with some aspect of the therapy outcome or process. These findings suggest that strategies for monitoring and enhancing patient satisfaction with the process and outcome of treatment may help patients stay in treatment longer and end treatment with fewer symptoms than if they had dropped out.     

The Negotiation of Values in Therapy

Values are integral to all social systemic operations and therefore to the heart of the therapeutic process. For the therapist, values are an essential component in defining and assessing a problem, determining goals, and selecting therapeutic strategy. Therapists do not have a choice about whether they need to deal with values in therapy, only about how well. The training of therapists about their values needs to be integrated with the training about their own emotional and family issues. This training should be carried out in the context of treating families and have as its primary focus the relationship of the therapists' personal issues to the conduct of their therapy with families. Personal insight and mastery over handling their own values and family issues will maximize therapeutic effectiveness.     

Relationship Between Homework Completion and Outcome in Cognitive Behaviour Therapy

Homework or between‐session learning has long been considered an essential aspect of effective cognitive behaviour therapy. However, it has received relatively less empirical attention than other components of cognitive behaviour therapy. In general, studies have found that homework completion is predictive of outcome in psychotherapy. However, the amount of homework completed by a patient represents only one aspect of this important therapeutic component. This study investigated both the quantity and the quality of homework completed during a 10‐week group cognitive and behavioural treatment program for anxious and depressed patients. It explored the relationship between various aspects of homework completion and outcomes on several different variables. A total of 94 patients were included in the analysis. It was found that both quantity and quality of homework completed predicted outcome on measures of depression, anxiety and quality of life at post‐treatment and at 1‐month follow‐up. The results were strongest for the amount of homework completed, suggesting that clinicians should encourage patients to complete homework even if the homework content is not entirely accurate. The results of this study highlight the importance of homework as a central part of effective cognitive and behavioural treatment.     

Learning Emotionally Focused Couple Therapy: Four Clinicians' Perspectives

This study examined the experiences of four clinicians learning emotionally focused couple therapy (EFT). Two group interviews, separated by 6 years, explored topics that included emotion, gender, model differences, personal practitioner impact, and the long-term influence of EFT training on clinical work. Emotion emerged as a major theme, with three subthemes at each phase. Phase 1 results indicated an increase in personal awareness of emotions, a positive impact on close personal relationships, and challenges for males in learning to elicit and use emotion. Phase 2 results, 6 years later, revealed that focusing on emotions remained salient and that EFT continues to influence the work of each clinician to varying degrees. Limitations, future research suggestions, and clinical implications are discussed.     

Creativity to Sexual Values as Factors of Importance,Frequency, and Feeling Ratings

Factor analyses identified one General and 23 Primary factors, grouping independently the dimensions of importance (attitudinal), frequency (of experiences), and pleasantness-unpleasantness (of bodily feelings) for 48 items that broadly reflect human values, activities, and feelings such that they are applicable cross-culturally. This Specific Value Scale was self-rated by 296 college students whose 13 “Values” (incorporating the three dimensions) ranged from Social Activities and Ethical Beliefs to Sexual Activities and Significance (importance feeling), these values being also reflected in factors. The importance of self-understanding and the pleasantness of clothes grooming and of friendship were emphasized. Deemphasized were rebelling, arguments, and negative feelings. No significant differences were found between the sexes.     

当事人的投入与会谈效果、咨询效果的关系研究

本研究探索了当事人会谈时的投入与即时会谈效果的关系;当事人咨询初期的投入与整体咨询效果的关系。结果发现当事人会谈时的投入与即时会谈效果、在咨询初期的投入与整体咨询效果都呈现显著的正相关。进一步回归分析发现,当事人在咨询初期的投入与整体咨询效果呈现正U型的偏态分布,少数投入水平最低的当事人获得中等水平的咨询效果,中等投入水平的当事人咨询效果最差,投入水平最高的当事人的咨询效果最好。     

白血病诱导分化治疗中的生态自然观

诱导分化是一种治疗白血病的新方法,它通过促使分化不完全的肿瘤细胞分化成熟,使恶性转为良性.临床应用全反式维甲酸(ATRA)和三氧化二砷(As2O3)诱导急性早幼粒细胞性白血病取得了较高的完全缓解率,毒副作用也较低.诱导分化治疗策略突破了将杀灭肿瘤细胞作为治疗肿瘤的惟一方法的思维局限,谋求在与白血病细胞的和谐中获得人类的健康,是生态自然观应用于医疗实践的成功范例.     

The Relationship of Work Values to Occupational Level in Young Adult Workers

This research was designed to assess the relationship of work values as measured by Super's Work Values Inventory to job level. A total of 202 young adult workers (136 males, 66 females) between the ages of 18 and 25 in unskilled, semiskilled, skilled, and clerical-sales positions were surveyed. Differences in work values by sex and job level were found. Implications for counselors are discussed.     

The Impact of Contextual Self‐Ratings and Observer Ratings of Personality on the Personality–Performance Relationship1

This study examined 2 possible ways of increasing the predictive validity of personality measures: using observer (i.e., supervisor and coworker) ratings and work‐specific self‐ratings of Big Five personality factors. Results indicated that among general self‐ratings of Big Five personality dimensions, Conscientiousness was the best predictor of in‐role performance, and Agreeableness and Emotional Stability were the best predictors of organizational citizenship behavior (OCB). Observer ratings of personality accounted for incremental variance in job performance (in‐role performance and OCB) beyond that accounted for by general self‐ratings. However, contrary to our expectations, work‐specific (i.e., contextual) self‐ratings of personality generally did not account for incremental variance in job performance beyond that accounted for by general self‐ratings.     

Using the Client's Religious Values to Aid Progress in Therapy

The client's religious values could be put to use to promote growth in therapy, as detailed in this brief report.     

Values and Ethics in Family Therapy

This article is an introduction to this special issue on values and ethical issues in family therapy. The author discusses the historical context for the rising interest in these issues in family therapy, describes the rationale for this special issue, and presents a framework for analyzing the core values of the prominent models of family therapy. The ethical debate over use of paradoxical techniques in family therapy is used as an illustration of a values clash between different models of family therapy.     

The Relationship of Sexual Values and Emotional Awareness to Sexual Activity in Young Adulthood

A sample of 170 college freshman completed assessments related to emotional awareness, sexual values, and levels of sexual activity. There was a significant relationship between sexual values and sexual activity. Abstinence values appear to be important in the decision to engage in sexual activity.     

Using Client Narratives to Identify Predictors of Outcome in Written Exposure Therapy and Cognitive Processing Therapy

Written exposure therapy (WET) is a brief, five-session treatment for posttraumatic stress disorder (PTSD) that aims to improve access to care. WET has been demonstrated to be an efficacious PTSD treatment with lower rates of dropout and noninferior PTSD symptom outcome compared to cognitive processing therapy (CPT), a 12-session, gold-standard treatment. To identify predictors of treatment outcome in both WET and CPT, the current study examined the content of participants’ written narratives. Participants were 123 adults with PTSD who were randomly assigned to receive WET (n = 61) or CPT (n = 62). The Change and Growth Experiences Scale (CHANGE) coding system was used to code all available narratives in both treatment conditions for variables hypothesized to be relevant to therapeutic change. Linear regression analyses revealed that in WET, higher average levels of accommodated (healthy, balanced) beliefs and an increase in accommodated beliefs from the first to the final impact statement predicted better PTSD symptom outcome at 12 weeks postrandomization. In CPT, higher average levels of overgeneralized and accommodated beliefs and lower levels of avoidance expressed in the narratives predicted better PTSD outcome. There were no significant predictors of outcome in analyses of change from the first to final impact statement in CPT. These findings add to research identifying predictors of change in WET and CPT by highlighting the importance of low avoidance in CPT and of trauma-related cognitions in both CPT and WET, even though WET is a brief written intervention that does not explicitly target cognitive change.     

教师工作价值观与工作绩效的关系研究

目的 探讨教师工作价值观与工作绩效的关系。方法 采用教师工作价值观量表和工作绩效量表,对645名中小学教师进行了测量,运用SPSS17.0对数据进行统计分析。结果 教师工作价值观与工作绩效间存在显著的正相关,但相关水平较低;利他奉献、安全稳定及声望地位维度是任务绩效、工作奉献及总体绩效的预测指标,利他奉献、安全稳定及人际关系维度是人际促进绩效的预测指标。结论 教师工作价值观能在一定程度上预测其工作绩效。     

Alliance Ratings as a Part of Trainee Evaluations Within Family Therapy Training

Client-reported therapeutic alliance scores were examined as a measure of improvement in therapeutic skills across master's-level marriage and family therapy (MFT) training. The results indicate significant correlations between alliance ratings and training variables, with the number of cumulative clinical hours identified as a significant predictor of alliance ratings according to a regression analysis. Trainees lacking the expected number of clinical contact hours in each level of training were found to be more likely to receive consistently marginal alliance ratings. Additionally, alliance ratings were especially useful in identifying trainees who were functioning at minimal levels of competency.