Training parents as behavior modifiers: self-recording of contingent attention

Two mothers of deviant young children were instructed to count their episodes of attention to appropriate child behavior in their homes, using wrist counters. Attention and appropriate child behavior were defined before counting began. Independent observations of parent-child interactions showed that, for each mother-child pair, the percentage of maternal attention given following appropriate child behavior increased, as did the child's appropriate behavior. Removal of the counters did not produce a reversal of the behaviors; instead the increased level stabilized. One mother was then instructed to count her attention to inappropriate child behavior and to decrease it. This instruction had little effect on her attention, and her child's behavior did not change. When both parents were again instructed to count their episodes of attention to appropriate behavior, further improvements in both mothers, and in their children resulted. These results were obtained despite inaccurate parent self-recording. Follow-up observations made over the next five months showed these behavioral gains to be durable. A third parent and his child were unaffected by this training procedure. Thus, there are instances in which self-recording may function as an effective and economical parent-training technique for effecting improvements in child behavior.     

The behavior of young children in a strange situation

Abstract. The social behavior of young children was assessed in a strange situation which was to become increasingly more stressful. The strange-situation procedure reported by Ainsworth & Wittig (1969) was repeated as closely as possible. Children between 1 and 1¹/₂ years were accompanied by their mothers or by a female stranger in various combinations, or were alone, according to a prearranged sequence. The data were subjected to a commonality analysis (Masters & Wellman, 1974). Common changes in the frequencies of 20 behavior items were noted across the different episodes. The physicaldistance relationship between the child and its companion, the exploratory behavior of the child, and individual differences among the children were analyzed in light of Bowlby's attachment theory. The results gave some support to the findings reported by Ainsworth and her group, but also pointed to functional differences between the behavior items examined. The results on crying were compared with those of Ainsworth & Wittig (1969), showing a fair degree of agreement. Finally, the subjects were divided into groups according to an operationalization of the criteria given by Ainsworth et al. (1971). Often children, only three could unequivocally be placed in one of eight groups. This suggests that it may be difficult to use the group characterization proposed by Ainsworth et al.     

Transformations in Therapeutic Practice

In her training of therapists, Virginia Satir sought to change the way her trainees perceived themselves, their clients, and the therapeutic endeavor. The change she sought was a movement from hierarchical models of therapy where clients were diagnosed in terms of paradigms of how they ought to be to an organic model where the therapist attempts to understand the client by entering the client's internal context. Contemporary training in the Satir model attempts to bring about the same change. Research indicates that the trainers are succeeding.     

The effect of self-recording on the classroom behavior of two eighth-grade students

The effects of self-recording on classroom behavior of two junior high school students was investigated. In the first experiment, study behavior of an eighth-grade girl in history class was recorded. Following baseline observations her counselor provided slips for the girl to record whether or not she studied in class. This resulted in an increase in study. When slips were withdrawn, study decreased and then increased once self-recording was reinstated. After teacher praise for study was increased, self-recording was discontinued without significant losses in study behavior. In the final phase, increased praise was also withdrawn and study remained at a high level. In the second experiment, the number of talk outs emitted by an eighth-grade boy were recorded during math period. Following baseline, slips for recording talk outs were issued for the first half of the period, for the second half, and then for the entire period. Talk outs decreased when self-recording was in effect and increased again when self-recording was discontinued. When self-recording was reinstituted in the final phase there was a slight, though not significant decrease in talking out when compared to the baseline condition.     

Primary-school stutterers: Have attitudes changed?

How concerned are primary-school-aged stuttering children about their communication problem? What are the clinical implications of this concern?Fifteen years ago, Silverman (1970) suggested that primary-school-aged children who stuttered were not concerned about their disfluencies. A clinical implication of that report was that the interpreted lack of concern might negatively affect the children's motivation and desire for change in therapy. Scant research exists to support or refute this implication. While research is available on reactions to stuttering, pretherapeutic attitudes—especially those of children—have not been systematically reported. Guitar (1976) measured the pre-treatment attitudes of 38 adult stutterers and reported that, “those stutterers with more negative attitudes measured just prior to treatment, were most likely to have high levels of stuttering a year later, even though all subjects left therapy entirely fluent.” In related areas, research by Kolb, Winter, and Berlen (1968), McFall (1970), and McFall and Hammen (1971) has indicated that clients who are more motivated do better in behavior modification programs.Whether or not these findings may be generalized to children, in the midst of a developmental process, is purely speculative.     

The development of socialization skills in an electively mute child

In a booth designed especially for work with both autistic and electively mute children, a 4-yr-old girl named Dolly, who had no communicative speech or imitative skills, was given a preliminary session in which her verbal output was assessed. To elicit sounds from Dolly, an instrument called a “color organ” was used as a positive reinforcer. After this baseline assessment, in 40 half-hour sessions, Dolly was taught to make eye contact with E, and to obey instructions—although it was first necessary to extinguish her disruptive behavior, particularly her opérant crying. In addition, she learned non-verbal imitative behavior, such as hand clapping; and verbal imitative behavior, such as saying “Hi!” Social (play) sessions were begun after session 21, and continued for the remaining time. These were helpful in generalizing Dolly's learned skills to an environment other than the booth; and to other tasks, such as singing “Ee-eye-ee-eye-oh” in the refrain of the song, “Old McDonald”; and pointing to E's eyes, saying “ice”.     

Eliminating versus reducing smoking using pocket timers

I want to stop smoking, any number of procedures can be recommended as effective temporarily. However, follow-up data for these methods are often lacking or disappointing (Marston and McFall, 1971). The two purposes of this study were to (a) replicate and provide follow-up data for a promising method developed by Upper and Meredith (1970), and (b) compare the success of those who set out to “quit” versus those trying merely to “cut down”. The method used is based on the theory that if smoking can be brought under the control of a single stimulus rather than the usual, multiple elicitors, then it can be more easily modified. The stimulus used in this particular approach was the buzz of a pocket timer.     

Feminist Pioneer: Annette Brodsky Paving the Way

ABSTRACT

Even when the culture imposed stringent limitations on women’s roles, Dr. Annette Brodsky refused to succumb to these restrictions. As one of only a few women in her graduate school cohort, she broke new ground during her pre-doctoral internship, her post-internship military placement, and in her faculty position at the University of Alabama. Her renowned work advocating for and studying the effect of consciousness-raising groups engendered critical scholarship that revealed the harm of therapists’ sexual abuse and facilitated improved ethics and guidelines for psychologists in their work with clients. Dr. Brodsky has served as a pioneering feminist psychologist for several generations of women.     

Three Aspects of the Therapeutic Conversation in Couples Therapy

Abstract

Feminist scholars have revealed the importance of examining the influence of gender on the therapeutic process. Gender differences in the treatment of clients may reveal inequitable or traditionally Stereotypie treatment of clients by therapists. This study examined gender differences in three conversational strategies widely used by therapists: expressions of empathy or understanding, compliments or praise, and challenges or requests for change. Fourteen tapes of live therapy sessions conducted by “master” therapists were examined using an exploratory, qualitative methodology based on Conversation Analysis. Results of this exploration revealed that therapists who are not self identified as “feminist challenged female clients more than male clients, and complimented male clients more than female clients. Feminist therapists challenged male clients more than female clients, and complimented female clients more than male clients. Feminist therapists used more challenges designed to facilitate non-stereo-typic gender behavior in both male and female clients. Only male therapists used disrespectful challenges of female clients, and were more often disrespectful to female clients than to male clients. Implications for the therapist-client relationship and the feminist critique are provided.     

The Moral Imperative

Abstract

Given recent evidence concerning the prevalence of impairment in practitioners and its deleterious effects upon clients, therapist self-care must be viewed as a moral imperative. Despite the perception that self-care is especially problematic for women psychotherapists, research indicates that we are less ambivalent about practicing self-care and engaging in personal therapy than men practitioners (Mahoney, 1997). We propose a classification system based upon the dimensions of awareness of impairment and commitment to self-care and offer practical suggestions in order to create a climate more amenable for women therapists to engage in self-care activities.     

Tom Thumb in hospital: The fairy tale workshop in a paediatric oncology and haematology ward

Abstract

Definitions of and attitudes towards countertransference have changed throughout the twentieth century. From being seen as a contaminant in the analytical process, countertransference has come to be seen by many therapists as a potentially useful source of information about a client and his or her problems. There are dangers as well as benefits associated with analysis and utilization of countertransference. This article reviews these issues and proposes some guidelines that therapists may find useful when contemplating their countertransference reactions to clients, and when considering how best to utilize these.     

Recording therapy sessions: What do clients and therapists really think?

Aims: Recording therapy sessions has become part of routine practice amongst trainee psychotherapists. To date most research has focused on the benefits of recording sessions to support clinical supervision. There are few data about the benefits or risks for clients. This study aimed to explore the views of clients who had had their therapy sessions recorded and therapists who had recorded sessions. Design: Five clients and 25 therapists completed a qualitative survey, the results of which were analysed using thematic analysis. Findings: All clients and several therapists reported that the recording devices are soon forgotten. Both therapists and clients reported the benefits of recording as being purely for the therapist with none identified for clients. Conclusions: It was observed that clients perhaps did not always understand how recordings were used, suggesting the need for clearer practice guidance.     

On mirroring in group psychotherapy

“A woman has two images. There is a magical person seen or remembered by those who love her, her finest qualities are flesh and spirit illuminated. She herself knows this ideal self; she projects it, if she is confident; or she daydreams her ideal self; or she recognizes it with gratitude in the admiring eye of others. There is at the same time a second image; the woman as seen by those who dislike or fear her. This cruel picture has an all too powerful mirror in her own negative idea of herself. She sees with fear her own ravaging impulses and most painful of all, a graceless, freakish, and unlovable physical self, this was the mirror her parents held before Edith. Her brothers saw her with love. She herself knew both images. Her life, and her poetry, constituted a flight from the second one.”     

Who,What, When,Where, How,and Mostly Why?

SUMMARY

The death of a client by suicide was very emotionally destabilizing to this therapist. She worked hard to distance herself personally from the pain at first and at the same time she found herself overfocused on the “psychological autopsy.” She had difficulty accepting new clients and wanted to withdraw from a meaningful appointment to a state advisory committee. Only when she was able to identify with the client's pain and realize how that pain touched her own history of loss was she able to grieve productively. She realized that gender was relevant in her identification with the victim and in sorting out each of their histories of loss.     

THE EGALITARIAN RELATIONSHIP IN FEMINIST THERAPY

Feminist therapy has revolutionized clinical practice and offered a model of empowerment for all therapy approaches. However, the long-assumed claim that feminist therapists are more likely to engage in power-sharing behaviors with their clients has not been supported by published quantitative research. In the current study, 42 female therapists who were asked whether or not they self-identified as feminist therapists completed measures assessing their use of feminist therapy behaviors (Feminist Therapy Behavior Checklist) and power-sharing behaviors (Therapy with Women Scale). One of each therapists' current female clients completed measures assessing her perceptions of both treatment collaboration (Working Alliance Inventory) and power-sharing behaviors (Client Therapy with Women Scale). As hypothesized, participants who identified as feminist therapists were more likely to report engaging in power-sharing behaviors when compared to participating therapists who did not. Furthermore, as hypothesized, clients of feminist therapists were more likely to report that their therapists engaged in power-sharing behaviors.     

A Single Intervention: A Visit to the Family

The following letter is reported unchanged except for disguised names. Concern with repairing disrupted relationships of adult members of a family with their own parents has been a matter of growing interest to a number of family therapists; Bowen (1), Boszormenyi-Nagy (2), and Framo (3), among others have stressed the importance of sending family members back to their families of origin. This report makes no effort to formulate the process in any particular theoretical framework (i.e., as reestablishing connectedness after an “emotional cut-off” or rebalancing a ledger of fairness, or whatever) but is intended only to illustrate the kind of outcome one may hope for in prescribing such a maneuver. It is offered simply as a clinical note. The letter needs little prefatory explication. Mr. Jack Newburgher had been a patient in psychoanalytic treatment for four years, with a quite successful outcome. On two occasions in the course of his therapy a joint session had been held with Mr. Newburgher and his wife, Muriel, when changes in his behavior had precipitated crises in the marital relationship. His therapy had terminated about two years before the visit referred to in the letter. Mr. Newburgher had called and asked for a joint consultation with Muriel about an acute family problem they were experiencing. Some — not all — of the background material was described, not nearly as coherently as it is reported in Muriel's letter, but in sufficient detail to make it plain that she was in distress about having to withdraw completely from her parents and that their family was in disarray as a consequence of her distress. The acuteness of the emotional disturbance, against a background of a lifelong adversary relationship between Muriel and her father and a history of ten years of illness on her fathers' part, suggested that the distress was the product of Muriel's anxiety and guilt over a decision to cut herself off completely from her parents. As a consequence, Muriel was urged to visit her family of origin, with the caveat that she might indeed discover them to be malignantly self-centered people indifferent to their effect on her and her family, but that she would at least have the gratification of having tried. The reference to “speaking French” was to the therapist having suggested that, on the other hand, she might find that her parents expressed their feelings in a different modality from her definitions of how feelings should be expressed, much as though their native tongue were French and she were insisting that they must speak to her in English.     

“Lord of the mirrors” and demon lover

Repeated object loss drove Sylvia Plath to create, and what she created were her greatest, and best-known poems, collected in the book Ariel. Yet the compulsion to create alternated with the compulsion to destroy. Her suicidal impulses were as intense as her poetic impulses (see Bach, 1985, on the "Marquis de Sade"). How these two contrasting impulses counter-balanced each other, until self-destruction took the lead, is the story of Sylvia Plath. What remains with us is the puzzle of her despair. This puzzle can only be pieced together by looking at the internal object relations of the father-daughter bond, which germinated like a ghost and spector within Sylvia Plath's soul.     

Licensing Parents Revisited

Although systems for licensing professionals are far from perfect, and their problems and costs should not be ignored, they are justified as a necessary means of protecting innocent people's vital interests. Licensing defends patients from inept doctors, pharmacists, and physical therapists; it protects clients from unqualified lawyers. We should protect people who are highly vulnerable to those who are supposed to serve them, those with whom they have a special relationship. Requiring professionals to be licensed is the most plausible way of doing that. Given the overwhelming support for the licensing of these professionals, I find it odd that so many people categorically reject proposals to license parents. Although the relationship between a parent and her children is different in some respects, it is also relevantly similar to that between a professional and those she serves. To defend these claims, I show how and why the rationale for licensing parents parallels the rational for licensing professionals. I then ask whether such a program could be justifiably implemented. Finally, I describe and reject what I see as the flawed view of the relationship between parents and their children.     

Therapeutic Multiple Family Groups

The therapeutic effects of interpretations by both therapists and other clients were recorded by observers in three cognitive–behavioral and three psychodynamic groups over a period of thirty one-and-one-half-hour group therapy sessions. There was no significant difference in the overall frequency of interpretations made in the two different therapy modalities; however, there was the expected difference in the types of interpretations made. Cognitive–behavior therapists and group members tended to interpret patterns of behavior or impact on others more frequently than did psychodynamic therapists and group members; while psychodynamic therapists and group members made more historical cause interpretations. However, contrary to expectations, both therapy modalities made more interpretations of patterns of present behavior than any other type. When these interpretations were converted into problem statements that were sent to outside raters after the termination of the groups, the outside raters judged that clients improved most when interpretations of a pattern of behavior were made; next most when interpretations of impact on others were made; and did not improve when interpretations of motive were employed in either modality.