Efficacy of booster sessions after training in assertiveness

28 subjects participated in a 6-wk. assertion training program. Of these, 22 remained in the study for a 6-mo. follow-up period, during which half received monthly booster sessions and half did not. Assignment to the booster and no-booster groups was random, with the qualification that subjects were equated on trait anxiety before training in assertiveness. Subjects filled out the Gambrill-Richey Assertion Inventory, the Spielberger State-Trait Anxiety Inventory, and the Zung Self-rating Depression Scale before the 6-wk. assertion training, after this program, at a 3-mo. follow-up, and at a 6-mo. follow-up. It was hypothesized that the booster group would exhibit significant superiority on these measures at the 3-mo. and 6-mo. follow-ups. On all measures both groups significantly improved from before to after the training program with good maintenance throughout the follow-ups. There were no differences between the booster and no-booster groups on the measures of assertiveness and anxiety. However, there was a significant interaction for the depression scores when the booster and no-booster groups were compared from posttreatment to 6-mo. follow-up. The depression scores of subjects in the booster group were lower than the depression scores of subjects in the no-booster group at the 6-mo. follow-up. These results were discussed with suggestions for further research.     

A randomized clinical trial of inpatient family intervention: VI. Mediating variables and outcome

In a randomized clinical trial of Inpatient Family Intervention (IFI) for 169 inpatients with schizophrenia, affective disorder, and a residual group of other diagnoses, results suggested significant effects favoring IFI for patients and their families. The treatment effects were limited to females and to two diagnostic groups: chronic schizophrenia patients and the bipolar subgroup of affective disorders.     

Brief crisis group psychotherapy versus the initial sessions of long-term group psychotherapy: An exploratory comparison

An attempt was made to specify the therapist behaviors characteristic of the brief crisis group (BCG) approach, to assess how patients experience BCG on dimensions of session impact and group climat, and to describe the changes possible from BCG on measures of outcome by contrasting this modality with the initial sessions of traditional long-term therapy groups in a preexperimental design. Data obtained from four eight-session BCGs and three beginning long-term groups (LTG) were used for analyses. Patients were administered the Session Evaluation (SEQ) and Group Climate (GCQ) Questionnaires at the end of each group session. Two judges sat in on each session and coded the types of therapist interventions using the Therapist Behavior Categories (TBC) system. Aspects of self-esteem and symptomatology were assessed as indices of change over the 8-week period in a pre-post fashion. Therapists in BCG evidenced a distinct pattern of interventions during midpoint group sessions (sessions 3–6), placing a greater emphasis on challenging patient perceptions and providing information than their LTG counterparts. The therapists' use of self as an issue in BCG increased as termination approached and apparently served a more limited function than in LTG. Patients in BCG reported a more rapid development of a working group and experienced greater session benefit. Patients in BCG also reported lower levels of conflict and avoidance and a greater decrease in these resistance behaviors. As expected, BCG patients reported substantially greater improvement on most outcome dimensions at the end of the 8-week period. Results are considered as clarifying the approach to and impact of BCG psychotherapy.An earlier version of this paper was presented at the 15th Annual Meeting of the Society for Psychotherapy Research, Lake Louise, Alberta, June 19–23, 1984.     

A cluster randomized controlled trial of brief follow-up practice sessions on intervention maintenance

Despite considerable knowledge of the factors that influence initial intervention response, little is known about how to sustain successful intervention response over time. The current study examined spring literacy outcomes for kindergarten (n = 177), second (n = 149), and third grade students (n = 204) who successfully exited an evidence-based tutoring program during the fall semester. Successful responders in kindergarten, second, and third grade were randomly assigned by school to receive either no follow-up support or access to a once-weekly oral practice session. Results were mixed across grades and outcomes, but in kindergarten and third grade, treatment corresponded to an approximately 15% increased likelihood of meeting year-end benchmarks on targeted literacy skills. Findings are discussed in the context of suggestions for higher-quality longitudinal research designs of educational interventions.     

A randomized controlled effectiveness trial of parent management training with varying degrees of therapist support

This study examined the effectiveness of a Swedish parent management training (PMT) intervention for parents of children aged 3 to 10 within the context of regular social service. Self-referred parents of 159 children (aged 3 to 10) with conduct problems were randomly assigned to either 11 practitioner-assisted group sessions (PMT-P), or a single instructional workshop followed by self-administration of the training material (PMT-S), or a waitlist control group. Intent-to-treat analyses showed that both PMT-P and PMT-S improved parent competence and reduced child conduct problems compared to the waitlist at posttest. Both training conditions showed further significant improvements at the 6-month follow-up. In direct comparison, PMT-P was superior to PMT-S on measures of child conduct problems at both posttest and follow-up. Improvement in child conduct was mediated by improvement in parent competencies and homework fidelity. The findings in this study have implications for large-scale dissemination of parent management training through different means of delivery.     

A controlled study of effectiveness and patient suitability for short-term group psychotherapy

A controlled, clinical trial investigation of short-term psychoanalytically oriented group psychotherapy (STG) was conducted which included eight psychotherapy groups led by experienced therapists. Patient psychological mindedness (PM) was investigated as a selection criterion and prognostic variable. Seventy-nine psychiatric outpatients experiencing prolonged or delayed grief reactions were matched for level of PM and then randomly assigned to STG or a wait list. There was repeated measurement of several areas and sources of outcome. Results indicated a strong main effect for STG but not for PM on outcome, and minimal evidence for an interaction effect. Benefits were maintained at six-month follow-up. Psychological mindedness emerged as highly predictive of attrition. A clinical discussion is presented wherein the efficacy of STG is considered as reflecting a good patient-treatment match.     

Problem-solving training for family caregivers of women with disabilities: A randomized clinical trial

ObjectiveTo examine the effectiveness of an individualized problem-solving intervention provided to family caregivers of women living with severe disabilities.DesignFamily caregivers were randomly assigned to an education-only control group or a problem-solving training (PST) intervention group. Participants received monthly contacts for 1 year.ParticipantsFamily caregivers (64 women, 17 men) and their care recipients (81 women with various disabilities) consented to participate.Main outcome measuresCaregivers completed the Social Problem-Solving Inventory – Revised, the Center for Epidemiological Studies Depression scale, the Satisfaction with Life scale, and a measure of health complaints at baseline and in three additional assessments throughout the year.ResultsMultilevel modeling was used to conduct intent-to-treat analyses of change trajectories for each outcome variable. Caregivers who received PST reported a significant linear decrease in depression over time; no effects were observed for caregiver health or life satisfaction. Caregivers who received PST also displayed an increase in constructive problem-solving styles over the year.ConclusionsPST may benefit community-residing family caregivers of women with disabilities, and it may be effectively provided in home-based sessions that include face-to-face visits and telephone sessions.     

Habit reversal versus supportive psychotherapy in Tourette's disorder: a randomized controlled trial and predictors of treatment response

Tourette syndrome (TS) is characterized by chronic motor and vocal tics. Habit reversal therapy (HR) is a behavioral treatment for tics which has received recent empirical support. The present study compared the efficacy of HRT in reducing tics, improving life-satisfaction and psychosocial functioning in comparison with supportive psychotherapy (SP) in outpatients with TS. In addition, we investigated whether impairments in response inhibition in patients with TS predict response to HR treatment which specifically aims to inhibit tics. Thirty adult outpatients with DSM-IV TS were randomized to 14 individual sessions of HR (n = 15); or SP (n = 15). HR but not SP reduced tic severity over the course of the treatment. Both groups improved in life-satisfaction and psychosocial functioning during active treatment. Reductions in tic severity (HR) and improvements in life-satisfaction and psychosocial functioning (HR and SP) remained stable at the 6-month follow-up. The extent of pre-treatment response inhibition impairment in the HR group predicted reductions in tic-severity from pre- to post-treatment. Our results suggest that HR has specific tic-reducing effects although SP is effective in improving life-satisfaction and psychosocial functioning. Assessments of response inhibition may be of value for predicting treatment response to HR.     

VR-based conversation training program for patients with schizophrenia: a preliminary clinical trial.

Schizophrenia is a devastating mental illness and is characterized by hallucinations and delusions as well as social skills deficits. Generally, social skills training designed to help patients develop social skills includes role-playing, but this form of training has typical shortcomings, which are largely due to a trainer's difficulties to project emotion. Virtual reality (VR)-based techniques have the potential to solve these difficulties, because they provide a computer-generated but realistic three-dimensional world and humanlike avatars that can provide emotional stimuli. In this paper, we report on a method of implementing virtual environments (VEs) in order to train people with schizophrenia to develop conversational skills in specific situations, which could overcome the shortcomings of or complement conventional role-playing techniques. The paper reports the efficacy of the proposed approach in a preliminary clinical trial with 10 patients with schizophrenia.     

Reflections on a do-it-yourself training program in clinical psychology

This paper is a somewhat modified version of the inaugural Rapaport—Klein Memorial Lecture at Austen Riggs Center presented June 21, 1974. The author describes the experiences, the series of “apprenticeships” and clinical exposures, which coalesced into his education, from teenage days in the New York Madison House settlement, through Harvard undergraduate and graduate work, to Worcester State Hospital as head of psychological services and research. In conclusion, the author discusses the effects of the kinds of training experiences he has described on the issues that arose in the formulation of formal standards of training in clinical psychology.     

A pragmatic trial evaluating the effectiveness of web versus live training in functional behavior assessment and interventions among special educators

This study adopted a pragmatic trial with randomization to investigate the relative effectiveness of web versus live training on special educators' competence and perceived skills in functional behavior assessments (FBA) and behavior interventions. Pragmatic trials seek to determine the effectiveness of an intervention in a real-world setting to ensure better application and generalizability in routine practice conditions. The live training group received an in-person workshop delivered in a lecture format via powerpoint slides. The web training group received asynchronous online instruction via a secure website. The same training content was delivered to both groups. Participants were randomly assigned across both instructional modalities and completed two pre- and post-test measures. Results indicated that participants (N = 104) in both groups showed a significant increase in theoretical competence of FBA and behavior interventions post training. Only participants in the live workshop group reported a significant increase in perceived skill scores. When comparing outcomes across groups, the live training group gained significantly more theoretical competence in FBA and behavior interventions than that in the web training group. These results shed light on the practical implications of online platforms for professional development among in-service teachers in behavior management for schools with children having disabilities and challenging behavior.     

A randomized clinical trial of transdiagnostic cognitve-behavioral treatments for anxiety disorder by comparison to relaxation training

Transdiagnostic cognitive-behavioral treatments (CBT) for anxiety disorders have been gaining increased attention and empirical study in recent years. Despite this, all of the research on transdiagnostic anxiety treatments to date have either not used a control condition, or have relied on no-treatment or delayed-treatment controls, thus limiting inferences about comparative efficacy. The current study was a randomized clinical trial examining the efficacy of a 12-week transdiagnostic cognitive-behavioral group treatment in comparison to a 12-week comprehensive relaxation training program. Results from 87 treatment initiators suggested significant and statistically equivalent/noninferior outcomes across conditions, although relaxation was associated with a greater rate of dropout despite no differences in treatment credibility. No evidence was found for any differential effects of transdiagnostic CBT for any primary or comorbid diagnoses.     

Component analysis of verbal versus spatial working memory training in adolescents with ADHD: A randomized,controlled trial

Adaptive training of working memory (WM) using the Cogmed-RM intervention has recently shown some efficacy as an alternative treatment for ADHD, but this intervention may not be optimally designed. A recent component analysis of WM has suggested that maintenance in primary memory (PM) appears to be largely intact whereas recall from secondary memory (SM) appears to be deficient in ADHD relative to age-matched controls. However, extrapolating from basic research, there is reason to believe that Cogmed-RM may target the PM component more than the SM component; though training with spatial exercises may target the SM component more than training with verbal exercises. To investigate, participants diagnosed with ADHD were randomly assigned to either a verbal training condition (n?=?24) or a spatial training condition (n?=?23) using a randomized, controlled design, and both groups were instructed to complete at least 20 days of training. The PM and SM components of WM were assessed immediately before and after training using both verbal and spatial free recall tasks. The main findings showed that both versions of the intervention enhanced the maintenance of information in PM regardless of test modality, but not the recall of information from SM. Therefore, the component of WM that is improved by Cogmed-RM is not the same component of WM that is deficient in ADHD.