Rorschach changes in long-term and short-term psychotherapy

Over a period of several years, repeat Korschach testing was done with two groups of patients receiving outpatient psychotherapy, a long-term group (n = 88) engaged in intensive, dynamically oriented psychotherapy and a short-term group (n = 88) involved in behavioral or gestalt therapy. Rorschach protocols were obtained at the beginning of the treatment and on three subsequent occasions, 1 year, 2 1/2 years, and 4 years later, when most of the long-term and all of the short-term patients had completed their therapy. The findings demonstrate generally beneficial effects of psychotherapy, greater change in long-term than in short-term therapy, and the validity of the Rorschach for measuring these effects and changes.     

Rorschach Changes in Long-Term Short-Term Psychotherapy

Over a period of several years, repeat Korschach testing was done with two groups of patients receiving outpatient psychotherapy, a long-term group (n = 88) engaged in intensive, dynamically oriented psychotherapy and a short-term group (n = 88) involved in behavioral or gestalt therapy. Rorschach protocols were obtained at the beginning of the treatment and on three subsequent occasions, 1 year, 21/2 years, and 4 years later, when most of the long-term and all of the short-term patients had completed their therapy. The findings demonstrate generally beneficial effects of psychotherapy, greater change in long-term than in short-term therapy, and the validity of the Rorschach for measuring these effects and changes.     

Concurrent brief versus intensive smoking intervention during alcohol dependence treatment.

Alcohol dependent smokers (N=118) enrolled in an intensive outpatient substance abuse treatment program were randomized to a concurrent brief or intensive smoking cessation intervention. Brief treatment consisted of a 15-min counseling session with 5 min of follow-up. Intensive intervention consisted of three 1-hr counseling sessions plus 8 weeks of nicotine patch therapy. The cigarette abstinence rate, verified by breath carbon monoxide, was significantly higher for the intensive treatment group (27.5%) versus the rate for the brief treatment group (6.6%) at 1 month after the quit date but not at 6 months, when abstinence rates fell to 9.1% for the intensive treatment group and 2.1% for the brief treatment group. Smoking treatment assignment did not significantly impact alcohol outcomes. Although intensive smoking treatment was associated with higher rates of short-term tobacco abstinence, other, perhaps more intensive, smoking interventions are needed to produce lasting smoking cessation in alcohol dependent smokers.     

Outcome of psychoanalytically oriented group psychotherapy

A study of 100 consecutive persons who terminated, once a week, psychoanalytically oriented group psychotherapy shows that it is an effective treatment for neurotic persons with good ego strength who remain in therapy a year or longer. Analytically oriented group therapy was less effective in treating severely ego-impaired persons, and group members of all levels of ego strength often required augmentation of their group therapy by individual sessions and psychotropic medications. Early dropouts (less than 30 sessions) seemed related to lack of motivation and poor fit with the group. Later dropouts (sessions 30–60) seemed related to low ego strength.     

Gameplay Decisions of University Badminton Students

This study used a modified multiple baseline approach across groups to determine the effects of a creative problem-solving intervention series on the game-play decision making of university badminton students. All subjects were videotaped five times (once per week) in five-minute game play sessions with the same partner each time. One group (experimental) underwent creative problem-solving interventions on a weekly basis. Following the interventions and videotaping, each five-minute segment was coded via computer for frequencies of occurring tactical decisions. Results suggest that although certain categories did not generate positive support, the experimental intervention tended to continually improve decision-making in the most strategic categories (running opponents and jamming them) during game play in badminton.     

Time-Limited Brief Therapy with Families: A One-Year Follow-Up Study

Families from a previously reported study of time-limited brief treatment were followed up one year after termination. Results based on questionnaires completed by the parents provide no evidence for deterioration after termination for families that had received six-session time-limited therapy, twelve-session time-limited therapy, or treatment without time limits. At one year, there were no significant differences in outcome between time-limited and unlimited approaches, between six-session and twelve-session treatment, or between treated families and a waiting list control group (most of whom had entered therapy by this time). As in the original study, the results do not support claims of increased therapeutic effectiveness for time and session limits. However, time limits did succeed in shortening treatment without significantly reducing its effectiveness or the durability of outcome.     

Parent-directed cognitive behavioral therapy for young anxious children: a pilot study

Anxiety in children age 8 years and above has been successfully treated with cognitive behavioral therapy (CBT). However, the efficacy of CBT for anxious children ages 4-7 years has not, to date, been fully investigated. This paper piloted a CBT intervention targeting child anxiety that was delivered exclusively to parents of 26 children with anxiety symptoms ages 4-7 years. The intervention consisted of four 2-hour group sessions of four to six parents (couples). These group sessions were followed by four individual telephone sessions, once per week across a 4-week period. The pre- and postintervention assessment involved measures of multiple constructs of child anxiety (anxiety symptoms, children's fears, behavioral inhibition, and internalizing symptoms) from multiple informants (parents, children, and teachers). Parents also reported parenting strategies they were likely to use to manage their children's anxiety pre- and postintervention. Results indicated a significant decrease in child anxiety and behavioral inhibition as reported by parents and teachers. Furthermore, mothers reported significant increases in their use of positive reinforcement, and modeling and reassurance, and a significant decrease in their use of reinforcement of dependency directly after treatment. Taken together, parent-directed CBT appears to be an effective approach for treating children ages 4-7 years with anxiety symptoms. Limitations of the current research are discussed.     

CONTINGENT REINFORCEMENT OF ABSTINENCE WITH INDIVIDUALS ABUSING COCAINE AND MARIJUANA

Two males diagnosed with cocaine dependence received a behavioral intervention comprised of contingency management and the community reinforcement approach. During the initial phase of treatment, reinforcement was delivered contingent on submitting cocaine-free urine specimens. The community reinforcement approach involved two behavior therapy sessions each week. Almost complete cocaine abstinence was achieved, but regular marijuana use continued. During a second phase, reinforcement magnitude was reduced, but remained contingent on submitting cocaine-free specimens. Behavior therapy was reduced to once per week. Cocaine abstinence and regular marijuana use continued. Next, reinforcement was delivered contingent on submitting cocaine- and marijuana-free specimens. This modified contingency resulted in an abrupt increase in marijuana abstinence and maintenance of cocaine abstinence. One- and 5-month follow-ups indicated that cocaine abstinence continued, but marijuana smoking resumed. These results indicate that the behavioral intervention was efficacious in achieving abstinence from cocaine and marijuana; maintenance, however, was achieved for cocaine only.     

Comparing memory skill maintenance across the life span: preservation in adults, increase in children

The authors examined life-span differences in the maintenance of skilled episodic memory performance by assessing 100 individuals (10 -11, 12-13, 21-26, and 66-79 years old) 11 months after termination of an intensive multisession mnemonic training program (Y. Brehmer, S.-C. Li, V. Müller, T. von Oertzen, & U. Lindenberger, 2007). Skill maintenance was tested in 2 follow-up sessions, the first without and the second with mnemonic reinstruction. Younger and older adults' average performance levels were stable across time. In contrast, both younger and older children's memory performance improved beyond originally attained levels. Older adults' performance improved from the first to the second follow-up session, presumably profiting from instruction-induced skill reactivation. Results suggest that (a) skill maintenance is largely intact in healthy older adults, (b) older adults need environmental support to fully reactivate their former skill levels (cf. F. I. M. Craik, 1983), and (c) children adapt a skill learned 11 months ago to their increasing cognitive capabilities.     

Six-month prognostic norms derived from studies of the Rorschach Prognostic Rating Scale

The Rorschach Prognostic Rating Scale (RPRS) was introduced in 1951 by Klopfer. Kirkner, Wisham, and Baker. The predictions of Klopfer et al. are compared to the outcomes in four studies of the RPRS. The originalinterpretation is shown to predict higher percentages of success than revealed by the empirical studies. A second interpretation of the scale is proposed on the basis of the experimental data. This interpretation relates RPRS scores to the chance for substantial improvement within 30 weeks of once weekly therapy by client-centered, rational-emotive, desensitization, aversion, or traditional methods. For any given RPRS score, the chance for substantial improvement is approximately the same for every type of therapy, and increases as the RPRS score increases. The second interpretation is proposed in both tubular and algebraic forms as a stimulus to further research and clinical applications.     

Individual psychotherapy as an adjunct to group psychotherapy

This paper describes a form of combined psychotherapy in which the individual sessions are used as an adjunct to group therapy. Each group member is seen regularly in individual sessions to focus primarily on the member's ongoing group work. The individual sessions are scheduled on a rotating basis. Typically, each group member is seen in an individual session once every four weeks. Additional individual sessions are available only when immediate attention is appropriate and necessary. The group is viewed as the primary therapeutic component. A cost-effective therapeutic approach that uses both individual and group methods, this modality lends itself well to a clinic and to a private practice setting.     

Coping in childhood: A comparative evaluation of different relaxation techniques

Abstract

This paper reports on the evaluation of relaxation trainings to improve the coping of children with stress situations. Over five training sessions, different relaxation techniques were presented to children to evaluate their short-term and long-term effects on different criteria. Included were a sensoric approach to relaxation (the Progressive Muscle Relaxation), an imaginative approach, and an imaginative approach with additional sensoric elements (combined training). Two control conditions were added. One of them presented non-tension producing stories instead of supplying a systematic relaxation training. The children of the second control condition participated at the measurements without any intervention. The participants were 826 children aged 7–14. The results show clear short-term effects on physiological parameters (blood pressure, pulse rate, body temperature) as well as on subjective ratings of the children's mood and somatic condition. In relation to the overall changes, the differences between the training conditions are comparatively small. Moreover, the long-term effects (recorded one week and two months after the five training sessions) were small in relation to the short-term effects.     

Group therapy with schizophrenic patients: a short-term, homogeneous approach

The author presents a short-term, homogeneous model for treating schizophrenic patients in discussion-oriented therapy groups. Typically, patients attend nine sessions in the open inpatient groups and 12 sessions in the closed outpatient groups. The two goals of this co-therapy approach are to help patients cope with psychotic experiences and improve their interpersonal relationships. Discussions focus on hallucinations, delusions, loose associations, and maladaptive relationships, and anxiety-producing topics are avoided. The format is interaction-oriented and emphasizes the here and now. Empirical evidence supports the value of this short-term group therapy approach when it is used in conjunction with antipsychotic medications and long-term follow-up.     

T-Group Theory and Laboratory Method: Innovation in Re-Education Edited by Leland P. Bradford,Jack R. Gibb,and Kenneth D. Benne

The authors conducted a quantitative examination of parallels between milieu and therapy group dynamics on a short-term inpatient unit. The Ward Atmosphere Scale was used to assess the milieu, and the Group Climate Questionnaire-S to measure processes in key groups. Assessments were made by patients and staff once each week for 10 months. The authors found clear parallels between ward and therapy group processes. The parallels reflected the impact of patterns utilization of the unit, its treatment philosophy, and the emotional dynamics of its constituents. Examination of these associations also revealed limitations of the treatment setting, clarified the potential impact of particular staff interventions, and demonstrated biases in the rating methods. Study of parallel process on the psychiatric unit is a rich source of information on the nature of inpatient treatment.     

Inpatient group processes parallel unit dynamics.

The authors conducted a quantitative examination of parallels between milieu and therapy group dynamics on a short-term inpatient unit. The Ward Atmosphere Scale was used to assess the milieu, and the Group Climate Questionnaire-S to measure processes in key groups. Assessments were made by patients and staff once each week for 10 months. The authors found clear parallels between ward and therapy group processes. The parallels reflected the impact of patterns utilization of the unit, its treatment philosophy, and the emotional dynamics of its constituents. Examination of these associations also revealed limitations of the treatment setting, clarified the potential impact of particular staff interventions, and demonstrated biases in the rating methods. Study of parallel process on the psychiatric unit is a rich source of information on the nature of inpatient treatment.     

Videotaped simulated families as a tool in family therapy outcome research

Twenty-two therapists who had treated 57 families in brief conjoint family therapy under supervision responded to a videotaped simulated family as if they were treating it. Their responses were audiotaped and coded on a system devised for this study. Positive relationships were found between the ratings of expertise based on the coding system, and independent ratings of the treated families' satisfaction with treatment and the status of the presenting symptoms 6 months after termination. Videotaped simulated families are potentially useful as standardizable methods of revealing individual differences in therapists for family therapy outcome research.     

The Love and Fear of Flying by Douglas D. Bond

A study of over 700 referrals for group therapy within a large university hospital setting revealed that such services were primarily provided for moderately to severely disturbed patients, mostly single white females from working and middle class backgrounds, university students, and unemployed, poorly educated minority group members. However, 41 percent of the patients initially referred never actually attended a therapy group. Among those who did begin group therapy, drop-outs occurred most frequently during early sessions. Over half the treated patients were seen for a total of twelve or fewer sessions. Data are interpreted as highlighting the importance of implementing careful referral and preparation procedures, and as underscoring the necessity for developing effective short-term group therapy approaches.     

A comparison of attachment outcomes in enactment-based versus therapist-centered therapy process modalities in couple therapy

Attachment issues are viewed by many therapists as lying at the heart of couple distress. It is critical to empirically validate therapy processes that facilitate couples in responding to each other's attachment needs. This study examined enactments as a therapy process and change mechanism to promote secure attachment in couple therapy. Sixteen couples were randomly assigned to 1 of 2 experimental groups--1 group received 3 therapist-centered sessions followed by 3 enactment-based sessions, and a second group received 3 enactment-based sessions followed by 3 therapist-centered sessions. To measure between-session and within-session change, each spouse completed presession and postsession measures of attachment security each week. Results showed that couples who received enactment-based sessions first reported greater increases in attachment security than those receiving therapist-centered sessions first. These same couples continued to show improvement after switching to the therapist-centered sessions. Conversely, couples who received therapist-centered sessions first did not increase attachment after switching to enactment-based sessions. For wives, enactment-based sessions produced the greatest improvement in attachment, yet both therapy process modalities led to some improvement. Conversely, for husbands, attachment improved only when they received enactment-based sessions first. Enactment-based sessions may therefore be more important for husbands than wives. Overall, with some qualification it appears that enactment-based therapy process may improve attachment more than a therapist-centered process. These observed trends and findings are generally consistent with previous research supporting use of enactments in couple therapy.     

Outcome evaluation in brief mother-infant psychotherapies: Report on 75 cases

The effects of brief mother–infant psychotherapies (maximum of 10 sessions) were examined in cases of functional and behavioral disturbances in children less than 30 months old. Seventy-five mother-infant dyads were assessed prior to treatment, at 1 week, and 6 months after therapy ended. The outcome measures were changes in the infant's symptoms, the behavioral interactions between mother and infant, and maternal representations. The effect of two forms of intervention—Psychodynamic Therapy and Interaction Guidance Therapy—were compared. Results indicated a significant symptom reduction; dyadic interactions became more harmonious (mothers became less intrusive and infants more cooperative). Maternal self-esteem grew significantly and negative affects decreased. Improvements lasted as least several months, with some positive improvement detected at the 6-month follow-up. No major difference in outcome was found between the effects of the two forms of intervention. Within the limitations of research in a clinical context, this study suggests that brief mother–infant psychotherapies are a cost-effective method of early intervention.     

The Use of Time Limits in Brief Psychotherapy: A Comparison of Six-Session,Twelve-Session,and Unlimited Treatment with Families

This study compared the relative effectiveness of two durations of time-limited psychotherapy with time-unlimited treatment and a waiting list control group. Thirty-seven families applying for treatment at a child guidance clinic were randomly assigned to one of four treatment conditions: (a) time-limited therapy of 6 sessions within 8 weeks; (b) time-limited therapy of 12 sessions within 16 weeks; (c) time-unlimited therapy; and (d) a waiting list control group in which families waited approximately four months before beginning treatment. Outcome was assessed from multiple sources: parents, child, therapist, family interaction ratings, and missed and canceled sessions. Analysis of data provided some evidence that families who received treatment fared better than those on the waiting list. There were no consistent differences between 6-session, 12-session, and unlimited therapy. A model is proposed for the further investigation of time-limited treatment.