Individual response patterns and the effects of different behavioral methods in the treatment of claustrophobia

The importance of individual response patterns in claustrophobic patients was examined in the present study. Thirty-four psychiatric outpatients with a phobia of enclosed spaces were assessed in a small test chamber. During the test their overt behavior was video-taped, heart-rate was measured continuously, and self-ratings of experienced anxiety were made at certain intervals. On the basis of their reactions in the test situation, the patients were divided into two groups showing different response patterns—behavioral and physiological reactors. Within each group the patients were randomly assigned to one behaviorally-focused method (exposure), one physiologically-focused method (applied relaxation) and a waiting-list control group. The patients were treated individually in eight sessions. The between-group comparisons showed that both exposure and applied relaxation were significantly better than the waiting-list condition. Furthermore, exposure yielded better results than applied relaxation for the behavioral reactors, while applied relaxation was better than exposure for the physiological reactors. The improvements were maintained at a follow-up assessment 14 months after the end of treatment. The results support the hypothesis that greater effects are achieved when the method used fits the patient's response pattern than when it does not.     

Individual response patterns and the effects of different behavioral methods in the treatment of agoraphobia

The importance of individual response patterns in agoraphobic patients was examined in the present study. Forty psychiatric outpatients with agoraphobia were assessed in individually relevant natural phobic situations. During this behavioral test their heart rates were measured continuously, and self-ratings of experienced anxiety were made at fixed intervals. On the basis of their reactions in the test situation, the patients were divided into two groups showing different response patterns—behavioral and physiological reactors. Within each group the patients were randomly assigned to one behaviorally-focused method (exposure in vivo, E) and one physiologically-focused method (applied relaxation, AR). The patients were treated individually for 12 sessions. Both treatments yielded significant improvements on most measures; 60% of the E group and 70% of the AR group patients were clinically improved after treatment. The between-group comparisons showed that both treatments did equally well both for behavioral and physiological reactors. Thus, the differential effects for these methods obtained in previous studies were not seen.     

Social phobia: individual response patterns and the effects of behavioral and cognitive interventions

In the present study, the role of individual response patterns in the treatment of social phobic patients was investigated. Seventy-four patients were diagnosed as social phobics. On the basis of extreme scores on a behavioral test (the Simulated Social Interaction Test) and on a cognitive measure (the Rational Behavior Inventory), the response patterns of 39 patients were analyzed, and the patients themselves were classified as either 'behavioral reactors' or 'cognitive reactors'. Half of the patients with each response pattern received a behavioral focused treatment, i.e. social skills training (SST), while the other half received a cognitive oriented treatment, i.e. rational emotive therapy (RET). Patients received group therapy in eight weekly sessions. Within-group differences showed a considerable improvement in all treatment groups. Between-group differences failed to lend support to the hypothesis that treatment that fits a response pattern (i.e. SST for behavioral reactors and RET for cognitive reactors) will result in a greater improvement than one that does not.     

Exposure in vivo vs applied relaxation in the treatment of blood phobia

Eighteen patients with phobia for bloodt, wounds and injuries were treated with exposure in vivo or applied relaxation. They were assessed on different self-report, behavioral and physiological measures before and after treatment. The patients were treated individually for 9 sessions, 1 per week. The within-group comparisons showed that both groups had improved significantly on most of the measures and that these improvements were sustained or furthered at the 6-month follow-up. Furthermore, 10 of the 16 who completed the treatment became blood donors. The between-group comparisons showed exposure to be better than applied relaxation on three of the self-report measures at post-treatment assessment, but not at follow-up. The groups did equally well on the behavioral and physiological measures. The conclusion that can be drawn is that the coping-orientated method of applied relaxation is as effective as exposure in vivo in the treatment of blood phobia.     

Ways of acquiring phobias and outcome of behavioral treatments

The way of acquisition of phobias was studied in relation to different behavioral treatments for phobias. Ss (N = 183) were clinical patients belonging to six different phobic groups (agoraphobics, claustrophobics, social phobics, animal phobics, blood phobics and dental phobics), and the treatments were categorized as behaviorally focused (exposure in vivo and social-skills training), physiologically focused (systematic desensitization and applied relaxation) and cognitively focused (self-instruction training and fading). Results showed that both for patients with direct conditioning experiences and indirect acquisition those treated with behavioral and physiological methods improved more than those receiving cognitive methods when looking at the change-score data. Regarding the proportion of clinically improved patients there was no difference between treatments among the Ss with a background of conditioning experiences. In the group with indirect acquisition, on the other hand, the cognitive methods were more effective.     

Applied tension, applied relaxation, and the combination in the treatment of blood phobia

Thirty patients with phobia for blood, wounds and injuries were treated individually with applied tension, applied relaxation, or the combination of these two methods for 5, 9 and 10 sessions, respectively. They were assessed on self-report, behavioral and physiological measures before and after treatment, and at a 6-month follow-up. All groups improved significantly on 11/12 measures, and the improvements were maintained at follow-up. Applying stringent criteria, 73% of the patients were clinically improved at the end of treatment and 77% were so at follow-up. Despite a failure to find between-group differences, on many measures there was a trend favoring applied tension. Since this method is as effective as the other treatments in only half the time, applied tension should clinically be the treatment of choice for blood phobia.     

Social interactions as predictors of children's likability and friendship patterns: A multiple regression analysis

The concurrent and predictive validity of four qualitative behavioral classes of social interaction (initiating and receiving positive and negative social interaction) was investigated using sociometric measures of peer acceptance (ratings) and friendship (nominations). Correlational analyses showed significant relationships between behavioral and sociometric measures supporting previous work with preschool populations. Stepwise multiple regression analyses suggested that receiving social interaction from peers best predicted overall acceptance, whereas initiating social interactions best predicted children's friendship patterns. Tentative implications for the behavioral assessment of children's social skills were discussed.The current data were gathered as part of a larger research project concerning social skills assessment and training in children.     

Assessing social dysfunction: the contributions of laboratory and performance-based measures

Reviewed research studies in which laboratory and performance-based measures were used with success to identify problematic social interaction patterns and social skills deficits associated with poor peer relationships. However, the clinical utility of these measures remains an empirical question. In this article, social competence is conceptualized as an organizational construct, reflecting the child's capacity to integrate behavioral, cognitive, and affective skills to adapt flexibly to diverse social contexts and demands. Correspondingly, performance-based measures of social functioning that include complex social interaction stimuli and require integrative responses appear more likely to demonstrate social validity than measures focused on isolated behaviors or cognitions. Research studies are reviewed that involve observations of children in three types of analogue social situations: play groups, friendship pairs, and social-challenge situations. In addition, studies that have utilized performance-based measures to screen and evaluate children for social skills training programs are reviewed. We conclude that performance-based measures are unlikely to be useful in determining whether a child is experiencing social dysfunction but may enhance the clinical analysis of the nature of the child's social difficulties. We identify gaps in the current knowledge regarding the clinical utility of performance-based measures of social dysfunction, along with directions for future research.     

Effects of social problem-solving training on classroom behavior of urban disadvantaged students

Sixty-four urban disadvantaged fourth- and fifth-grade students were assigned to one of the following four treatment conditions: social problem-solving training, response cost, social problem-solving training plus response cost, and no treatment control. Those exposed to problem-solving training improved on measures of alternative thinking and consequential thinking skills. The training, however, did not affect teacher ratings of student behavior or observed classroom behavioral functioning. In addition, the response cost procedure did not enhance acquisition or utilization of problem-solving skills.     

Effects of Behavioral Group Therapy on chronic Pain

Abstract

Benign chronic pain is frequently reported among rehabilitation patients. The present study investigates a behavioral treatment model used with 3 consecutive groups of 8 chronic pain outpatients. The behavioral strategy used was to identify specific pain behaviors such as verbal expression of pain, consumption of analgesics and inactivity and to teach the patient to modify these patterns. The treatment was provided by a rehabilitation team and included contingency management of pain behaviors, applied relaxation and social skills training. Results showed significant 6 month follow-up reductions in the expression of pain, analgesics intake and level of rest for the group as a whole subsequent to intervention. In addition, two thirds of the group were engaged in formal pre-occupational training at follow-up.     

A comparison of peer verbal responding directed toward adolescents with behavioral disorders and nonhandicapped peers

One of the primary intents of inclusion is the maximization of interaction between persons with and without disabilities. The purpose of this study was to analyze the verbal responding that peers directed toward adolescents with behavioral disorders and, to this effect, several comparisons were made: verbal responding of peers directed toward adolescents with behavioral disorders was compared to verbal responding of peers directed toward regular class adolescents; verbal responding of peers directed toward the same adolescents with behavioral disorders was compared across their self-contained and integrated settings; and verbal responding of peers directed toward adolescents with behavioral disorders in integrated settings was compared to verbal responding of peers directed toward regular class adolescents. Data, collected in real time using portable microcomputers, focused on positive, negative, and neutral social responding and positive, negative, and neutral academic responding. All verbal responding of peers directed toward 14 adolescents with behavioral disorders and 14 regular class peers was recorded. Data were analyzed by group and setting, as well as by social or academic content. Results of the study support inclusion, with high levels of peer responding directed toward adolescents with behavioral disorders in integrated classrooms. Almost all peer responding was positive or neutral in content. Results were discussed as they related to placement of students, social skills training, and previous research.     

Social Skills Training To Improve Job Maintenance

A social skills training procedure, which included videotaped feedback, videotaped modeling, focused instructions, coaching, and behavioral rehearsal, was implemented. Treatment effectiveness was evaluated and the results indicate that social skills training can be an effective treatment for job-related stress.     

Group interpersonal skills training in a natural setting: an experimental study.

This study assessed effectiveness of group interpersonal skills training conducted in a natural setting with nonanalogue clients. Subjects (Ss) in a behavioral-training condition received 4 hr of instruction consisting of modeling, behavioral rehearsal, coaching, feedback and reinforcement. Training focused on positive and negative social responses and on initiating interactions, as well as reacting to interactions initiated by others. Subjects in a discussion-control condition engaged in focused discussion of interpersonal concerns but received no experiential practice. Within a pre-test-post-test control group design, subjective and objective measures were used to assess training effects. When compared to Ss involved in group discussion. Ss participating in group behavioral training revealed greater pre- to post-test changes on selfreported probability of engaging in selected interpersonal responses and on objective measures of eye contact, speech duration, positive affective responses, use of no-statements, compliance, refusals and requests for new behavior. Support for generalization of training is presented and methodological issues are discussed.     

SOCIAL VALIDATION AND TRAINING OF EMERGENCY FIRE SAFETY SKILLS FOR POTENTIAL INJURY PREVENTION AND LIFE SAVING

A multifaceted behavioral program designed to teach emergency fire escape procedures to children was evaluated in a multiple-baseline design. Five children were trained to respond correctly to nine home emergency fire situations under simulated conditions. The situations and responses focused upon in training were identified by a social validation procedure involving consultation with several safety agencies, including the direct input of firefighters. Training, carried out in simulated bedrooms at school, resulted in significant improvements in both overt behavior and self-report of fire safety skills. The gains were maintained at a post-check assessment 2 weeks after training had been terminated. The results are discussed in relation both to the importance of social validation of targets and outcomes and the implications for further research in assessing and developing emergency response skills.     

VALIDATION OF SOCIAL SKILLS OF ADOLESCENT MALES IN AN INTERVIEW CONVERSATION WITH A PREVIOUSLY UNKNOWN ADULT

Seventy convicted young male offenders were videotaped during a 5-min standardized interview with a previously unknown adult. In order to determine the social validity of the behavioral components of social interaction for this population, measures of 13 behaviors were obtained from the tapes. These measures were then correlated with ratings of friendliness, social anxiety, social skills performance, and employability made by four independent adult judges from the same tapes. It was found that measures of eye contact and verbal initiations were correlated significantly with all four criterion rating scales. The frequencies of smiling and speech dysfluencies were both significantly correlated with ratings of friendliness and employability. The amount spoken was found to be a significant predictor of social skills performance whereas the frequency of head movements influenced judgments of social anxiety. The latency of response was negatively correlated with social skills and employability ratings and the frequency of question-asking and interruptions correlated significantly with friendliness, social skills, and employability ratings. Finally, the levels of gestures, gross body movements, and attention feedback responses were not found to influence judgments on any of the criterion scales. The implications of the study for selection of targets for social skills training for adolescent male offenders are discussed.     

Issues in the treatment of depressed children

Basic research into the cognitive, behavioral, familial, and physiological disturbances associated with depressive disorders during childhood is reviewed. Implications for the development of a treatment program are discussed and a comprehensive treatment model is proposed. The proposed model includes intervention strategies for the child, parents, family, and school. The child component consists of intervention strategies for the affective, cognitive, behavioral, and physiological disturbances that are evident from the existing research. The parent training component is designed to address disturbances in parenting due to cognitive disturbances and skills deficits. The family therapy component emphasizes changing interaction patterns that communicate schema-consistent maladaptive interactions. A school consultation component is proposed in which school personnel support the skills training through prompting use of the skills and reinforcement of the use of the coping skills.     

APPLICATION OF A SOCIAL SKILLS TRAINING PROGRAM IN THE MODIFICATION OF INTERPERSONAL DEFICITS AMONG RETARDED ADULTS: A CLINICAL REPLICATION

Six mentally retarded adults, equally divided into two treatment groups, were provided with individualized social skills training programs. Treatment, evaluated via a multiple-baseline design strategy, was sequentially and cumulatively applied across target behaviors over a four-week intervention period. Behavioral observation probes and social validation measures served as the primary dependent variables. Results indicated that (a) treatment was effective for virtually all behaviors across all subjects, (b) improvements occurred for both training and generalization scenes, and (c) behavioral performance was maintained one month following the termination of treatment.     

Social skill performance among normal and psychiatric inpatient children as a function of assessment conditions

The present investigation examined the effects of varying the standard assessment conditions on performance of social skills among normal and psychiatric inpatient children. Sixty children (30 normals, 30 patients), ages 6–12, completed behavioral and self-report measures of social skills on two separate occasions. During the second assessment, half of the children received feedback and incentives for performance; the other half did not. The testing conditions consistently altered social skill performance. Children who received the incentives during assessment showed significantly higher levels of social skills, as reflected in concrete behavior (e.g. eye contact, facial expressions), and molar responses (e.g. giving compliments, responding to provocation). The results suggest that social skills performance varies considerably as a function of the assessment conditions. Training programs should not assume that persons do not have the responses in their repertoires merely because of low pretest performance unless more extensive efforts are made to evoke appropriate responses.     

Social skills: A review of cognitive-behavioral training procedures with children

Thirty-one studies utilizing cognitive-behavioral procedures to train social skills were reviewed. The review was organized around six methodological issues: (a) age of subjects; (b) training procedures; (c) outcome measures; (d) research design; (e) evidence for generalization; and (f) social validation. Suggestions for future applied research are discussed, such as investigations regarding developmental changes in socially skilled behavior, increased use of multiple dependent measures, more intensive programming for generalization, and the establishment of the social importance of the effects of social skills training programs.     

Modification of Cognitive-Behavioral Techniques in the Treatment of a Five Year-Old Girl with Social Phobia

Social phobia is a debilitating anxiety disorder that often goes undetected in young children, but can be effectively treated with cognitive-behavioral interventions. For children and adolescents, treatment usually includes education, social skills training, cognitive restructuring, relaxation training, and exposure. However, for very young children who present with social phobia, it is necessary to adapt treatment to the developmental level of the child. A case illustration demonstrates the way in which cognitive behavioral treatment (CBT) was modified for the treatment of a five year-old girl with social phobia. Several modifications were made, including utilizing novel exposure techniques and emphasizing parent management training in order to promote generalization of treatment gains outside of session.