The rapid-smoking technique: Some physiological effects

The effects of rapid smoking on the blood pressure, pulse rate and cardiac functioning of 58 smokers (30 women and 28 men) are reported. All subjects were healthy volunteers, 45 were under 40 yr of age, the remaining 13 between 40 and 50 yr. They received between 6 and 12 rapid smoking sessions. It was found that, in both the under and over 40 age groups, blood pressure levels and pulse rates increased significantly following rapid smoking sessions. There were, however, significant decreases between sessions and no evidence of a cumulative effect of successive rapid smoking sessions. Some qualitative changes in cardiac functioning were observed, namely the appearance of T wave flattening and S-T depression. None of the changes were considered to be of sufficient magnitude to necessitate exclusion from the programme, but confirm the need to monitor closely the physiological functioning of persons undergoing rapid smoking.     

The rapid-smoking technique: Subject characteristics and treatment outcome

There is a lack of consistency in findings regarding subject (S) characteristics and the effects of smoking-control programmes. Research workers appear to assume that abstinence and reduction in smoking rate are merely different points in the same continuum, and therefore seek to correlate S variables with percentage reductions in smoking rate. It is argued that abstinence and reduced smoking are more appropriately viewed as potentially discrete outcomes. Conceptualizing outcome in this manner, a discriminant function analysis was employed to determine whether it is possible to differentiate between Ss who do, or do not, abstain following participation in a treatment programme involving rapid-smoking. It was found that it is possible to discriminate between the two groups of Ss. Advantages deriving from this approach to the investigation of S characteristics and treatment outcome are discussed.     

Therapeutic strategy and psychoanalytic technique

The role of therapeutic strategy within psychoanalytic technique is described. An antistrategic bias inherent in certain aspects of the "classical" technique is explored in relation to the historical development of psychoanalysis. Clinical expertise, which includes the making of strategic or tactical choices, is relegated to the "unofficial," due in part to this negative bias impeding the study of technical differences in favor of general agreement about a theory of technique that may differ considerably from actual clinical work. A case is presented that illustrates strategic choices in the management of a severe character resistance in a supervised analysis. Some consequences of a negative bias against therapeutic strategy as it relates to psychoanalytic training is described.     

The Therapeutic Alliance: Implications for Therapeutic Process and Therapeutic Goals

Interest in the importance of the therapeutic alliance to the psychotherapeutic process has recently grown across theoretical domains. Through a case example the author demonstrates that in some cases a familiar pattern of relating with the therapist may be more important for the client in terms of treatment success than positive regard early in treatment. Also, charting shifts in the quality of the relationship rather than quantitative changes in the alliance may help the therapist navigate the recursive emergent properties of relationship, goals of treatment and choice and timing of interventions. Finally, the author suggests that the therapist’s internalization of the client may represent a significant leap in the relationship, and help reduce some of the “sloppiness” that is inherent in the therapeutic process.     

Intensive specialised multi-family therapy for multi-stressed families: Therapeutic alliance as predictor for effectiveness

The effectiveness of intense specialised multi-family therapy (ISMFT) for 111 multi-stressed families, and the therapeutic alliance as a possible predictor of outcome, were examined. A repeated measures design was used, where changes in all ISMFT phases (preparation, multi-family therapy and follow-up) were assessed and compared for both mothers and fathers. Evidence was found for improved family functioning after the therapy period, which was maintained at 3 months follow-up, although the multi-stressed families still functioned in the problematic range. The therapy did however not decrease parenting stress, or did so only temporarily. Observations of the therapeutic alliance with the System for Observing Family Therapy Alliances (SOFTA) scales indicated that high therapist engagement was related to positive therapy outcomes, both at the start of therapy and later. High family engagement also predicted therapy effectiveness, but only at the start of therapy. The present study shows that solution-focused multi-family therapy at least seems to provide the first step in alleviating problems in multi-stressed families.     

Therapeutic effectiveness of differentially targeted humorous remarks in group psychotherapy

Video records of five different sessions of a single therapy group were scored for the occurrence of laughing, smiling, and talking. Successive five-minute intervals were also scored for therapeutic level through ratings derived from the Hill Interaction Matrix. Humorous remarks were categorized according to humor target: self, other in group, and generalized other. Results indicated that the vast majority of humorous remarks were directed at some specific target, and that over 50% of these remarks were negative in tone. Results also revealed that remarks targeted at others in the group tended to decrease therapeutic effectiveness whereas remarks targeted at individuals or institutions not presently in the group were found to increase therapeutic effectiveness. Selftargeted remarks were found to produce inconsistent effects. These findings are discussed in terms of their significance for a more general analysis of group humor as well as in terms of their more specific implications for therapeutic interventions.     

Therapeutic technique in psychoanalysis and psychoanalytic psychotherapy.

As the distinctions between what we consider to be psychoanalysis and what we consider to be psychoanalytic psychotherapy have become more uncertain and more blurred, it follows that it is equally difficult to designate the techniques that would be appropriate and specific for each modality. The problem has been compounded by the fact that in recent years psychoanalysis in the United States has become considerably less homogeneous than in the past and the ego-psychological structural model is no longer the only point of view in the psychoanalytic marketplace. Further, with alterations in the criteria for analyzability, cases which, generally, had not been viewed as suitable for analysis, have been appearing with increasing frequency on psychoanalysts' couches. We have also recognized that the degree of congruence between our expectations from and the results of psychoanalytic treatment was often less than anticipated. It appears that analysts have become considerably less arbitrary about what psychoanalysis is and how a psychoanalysis can be carried out. The author is unable to delineate one technique that is intrinsic to and limited to psychoanalysis. There are, however, differences in degree and emphasis in the ways in which various techniques are applied in the therapy of psychoanalysis as compared to the therapy of psychoanalytic psychotherapy. Special attention is given to the role of a psychoanalytic process and the central place the analysis of resistance plays in psychoanalytic therapy.     

Maintaining Therapeutic boundaries: The Motive Is Therapeutic Effectiveness,not defensive Practice

In his article "How Certain Boundaries and Ethics Diminish Therapeutic Effectiveness," Lazarus asserts that many clinicians are adhering to strict therapeutic boundaries and ethics in a fear-driven effort to avoid unwarranted malpractice claims. Although I agree that maintenance of conventional therapeutic boundaries is apt to minimize malpractice claims in most cases, I believe that is because such boundaries are critical to protect patients' welfare and thereby promote effective treatment. My reasoning, discussed next, revolves around the following premises: 1. For many, if not most, types of patient problems and patient populations, boundaries and the personal meaning of the therapeutic boundaries are an arena in which critical emotional issues are manifested and worked through. 2. Clear, consistent boundaries provide a structure and safety for many patients that is a curative factor in itself. 3. Patients' reactions to alterations in usual therapeutic boundaries are often unpredictable ahead of time (even if requested by the patient) and typically complex, ambivalent, and heavily colored by transferential meaning. 4. Because alterations in therapeutic boundaries typically add a new therapist role or activity that involves potential gratification of personal needs of the therapist, objectivity in evaluating such a change may be compromised by the inherent self-interest. 5. Consistent, clear boundaries need have no impact on therapist warmth and empathy.     

The effectiveness of a simulation technique as an integral part of a school psychology training program

A modified Solomon design was employed to study the effects of a school psychology simulation package on the enacted and written response of a group of school psychology preservice students. Fifty-two school psychology students from five training programs enrolled in the last quarter of school psychology training prior to internship were divided into two groups. The experimental group (N=20) received the simulation experience, whereas the control group (N=32) did not. Results generally indicated the superiority of the experimental group and suggested that simulation as an integral part of a school psychology training program is an effective method of instruction. Pretesting in combination with the simulation training improved posttest performance more than simulation training alone.     

Tabacco deprivation: The foot-in-the-door technique versus the low-ball technique

The present experiment was aimed at comparing the efficiency of the foot-in-the-door technique (Freedman and Fraser, 1966) to that of the low-ball technique (Cialdini Bassett, Cacioppo and Miller, 1978). Subjects were requested to abstain from smoking for 18 hours. The results demonstrated the superiority of the low-ball technique. An original method of operationalizing the low-ball technique (the use of intermediate behaviours) is presented herein.     

The Lesbian Coming Out Process: Therapeutic Considerations

The problems and therapeutic needs of women in the process of identifying themselves as lesbians are described. Means of working through denial rationales are explored.     

The effectiveness of creativity training: A quantitative review

Over the course of the last half century, numerous training programs intended to develop creativity capacities have been proposed. In this study, a quantitative meta‐analysis of program evaluation efforts was conducted. Based on 70 prior studies, it was found that well‐designed creativity training programs typically induce gains in performance with these effects generalizing across criteria, settings, and target populations. Moreover, these effects held when internal validity considerations were taken into account. An examination of the factors contributing to the relative effectiveness of these training programs indicated that more successful programs were likely to focus on development of cognitive skills and the heuristics involved in skill application, using realistic exercises appropriate to the domain at hand. The implications of these observations for the development of creativity through educational and training interventions are discussed along with directions for future research.     

The Effect of Tomm's Therapeutic Questioning Styles on Therapeutic Alliance: A Clinical Analog Study

10 suggests that circular and reflexive questions tend to elicit feelings of freedom/acceptance whereas lineal and strategic questions usually trigger feelings of judgment/constraint. Employing an analog methodology, each of Tomm's four questioning styles was portrayed in the form of a 5-minute videotaped intake scenario. Forty family triads with a mother, father, and adolescent son were randomly assigned to one of four experimental conditions with ten families each. Each condition involved viewing one of four questioning style scenarios. All participants (N = 120 individuals — 40 mothers, 40 fathers, and 40 adolescent sons) completed the Family Therapy Alliance Scale (FTAS; 9 ) and a validity-check instrument. The results indicated that circular and reflexive questioning styles elicited significantly higher (p < .001 ) alliance scores on the FTAS than did either lineal or strategic questions. Implications for the use of different types of questions in family therapy are discussed.     

Trust within teams: The relation with performance effectiveness

The acknowledgement that trust is important for the functioning of organizations has increased the demand for research showing how this importance is reflected on the behaviour of its members. In this article we focus on trust within teams and explore the relation with performance effectiveness. A model was tested relating trust with perceived task performance, team satisfaction, relationship commitment, and stress. In this model trust is presented as a multi-component variable with distinct but related dimensions. These include propensity to trust, perceived trustworthiness, cooperative and monitoring behaviours. Data from 112 teams collected in three social care institutions in The Netherlands were analysed with structural equation modelling to test the model. The results are supportive of the multi-component structure of trust and confirmed the importance of trust for the functioning of teams in organizations. The results suggest that trust is positively related with perceived task performance, team satisfaction, and relationship commitment, and negatively related with stress. In addition, perceived task performance was positively related with team satisfaction.     

The effectiveness of workplace counselling: A systematic review

Background: In response to the stresses of the contemporary workplace, the challenges of maintaining satisfactory work-life balance, and the costs to business of employee mental health problems, many organisations have contracted to make counselling services available to their staff. It is essential to evaluate the effectiveness of workplace counselling, in order to maintain standards, and to identify examples of good practice. Objectives: This paper presents a comprehensive, systematic review of the effectiveness of workplace counselling. Findings are analysed in terms of client satisfaction, psychological functioning, the meaning of work, work behaviour, and negative outcomes. Findings: Taken as a whole, the results of research suggest that counselling is generally effective in alleviating psychological problems, has a significant impact on sickness absence, and has a moderate effect on attitudes to work. Discussion: Methodological issues are discussed, and it is recommended that more high-quality research is required in order to reinforce the evidence base for workplace counselling in relation to a number of key questions.     

The Therapeutic Frame: On the Need for Flexibility

A fundamental function of the therapeutic frame is protection of the therapeutic process from the intrusion of elements antithetical to the best interest of the client and detrimental to treatment outcome. It is argued that dogmatic interpretation of the frame promotes conformity rather than growth in the client, blinds the therapist to legitimate issues of client diversity, and constricts the therapist's ability to be appropriately responsive to the client. It is suggested that while the frame is essential to maintain the focus of treatment on the welfare of the client, inflexible adherence undermines this purpose.     

The Therapeutic Factors Inventory: Development of a Scale

Although Yalom's (1995) framework of the therapeutic factors facilitating outcome in group has been accepted by group specialists, no empirically based instrument assesses all of these factors. The Therapeutic Factors Inventory (TFI), with 11 scales based on the therapeutic factors, has been designed to fill this gap. This article summarizes the development and preliminary reliability testing of the TFI. Each scale of the instrument demonstrated high internal consistency; however, one scale obtained unacceptably low test-retest reliability. Further validity testing is needed. Implications of these findings are discussed.     

Two Families: The Origins of a Therapeutic Crisis

The treatment by individual and family therapy of a hospitalized young woman is presented as it reflects the historical and current family dynamics of the patient and her individual psychotherapist. The contribution of these factors to a therapeutic crisis is discussed.