The Iatrogenic Effects of Group Intervention for Antisocial Youth: Premature Extrapolations?

Group intervention for antisocial youth has received harsh criticism in recent years. This paper reviews relevant research focused on the influence of contact with delinquent peers on the development of antisocial activity. Also reviewed are studies reporting outcomes of group intervention for antisocial youth. Although a few studies have found iatrogenic effects for group intervention with antisocial youth, the majority have not. Well-developed models of group intervention have produced substantial reductions in youth antisocial activity. We describe one such program, a family-style residential program based on behavioral learning principles, and review outcomes of this program. We conclude that treatment of antisocial youth in groups is feasible and can be effective in reducing delinquent behavior.     

You are not alone – adolescents’ experiences of participation in a structured skills training group for ADHD

Little is known about how adolescents with attention deficit/hyperactivity disorder (ADHD) experience participating in group therapy, an important factor to consider when developing treatment methods for this age group. This study aimed to explore how adolescents with ADHD experience participating in a structured skills training group program based on dialectical behavioral therapy. Semi-structured interviews were conducted with 20 adolescents (15–18 years of age) with ADHD after participating in a structured skills training group. The interviews were transcribed verbatim and qualitative content analysis were used to analyze the text. The participants emphasized the value of meeting other adolescents with ADHD and the opportunity to exchange experiences, strategies and tips. Participating in the group treatment made the adolescents realize that they were not alone, and feelings of togetherness and an increased acceptance of themselves were described. The participants associated the treatment with elevated knowledge and understanding, for example, about ADHD, their own functioning and helpful strategies. They also described emotional and behavioral changes, such as higher self-esteem, fewer inter-personal conflicts and improved concentration. Activating and experiential exercises were considered important elements of the treatment, and the participants expressed a need for a variation of exercises, as well as more time for practicing skills, discussions and breaks. The results indicate that the group format add an extra value to the treatment and that the use of an active approach throughout the treatment is of importance for this group of patients.     

Ready or not? Stages of change as predictors of brief group therapy outcome in bulimia nervosa

Although group therapy is often recommended for the treatment of bulimia nervosa, relatively little is known about predictors of short-term outcome. This pilot study examined whether a standardized measure of readiness for change might be related to changes in binge frequency. Sixteen bulimic patients participated in short-term cognitive behavioral group therapy for twelve weeks. Each patient completed the Change Assessment Scale prior to treatment, along with a battery of symptom measures which were readministered at the conclusion of therapy. Bulimic patients with positive outcome in binge frequency were at a higher stage of readiness for change at pretreatment than were patients with negative outcome. Results indicated that there may be methods of determining who would be most likely to benefit from cognitive behavioral group therapy, and tentatively suggest that interventions may be more successful when readiness for change is taken into consideration.     

Relationship Between Homework Completion and Outcome in Cognitive Behaviour Therapy

Homework or between‐session learning has long been considered an essential aspect of effective cognitive behaviour therapy. However, it has received relatively less empirical attention than other components of cognitive behaviour therapy. In general, studies have found that homework completion is predictive of outcome in psychotherapy. However, the amount of homework completed by a patient represents only one aspect of this important therapeutic component. This study investigated both the quantity and the quality of homework completed during a 10‐week group cognitive and behavioural treatment program for anxious and depressed patients. It explored the relationship between various aspects of homework completion and outcomes on several different variables. A total of 94 patients were included in the analysis. It was found that both quantity and quality of homework completed predicted outcome on measures of depression, anxiety and quality of life at post‐treatment and at 1‐month follow‐up. The results were strongest for the amount of homework completed, suggesting that clinicians should encourage patients to complete homework even if the homework content is not entirely accurate. The results of this study highlight the importance of homework as a central part of effective cognitive and behavioural treatment.     

Group Psychotherapy and Existential Concerns: An Interview with Irvin Yalom

Group psychotherapy can be used to help clients deal with most forms of emotional distress or problems with interpersonal functioning. Also, group therapy can be useful when helping clients to confront existential concerns such as isolation or meaning in ones life. During a recent interview, Irvin Yalom discussed a variety of issues related to group processes and existential matters that are involved in effective psychotherapy.     

Visual Motor Behavior Rehearsal. The Basic Technique

The past decade has witnessed a significant shift toward a more cognitive emphasis in our understanding and treatment of obsessive‐compulsive disorders (OCD). This article discusses the shortcomings in more standard behavioral treatment of OCD, which despite its demonstrated efficacy, led to the recent cognitive‐behavioral approaches to the disorder. Current cognitive behavior therapy for OCD is described and a short critical review of the comparative treatment outcome literature on cognitive behavior therapy vs exposure and response prevention is provided. The article concludes that although the clinical utility of a more cognitive approach to OCD has not been consistently demonstrated, it would be premature to abandon cognitive formulations until some key research questions have been addressed.     

Acting Nasty in the Face of Failure? Longitudinal Observations of “Hard-to-Manage” Children Playing a Rigged Competitive Game with a Friend

Peer problems are almost universal among children with disruptive behavior disorders, and have been linked to social information processing deficits that lead to heightened threat responses (K. A. Dodge, 1980). This 2-year longitudinal study uses direct observations to examine the real-life significance of this finding. Forty hard-to-manage children and 40 typically developing control children were filmed at ages 5 and 7 playing a rigged competitive game in which they experienced a clear threat of losing. Group differences in negative behavior (hard-to-manage > controls) were stable over time and independent of verbal ability. Predictors of individual differences in negative behavior were also examined. Previous studies with this sample have shown that at 4 years of age, the hard-to-manage children displayed elevated frequencies of violent pretend play (J. Dunn & C. Hughes, 2001), coupled with poor performance on tests of executive function and theory of mind (C. Hughes, J. Dunn, & A. White, 1998). In this study, 4-year-olds whose pretend play indicated a preoccupation with violence were more likely to respond negatively to the threat of losing a competitive game at age 5 and at age 7. Four-year-olds who performed poorly on tests of theory of mind and executive function showed higher rates of negative behavior at age 5 but not age 7. These findings highlight just a few of the multiple paths leading to peer problems among children with disruptive behavior problems.     

一例一般心理问题的咨询案例分析报告

本文详细介绍了一例因为英语四级考试没有通过引发的一般心理问题的咨询过程。来访者韩某,女,20岁,是一名大二学生,因为英语四级考试没有通过而出现了睡眠质量差,学习效率下降,情绪低落等症状,来访者主动求助于校心理健康中心,迫切希望改变现状,能够正常的学习生活。咨询师在和来访者商议后根据其个性特征和问题的特点采用了合理情绪疗法对其进行干预,帮助她改变了其非理性的信念,经过咨询,来访者情绪好转,可以正确看待困难,取得了比较好的咨询效果。     

Treating Procrastination Using Cognitive Behavior Therapy: A Pragmatic Randomized Controlled Trial Comparing Treatment Delivered via the Internet or in Groups

Procrastination is a common problem among university students, with at least half of the population reporting great difficulties initiating or completing tasks and assignments. Procrastination can have a negative impact on course grades and the ability to achieve a university degree, but can also lead to psychological distress. Cognitive behavior therapy (CBT) is believed to reduce procrastination, but few studies have investigated its effectiveness in a regular clinical setting. The current study explored its effects using a pragmatic randomized controlled trial comparing treatment delivered during 8 weeks as self-guided CBT via the Internet (ICBT) or as group CBT. In total, 92 university students with severe procrastination were included in the study (registered as a clinical trial on Clinicaltrials.gov: NCT02112383). Outcome measures on procrastination, depression, anxiety, and well-being were distributed at pre- and posttreatment as well as 6-month follow-up. An outcome measure of procrastination was administered weekly. Linear mixed and fixed effects models were calculated, along with improvement and deterioration rates. The results showed large within-group effect sizes on procrastination, Cohen’s d of 1.29 for ICBT, 95% Confidence Interval (CI) [0.81, 1.74], and d of 1.24 for group CBT, 95% CI [0.76, 1.70], and small to moderate benefits for depression, anxiety, and well-being. In total, 33.7% were regarded as improved at posttreatment and 46.7% at follow-up. No differences between conditions were observed after the treatment period, however, participants in group CBT continued or maintained their improvement at follow-up, while participants in self-guided ICBT showed some signs of deterioration. The findings from the current study suggest that CBT might be an effective treatment for those struggling with severe procrastination, but that a group format may be better for some to sustain their benefits over time and that the clinical significance of the results need to be investigated further.     

Wilderness family therapy: An innovative treatment approach for problem youth

We present a treatment program (The Family Wheel) designed to integrate wilderness therapy interventions with family therapy for the treatment of troubled adolescents. The Family Wheel program was conducted in the high desert of southern Idaho. Participation in this four-day program required parents and their adolescent children to engage in an intensive experiential family therapy while camping and trekking in the wilderness. An evaluation of the program revealed positive outcomes for the programs' participants. The theory, research, and pragmatics of conducting such an innovative program are discussed.     

Impact of play therapy on parent-child relationship stress at a mental health training setting

This study investigated the impact of Child-Centred Play Therapy (CCPT)/Non-Directive Play Therapy on parent-child relationship stress using archival data from 202 child clients divided into clinical behavioural groups over 3-74 sessions in a mental health training setting. Results demonstrated significant differences between pre and post testing on the Parenting Stress Index. CCPT appeared to be especially effective with children identified with clinical externalising behavioural problems, combined externalising and internalising behavioural problems, and children who were not categorised with clinical problem behaviours but whose parents sought counselling services for them. There were also significant differences determined by length of therapy. Results are discussed concerning implications for clinical practice and further research.     

One Parent-Child Activity Group

Abstract

The framework that the author developed for parent-child activity groups is described. This is followed by “snapshots” of a group session to enhance the readers' understanding of the framework. Excerpts of the author's logs from her participant observation of the parent-child activity group that she studied are organized sequentially to provide examples of each part of a parent-child activity group session.     

一例失恋心理的案例报告

本文是一例使用合理情绪疗法咨询一般心理问题的个案。咨询中综合使用各种技术方法,让来访者与其不合理信念进行辩论,帮助其识别自己的不合理信念并代之以合理的信念,同时协助来访者对咨询效果进行巩固。通过心理咨询,来访者的悲伤情绪得以缓解,社会适应能力及心理承受能力都得到了提高,人格进一步完善。