Psychoanalytic Explorations in Art by Ernst Kris

A review of 43 controlled studies was conducted which evaluated the effectiveness of group therapy for schizophrenics. Group therapy was judged to be an effective modality of treatment for schizophrenics in 67 percent of the inpatient studies. It was especially useful in groups lasting more than three months. Therapy groups were effective for schizophrenics in 80 percent of the outpatient studies. Interaction-oriented approaches were more effective than insight-oriented approaches, which were found to be harmful for some schizophrenics.     

Changing Concepts of Psychoanalytic Medicine Edited by Sandor Rado and George G. Daniels

A meta-analysis was conducted combining results from nine studies, using seventy-five outcome measures of 349 subjects. Only studies that contrasted group, individual, and control treatments with a pretest-posttest design were selected. Estimates of effect sizes were calculated for group, individual, and control treatments across all studies, according to treatment modality (psychotherapy, counseling, or psychoeducation), type of control (no treatment or some treatment), date of the study (1955–1969 or 1977–1982), and the subjects' age (adult, adolescent, or child). Results indicated that both group and individual treatments had a measurable effect that was consistently greater than that of controls. Further, (1) counseling produced much more of an effect than either therapy or psychoeducation; (2) the more recent treatments produced larger effects than the older studies; and (3) group treatments were more effective than individual methods in the treatment of adolescents, but were less effective in the treatment of children.     

Sidman or statistics?

Murray Sidman's statements regarding variability, experimental control, and generality are interwoven with examples from the literature on conditional discrimination. Sidman's position was that statistical inferences from group studies produce no information about the behavior of individual subjects and that statistical treatment of individual subject data masks variability which may represent conditions that are not controlled. Sidman's work on conditional discrimination provides excellent examples of how complex discriminations should be examined in detail with accuracy levels obtained for each type of discrimination within an experiment. Sidman made important contributions to the foundation of behavior analysis with extensive basic research as well as applications of methods and principles to clinical and educational settings.     

Does family therapy produce change? an overview of outcome studies

Summary Families were randomly assigned to one of two forms of conjoint marital therapy: an insight-oriented treatment (n=10) or a problem-solving intervention (n=10.). The results on self-report measures of family functioning indicate that the problem-solving intervention produced more favorable changes after three months. However on long-term follow-up after a year, this more positive effect did not apparently persist, since the insight treatment group reported better results. Experienced therapists did better than inexperienced therapists in the insight treatment condition, but level of experience did not make a difference in the problem-solving intervention. A group of eight families who dropped out of the insight treatment group provided data on correlates of premature termination. Several of the practical obstacles to implementing an experimental design in a clinic setting are illustrated by the research.As we develop more sophisticated methodology, we hope that is the near future family therapy researchers will be better able to state which type of approach is more effective for whom and under what circumstances. A review of current studies of family therapy outcome research indicates that family therapy seems to be as effective as individual psychological treatment.     

Peer-Nominated Deviant Talk Within Residential Treatment: Individual and Group Influences on Treatment Response

This research examined deviant talk during summer residential treatment using peer nominations and extensive field observations. Participants were 239 youth (M _age = 12.62, SD = 2.60; 67% male), nested in 26 treatment groups. Deviant talk was present in this setting, showed individual differences, and increased over time, especially for younger boys. As expected, its relationship to treatment response was moderated by peer behavior. Initial levels of individual deviant talk were related to clinical improvement, but primarily when peer deviant talk was low. Initial levels of peer deviant talk were related to higher than expected end of treatment aggression, especially for youth who were high in deviant talk. Deviant talk effects were observed for staff impressions of change and observations of aggression and adjustment. Initial antisocial behavior affected whether individual or peer levels of deviant talk more heavily influenced treatment response. Implications for clinical assessment and treatment monitoring are discussed.     

Focused group therapy: An integrative approach

Focused Group Therapy (FGT) was developed within a research project on treatment for burned out patients on long-term sick leave. The core of FGT is to find and formulate an individual focus expressed in behavioural terms. This focus is then worked with in the here-and-now of the group therapy. It is argued that the use of common factors in group therapy, rather than a special technique, improves the clinical work. Thesupport factor in group therapy is understood in terms of cohesion, therapeutic alliance and goal-corrected empathic attunement. Thelearning factors that are stressed are the experience of being a part of a developing group, building on similarities instead of differences, affective communication and the implicit knowledge developed in new ways of dealing with interpersonal relations. Theaction factor is considered to consist of challenging interpersonal situations corresponding to the individual focus, which are mastered in the here-and-now of the group.     

Children's Adjustment to Parental Physical Illness

We review recent empirical literature examining the impact of parent physical illness on child functioning. We review studies of illness characteristics (n = 16), individual characteristics (n = 6), and family characteristics (n = 6). Although children's self-reports indicate heightened distress, parental reports do not suggest more problematic functioning. Child adjustment appears to be more closely related to perceptions of stressfulness rather than to objective illness severity indices. Adolescent girls seem to represent a group at heightened risk. Preliminary results suggest that family variables such as cohesion, conflict, and individual and family coping styles are important predictors of child adjustment.     

The making of a group psychotherapist: Needs and goals for graduate and postgraduate training

Group therapy is a widely practiced, effective, but underrated specialty. Unfortunately, group therapy seems to be taught more haphazardly, with less attention to quality, than is individual therapy. Group therapy has a technique, history, and literature of its own and should be taught independently from individual psychotherapy. The training of psychiatric residents is particularly crucial for group therapy to prosper and be seen as more prestigious. A common core of experience is vital for training in group therapy, whether the trainee's background is psychiatry, psychology, social work, pastoral counseling, or nursing. This core consists of: 1) clinical experience doing group therapy; 2) supervision; 3) a professional training group experience; 4) observation of experienced group therapists; 5) exposure to current thinking in the field; 6) personal group therapy; and 7) a didactic course in theory and technique. Clinical experiences involving cotherapy and combined individual and group treatments are especially useful, both as training and as treatment modalities.He is on sabbatical leave from John Jay College of Criminal Justice where he is Professor of Psychology and was founding Chairman of the Psychology Department.The authors wish to thank Arnold Rachman, Ph.D., Michael Lapidus, M.D., Fayek Nakhla, M.D., Nyapati R. Rao, M.D., and Dorothy Gartner, Ph.D., for their helpful comments on earlier versions of this paper, and Ms. Deloris J. Johnson for her typing and editorial assistance.     

A meta-analysis of estimated effect sizes for group versus individual control treatments

A meta-analysis was conducted combining results from nine studies, using seventy-five outcome measures of 349 subjects. Only studies that contrasted group, individual, and control treatments with a pretest-posttest design were selected. Estimates of effect sizes were calculated for group, individual, and control treatments across all studies, according to treatment modality (psychotherapy, counseling, or psychoeducation), type of control (no treatment or some treatment), date of the study (1955-1969 or 1977-1982), and the subjects' age (adult, adolescent, or child). Results indicated that both group and individual treatments had a measurable effect that was consistently greater than that of controls. Further, (1) counseling produced much more of an effect than either therapy or psychoeducation; (2) the more recent treatments produced larger effects than the older studies; and (3) group treatments were more effective than individual methods in the treatment of adolescents, but were less effective in the treatment of children.     

How to achieve synergy in group decision making: Lessons to be learned from the hidden profile paradigm

Based on over 25 years of research on hidden profiles and information sharing in groups, and particularly our own work in this area, we outline a general model of how groups can achieve better decisions in a hidden profile situation than their individual members would have been capable of (i.e., synergy). At its core the model defines intensity and bias as the two key parameters that have to be optimised with regard to both the discussion of information and the processing of information in order to ensure synergy in group decision making. We review the empirical literature on information sharing and group decision making in the hidden profile paradigm (with a particular focus on our own studies) to illustrate how group decision quality can be enhanced by increasing intensity and decreasing bias in the discussion and processing of information. Finally we also outline why we think that the lessons learned from research using the hidden profile paradigm can be generalised to group decision-making research in general, and how these lessons can stimulate studies in other fields of group decision-making and group performance research.     

Efficacy of guided self-help behavioural activation and physical activity for depression: a randomized controlled trial

Behavioural activation and physical activity have received empirical support that highlight their efficacy in reducing depression. Even though both behavioural activation and physical activity share the common goal of reactivating the individual, limited research has directly compared these interventions, and more research is required to evaluate their efficacy when offered in low-intensity formats. The present study involves a randomized controlled clinical trial comparing the efficacy of two guided self-help interventions for the treatment of depression: behavioural activation and physical activity. Fifty-nine participants presenting mild-to-moderate symptoms of depression were randomized either to a behavioural activation intervention (n = 20), a physical activity intervention (n = 19) or a wait-list control group (n = 20). All participants completed symptom measure pre-, mid- and post-intervention, as well as at a two-month follow-up. Mixed-model analyses of variance revealed that both interventions were significantly more efficacious in reducing depressive symptoms in comparison with the control group. Physical activity involved significantly less time-investment compared to the behavioural activation condition (less than half the amount of time). These results indicate that physical activity and behavioural activation both effectively reduce depressive symptoms and are favourably applicable in low-intensity formats. Implications of these results and avenues for future research are discussed.     

The Köhler Group Motivation Gain: How to Motivate the ‘Weak Links’ in a Group

A recurring question of successful group work is how to maintain high task motivation of the individual members. This paper reviews research on one well documented group motivation gain phenomenon, where group members are more highly motivated than comparable individual performers – the Köhler motivation gain effect. The basic effect is attributed to two psychological mechanisms, one involving upward social comparisons and a second involving the indispensability of group members’ efforts. In addition to summarizing research on the discovery and causes of the basic effect, this review identifies probable moderators of each contributing causal mechanism. Moreover, promising topics for future research as well as implications for the application of the Köhler effect in real group work are discussed.     

Engagement in Behavioral Parent Training: Review of the Literature and Implications for Practice

Engagement in behavioral parent training (BPT), including enrollment, attrition, attendance, within-session engagement, and homework completion, has long been a critical issue in the literature. Several estimates of various aspects of engagement have been suggested in the literature, but a systematic review of the available literature has never been accomplished. This review examines engagement data across 262 studies of BPT. Recruitment attrition, program attrition, attendance, and within-session engagement are examined across studies, with particular emphasis on the impact that SES, study purpose (efficacy vs. effectiveness), treatment format (individual vs. group), and age of child may have on those rates. Results of this review suggest that the significant amount of attrition occurs prior to enrollment in BPT, with at least 25 % of those identified as appropriate for BPT not enrolling in such programs. An additional 26 % begin, but drop out before completing treatment. Still the combined dropout rate of at least 51 % leaves at best half of identified parents completing treatment. While SES status had a small effect on attrition, other variables were not found to meaningfully impact engagement. Information on within-session engagement (homework and ratings of participation) was not often reported in studies. Key issues in this literature (e.g., varying definitions of engagement, limited attention to reporting key aspects of engagement) are discussed, and recommendations are made to further improve this important area of research and clinical practice.     

Order effects and memory for evidence in individual versus group decision making in auditing

Sequential processing of evidence may lead to recency effect, a potential bias in judgment. The present research seeks to extend the literature on recency effects by assessing the potential moderating influence of team work: whether group decision making moderates the severity of recency effects predicted by Hogarth and Einhorn (1992), and whether group processing influences the accuracy of, and confidence in memory for evidence. Experienced auditors from a Big‐6 accounting firm made audit judgments, either individually or as groups. They were randomly assigned to one of two levels of evidence presentation order. After performing the judgment task, participants completed two evidence recognition tests. Consistent with prior findings, recency effects on judgments were observed, but only for individuals. Group judgments or audit reports were not affected by recency. Order effects, however, did not translate into different choices of audit reports, and did not persist in memories of either individuals or groups. As expected, group memory was more accurate than individual memory and groups were more confident than individuals. Overall, confidence in accurate memories was greater than in inaccurate ones. Copyright © 1999 John Wiley & Sons, Ltd.     

A current look at transference in combined analytic therapy

This article examines transference from the vantage point of combined analytic therapy, a model that starts the patient in individual analytic treatment, then introduces him/her to group with the same therapist. Definitions of transference in the psychoanalytic literature are noted, as is the designation of transference interpretation as the distinguishing characteristic of psychoanalytic treatment. Working with transference is examined clinically, with attention to archaic transferences as well as more developed responses. In comparison with individual treatment, combined therapy offers an enlarged arena for the transference to emerge, because of the reexperiencing of the family gestalt in the group, and the more immediate stimulation in the group of envy and competition. Communications in the individual session enlighten the therapist further about what has gone on in the group.     

Use of Groups in Various Modalities of Hospital Treatment

The authors provide a comprehensive survey of the research literature on pretherapy training for group psychotherapy. The twenty studies identified during the twenty-five-year period 1962–1987 were fraught with various methodological and design inadequacies. Despite the widespread positive endorsement found in the clinical literature, the research evidence for the benefit of pretherapy training is not particularly impressive. While there is evidence of certain immediate effects (e.g., improved attendance), results concerning process and outcome effects are, at best, only suggestive. In the face of the disappointing findings, the authors are nonetheless optimistic regarding the potential value of pretherapy training.     

The Archaic Personality Structure of Alcoholics and Its Implications for Group Therapy

The purpose of this investigation was to obtain a better understanding of the nature of expectations about group psychotherapy, given a consistent body of research pointing to the relationship between specific treatment expectancies and premature termination. The Group Therapy Survey was developed and utilized to assess the predominant beliefs, attitudes, and expectations of 206 clinical and nonclinical subjects toward group therapy. The results of the investigation reflected three major categories of expectations: (1) Group therapy is unpredictable, (2) group therapy is not as effective as individual therapy, and (3) group therapy can be detrimental to participants. Possible explanations for the origin and development of such expectations are entertained, including the publicizing of the more radical aspects of the encounter group movement and other negative portrayals of group therapy in the media and the film industry. Recommendations are offered concerning the use of the survey prior to intake or a pregroup orientation interview in order to tailor a discussion to the prospective client's personality, expectations, and problems.     

The Effectiveness of the Within Our Reach Relationship Education Program for Couples: Findings from a Federal Randomized Trial

This study examined the effectiveness of a couple‐based relationship education program, Within Our Reach. Secondary data (n = 3,609) were analyzed from the federal Supporting Healthy Marriage project. Couples were randomly assigned to receive Within Our Reach and associated services or to a no‐treatment (treatment‐as‐usual) control group. Those assigned to Within Our Reach reported better couple and individual outcomes on 8 of 12 outcomes measured (M ES = .15) at the 12‐month follow‐up and 6 of 10 outcomes measured at the 30‐month follow‐up (M ES = .14), including higher relationship happiness, more warmth and support, more positive communication, less negative behavior and emotion, less psychological abuse, less physical assault (for men), lower psychological distress (for women), and less infidelity. They were also less likely to report that their marriage was in trouble. These effects were generally small in size and many were replicated across the two follow‐ups. There were no significant differences between those assigned to Within Our Reach versus control on cooperative parenting, severe psychological assault, or percent married. Implications for future research, programming, and policy are discussed.     

Untapped Potential: Psychologists Leading Research in Clinical Practice

Enhancing the capacity of allied health professionals to engage in research is central to improving healthcare delivery. Psychologists have research skills given their training focus that emphasises the scientist‐practitioner model. We aimed to investigate among psychologists the link between individual research capacity and their current level of research activity, how this compares with other allied health professions, and the role of team and organisation research capacity. Psychologists (n = 60) working in clinical roles in a large metropolitan public health setting completed an online survey consisting of the validated Research Capacity and Culture tool, and questions related to current research activities, barriers, and motivators. The results indicated that psychologists reported relatively high individual research capacity, higher than both team and organisation levels, and greater individual research capacity compared with studies of dietitians and a mixed group of allied health. Preliminary findings suggested that team research capacity mediated the link between individual research capacity and the level of current research activity. Finally, barriers and motivators to research activity were similar compared with studies of other allied health professions. Overall, a multi‐strategy approach that focuses on and facilitates practice‐based and interdisciplinary research, and enhances the leadership skills of psychologists in research, as well as broader efforts from an organisational perspective to build a strong and sustainable research culture, may contribute to the rapid use of research skills in clinical practice and improve health and healthcare delivery.     

An outcome evaluation study of a psycho‐educational course in a primary care setting

Rationale: To date relatively little research has examined the effectiveness of psycho‐educational courses provided in a primary care setting to adults with mild‐to‐moderate mental health concerns. Aims: To determine whether group psycho‐education could be a viable alternative to individual counselling by (1) assessing the clinical effectiveness of an 8‐week psycho‐educational course, and (2) examining the group outcomes in comparison with individual treatment outcomes from a previous study in the same counselling service. Method: A total of 57 participants attending a psycho‐educational course provided data over a 36‐month period, using the Clinical Outcomes in Routine Evaluation – Outcome Measure (CORE‐OM) pre‐ and post‐intervention. A comparison was then made with the data of 58 previous participants of individual counselling evaluation, using the same CORE‐OM system. Results: Participants reported significantly lower levels of psychological distress after attending the course and these results are comparable to outcomes measured in the same service for individual counselling, indicating that group interventions could be considered a legitimate alternative to individual counselling, thus increasing cost effectiveness and reducing waiting times. Limitations of the study and implications for practice and further investigation are considered.