Cognitive-behavioral treatment of childhood obsessive-compulsive disorder in community-based clinical practice: clinical significance and benchmarking against efficacy

Objective

To evaluate the feasibility and outcomes of evidence-based (EB) manualized, cognitive-behavioral treatment (CBT) for childhood obsessive-compulsive disorder (OCD), when delivered in an outpatient community-based specialist clinic.

Method

This study, conducted in an outpatient private clinic in South-East Queensland Australia, involved thirty-three children and adolescents with OCD. Children were assessed at pre- and post-treatment, by means of diagnostic interviews, symptom severity interviews, and self-report. Treatment involved 12 sessions CBT delivered either individually or in small groups and included parental involvement.

Results

Manualized CBT could be transported to the community setting effectively, with 63% of the current sample responding positively, based on post-treatment diagnosis. Significant change was evident across a wide-range of outcomes; including, diagnostic severity, symptom severity, child reported depression and anxiety, and both child and parent reported OCD functional impairment.

Conclusions

This study provides evidence for the transportability of manualized CBT in clinical community practice for pediatric OCD. The next important step is larger community based dissemination and effectiveness studies to advance both research and clinical practice outcomes.     

The validity of psychotherapy 1

How good is psychotherapy as a tool of research into human nature? There is an orthodox defence of it as a research tool, which relies on showing that interpretations are true of the patient when they satisfy certain criteria. This defence is examined and rejected. The reply is considered that an interpretation which ‘keeps things moving’ is true, or an approximation to the truth. This reply is rejected by comparing and contrasting an interpretation in psychotherapy with one from brainwashing sessions. Two suppositions about psychotherapy (which weaken its discovery powers) are deliberately adopted — the suppositions that the material produced is ‘perspective’ and ‘method’ dependent. An unorthodox defence of psychotherapy is then offered — by means of a watery sense of ‘discover’. This enables us to outline a weak sense in which psychotherapy is a valid enterprise, but one which is still strong enough for research purposes.     

“Not in My Back Yard”: The Situational and Personality Determinants of Oppositional Behavior1

The present study considered situational and dispositional factors underlying behavioral opposition characteristic of a “not‐in‐my‐back‐yard” (NIMBY) response to a change having adverse personal consequences. Students considered the proposition of comprehensive exams required for graduation taking effect in the near or distant future (high and low vested interest, respectively). Although both groups had similarly negative attitudes toward the idea, the high vested interest group perceived greater personal consequence and expressed greater intention to oppose the plan. From a situational‐dispositional interactionist perspective, it was the impact of the situation (perceived stake), rather than personality traits presumed to underlie a NIMBY response, that proved to be the primary determinant of oppositional behavior.     

Authoritarianism and Political Impoverishment: Deficits in Knowledge and Civic Disinterest

Past research shows that authoritarian individuals hold strong opinions about a variety of political and social issues, such as race relations and military conflict. What has not been established, though, is the amount of general political knowledge that authoritarians possess. In this study, three groups of college students were administered Altemeyer's Right-Wing Authoritarianism (RWA) scale; most of them also received items assessing general political knowledge and specific knowledge about the 2000 presidential election, as well as items assessing interest in politics. Relative to students with low RWA scores, those with high scores possessed less political knowledge; moreover, they expressed less interest in learning about politics. In general, authoritarianism was unrelated to how individuals got their political information or how credible they found their sources. The implication that authoritarians hold strong attitudinal beliefs with weak political knowledge is discussed.     

Success and Gender: Determining the Rate of Advancement for Intercollegiate Athletic Directors

Since the demise of the Association for Intercollegiate Athletics for Women (AIAW), female sport administrators have continued their struggle to reestablish their place as athletic directors. The purpose of this study was to assess the rate of advancement (success ratio) of intercollegiate athletic directors, with a primary focus on gender. Athletic directors from 157 NCAA (National Collegiate Athletics Association) member institutions participated in the study. The preliminary results confirmed the expected findings that hegemonic masculinity was entrenched within intercollegiate athletics. The success ratio of male athletic directors differed from that of female athletic directors, and the difference was significant (p ≤ .05). The success ratio for men was higher than the ratio for women. Further analyses, however, showed that female athletic directors had higher success ratios than their male peers at lower level institutions. Although parity in numbers has not yet been achieved across the NCAA, the glass ceiling at Division I institutions may begin to crack as more women achieve success at the lower level institutions.     

Blood donation is an act of benevolence rather than altruism.

OBJECTIVES: Blood donation is described as an archetypal altruistic behavior, and recruitment/retention campaigns emphasize altruism. Here, a benevolence hypothesis for blood donation (both the donor and recipient benefit) rather than the altruism hypothesis (only the recipient gains) is proposed. DESIGN: Three United Kingdom-based studies contrasted benevolence and altruism: (a) a 6-month prospective study of blood donor behavior (Study 1: N = 957), (b) a cross-sectional study of blood donors' intentions (Study 2: N = 333), and (c) an experimental study examining the effect of benevolent and altruistic messages on willingness to help across high- and low-cost helping behaviors for committed and noncommitted blood donors (Study 3: N = 200). MAIN OUTCOME: Donor behavior and intentions-willingness. MEASURES: Beliefs in personal and societal benefit (Time 1) and actual donations (Time 2) were assessed in Study 1; beliefs in benevolence, altruism, hedonism, and kinship along with donation intentions were assessed in Study 2; and empathy, donor commitment, and willingness to donate blood, money, fund-raise, and staff a telephone helpline were assessed in Study 3. RESULTS: Beliefs in personal rather than societal benefit predicted actual future donation. A path model showed that only beliefs in benevolence were associated with intentions to donate. Committed blood donors were more willing to donate blood when exposed to a benevolent message rather than an altruistic one. This effect was not observed for other forms of helping. CONCLUSIONS: The benevolence hypothesis is supported, suggesting that blood donor motivation is partly selfish. Blood donation campaigns should focus on benevolent rather than purely altruistic messages.