Development and evaluation of a scale assessing therapist fidelity to guidelines for delivering therapist-assisted Internet-delivered cognitive behaviour therapy

Internet-delivered cognitive behaviour therapy (ICBT) is often accompanied by therapist emails, but there is limited research on the quality of this therapist-assistance. In this study, an ICBT Therapist Rating Scale (ICBT-TRS) was developed and evaluated to assess whether therapist emails showed fidelity to specific therapist behaviours. Using data from a previous ICBT trial for depression and anxiety, the ICBT-TRS was used to rate 706 emails sent by 39 therapists to 91 randomly selected patients. Emails were rated for adherence (absent/present) and quality (inadequate/competent) on the following behaviours: Builds Rapport, Seeks Feedback, Provides Symptom Feedback, Provides Psychoeducation, Facilitates Understanding, Praises Effort, Encourages Practice, Clarifies Administrative Procedures, and Communicates Effectively. Inter-rater reliability was high. Most behaviours were identified as present in 72–100% of emails, with the exception of Provides Symptom Feedback and Facilitating Understanding which were only present in 54 and 61% of emails. The majority of emails were rated as high quality (88–98% of messages). While not related to symptom improvement, ICBT-TRS ratings were higher when patients were more engaged in ICBT (e.g. log-ins) and among therapists who specialized in ICBT or had a background in Psychology. The ICBT-TRS has potential to facilitate ICBT research and clinical training.     

The relationship between therapeutic engagement,cognitive errors,and coping action patterns: An exploratory study

Aim: This exploratory study examined the relationship between clients’ involvement in therapy and their cognitive errors (CE) and coping action patterns (CAP). Method: Therapy sessions from N = 26 clients were rated for CE and CP using the CE and CAP methods. Client involvement was measured with the Positive and Negative Affect Schedule, as well as the . Results: The CEs’ ‘magnification of the negative or minimisation of the positive’ and ‘labelling’ were associated with measures of affective therapeutic engagement. The coping styles ‘negotiation’, ‘opposition’, ‘submission’, ‘isolation’, ‘support seeking’, ‘information seeking’, ‘delegation’, and ‘escape’ were found to be associated with affective and behavioural dimensions of therapeutic involvement. Conclusions: These findings provide preliminary supporting evidence that CE and CP are related to the extent to which clients engage in the work of therapy. Implications for researchers and therapists are discussed.     

Pattern and flicker detection examined in terms of the nasal-temporal division of the retina

Contrast thresholds for the detection of flicker and the detection of pattern were measured for nasal and temporal retinae of each eye separately. While confirming that these two types of threholds can differ, depending on the spatial frequency, the results provide no support for hemiretinal or hemispheric asymmetries in the distribution of the putative pattern and movement channels.     

On assessing individual differences in rumination on sadness

The Rumination on Sadness Scale (RSS), an individual-difference measure of rumination on sadness, was developed as an alternative to the Ruminative Responses scale of the Response Styles Questionnaire (RRRSQ; Nolen-Hoeksema & Morrow, 1991). Research has shown the RRRSQ to consist of multiple, not highly intercorrelated factors; only I factor explicitly addresses rumination. In Study 1, a 1-factor solution to a principal components analysis was shown to hold for responses to the RSS. The RSS was also shown to be reliable. In Study 2, convergent and discriminant validity of the RSS were assessed. In Study 3, individuals with high RSS scores exhibited more distress regarding current concerns with the introduction of a delay period (to allow them to ruminate) after a sad mood induction.     

Late adolescent perceptions of parent religiosity and parenting processes

The current investigation examined the relations between adolescent reports of parent religiosity and parenting processes, using both a dimensional and a typological conceptualization of parenting. Self-report data were collected from 357 late adolescents. Partial correlations indicated that parent religiosity was associated with both parenting dimensions and parenting styles in conceptually expected directions. Regression analyses provided evidence that the dimensional conceptualization of parenting explained additional variability in perceived parental religiosity above and beyond parenting style effects. Findings suggest that a dimensional conceptualization of parenting processes extends the literature on parent religiosity because it yields more nuanced information about how parental religiosity may be related to differentiated parenting behaviors. Potential therapeutic implications of the findings are discussed.     

A Review of Spiritual and Religious Measures in Nursing Research Journals: 1995--1999

Background: A series of systematic reviews has revealed relatively high levels of interest in religion and spirituality in different nursing specialties, but not in general nursing research journals. Purpose: To identify the extent to which spirituality and religiousness were measured in all quantitative and qualitative research articles published in Research in Nursing and Health, Nursing Research, Advances in Nursing Science (ANS), and Image: The Journal of Nursing Scholarship from 1995 to 1999. Methods: A full-text search was conducted of ANS and Image using the Ovid search system. Nursing Research and Research in Nursing and Health were hand searched for spiritual/religious measures. Characteristics of selected studies, the measures taken, and their uses were coded for data analysis. Results: A total of 564 research studies were identified, of which 67 (11.9%) included at least one measure of spirituality or religiousness. A significant difference was found between the percentage of qualitative and quantitative studies that contained measures of these concepts. Of the 119 qualitative studies, 23 (19.3%) contained a measure of religion or spirituality, compared to 44 of the 445 (9.9%) quantitative studies. Nominal indicators of religious affiliation were the most commonly used measures in the quantitative studies and measures of religion and spirituality were rarely used in the analyses. Although only a few quantitative or qualitative studies intended to focus on religion or spirituality, these themes often emerged spontaneously in the qualitative research. Conclusions: Research in Nursing and Health, Advances in Nursing Science, Nursing Research, and Image: The Journal of Nursing Scholarship all published research measuring spirituality and religiousness during the time-period studied. The rate at which spirituality and religion appeared in these nursing research articles is substantially higher than that found in most fields outside of nursing. Even more frequent inclusion of spiritual and religious variables and richer measures of spirituality and religiousness would help to increase the available scientific information on the role of spirituality and religion in nursing care.     

Validation of the holyoake codependency index

Some clinicians working with families with alcohol or other drug problems continue to use the codependency model to guide their practice despite the limited empirical support for this approach. Research into codependency has been hampered by the lack of psychometrically sound instruments. The Holyoake Codependency Index (HCI; G. E. Dear & C. M. Roberts, 2000) is a 13-item self-report measure of codependent traits that has previously shown adequate to high reliability, initial evidence of construct validity, and an internal structure that is consistent across samples. In the 4 studies reported here, the internal structure of the HCI was confirmed using confirmatory factor analysis, and further evidence of construct validity was found in that the HCI subscales showed meaningful associations with other psychological and demographic variables.     

Attempts to control unwanted thoughts in the night: development of the thought control questionnaire-insomnia revised (TCQI-R)

The attempted control of intrusive, uncontrollable thoughts has been implicated in the maintenance of a range of psychological disorders. The current paper describes the refinement of the Thought Control Questionnaire Insomnia (TCQI; Behav. Cogn. Psychoth. 29 (2001)) through its administration to a sample (n=385) including good sleepers and individuals with insomnia. Several items with poor psychometric properties were discarded, resulting in a 35-item revised TCQI. Factor analysis revealed six factors; aggressive suppression, cognitive distraction, reappraisal, social avoidance, behavioural distraction, and worry. The attempted management of unwanted thoughts was compared across individuals with insomnia and good sleepers, and the impact of these strategies on sleep quality, anxiety and depression was investigated. With the exception of cognitive distraction, individuals with insomnia, relative to good sleepers, more frequently used every thought control strategy. The strategies of aggressive suppression and worry, in particular, appeared to be unhelpful, with the use of these strategies predicting sleep impairment, anxiety and depression. The strategy of cognitive distraction appeared to be helpful, with the use of this strategy predicting better sleep quality.     

Synchronized cortical potentials and wavelet packets: a potential mechanism for perceptual binding and conveying information

Temporal synchronization in neuronal assemblies has been linked to the functional roles of perceptual binding, sensory-motor integration, attention, and information coding. We report new evidence for a common underlying mechanism that uses specific temporal patterns of synchronized neuronal activity as a basis for conveying information. The temporal patterns of stimulus-related synchronized neuronal discharges are structured to closely resemble specific members of the Symlet wavelet packet family employed in a computational framework. Together, these results suggest that temporal patterns of synchronized activity may act as a parallel, distributed code for information through a mechanism computationally equivalent to wavelet packet analysis.     

The Relationship of the Self of the Therapist to Therapy Process and Outcome: are Some Questions Better Left Unanswered?

Gurman (1987) has challenged the field of marital and family therapy to answer questions concerning the relationship of the therapist to outcome. An examination of conceptual and empirical literature regarding the relationship of the self of the therapist to process and outcome in marital and family therapy discloses that empirical evidence for such relationship is not persuasive. The author constructs a crucible for the field of marital and family therapy.