Acceptance and Commitment Therapy for a Heterogeneous Group of Treatment-Resistant Clients: A Treatment Development Study

Acceptance and commitment therapy (ACT) has been shown to have broad applicability to different diagnostic groups, and there are theoretical reasons to consider its use with clients with chronic mental health problems. We report an innovative treatment development evaluation of ACT for a heterogeneous group of ”treatment-resistant clients” (N = 10) who had attended a mean of 3.5 previous psychological interventions. All clients had Axis I presentations and half met diagnostic criteria for Axis II disorders. Functioning, assessed at pre- and postintervention, and at 6- and 12-month follow-up, showed improvements over time on all primary outcome measures, driven largely by significant changes occurring between baseline and 6-month follow-up. Improvements were associated with ACT processes of change. The data thus suggest that a broad range of clients who had not benefited from standard care may benefit from ACT.     

Paradigms and crises in psychoanalysis

The use of T. S. Kuhn's Structure of Scientific Revolutions as a model for the history of psychoanalysis is addressed. It is shown that his categories have been regularly misapplied in the interest of establishing the scientific status of psychoanalysis, or of proposing a new theoretical structure. It is argued that Kuhn's model may nevertheless be useful for the history of psychoanalysis on condition that its categories are used precisely, and their correspondence to the data is tested rather than assumed.     

The psychological precipitants of transient postpartum depression: A review

Studies reporting incidence rates for the “postpartum blues” (defined as atransient depressive episode occurring in the first 10-14 days after childbirth) are surveyed, and the methodological issues involved in collecting these data are considered. When women provide self-report ratings of depression on each day in the first postpartum week, the incidence of the blues is about 66%. Psychological factors found to be associated with the blues include a history of psychiatric disturbance or depression during pregnancy, menstrual distress, and a trouble-free pregnancy. Other factors not shown to be related to the blues include maternal age, socioeconomic status, prenatal anxiety, method of feeding, and whether the pregnancy was wanted. There is no evidence concerning the effect of the blues on maternal attachment, and the relationship between the blues and postpartum depression is unclear. There is discussion of the significance of the blues as a measure of the effectiveness of antenatal preparation and adjustment to the crisis of childbirth.     

Child custody disputes: A review of legal and clinical resolution methods

This paper reviews existing practices from the mental health, marriage and family therapy, and legal professions which offer alternatives to traditional adversarial custody resolution methods. Based upon suggestions from legal and mental health professionals, the authors advocate allocating state resources for interprofessional family courts which would provide custody counseling, mediation, evaluation, and consultation as alternatives to adversarial methods.     

AN EVALUATION OF THE RELATIONSHIP BETWEEN RECEPTIVE SPEECH SKILLS AND EXPRESSIVE SIGNING

We examined the effects of receptive speech on the acquisition of manual signing among three mentally retarded children. In an alternating treatments design, we compared the acquisition of expressive signs that were, versus were not, in a child's receptive vocabulary. The children were trained via total communication in which pictorial referents were named during sign training. Signs corresponding to known words were generally acquired faster and retained better than signs corresponding to unknown words. We conducted posttests to assess the stimulus control of signing and any changes in expressive and receptive signing and speech. Observed changes in performance could be accounted for by attention to aspects of the stimulus complex during training and functional equivalence of stimuli established by training.     

Inferring decay in short-term memory: The issue of capacity

Experiments examining the issue of decay in short-term memory have assumed a single undifferentiated source of processing capacity which cannot be devoted to rehearsal when consumed in the processing of a nonverbal interpolated task. Three experiments reported here call this logic into question, since variations in difficulty in the nonverbal interpolated task failed to affect recall. Slight forgetting produced by a nonverbal interpolated task, relative to a no interpolated task control, was attributed to qualitative differences from performing two tasks simultaneously rather than only one. Results from the third experiment indicated that retrieval after a period of nonverbal interpolated activity is from primary rather than secondary memory.     

Speed-accuracy tradeoff in double stimulation: II. Effects on the second response

In the double-stimulation paradigm subjects respond to two successive stimuli. Previous research (Knight & Kantowitz, 1974) showed that a subject's speed-accuracy tradeoff (SAT) strategy interacted with the interval between the two stimuli to determine response performance to the first stimulus. The present experiment examined the influence of SAT strategy on response performance to the second stimulus. Interest focused on effects of SAT strategy upon the psychological refractory period (PRP) effect. If a single mechanism underlies beth first-and second-response performance (e.g., the PRP effect) in double stimulation, effects of SAT upon the second response should be similar to effects upon the first response. Results showed that the PRP effect appeared only when second-response accuracy was stressed. Under speed emphasis double-stimulation second-response latency never exceeded a single-stimulation baseline. This was analogous to first-response latency effects found by Knight and Kantowitz (1974). Response grouping was strongly influenced by SAT strategy and two response-grouping mechanisms were distinguished. Implications of these and interresponse time data for models of double-stimulation performance are discussed.