Id analysis and technical approaches

The author argues that the technical advances stemming from Freud's (1923) introduction of the structural theory permit a more naturalistic and specific approach to analyzing unconscious conflict, thus facilitating id analysis. The earlier topographical technique underestimated the role of suggestion; often, it entailed interference with patients' capacity for self-observation, as well as with the exploration of their own drive derivatives. In order to illustrate the type of id material obtainable with a contemporary ego psychology approach, the author presents clinical vignettes and commentaries. It is recognized that clarifications, defense interpretations, and Gray's close-process interventions may need to be adapted to different cultural milieus.     

Utility of verbal-nonverbal correspondence-training techniques in outpatient pediatric settings

Verbal-nonverbal correspondence training is a behavioral approach recommended in the development of adaptive behaviors and the reduction of problem behaviors. This paper summarizes research findings involving 4 verbal-nonverbal correspondence-training techniques and then illustrates the potential utility of these techniques in general pediatric settings. Particular emphasis is placed on strategies pediatricians could employ to teach patients how to use these techniques effectively to decrease problem behaviors at home (e.g., ADHD, refusing to take the prescribed medication, eating problems) among children seen in outpatient pediatric settings.     

Management of hyperactive children through correspondence training procedures: A preliminary study

This study examined the clinical effects of correspondence training procedures in the management of three hyperactive boys between the ages of seven and 10 years. Two subjects were intervened with the “reinforcement of corresponding reports” procedure: reports about the inhibition of hyperactivity (inattention and overactivity) were reinforced only if they corresponded with the actual inhibition of hyperactivity. The “reinforcement set up contingent upon promises” procedure was used with the third subject: the reinforcer was set up (or displayed) contingent on the patient's promises about the inhibition of hyperactivity in the immediate future, and delivered contingent upon fulfillment of the promise (actual inhibition of hyperactivity). These interventions were programmed in a multipie baseline design across two subjects and a multiple baseline design across two behaviors. A changing-criterion design was also used with all subjects: the nonoccurrence of hyperactivity had to be observed across a pre-established criterion level for the actual delivery of the reinforcer. Consistently higher levels of correspondence occurred during treatment, relative to baseline observations. The results also demonstrated the generalization and maintenance of treatment effects. The use of correspondence training as a potential alternative in the development of hyperactive children's self-control is discussed.     

Assumptions of agreement and familiarity on the abbreviated conners teachers rating scale

Implicit in the development and use of the Conners' scales are the assumptions that the raters will agree upon their rating of hyperactivity regardless of a lack of operational defitions of items in such scales, and that the cut-off score (1.5) for ADHD should be higher in cases where the rater has some familiarity with the clinical case. This study describes a method for the evaluation of both assumptions. Seven children were rated by nursing staff and school teachers using the Abbreviated Conners Teachers Rating Scale (ACTRS) daily. Observations were conducted during the 7 a.m.-3 p.m. and 3 p.m.–7 p.m. shifts in order to provide two separate scores across raters. The results supported the assumption of agreement within (for example nurses' ratings during the 7 a.m.–3 p.m. period) and between (i.e. nurses' ratings versus teachers' ratings) settings. The results did not support the assumption of familiarity: scores during early observations were similar to the scores during later observations (when more familiarity with the clinical case is assumed). It was concluded that familiarity with the clinical case does not necessarily lead to higher scores (i.e. a better prediction of hyperactivity as a function of the rater's familiarity with the case) on the ACTRS. Agreements within and between observers could be a function of the raters' agreement in terms of using a specific cut-off point (i.e. 1.5) in their definition of a case as ‘hyperactive’, rather than the raters' agreement on reporting similar scores across observers.