What Makes a Quality Therapy? A Consideration of Parsimony,Ease, and Efficiency

Evaluations of psychotherapy have traditionally focused on symptom reduction as the primary standard by which their value is determined. This has contributed to the appearance of equivalence between many therapies that may differ considerably in complexity, feasibility, amount of homework and therapist contact required, expected cost, speed of symptom decline, and transdiagnostic utility. In the current paper, I make the case that these are fundamental features related to quality that should be considered in psychotherapy development, randomized controlled trials, and dissemination efforts. Empirically supported treatments for different disorders are evaluated based on these criteria, and special consideration is given to cognitive-behavioral treatments for anxiety disorders. Specific recommendations for a quality-oriented clinical research agenda are also provided.     

The Necessities of Perfect Freedom

This article is a reflection on Augustine's suggestion that Christians have significant theological reasons to accept that freedom need not be correlated with having choices. Following his lead, I explore questions about freedom and agency raised by the perfect freedom of the saints in heaven, Jesus' sinless earthly life and the freedom with which the triune God is eternally blessed. My thesis is that those who worship the triune God and praise the sinless perfection of Christ and the heavenly saints have reason to accept a ‘normative’ conception of freedom, according to which certain kinds of necessity are not merely compatible with perfect freedom but intrinsic to it.     

Initial relationship goal and couple therapy outcomes at post and six-month follow-up

The purpose of this study was to investigate the relationship between client initial goal for couple therapy (i.e., improve the relationship or clarify the viability of the relationship) and the outcomes (including their relationship status, i.e., separated or together) at posttreatment as well as at 6-month follow-up. Two hundred forty-nine couples (N = 498 individuals) seeking treatment for relationship distress in a naturalistic setting were treated by 20 therapists. Client initial relationship goal was attained by intake paperwork protocol, which included client initial goal for couple therapy and client perception of partner goal. Clients who reported that their goal was to improve the relationship reported better outcomes at post. Couples who reported their goal was to improve the relationship were less likely to break up at a 6-month follow-up. Of the 115 couples stating they wanted to improve the relationship, only nine (7.8%) couples were separated at 6 months. In contrast, of the 16 couples in which both partners wanted to clarify the relationship prior to therapy, nine (56%) were separated at follow-up. Therapist awareness of each individual's relationship goal prior to couple therapy could enhance outcomes, and treatment tailored according to initial goals could set the stage for positive outcomes however defined.     

Fast thought speed induces risk taking

In two experiments, we tested for a causal link between thought speed and risk taking. In Experiment 1, we manipulated thought speed by presenting neutral-content text at either a fast or a slow pace and having participants read the text aloud. In Experiment 2, we manipulated thought speed by presenting fast-, medium-, or slow-paced movie clips that contained similar content. Participants who were induced to think more quickly took more risks with actual money in Experiment 1 and reported greater intentions to engage in real-world risky behaviors, such as unprotected sex and illegal drug use, in Experiment 2. These experiments provide evidence that faster thinking induces greater risk taking.     

Acceptance and Commitment Therapy and Habit Reversal Training for the Treatment of Trichotillomania

Trichotillomania is a behavioral problem, and is often referred to as a habit disorder, but it is important to consider the cognitive and emotional components of the behavior. Current treatment recommendations include a traditional behavioral approach (Habit Reversal Training; HRT) combined with an approach that addresses the cognitive and emotional components of the behavior (Acceptance and Commitment Therapy [ACT] or Dialectical Behavior Therapy [DBT]). Current evidence indicates a combination of ACT and HRT is an effective treatment for trichotillomania. The goal of this article is to replicate the effectiveness of the ACT/HRT treatment package for trichotillomania and to provide practical clinical guidance on how to deliver the treatment. This guidance is presented in the context of an empirical study in which 5 participants demonstrating high levels of pulling at pretreatment were treated with 8 sessions of a combination of ACT and HRT. Treatment resulted in an 88.87% reduction in pulling across participants from pretreatment to posttreatment, and all 5 responded to the treatment. At 3-month follow-up, 2 participants maintained the treatment gains, 2 lost half of the treatment gains, and 1 was at pretreatment levels. A discussion of the results is presented along with implications for clinical practice and future directions for research.     

Recycling gone bad: When the option to recycle increases resource consumption

In this study, we propose that the ability to recycle may lead to increased resource usage compared to when a recycling option is not available. Supporting this hypothesis, our first experiment shows that consumers used more paper while evaluating a pair of scissors when the option to recycle was provided (vs. not provided). In a follow-up field experiment, we find that the per person restroom paper hand towel usage increased after the introduction of a recycling bin compared to when a recycling option was not available. We conclude by discussing implications for research and policy.     

Lost in the crowd: Entitative group membership reduces mind attribution

This research examined how and why group membership diminishes the attribution of mind to individuals. We found that mind attribution was inversely related to the size of the group to which an individual belonged (Experiment 1). Mind attribution was affected by group membership rather than the total number of entities perceived at once (Experiment 2). Moreover, mind attribution to an individual varied with the perception that the individual was a group member. Participants attributed more mind to an individual that appeared distinct or distant from other group members than to an individual that was perceived to be similar or proximal to a cohesive group (Experiments 3 and 4). This effect occurred for both human and nonhuman targets, and was driven by the perception of the target as an entitative group member rather than by the knowledge that the target was an entitative group member (Experiment 5).     

Alternative measures of cognitive complexity as predictors of communication performance

Two studies were conducted to compare the predictive validity of the two of the most popular measures of cognitive complexity: Bieri et al.'s (1966) grid-based measure (elicited and provided versions) and Crockett's (1965) Role Category Questionnaire (RCQ). Two other grid-based measures of construct system quality also were included. Criterion measures included indices of the accommodative, person-centered quality of communication behavior and social reasoning in a variety of contexts.

Results of both studies consistently show Crockett's measure to be a significant predictor of all criterion measures. Bieri et al.'s measures were generally unrelated, although the elicited construct version performed best as a predictor. The two measures of complexity were essentially unrelated in both studies. Implications of the findings for future use of the RCQ and grid-based measures of complexity are discussed. For those interested in the relation of constructs and communication behavior, the RCQ is recommended.