Assessment of Knowledge Gains in Proactive Training for Postvention

This paper describes the development of a knowledge measure for the evaluation of a proactive training program for suicide postvention and analyses of its psychometric properties. The 25-item true–false knowledge test was administered before and after each of 12 training sessions; a total of 205 school personnel participated in the training and evaluation. Participants showed significant improvement in overall test scores and on several individual items following the training. Analyses suggested that the measure has construct validity, and that it taps a single underlying dimension. Strengths and weaknesses of the measure, and measurement issues in program evaluation are discussed.     

Burn-out

At first the concept of burnout will be critically reflected in the context of the discussion in a position paper of the German Society for Psychiatry Psychotherapy and Neurology. An investigation of preventive stress management interventions at the workplace will be reported. The treatment concept of the day clinic of the Department for Psychosomatic Medicine and Psychotherapy of the Munich-Harlaching hospital for occupational stress-related disorders will be presented. An empirical study of the effectiveness of this treatment will be reported comparing patients with occupational stress-related disorders (n?=?95) to other patients treated in the day clinic during the same time interval (n?=?154). Furthermore, a qualitative analysis of 102 patient charts with occupational stress-related disorders will be described. Two case histories typical for mental health disease with burnout syndrome are presented to illustrate the conclusions.     

Die verbale Aktivit?t in therapeutischen Dialogen

The discourse in psychotherapeutic treatment is less specific than usually expected so the question arises whether different therapy methods are different in the style of communication. In this study the verbal activity and other characteristics of the discourse of therapist and patient for sessions from two psychoanalytic, two psychodynamic and two cognitive behavior therapies were compared. Psychoanalytic therapists were found to talk the least and behavior therapists the most. Patients talk nearly the same amount in all therapies. As therapists of psychoanalytic treatment talk less than behavior therapists the percentage of patient talking is highest in psychoanalytic therapy. Further formal characteristics: statements are the most frequent form of intervention in behavior therapy (51?%), followed by psychodynamic (36?%) and psychoanalytic therapy (27?%). The most frequent form of intervention in psychodynamic and psychoanalytic therapy is listening, whereas it is only a small part of communication in behavior therapy. Questions are asked most often in behavior therapy. Hence there are significant differences which correspond to the theory of treatment, between the three methods in discourse behavior on a single case level.     

Werkzeugkasten des psychodynamischen Psychosetherapeuten

The authors describe the modification of the classical psychoanalytic treatment technique, which was developed in the past decades to treat people with schizophrenic psychosis. The technique which can be used in modified psychoanalytic as well as other psychodynamic settings, was adjusted to the specific problems which occur in the psychotherapy of patients with schizophrenia. This specific modified psychotherapy deals with a paradigmatic experience in the therapeutic relationship to reduce traumatic fear and to overcome interpersonal and intrapsychic dilemmas. This modification increases the possibility to reconstruct the personal history of the psychosis in a dialogical process together with the patient.     

ASSESSING AND PROGRAMMING GENERALIZED BEHAVIORAL REDUCTION ACROSS MULTIPLE STIMULUS PARAMETERS

Generalization across three stimulus parameters was examined for 5 individuals whose self-injurious behavior was maintained by escape from task demands. Prior to treatment, three stimulus parameters (therapist, setting, and demands) were systematically varied across baseline sessions. These variables were held constant during treatment, which consisted of escape extinction. When treatment was completed, three novel stimulus parameters were probed. If the rate of self-injury was high during this probe, treatment was reimplemented with one new stimulus parameter (the other two were the same as in the original treatment condition). Following this second treatment, another probe with three novel stimuli was conducted. If the rate of self-injury was again high, treatment was implemented again while a second stimulus parameter was changed. This sequence continued until generalization was observed across the three parameters. Results showed idiosyncratic differences in generalization. The behavior of 2 subjects showed complete generalization during the first novel probe. A 3rd subject's behavior showed generalization following treatment across two stimulus parameters (setting and therapist). The behavior of the 2 remaining subjects showed a complete lack of generalization across the three parameters; both subjects required training for novelty by randomly varying the stimulus parameters for a substantial number of sessions.     

AN ANALYSIS OF THE REINFORCING PROPERTIES OF HAND MOUTHING

Hand mouthing often has been described as a stereotypic response that is maintained by non-social (automatic) reinforcement; however, data supporting this conclusion can be found in relatively few studies. This series of studies presents an experimental analysis of conditions associated with the maintenance of hand mouthing. In Experiment 1, a functional analysis was conducted for 12 individuals who engaged in chronic hand mouthing to determine whether the behavior is usually maintained independent of social contingencies. Results obtained for 10 subjects were consistent with an automatic reinforcement hypothesis; the remaining 2 subjects' hand mouthing was maintained by social-positive reinforcement. Based on these results, Experiment 2 was designed to identify the specific reinforcing properties of hand mouthing. Each of 4 subjects was provided with a toy that substituted for hand mouthing, and preference for a specific topography of toy manipulation (hand-toy contact or mouth-toy contact) was measured. Results indicated that hand stimulation was the predominant reinforcer for all subjects. Experiment 3 provided an extension of Experiment 2 in that the same responses were measured across a variety of toys presented to each of 5 subjects. Results again indicated that hand stimulation was the predominant reinforcer for all subjects. Implications of these results are discussed with relevance to treatment.     

Reinforcement magnitude: an evaluation of preference and reinforcer efficacy

Consideration of reinforcer magnitude may be important for maximizing the efficacy of treatment for problem behavior. Nonetheless, relatively little is known about children's preferences for different magnitudes of social reinforcement or the extent to which preference is related to differences in reinforcer efficacy. The purpose of the current study was to evaluate the relations among reinforcer magnitude, preference, and efficacy by drawing on the procedures and results of basic experimentation in this area. Three children who engaged in problem behavior that was maintained by social positive reinforcement (attention, access to tangible items) participated. Results indicated that preference for different magnitudes of social reinforcement may predict reinforcer efficacy and that magnitude effects may be mediated by the schedule requirement.     

DESCRIPTIVE ANALYSIS OF TEACHERS' RESPONSES TO PROBLEM BEHAVIOR FOLLOWING TRAINING

The procedures described by Sloman et al. (2005) were extended to an analysis of teachers' responses to problem behavior after they had been taught to withhold potential sources of positive and negative reinforcement following instances of problem behavior. Results were consistent with those reported previously, suggesting that escape from child problem behavior may shape and maintain adult behavior that is potentially countertherapeutic.     

Extinction learning, reconsolidation and the internal reinforcement hypothesis

Retrieving a consolidated memory--by exposing an animal to the learned stimulus but not to the associated reinforcement--leads to two opposing processes: one that weakens the old memory as a result of extinction learning, and another that strengthens the old, already-consolidated memory as a result of some less well-understood form of learning. This latter process of memory strengthening is often referred to as "reconsolidation", since protein synthesis can inhibit this form of memory formation. Although the behavioral phenomena of the two antagonizing forms of learning are well documented, the mechanisms behind the corresponding processes of memory formation are still quite controversial. Referring to results of extinction/reconsolidation experiments in honeybees, we argue that two opposing learning processes--with their respective consolidation phases and memories--are initiated by retrieval trials: extinction learning and reminder learning, the latter leading to the phenomenon of spontaneous recovery from extinction, a process that can be blocked with protein synthesis inhibition.