Augmentation of in vivo exposure treatment for agoraphobia by the formation of neighbourhood self-help groups

The advantages of selecting agoraphobic patients for treatment by group exposure according to their residential geographic neighbourhood were evaluated in terms of facilitation of ‘homework’ practice and increased social contact. Both ‘zoned’ and ‘unzoned’ groups showed gains in ability to perform hierarchy items after 11 sessions of exposure, relative to a no-treatment control group. However only zoned subjects showed significant reductions in experienced anxiety when executing such items. Self-ratings of overall phobic severity also suggested a zoned group was superior to unzoned while assessors' ratings indicated both groups as equally improved. Only zoned subjects showed a significant increase in social range. Improvements were maintained at 3-months follow-up. No effect of treatment was found on either the Zung measure of anxious mood or on social integration.These results suggest that, where practical, zoning might offer the means for desirable continuation of intensive clinic-based group treatment as well as the benefit of extending treatment into the patients' environment as in home-based treatments. Crucial levels of group cohesion might also be increased although therapists should be prepared to negotiate resistance to a socially demanding programme from patients with significant additional social phobias.     

Measurement of sexual arousal in several paraphilias: The effects of stimulus modality,instructional set and stimulus content on the objective

The effects of instructional set (become aroused or suppress arousal), stimulus modality (videotape, audiotape, slides, free fantasy) and stimulus content (paraphilic or non-paraphilic) on sexual arousal, as measured by penile plethysmograph, of six different groups of paraphilics, pedophiles, rapists, exhibitionists, homosexuals, sado-masochists and fetishists, were determined. The results showed significant main effects of instructional set and of stimulus modality (videotape was clearly more arousing) as well as several complex interactions of diagnostic group with the other independent variables.     

Client,Treatment, and Therapist Variables Related To Outcome in Brief,Systems-Oriented Family Therapy

Client, therapist, and treatment characteristics were examined with respect to how much of the variance they could account for in a variety of outcome measures. Multiple regression analyses were used to examine relationships among each of the client, therapist, and treatment characteristics studied and the various outcome measures. For the 219 families that were treated with brief family therapy, only a relatively low amount of variance in any of the outcome measures could be accounted for. The amount of explained variance, however, varied considerably from one outcome measure to the other. When the more homogeneous groups of clients (single parents or adolescent identified patients) were considered, the amount of explained variance generally showed an increase. Different sets of client, therapist, and treatment variables accounted for the variance in these outcome measures across client groups, demonstrating both the complexities of the relationships and the relative independence of various outcome measures. New variables are suggested for future research.     

Engaging “Resistant” Families in Treatment

Many families, when presented with the option of family therapy, are less than eager to participate. This paper comprises the second and third parts of a series on engaging “resistant” families. ¹ 1 The first paper in this series, authored by J. M. Van Deusen, M. D. Stanton, S. M. Scott, and T. C. Todd, is entitled “Engaging “Resistant” Families in Treatment: I. Getting the Drug Addict to Recruit His Family Members” and appeared in the International Journal of the Addictions 15 (7): 1069–1089, 1980. A revised and expanded version of Part II is presented in M.D. Stanton, T. C. Todd, and Associates, The Family Therapy of Drug Abuse and Addictions New York, Guilford, in press.
Part II presents 21 principles and a number of techniques and strategies that have been developed for successfuly recruiting such families. These techniques should be applicable for engaging resistant families with all types of presenting problems. Part III provides an analysis of the important variables involved, along with data on cost efficiency and administrative costs. It was found that when therapists had administrative control of their cases, serving in dual roles as both therapists and drug counselors, the recruitment effort was (a) more effective (i.e., complete families, including both parents or parent surrogates, were recruited in 77 per cent of the cases), and (b) twice as cost efficient. Two-thirds of the non-engaged families were not recruited because the index patient would not allow family members to be contacted. Black families were more difficult to recruit than whites. Data on cost efficiency and on the actual administrative costs of recruiting families are also provided. We conclude that the engagement process requires a revision in therapeutic philosophy, since such families are often desperately in need of help but are unavailable unless therapists make a special effort to reach them.     

Design and implementation of a microcomputer-based adaptive testing system

Adaptive testing is a relatively new form of test administration in which a test is tailored to the individual taking it by choosing items most informative about that person. Methods for determining which items are most appropriate take on a variety of forms, some requiring extensive computation, and almost all requiring administration by a computer. The increasing availability of inexpensive microcomputer systems has made adaptive testing possible when access to larger computer systems is impractical. To make implementation of a variety of adaptive testing methods feasible on a microcomputer, a system efficient from both the examinee’s and the test constructor’s perspectives is necessary. This paper begins by briefly outlining the strategies of adaptive testing developed to date and showing how, structurally, they can be grouped into three general categories. Considerations in design of a test-specification subsystem are then discussed as they relate to this categorization. Finally, a specific implementation of a subsystem for use under the CP/M microcomputer operating system is described. Techniques used to make the extensive computations required by adaptive testing feasible on a microcomputer are presented.     

Integrality over different paradigms: Card sorting and two-stimulus matching

Orthogonal interference—indicating the cohesiveness between geometrical dimensions—was examined using two separate tasks: (1) card sorting and (2) two-stimulus matching requiring same/different responses. The card-sorting results of the present experiment were contrasted with the results of our previous research (1977, 1979) which used the two-stimulus matching task. Results were generally similar in that the orthogonal interference and, consequently, the degree of integrality/separability were the same for both tasks. Evidence was found for the emergence of a new nominal dimension. This and other results are only compatible with a weaker form of the global-to-local hypothesis of perceptual processing.