Exploring Counselor-Client Agreement on Clients’ Work Capacity in Established and Consultative Dyads

Counselor-client agreement on the work capacity of clients living with serious mental illnesses informs the counseling relationship and facilitates accurate assessments of client eligibility for public programs. In this exploratory mixed-methods study, we assessed counselor-client agreement on clients’ work capacity in 61 established therapeutic dyads and compared it with 30 dyads involved in an initial assessment session. Intraclass correlation coefficients and mountain plots were used to examine counselor-client agreement. Results revealed moderate counselor-client agreement of work capacity for both dyads. Counselor interviews illuminated sources of discordance. These results have practical implications for assessing the work capacity of clients.     

A free and simple computerized screening test for visual field defects

About 30–40% of stroke patients suffer from visual field defects following injury. These can interfere with the standard neuropsychological assessment and complicate the interpretation of tests that use visual materials. However, information about the integrity of a patient's central visual field is often unavailable. We, therefore, designed a screening tool, the computerized visual field test (c‐VFT), specifically targeted at providing easily available, but rough, information about patients' central visual field. c‐VFT was tested in two samples of stroke patients. Eleven patients were tested on c‐VFT and on the Esterman test. Five patients were tested on c‐VFT and the Humphrey Visual Field Analyzer (HFA), central 10‐2. Criterion validity of the c‐VFT was investigated by calculating quadrantwise intraclass correlation for both comparisons. For the HFA comparison, we also calculated point‐to‐point intraclass correlation, sensitivity, and specificity. Analyses revealed moderately good correspondence between c‐VFT and the Esterman test, and between c‐VFT and HFA 10‐2, respectively. When looking specifically at test points within one degree of visual angle apart in the two tests, intraclass correlation increased. For these points, the sensitivity of c‐VFT was 0.89 and specificity was 0.97. While the c‐VFT is not designed to be diagnostic nor to replace the detailed visual field analysis, this study shows that it provides a reasonable screening of the central visual field. The test can easily be used and will be made freely available to neuropsychological clinicians and researchers.     

SOCIAL-SKILLS TRAINING TO MODIFY ABUSIVE VERBAL OUTBURSTS IN ADULTS

Social-skills training was used to modify abusive verbal outbursts displayed by two adult psychiatric patients. Five target behaviors—looking, irrelevant comments, hostile comments, inappropriate requests, and appropriate requests were monitored during role-played situations. Social-skills training, consisting of behavior rehearsal with modelling, focused instructions, and feedback, was introduced in a multiple-baseline design across individuals. Training improved all target behaviors. The improved behavior generalized to: (1) novel scenes role-played with the original respondent, (2) training and novel scenes role-played with a different respondent, and (3) interpersonal situations on the hospital ward.     

A tachistoscopic software system for use in remote timesharing applications

A program is described that permits the use of an Imlac PDS-1 display computer, in conjunction with a host timeshare system, as a software-controlled tachistoscope. Alphanumeric and graphic message strings are received from the host computer over a telephone line, and are then displayed for specified periods of time in sequence. The display computer records the S’s responses and reaction time and reports this information back to the host computer for recording and analysis. The system is designed so that the burden of software development for the realization of a specific experimental plan is shifted to the large-capacity host machine, and it can utilize all of the features of standard FORTRAN as implemented on the host computer system.     

MODIFYING HOW PEOPLE SMOKE: INSTRUCTIONAL CONTROL AND GENERALIZATION1

The modification of smoking behavior usually involves the target goal of total abstinence. However, many smokers are unable or unwilling to quit completely. An alternative is to teach people to smoke in ways that minimize the associated health risks. Such an approach would involve decreasing smoking rate, switching to “safer” tobacco products, and modifying the topography of consumption. Previous research has shown that topographical components of smoking behavior such as puff frequency, puff duration, cigarette duration, and amount smoked can be reliably measured and experimentally manipulated (Frederiksen, Miller, and Peterson, Addictive Behaviors, 1977, 2 , 55–61). Further, there is preliminary evidence from a single-subject experiment that topography can be changed in clinically relevant directions and that such changes can generalize to the smoker's natural environment (Frederiksen and Simon, Behavior Therapy, in press). To replicate and extend these findings, three single-subject experiments were conducted. In each experiment, verbal instructions to modify individual components of smoking topography were sequentially introduced using a multiple-baseline design across components. The components of puff frequency and puff duration were modified in three experiments. Cigarette duration was also modified in two experiments. Following the topography change phase, daily smoking rate was stabilized, using a behavioral contracting procedure (Frederiksen, Peterson, and Murphy, Addictive Behaviors, 1976, 1 , 193–196). Generalization was assessed during sessions in which no instructions were given (Subjects 1 and 3) and at six monthly followups (Subjects 2 and 3). For Subjects 2 and 3, data were also available on the amount of carbon monoxide (CO) uptake associated with the consumption of a cigarette (postcigarette CO-precigarette CO). This physiological measure is important because CO and its byproducts constitute a major health risk (Russell, Lancet, 1974, 1 , 254–258). Results showed that instructions were effective in modifying components of smoking topography. These changes generalized to sessions in which no instructions were given and across six months of followup. Daily smoking rate did not increase during topography change nor did smoking topography deteriorate when smoking rate was subsequently stabilized on a behavioral contract. Subjective ratings of smoking enjoyment decreased during topography change for two of three subjects but subsequently returned to baseline levels during followup. The observed topography changes were associated with a decrease in the amount of each cigarette smoked. Mean CO uptake was also reduced from baseline levels of 6.0 ppm and 8.0 ppm (Subjects 2 and 3, respectively) to followup levels of 3.3 ppm and 2.1 ppm. These results replicate and extend previous work and suggest that moderate or “controlled” smoking is an approach that deserves continued attention. The importance of assessing smoking topography and physiological variables, as well as directions for subsequent investigation, are discussed.     

Schedule-induced aggression in humans and animals: A comparative parametric review

Studies of animal and human aggression induced by schedules of reinforcement are reviewed. Parameters reviewed include: schedules, characteristics of induced aggression, subject variables, target variables, and the control or modification of schedule-induced aggression. With the exception of temporal locus of schedule-induced attack, the parameters identified with animal subjects are remarkably similar to those identified with human subjects.     

A propositional analyst’s assistant

A system (PAN) that is designed to assist both the inexperienced and the experienced user in performing propositional analysis is described. The system is implemented in UCSD Pascal on the Apple II and Apple He microcomputers.