Improving our understanding of therapeutic failure: A review

This paper argues the need to consider carefully the phenomenon of therapeutic failure in counselling and psychotherapy. The scant literature on therapeutic failure is reviewed, this literature suggests that there are large individual differences in therapists' overall effectiveness. A conceptual model of therapeutic failure is proposed, organized around the assumption that failure results from a therapist's inability to meet the needs of a particular client. Suggestions aimed at reducing the likelihood of therapeutic failure are offered.     

Male-female differences in sexual fantasy

A questionnaire about thoughts and ideas during sexual activity was returned by 51 females and 50 males in a random sample of college undergraduates. A high response rate (91%) and the similar sexual experience of male and female respondents make possible a strong conclusion about the college population sampled: Males are thinking more about past experiences and current behavior, while females are thinking more of imaginary experiences. This difference occurs for thoughts during masturbation as well as for thoughts during heterosexual activity. It appears that females prefer a different kind of sexual fantasy than males, rather than being generally less interested in sexual fantasy as claimed by Kinsey, Pomeroy, Martin, and Gebhart (Sexual behavior in the human female, Philadelphia: Saunders, 1953).     

Tripartite model of anxiety and depression: psychometric evidence and taxonomic implications

We review psychometric and other evidence relevant to mixed anxiety-depression. Properties of anxiety and depression measures, including the convergent and discriminant validity of self- and clinical ratings, and interrater reliability, are examined in patient and normal samples. Results suggest that anxiety and depression can be reliably and validly assessed; moreover, although these disorders share a substantial component of general affective distress, they can be differentiated on the basis of factors specific to each syndrome. We also review evidence for these specific factors, examining the influence of context and scale content on ratings, factor analytic studies, and the role of low positive affect in depression. With these data, we argue for a tripartite structure consisting of general distress, physiological hyperarousal (specific anxiety), and anhedonia (specific depression), and we propose a diagnosis of mixed anxiety-depression.     

Treatment of panic attacks using cognitive therapy without exposure or breathing retraining

Cognitive treatment of panic attacks is based on the hypothesis that panic results from the catastrophic misinterpretation of bodily sensations, and that changing such misinterpretations will block the occurrence of panic. The treatment normally involves an integrated set of cognitive and behavioural techniques. In a consecutive series of panic patients, a multiple baseline across subjects design was used to investigate whether a modified form of treatment involving only cognitive procedures could reduce panic attack frequency. The results provide preliminary evidence that cognitive procedures directed at changing misinterpretations of bodily sensations can reduce panic attack frequency, and also that cognitive procedures which do not target misinterpretations may not reduce panic.     

Visible persistence following a brief increment in stimulus luminance

In previous studies, it has been demonstrated that visible persistence--the period for which the perceived duration of a stimulus exceeds its physical duration--can be extended by briefly incrementing the luminance of the stimulus immediately prior to offset. Using a two-component pattern integration task, we show that this effect is not an artifact of change in the total luminous flux within the stimulus. Visible persistence was unaffected by overall luminance of the stimulus. It was also time-locked to the luminance increment. Visible persistence is seen to result from a process that is initiated by stimulus onset and that can be either wholly or partially reinitiated by the onset of the luminance increment. The duration of this process (which determines the duration of stimulus visibility) can be modified in a graded fashion by stimulus events that occur after its initiation. We outline a single-process inhibitory feedback model of the persistence mechanism that accounts for the present findings.     

The development of therapeutic consultations in child-focused family work

This paper outlines the theoretical influences that have led to our use of a consultation approach to work with children and families. Winnicott's notion of therapeutic consultation, the narrative approach in family therapy, the use of letters in therapeutic work and the two-plus-one model of therapeutic contact are discussed. A model of the consultation interview and process is presented together with examples of consultation letters responding to typical client expectations of the process.     

Formal and Informal Counselling Help: Students' Experiences

The experiences reported by students who sought help from formal counselling sources were compared with those reported by students who sought assistance from informal helpers. The two groups of students had similar types of problems, but the counselling clients reported (a) higher levels of problem seriousness, (b) lower levels of comfort with the interaction, and (c) higher levels of satisfaction with the help offered.     

Personality factors in dysphoria: A psychometric refinement of beck's Sociotropy-Autonomy Scale

The Sociotropy-Autonomy Scale (SAS) was developed as a means of assessing two cognitive-personality constructs postulated as vulnerability factors in depression (Beck, 1983). While studies have confirmed the validity of the SAS Sociotropy Scale, the construct validity of the Autonomy Scale has not been well supported. The present study was conducted to improve on the measurement of autonomy by generating additional items which were added to the original questionnaire. This 93-item SAS was administered to 485 undergraduates along with the Beck Depression Inventory, Beck Anxiety Inventory, PRF Affiliation and Autonomy Scales, Positive and Negative Emotionality Measures, and Marlowe-Crowne Social Desirability Scale. Four factors labeled Sociotropy, Solitude/Interpersonal Insensitivity, Independence, and Individualistic Achievement emerged from a principal-factor analysis of the SAS item pool. Hierarchical multiple regression analyses indicated that positive emotionality and solitude/interpersonal insensitivity were specifically related to dysphoria, while negative emotionality and sociotropy had significant associations with both anxious and depressed mood states.This research was supported by University of New Brunswick Research Grant 22–51 awarded to the first author.