Do Cognitive Behaviour Therapies Validate Cognitive Models of Mood Disorders? A Review of the Empirical Evidence

The efficacy of Cognitive Behaviour Therapy (CBT) in the treatment of depression is now established. However, explanations for the efficacy of CBT are mixed. The evidence needed to support the explanation advanced by cognitive theory is lacking. This paper critically reviews the available empirical evidence. Forty-four outcome or process studies of therapy with depression are reviewed and 21 of these are subjected to a meta-analysis to investigate the relationship between change in cognitions and change in level of depression during different kinds of therapy. Our analysis shows that: (1) change in cognitive style occurs in all four categories of treatment: CBT, Drug Therapy, Other-Psychological Therapy, and Waiting List; (2) there was a significant difference between Waiting List and all the active treatments in change in cognitions, but not between active treatments; (3) the degree of change in cognitive style is significantly related to change in depression as measured by the Beck Depression Inventory (BDI), but not the Hamilton Rating Scale for Depression (HRS-D); and (4) the relationship between cognitive change and depression is not unique to CBT. Our findings show that CBT does provide some support for the cognitive models of depression but the relationship between cognitive change and recovery from depression is not unique to CBT.     

Effects of parental alcoholism and life stress on hispanic and non-hispanic caucasian adelescents: A prospective study

Investigated ethnicity and parental alcoholism as factors that might influence the stress vulnerability of adolescents. It extended an initial cross-sectional study of this same sample by adding two annual assessments which allowed for additional cross-sectional analyses and longitudinal tests. Hispanic and Caucasian adolescents (N=306 at Time 1) completed measures of their own life stress, family conflict, and alcohol use. Their parents reported on adolescents' internalizing and externalizing symptoms. Cross-sectional analyses at Time 2, and prospective analyses involving Time 1 and Time 2 measures were, for the most part, consistent with the original study's results. Caucasian adolescents and children of alcoholic parents appeared to be more vulnerable to stress than Hispanic adolescents and children of nonalcoholic parents. Family conflict was a partial explanation for this increased vulnerability. This research was supported by National Institute on Drug Abuse Grant DA05227 to Laurie Chassin (pricipal investigator) and Manuel Barrera, Jr. (coprincipal investigator). Susan Li was supported by an American Psychological Association Minority Fellowship Award. Portions of this research were presented at the conference, “Resiliency in Families: Racial and Ethnic Minority Families in America” that was held at the University of Wisconsin, May 31–June 2, 1994.     

Stories for therapy: The right story to the right person at the right time

In the postmodern information era with its increasing complexity and demands on my time, I find storytelling increasingly attractive. The right story told to the right person(s) at the right time in the right way can powerfully define and shape both individuals and the systems into which they organize themselves. As interventions go, I find stories to be relatively high impact, low-risk, parsimonious, and user-friendly. This paper contains some of my favorite teaching stories and describes why and how I use them as both a family therapist and teacher of family therapy.     

The self-narrative and acute psychosis

The aim of this study was to apply the narrative approach in analyzing family therapy meetings in cases of acute psychosis. The self-narrative is essential in acute psychosis since it is either collapsed or not coherent enough. The results indicate that it is important to create concrete practices that produce stories concerning the patient in relation to others. The self-narrative must be re-authored by the patient even though it is socially constructed. This is achieved by creating multiple perspectives of self-narratives in so-called therapy meetings with the patient, family members, and staff members representing different professionals.     

“Not with me you don't”: A story of narrative practice and dissociative disorder

This paper discusses issues relating to therapeutic practice based upon the narrative metaphor. A case of someone suffering the effects of Dissociative Identity disorder is used to illustrate the difficulties that clients can experience with the “expert” knowledge conception of therapy. The value of the “respectful” and “non-expert” emphasis of Narrative Practice emerges even when the therapist believes that he or she lacks expertise in the client's apparent “condition.” Three themes emanating from the case form the basis for the discussion: the client's experience of being recruited into accepting the diagnostic label of Dissociative Identity Disorder; the effects of being forced to accept a contract to eliminate self-abusive behaviour; and the therapist's dealing with a gun in the therapy room.     

The recovering female alcoholic: A family affair

Supported by a review of relevant literature and a case study, the author argues that family therapy intervention enhances the likelihood of a female alcoholic's positive prognosis. With a basis in systems theory, family therapy views the family as a system and, hence, perceives the alcoholism as a symptom of that family. A profile of the female alcoholic, how her drinking affects her family, and the role that family therapy plays in the recovery process are examined.     

Toward culturally sensitive intervention with arab families in Israel

Over the past three decades, Arab society in Israel has been undergoing processes of transition. These processes are manifested by changes in the economy, education, the status of women, family structure, and by socio-cultural changes and transformations in patterns of coping with social problems. There is a serious lack of empirical research on the implications of this process for the value systems of Arab society and families in Israel and a dearth of relevant intervention-oriented literature. This article outlines the basic cultural values in the Arab society in Israel in an attempt to illuminate the relevance of these values for family structure and for direct interventions with Arab families in Israel.     

Art in existential psychotherapy with couples and families

The authors describe and outline how art can be used in existential psychotherapy to help a couple or family uncover, discover, and make use of the meanings and meaning potentials to be found in marital and family life. In existential psychotherapy with couples and families, art can be used to help the members of the relationship notice meaning potentials in the future, honor meaning potentials that have been actualized and deposited in the past, and discover new ways to actualize meaning potentials in the here and now.     

临床经验对诊断的双重作用及改造

文中用辩证唯物主义的观点,阐述了临床经验的定义、来源及指导实践过程中的意义,指出其具有促进诊断和引起误诊的双重作用,并用临床病历例子详细说明其双重作用的形式、导致结果及产生的原因。指出临床经验的双重作用在临床工作中的重要性及局限性,提出对经验的改造完善途径,以能充分表现出其促进诊断的作用,而最大限度降低其导致误诊的程度,发挥在临床工作中的良性作用。