Treatment of alcoholic couples in outpatient group therapy

This paper summarizes special issues that group leaders are likely to encounter when adapting their skills to outpatient group therapy with alcoholic couples. More specifically, the paper: (a) discusses the advantages of treating alcoholic couples in a group as opposed to individual couple's therapy; (b) outlines the parameters of a couples group with alcoholic members that differentiate it from working with other kinds of couples in group; and (c) provides guidelines and techniques for tackling some of the specific kinds of problems and situations that arise.This paper was presented at the Annual Meeting of the American Group Psychotherapy Association, New York City, February, 1985.The author wishes to acknowledge the contribution of Geraldine Alpert, Ph.D., whose thoughtful comments and discussion helped to crystallize the concepts presented.     

Use of nonsexist pronouns as a function of one's feminist orientation

Subjects of both sexes were shown several sentences that contained a blank space where a third-person singular pronoun should be, and were asked to indicate what pronoun they would choose to complete the sentence. Some sentences referred to traditionally masculine positions (e.g., lawyer), some referred to traditionally feminine positions (e.g., secretary), and some referred to positions with generic titles (e.g., spokesman). As hypothesized, subjects with high scores on Spence and Helmreich's (1972) Attitudes toward Women Scale (AWS) chose nonsexist pronouns more frequently on all three types of sentences than did subjects with low AWS scores. Less feminist trends in the subjects' pronoun choices are discussed.     

Physical stigma and the pregnancy role: Receiving help from strangers

Previous research has demonstrated several similarities in the reaction of others to pregnant and to physically stigmatized individuals. This study recorded helping behavior (assistance in picking up scattered keys) directed toward an apparently pregnant, nonpregnant, or facially disfigured woman in an elevator either alone, with a female companion, or with a male companion. A predicted interaction revealed that significantly more assistance was given to the pregnant woman than to either of the other two only when she was alone or with a female companion; she was helped less than the non-pregnant experimenter when she was accompanied by a male. Differences and similarities in the norms that govern behavior toward pregnant women and the physically stigmatized are discussed in light of their relevance to women's development during the childbearing years. The well-documented negative effect of group size on helping was replicated. Unexpected sex differences were found in rate of helping. Women virtually never helped in this situation—even in all-female groups. These findings are discussed in light of previous work on sex differences in helping.Preparation of this article was supported by a faculty development grant awarded to the first author by Rhodes College. We wish to thank Bella DePaulo, Robert Vidulich, and Chris Wetzel for their helpful comments on an earlier draft of the paper.     

Bulimia nervosa and dietary restraint

Patients with bulimia nervosa were compared with non-bulimic restrained and unrestrained eaters on several questionnaire and interview measures related to eating patterns, preoccupation with dieting and food, and general psychopathology. Bulimic subjects did not differ significantly from non-bulimic restrained eaters on measures of fear of weight gain, dietary restraint, and the Eating Disorders Inventory (EDI) subscales of Drive for Thinness and Body Dissatisfaction, although both groups scored significantly higher on these measures than unrestrained eaters. Subjects with bulimia nervosa differed significantly from both restrained and unrestrained eaters on the Eating Habits Checklist, the Beck Depression Inventory, the EDI total score and Interoceptive Awareness, Introversion and Bulimia subscales, the Three Factor Eating Questionnaire (TFEQ), Disinhibition subscale and the Symptom Checklist 90-revised version. These findings show that bulimic patients may be quite similar to their restrained, non-bulimic counterparts on dietary concern and ideals of slenderness and suggest the importance of including a restrained control group in attempts to isolate the variables that differentiate individuals with the clinical eating disorder from their peers who demonstrate normative discontent about body weight and shape.     

IMPROVING RESIDENTIAL TREATMENT SERVICES: IMPLEMENTATION AND NORM-REFERENCED EVALUATION OF A COMPREHENSIVE MANAGEMENT SYSTEM

Ensuring effective service delivery by direct-care personnel in institutional living units for persons with developmental disabilities historically has been a difficult process, despite considerable attention from researchers, service providers, and governmental regulatory agencies. In this investigation, we conducted a normative evaluation of the extent and quality of treatment services currently provided in residential living units (Experiment 1) and evaluated a comprehensive management system designed to improve such services (Experiment 2). Results of the first experiment, encompassing 22 living units in three states, indicated that on the average two thirds of observed resident behavior did not involve any therapeutic activity. The results also provided social validity for the criteria used to evaluate the quality of treatment provision based on opinions of mental retardation professionals. Results of the second experiment indicated that a behavioral management program implemented during 23 separate time periods across five living units was accompanied by consistent and durable decreases in resident nontherapeutic activity as well as increases in specifically designated habilitative activity. The results provide support for the successful incorporation of behavioral management technology into human service settings on a large-scale, long-term basis.     

Inferential theory for partially disattenuated correlation coefficients

Four measurement designs are presented for use with correlation coefficients corrected, in one variable, for attenuation due to unreliability—coefficients that we term partially disattenuated correlation coefficients. Asymptotic expressions are derived for the variances and covariances of the estimates accompanying each design. Empirical simulation results that bear on the preceding mathematical developments are then presented. In addition to providing insights into the distributions of the estimates, the empirical results demonstrate satisfactory Type I error control for typical inferential applications. Power is shown to be equal to or greater than that of corresponding product-moment correlations in three of the four designs. Implications for practice are discussed.Support for the research reported in this article was provided by the Natural Sciences and Engineering Research Council of Canada. The authors acknowledge with thanks the contributions of Nancy E. Heckman to some of the theoretical aspects of the study.     

Dynamically oriented group therapy with alcoholics: Making it work despite the prevailing bias

A bias exists in the psychiatric community against dynamically oriented group therapy with alcoholics. The basis for this bias lies primarily in negative experiences of practitioners who have attempted to use traditional therapy with alcoholic patients who continued to drink. At Appleton Outpatient Clinic, we have found that dynamically oriented group therapy is a highly suitable treatment modality for alcoholic patients when negative biases of treators can be addressed and when initial preparatory work is done with patients. This preparatory work includes: (a) building a working alliance around abstinence and providing adequate supports to make this possible; (b) explicit contracting that establishes clear treatment goals and consequences should the goals not be met; (c) preparatory short-termgroup experiences.This paper was presented at the 1988 annual meeting of the American Group Psychotherapy Association.