Comparing Alliance in Two Cognitive-Behavioural Therapies for Adolescents With ADHD Using a Randomized Controlled Trial

Alliance is defined as the client-therapist bond and their ability to collaborate on therapeutic activities. Treatment for adolescents with ADHD is rarely studied in terms of alliance. In this study, two cognitive-behavioral treatments (CBT; one structured treatment aimed at planning skills and one less-structured solution-focused treatment, both delivered in the style of Motivational Interviewing) were compared with regard to alliance and alliance-outcome association. The influence of therapist competence on this alliance-outcome association was also evaluated. The alliance between 69 adolescents diagnosed with ADHD and their therapists was measured early in treatment, using the Therapy Process Observational Coding System for Child Psychotherapy–Alliance scale. Observer-rated therapist competence was measured using the Motivational Interviewing Treatment Integrity scale (version 3.1.1.). Outcome variables were the adolescents’ reduction in planning problems and ADHD symptoms. The alliance, and, more specifically, collaboration on therapeutic activities, was significantly higher for the more structured CBT (p = .04; moderate effect size). Alliance was not related to outcome in the more structured CBT, while the alliance was positively related to the reduction in planning problems in the less structured CBT. Finally, alliance was a significant mediator between therapist competence and treatment outcome for the less-structured CBT. The clarity and structure of CBT may help facilitate alliance formation for adolescents with ADHD who often have difficulty implementing structure themselves. Therapists may need to invest more in alliance formation in less structured CBT as the alliance affects outcome. Moreover, enhancing therapist competence in less structured CBT may help improve outcomes in less structured CBT, as therapist competence may impact outcome through alliance.     

How effective is workplace counselling? A review of the research literature

The provision of counselling for work‐related problems has expanded in recent years, as organisations have recognised the value of this approach to staff support. However, there has been relatively little research into the outcomes of workplace counselling, and no systematic reviews have been conducted into the effectiveness of counselling in this setting. This paper presents the results of a preliminary review of evidence in this area. 34 studies of the effectiveness of workplace counselling were identified, of which 16 were sufficiently well designed to be considered as comprising reliable findings. The results of these studies suggest that, in general, workplace counselling is effective for clients for a wide variety of type and severity of presenting problems, employed across a range of different organisational contexts. The paper includes discussion of methodological issues associated with this research, recommendations for further research, and implications for practice.     

An administratively created reality: Some problems with the use of self‐report questionnaire measures of adjustment in counselling/psychotherapy outcome research

Outcome research in counselling and psychotherapy has come to rely heavily on the use of self‐report questionnaire measures of anxiety, depression and general symptomatology. The validity of these measures in the context of psychotherapy research has, in general, been taken for granted. This paper proposes that, despite the success of self‐report questionnaires in personality research and personnel selection, there are significant problems involved in the use of these methods in research into therapeutic change. Specifically, three areas of difficulty are reviewed. First, questionnaires are completed in a social setting that itself changes as a result of therapy. Second, the experience of psychotherapy changes the way that clients make sense of questionnaire items (the ‘response shift’ phenomenon). Third, the conceptualisation of the person implicit in questionnaire design is not compatible with the conceptualisation of persons espoused by most contemporary therapeutic approaches. It is argued that the continuing popularity of self‐report questionnaires can be understood in terms of Kurt Danziger's model of the social construction of psychological knowledge.     

'This is our life': strong evaluation in psychotherapy narrative

This paper examines the relevance of both client and counsellor conceptions of the ‘good life’ in relation to a narrative analysis of the first session of a case of successful client-centred therapy.In this opening session, the client embeds her ‘problem’ story within contrasting cultural narratives of what it means to live a good life. The therapist discourse also consistently draws upon a therapeutic meta-narrative that conveys an implicit story of how to live life well. This material is discussed from the perspective of the concept of ‘strong evaluation’ offered by the philosopher CharlesTaylor.Implications for research and practice are discussed.     

Visual reaction time and high-speed ball games

Laboratory measures of visual reaction time suggest that some aspects of high-speed ball games such as cricket are 'impossible' because there is insufficient time for the player to respond to unpredictable movements of the ball. Given the success with which some people perform these supposedly impossible acts, it has been assumed by some commentators that laboratory measures of reaction time are not applicable to skilled performers. An analysis of high-speed film of international cricketers batting on a specially prepared pitch which produced unpredictable movement of the ball is reported, and it is shown that, when batting, highly skilled professional cricketers show reaction times of around 200 ms, times similar to those found in traditional laboratory studies. Furthermore, professional cricketers take roughly as long as casual players to pick up ball flight information from film of bowlers. These two sets of results suggest that the dramatic contrast between the ability of skilled and unskilled sportsmen to act on the basis of visual information does not lie in differences in the speed of operation of the perceptual system. It lies in the organisation of the motor system that uses the output of the perceptual system.     

Cooperative behavior as a function of interpersonal style in preschoolers

A study of the effectiveness of preschoolers interpersonal interactions was conducted based upon a circumplex model of interpersonal behavior and the corollary complementarity hypothesis developed by Leary (1957) and Carson (1969) The interpersonal styles of 92 preschoolers' interpersonal interactions was rated in a naturalistic free-play environment These ratings were used to obtain status and affiliation scores for each child which, in turn, were the basis for assigning subjects a complementary or an anticom-plementary partner It was predicted and found that complementary pairs performed a difficult puzzle task more efficiently than did anticomplementary pairs The usefulness of the complementarity hypothesis and implications for its use in future research were discussed     

Communication Patterns in an International Student Dormitory: A Modification of the “Small World” Method1

Milgram's “small world” method was modified to trace communication patterns in an international student dormitory containing 500 residents from 38 different countries. Eighteen residents served as “starters” for chain-booklets that circulated through the dormitory from friend to friend. Social networks were inferred from the circulation pattern of booklets. Sixteen chains progressed beyond their respective starters, and a total of 86 transactions were recorded. Four determinants of social relations were investigated: culture similarity, sex, organizational affiliation, and residential propinquity. The circulation pattern of the booklets showed that culture similarity was a major determinant of social interaction among the residents. The other main determinant was sex similarity. Organizational affiliation was less important, and proximity played only a minor role in determining communication patterns in the dormitory.     

Optic-flow and cognitive factors in time-to-collision estimates

Time-to-collision (Tc) estimates were obtained from twenty-four subjects who viewed film clips for varying lengths of time. The film clips showed the view from a moving car travelling towards a stationary target car, but ended 100 m before reaching the target. Viewing time varied from 2 to 6 s, approach velocity from 40 to 100 km h-1, and Tc from 3.6 to 9.0s. It was hypothesised that, if time were needed to calculate Tc, the accuracy of Tc estimates would increase with viewing time up to some maximum. However, the results showed no effect of viewing time, and this was taken to indicate that estimates were based upon information directly available from the changing optic array at the eye of the observer. A significant velocity effect was found, accuracy increasing with velocity. Since velocity was inversely correlated with Tc, this probably implies that accuracy decreases with increasing Tc. Sex differences were found, with males giving higher and more accurate estimates than females. The relevance of these findings to the nature of Tc information is discussed.     

Describing behavior in small groups with the Datamyte event recorder

A technology for coding and analyzing behavior in human groups is described. The behavior code is based on the scoring of verbal and physical contacts, emotional affect, and commands and complies. The code is reasonably valid and produces sufficiently high levels of observer agreement. Currently available computer programs for analyzing frequencies, rates, and proportions of behavior, as well as equity and reciprocity in behavioral transactions, are discussed. The development of programs for analyzing more microscopic features of interaction is also noted.