Group analytic therapy with schizophrenic outpatients

This paper describes a model for group analytic psychotherapy with patients who have been psychotic, namely, schizophrenics and manic depressives. The groups are run on the group centered principles of S. H. Foulkes. They are continuous, slow-open groups, in line with these patients' needs for long-term therapy. A theory is proposed which justifies treating these patients in group-centered groups despite their great dependency needs. The paper also describes the task of the therapist in building and running such a group.Acknowledgments to Geoffrey Elkan, Marcia Levene, Noa Rotem, Aya Levi-Posnanski, Yossi Ezrati, S. Littman, Tamar Sternberg, E. Danilowitz, and C. Kauffman.     

Self-Monitoring negative statements

We examined the effects of a self-monitoring program on reducing the frequency of negative statements of a student with mild mental retardation who was enrolled in a self-contained classroom at a middle school. A changing criterion design was used within a multiple baseline design across two classroom periods. Additionally, the frequency of positive statements was reported. The results showed a decrease in the number of negative statements, and an increase in the number of positive statements. Maintenance data collected up to 8 weeks after the program ended indicated that the student continued to emit positive rather than negative statements. The use of this procedure to decelerate undesirable behavior is discussed.     

Family preservation using multisystemic treatment: Long-term follow-up to a clinical trial with serious juvenile offenders

In a randomized clinical trial, multisystemic family preservation was shown to significantly reduce rates of criminal activity and incarceration in a sample of 84 serious juvenile offenders and their multi-need families. In the current study, archival records were searched for re-arrest an average of 2.4 years post-referral. Survival analysis showed that youths who received multisystemic family preservation were less likely to be re-arrested than were youths who had received usual services. Such results represent the first controlled demonstration that family preservation, when delivered via a clearly specified treatment model, has lasting effects with serious juvenile offenders. Implications for family preservation and juvenile justice research are discussed.     

Nonsuicidal physically self-damaging acts in adolescents

To determine the frequency and correlates of nonsuicidal physically self-damaging acts in 12–14 year olds, a two stage epidemiologic survey with a self-administered questionnaire (N=3283) followed by a psychiatric interview of a subsample of the adolescents and their parents (N=444) was used. Prevalence estimates of interview validated nonsuicidal physically self-damaging acts were 2.46% in males and 2.79% in females. Significant relationships were found between nonsuicidal physically self-damaging acts and suicidal ideation, major depression and undesirable life events. Data suggest that physically self-damaging acts occur at substantial rates during early adolescence. The strong correlation between nonsuicidal self-destructive acts and both suicidal ideation and major depression clarifies prior conflicting reports in the literature and suggests that a history of self-damaging acts should be taken into consideration when evaluating for possible depression and suicide risk.     

The aggression-coercion cycle: Use of seclusion and restraint in a child psychiatric hospital

The widespread use of seclusion and restraint in child psychiatric hospitals to manage aggression and noncompliance is based on the assumption that coercive consequences reduce the frequency of undesirable behaviors exhibited by the patients. We report a study of the use of seclusion and restraint in a public child psychiatric hospital during a 3-year period. Twenty-eight percent of the patients had been secluded or restrained a total of 1670 times. About 25% of these patients had been secluded more than five times during their hospitalization, and 32% had been placed in restraints more than once. Behaviors that typically resulted in repeated seclusion included physical aggression toward staff, verbal aggression toward peers, non-compliant or oppositional behavior, and self-harm. Variables that predicted patients most at risk for repeated seclusion included age, gender, and psychiatric diagnosis. The predictor variables for those most at risk for repeated restraint included age, property destruction, and self-harm. The high rates of use of seclusion and restraint suggest that these methods for controlling the behavior of children and adolescents in this child psychiatric hospital may not have been therapeutic. We suggest that staff in such hospitals engage in a pattern of behavior characterized by an aggression-coercion cycle, in which increasingly aggressive and coercive behaviors are exhibited by both patients and staff.     

Development of knowledge bases and the reliability of a decision support system for behavioral treatment consultation for persons with mental retardation: The Mental Retardation-Expert

The development of expert and decision support systems requires the collection, organization, codification, and storage of a body of specialized knowledge. The development, using reconstructive methods, of two such knowledge bases, the first containing the current scientific literature and the second containing an expert’s knowledge, is described for an automated decision support system, the Mental Retardation-Expert. This system provides practitioners with assistance in the treatment of aggressive, self-injurious, and destructive behaviors displayed by individuals with mental retardation or developmental disabilities. The average interobserver reliability of the expert knowledge base ranged from 92.5% to 95.0% when calculated across four clinicians’ assessments of 31 abstracted cases.     

Evaluating student achievement with a relational database

Commercial database programs such as dBase and Paradox, although developed originally for business applications, are versatile and powerful tools that can be used for an academic purpose such as evaluating student performance. They can be used to write and store test questions, assemble and print classroom or on-line laboratory tests, and calculate grades, test statistics, and so forth. Databases are flexible, unlike textbook “ancillary” test bank programs that are inextricably bound to the strictly linear format and brief shelf life of specific textbook editions. A prototypical relational database program is described, with which an instructor can produce tests based on generic terms adapted from Boneau’s (1990) study of psychological literacy, as well as on behavioral learning objectives adapted from Bloom’s (1956) taxonomy of educational objectives. As a relational database, the program integrates terms, objectives, questions, tests, and test scores, and avoids unnecessary data duplication and waste of computer storage space.     

Calibration of a color monitor for visual psychophysics

It has become common for stimuli used in visual psychophysical experiments to be presented on high-resolution color cathode-ray tubes (CRTs) such as the Barco CDCT 6551. These enable a flexibility of color, spatial-frequency content, temporal-frequency content, duration, size, and position that is not provided by most other media. CRTs are, however, not perfect; they suffer from the effects of temporal instability, spatial variability, lack of phosphor constancy, gun interdependence, and gun nonlinearity. This paper describes methods of assessing these aspects of monitor performance with respect to how significant each may be in psychometric terms. Although every application of CRT use in visual psychophysics is different, some general rules can be formulated to help ensure that unwanted effects are kept to a minimum. For the CRT used in this study (Barco CDCT 6551), a warm-up time of 30-45 min is necessary before chromatic and luminous stability ensues. Restriction of individual gun outputs to within 10%-90% of the possible range ensures that the effects of gun interdependence and lack of phosphor constancy are negligible. Calibration methods dealing with the linearization of gun output are also discussed.