Staff and Resident Involvement in a Therapeutic Community: For Better or Worse?

Therapeutic communities are a commonly used context for counseling persons with drug problems or emotional problems and for other populations of clients. The group dynamics of therapeutic communities are very complex. When the staff members of a therapeutic community develop communication problems with one another or when these staff members become overly involved with residents, staff problems almost always have a negative impact on the program of the therapeutic community. This article describes how staff problems can negatively affect the program of a therapeutic community and also relates the kinds of problems encountered in a therapeutic community to the problems encountered in rehabilitation programs in other settings.     

Public transportation training: in vivo versus classroom instruction

This study evaluated a classroom program to teach public transportation usage (bus-riding skills) to retarded persons. Based on a task analysis of specific skills, five retarded male students were taught each of the components of locating, signalling, boarding and riding, and exiting a bus. These skills were taught sequentially, using training procedures consisting of role playing, manipulating the actions of a doll on a simulated model, and responding to questions about slide sequences. Before, during, and after training, subjects were tested on generalization probes in the classroom and in the natural environment. Results of a multiple-baseline design across subjects indicated that up to 12 months after termination of training, each subject exhibited appropriate bus-riding skills on actual city buses. Two other subjects were trained on each skill component in vivo, on city buses, in order to compare the relative effectiveness and efficiency of classroom versus in vivo training. Both of these subjects acquired appropriate bus-riding skills; however, the in vivo training procedure was both more time consuming and expensive than classroom training. These findings further demonstrate the effectiveness and practicality of properly designed classroom training procedures for teaching community survival skills to retarded persons.     

Repetition learning in the immediate serial recall of visual and auditory materials

In 5 experiments, a Hebb repetition effect, that is, improved immediate serial recall of an (unannounced) repeating list, was demonstrated in the immediate serial recall of visual materials, even when use of phonological short-term memory was blocked by concurrent articulation. The learning of a repeatedly presented letter list in one modality (auditory or visual) did not transfer to give improved performance on the same list in the other modality. This result was not replicated for word lists, however, for which asymmetric transfer was observed. Inferences are made about the structure of short-term memory and about the nature of the Hebb repetition effect.     

Reflections on the Evaluation of a Cambodian Youth Dance Program

Evaluating a youth program whose goals are to provide instruction in Cambodian dance, increase awareness and pride in Cambodian culture, promote healthy behaviors, and create linkages within the community has been a challenge. A primary source of conflict was incorporating evaluation methods that were required of all funded programs with our own specifically tailored measures. One of our concerns was that the required tools were not culturally appropriate for our participants. Our experiences reinforce the importance of forming partnerships that embrace principles of respect, equity, and empowerment among all involved before establishing a research agenda. The choices we made and did not make contributed to our struggles and frustration and also to the insight that was gained. Our analysis examines the importance of clear communication, cultural awareness, tailoring evaluation, and meaningful participation. We believe that the lessons we learned will help facilitate the conduct of culturally sensitive community-based research.     

Cognitive behavior therapy for fear of flying: sustainability of treatment gains after September 11

This study examines the long-term efficacy of cognitive-behavioral therapy (CBT) for fear of flying (FOF) after a catastrophic fear-relevant event, the September 11, 2001, terrorist attacks. Participants (N = 115) were randomly assigned to and completed treatment for FOF using 8 sessions of either virtual reality exposure therapy (VRE) or standard exposure therapy (SE) prior to September 11, 2001. Individuals were reassessed in June, 2002, an average of 2.3 years after treatment, with a response rate of 48% (n = 55). Analyses were run on the original data and, using multiple imputation procedures, on imputed data for the full sample. Individuals maintained or improved upon gains made in treatment as measured by standardized FOF questionnaires and by number of flights taken. There were no differences between VRE and SE. Thus, results suggest that individuals previously treated for FOF with cognitive-behavioral therapy can maintain treatment gains in the face of a catastrophic fear-relevant event, even years after treatment is completed.     

Virtual reality exposure therapy and standard (in vivo) exposure therapy in the treatment of fear of flying

This controlled clinical trial tested virtual reality exposure (VRE) therapy for the fear of flying (FOF), a relatively new and innovative way to do exposure therapy, and compared it to standard (in vivo) exposure therapy (SE) and a wait list (WL) control with a 6- and 12-month follow-up. Eighty-three participants with FOF were randomly assigned to VRE, SE, or WL. Seventy-five participants, 25 per group, completed the study. Twenty-three WL participants completed randomly assigned treatment following the waiting period. Treatment consisted of 4 sessions of anxiety management training followed either by exposure to a virtual airplane (VRE) or an actual airplane at the airport (SE) conducted over 6 weeks. Results indicate that VRE was superior to WL on all measures, including willingness to fly on the posttreatment flight (76% for VRE and SE; 20% for WL). VRE and SE were essentially equivalent on standardized questionnaires, willingness to fly, anxiety ratings during the flight, self-ratings of improvement, and patient satisfaction with treatment. Follow-up assessments at 6 and 12 months indicated that treatment gains were maintained, with more than 70% of respondents from both groups reporting continued flying at follow-up. Based on these findings, the use of VRE in the treatment of FOF was supported in this controlled study, suggesting that experiences in the virtual world can change experiences in the real world.