Age analysis of cognitive-behavioral group therapy for chronic pain outpatients

This study explored the effectiveness, in terms of age of the client, of a 10-week cognitive-behavioral group therapy (stress inoculation training) for chronic pain. A total of 69 outpatients between the ages of 27 and 80 (M = 52.74 years, SD = 14.40) with diverse types of chronic pain were assigned randomly to immediate or wait-list-delayed therapy. Self-report measures of pain, activities, coping, and the use of medications and other physical pain control techniques were obtained at baseline, during therapy, and at 1- and 6-month follow-up. Treatment decreased the degree to which pain interfered with activity, increased ability to cope with pain, and decreased use of some medications and other physical treatments. It had little effect on perceived pain intensity. Gains were maintained through 6-month follow-up. Age was unrelated to outcome. Stress inoculation training appears to be an effective method of ameliorating the interference of chronic pain with the daily activities of life for adults of all ages.     

Relaxation therapy for tension headache in the elderly: a prospective study

We evaluated the effects of an 8-week progressive muscle-relaxation therapy regimen on the headache activity of 10 elderly tension-headache subjects. Posttreatment assessment at 3 months revealed significant decreases in overall headache activity (50% or greater) in 7 subjects. Significant clinical or statistical prepost differences, or both, were also found for the number of headache-free days, peak headache activity, and medication index. This is the first prospective study of tension headache in an elderly population, and, unlike previous retrospective studies, it suggests that relaxation therapy may be an effective intervention in the treatment of such headaches.     

Daily stress and anxiety and their relation to daily fluctuations of symptoms in asthma and chronic obstructive pulmonary disease (COPD) patients

Although stress and anxiety have long been assumed to play an exacerbatory role in asthma, no study has systematically documented that daily exacerbations of asthma symptoms are related to stress and/or anxiety. In this study, 24 airways obstruction patients (12 asthmatics and 12 chronic obstructive pulmonary disease patients) were instructed to monitor the severity of daily respiratory symptoms. In addition, subjects recorded their daily anxiety level and the number and perceived impact of daily stressors. The results showed that although there were differences between high- and low-stress days for both groups, there were no differences between groups on symptom severity or between high- and low-anxiety days, as measured by the State-Trait Anxiety Inventory (STAI). Thus, although the number and impact of daily stressors were found to be directly associated with the severity of asthma symptoms, anxiety does not appear to have a direct role in the exacerbation of asthma. The findings failed to support the anxiety theory of asthma but provided an explanation for the poor results obtained in previous treatment studies which employed anxiety management with asthmatics.     

August Dvorak (1894-1975): Early expressions of applied behavior analysis and precision teaching

August Dvorak is best known for his development of the Dvorak keyboard. However, Dvorak also adapted and applied many behavioral and scientific management techniques to the field of education. Taken collectively, these techniques are representative of many of the procedures currently used in applied behavior analysis, in general, and especially in precision teaching. The failure to consider Dvorak's instructional methods may explain some of the discrepant findings in studies which compare the efficiency of the Dvorak to the standard keyboard. This article presents a brief background on the development of the standard (QWERTY) and Dvorak keyboards, describes parallels between Dvorak's teaching procedures and those used in precision teaching, reviews some of the comparative research on the Dvorak keyboard, and suggests some implications for further research in applying the principles of behavior analysis.     

Leadership behavior,group climate and outcome in group psychotherapy: A study of outpatient psychotherapy groups

A recent clinical study of outpatient psychotherapy groups in a community mental health center explored the linkage between group leadership variables, group climate, and outcome. The study involved nine outpatient therapy groups, over 50 group clients, and several group therapists. A repeated measures design involving assessment of clients' outcome and level of functioning, group leadership style, and group climate was used to assess changes over a 6-month period. The findings suggest: 1) a reduction in symptoms and improved functioning for clients; 2) a similarity of perceptions by members and leaders of perceived leadership behaviors and group climate; 3) the presence of direct and indirect influences of group climate and leadership behavior on clients' outcome; and 4) a linkage between leadership behavior and group climate with the theoretical orientation of the group. The findings of the research are discussed in relation to the understanding of specific effects in group psychotherapy and the implications for construction of group psychotherapy theory.The authors would like to thank Robert Dies, Ph.D., for his helpful suggestions in the early phase of this study; Roy MacKenzie, M.D., for permission to use the Group Climate Questionnaire; Diane DePalma, Ph.D., for permission to use the Global Leadership Behavior Index; Chris Boltwood, B.A., for her untiring efforts in administering the instruments and coding and entering the data; and most importantly, the psychotherapy group members and the group therapists for their cooperation in this endeavor—without their help, this clinical study would not have been possible.A version of this paper was presented at the Annual Meeting of the American Group Psychotherapy Association, 1987, New Orleans, Louisiana. Lenore Phipps, R.N., M.S., C.S., was formerly Director, Group Psychotherapy Program at Park Ridge Mental Health Center, Rochester, now in private practice at Guild Medical Center, Norwood, MA 02062.     

Personal computer software for teaching differential psychodiagnostics

The third edition of theDiagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 1980), outlines for the student what symptoms to consider when attempting to arrive at an accurate differential diagnosis of eight broad psychiatric categories. This paper describes a program developed to instruct a medical or graduate student in the science of such decision making.     

The Utility of Problem-solving Training that Emphasises Selfmanagement Principles

This study examined the usefulness of an 8-week applied problem-solving training program. Specifically, the study examined (a) whether problem-solving training that emphasised self-management principles would be useful, (b) if the effects of training would persist over time, (c) whether an individual difference variable (problem-solving appraisal) would affect training outcomes, and (d) whether the cognitive responses of the subjects during the course of training were related to their problem-solving appraisal or the change process. Results indicated that problem solving training was effective at enhancing students’ problem-solving appraisal, and that the self-report changes were maintained at a 1 year follow-up. In particular, training seemed most useful for students who initially appraised their problem solving very negatively. Finally, the results suggested that the process-oriented cognitive responses were related to students' initial problem-solving self-appraisal as well as the impact of training. Implications of the results are discussed in terms of counselling interventions, problem solving training, the interpersonal influence process, and future research.     

Epistemological and ontological issues in counseling: Implications of social systems theory

Philosophical issues related to theoretical and methodological developments in counseling are addressed, especially related to epistemology (theory of knowledge) and ontology (theory of reality). Social systems theory is described as an epistemologically and ontologically significant challenger to psychological theory, which has traditionally predominated as a foundation for counseling approaches. Recent developments from cognitive biology are used to demonstrate how systems theory may be metatheoretical to the psychological point of view, accounting for all that psychological theory can account for, and more.