The written summary in group psychotherapy revisited

This paper addresses the use of the weekly written summary with patients in group psychotherapy. In an effort to stimulate group process and effect cotherapist communication, the authors instituted this group recording in an ongoing psychodynamically oriented mixed adult group. While the utilization of this device did, in fact, stimulate the group process and became an important part of the group's life, the therapists additionally saw significant effects upon their working alliance. These included increased focused dialogue upon group dynamics, more purposeful planning for group interventions, and heightened awareness of the significance of interventions in the group.Ms. Bosman-Clark is formerly Clinical Instructor, Department of Psychiatry, Baylor College of Medicine.     

Countering perfectionism in research on clinical practice I: Surveying rationality changes after a single intensive ret intervention

The failure of controlled experimental research on therapy out-come to produce findings of clinical as well as statistical significance seems at least partly due to irrational, perfectionistic, beliefs about how research can be used to infer causes of therapeutic change. Irrational beliefs about controlled experimental designs and about incomplete sampling, in particular, appear to prevent appropriate consideration of probatively valuable quasi-experimental research. Models of more rational alternatives are identified, and an example of the functional advantages of adopting these rational beliefs is explicated. The example demonstrates that single-shot pre-post survey data from self-selected catch-as-catch-can samples can permit legitimate, but not absolutely certain, conclusions about the efficacy and efficiency of RET.Albert Ellis, Ph.D. is executive director of the Institute for Rational-Emotive Therapy in New York City.     

Automated data collection using bar code

Using bar code technology to automate data collection provides a rapid and reliable alternative to paper-and-pencil tracking or keyboard entry into pocket or laptop computer. An array of bar code symbols is printed on a data menu, with a unique symbol corresponding to each possible observation. Bar code symbols are scanned using hand-held readers, which record the event, log the observation time, and store data for transfer to a personal computer. Advantages of the bar code monitoring system include: (1) ease of use by staff with minimal technical training, (2) reduced data entry errors and increased entry speed, (3) reliable portable operation, and (4) low-cost hardware. While the bar code system described here is used for behavioral monitoring in a residential treatment setting for the developmentally disabled, with minimal modification this system can be adapted for use in a wide variety of research and clinical applications.     

Dental phobias and anxieties: evidence for conditioning processes in the acquisition and modulation of a learned fear

The present study investigated some of the factors which differentiate individuals with dental anxieties and phobias from those without such fears. In particular, two questions were addressed: (i) What differentiates subjects who have never been anxious about dental treatment from subjects who at some time have been anxious? and (ii) What factors lead to subjects changing their attitudes either from anxious to relaxed or from relaxed to anxious? The results suggest that the factors which influence the acquisition and modulation of dental anxieties are consistent with the associative and representational processes portrayed in contemporary models of human conditioning. Subjects who reported never having had anxieties about dental treatment were less likely to have had a painful dental treatment than subjects who did report an anxiety. Subjects who did report a painful dental experience but did not acquire anxiety reported a history of dental treatment favourable to the operation of latent inhibition. Subjects who reported that they were good at enduring pain were more likely to report a longer interval between their very first dental treatment and their first painful dental treatment. Under some conditions in which latent inhibition should have precluded the acquisition of a dental fear, an anxiety appeared to be acquired because a very painful experience had attenuated the latent inhibition process. Subjects whose dental anxiety did not remit reported significantly more painful and traumatic dental experiences than subjects whose anxiety did remit.     

A controlled comparative investigation of psychological treatments for chronic sleep-onset insomnia

A sample of physician-referred chronic insomniacs was randomly allocated to either progressive relaxation, stimulus control, paradoxical intention, placebo or no treatment conditions. Treatment process and outcome were investigated in terms of mean and standard deviation (night to night variability) measures of sleep pattern and sleep quality. Only active treatments were associated with significant improvement, but the nature of treatment gains varied. In particular, stimulus control improved sleep pattern, whereas relaxation affected perception of sleep quality. All improvements were maintained at 17 month follow-up. Results are discussed with reference to previous research and guidelines are given for clinical practice.     

Adolescent suicide attempters presenting to a pediatric facility

This study profiles the characteristics of adolescent suicide attempters and the treatment they received in a pediatric emergency room (ER). A retrospective chart review of 4,072 adolescents seen in the ER at a children's hospital (CH) from July 1984 to June 1985 was undertaken. Twenty-seven adolescents who had deliberately injured themselves were identified. The average age was 14 years 7 months (range 11-19 years). Fifty-two percent of the patients were white and 78% were female. Ingestion was the most common method (78%), followed by attempted hanging (11%), and wrist laceration (7%). After evaluation by a pediatrician in the ER, 30% of the patients were treated and released, 11% were transferred directly to a psychiatric hospital, and 59% were admitted to the CH, with an average hospital stay of 1.88 days. Once hospitalized, consultations from psychiatry (81%), social service (50%), psychology (19%), and neurology (6%) were obtained. At the time of discharge from either the ER or CH, the patients had a variety of plans for ongoing care, with 52% being referred to outpatient counseling, 37% being transferred to a psychiatric hospital, and 11% having no documented plan for ongoing care. These results demonstrate that the evaluation of suicidal adolescents cared for in a pediatric facility may be episodic and suggest the need for a comprehensive program to approach the problem.     

The changing face of visual persistence

In three experiments, the effect of target luminance on estimates of visual persistence was determined on a popular successive-field task. Even though the experiments differed from each other only in terms of minor changes in stimulus conditions, very different effects were obtained across the three experiments. The different findings were attributed to the often overlooked roles of masking and target degradation on tasks of persistence. Implications for the numerous contradictory findings in the persistence literature are discussed, and the current popularity of the successive-field task is questioned.     

Occult participation: its impact on adolescent development

This study investigated the relationship between occult participation, substance abuse, and level of self-esteem in adolescents. Data were collected from 50 adolescents who ranged in age from 12 to 19 years and who spoke English as their primary language. The combined group of adolescents consisted of 25 clinical and 25 nonclinical youth. Participants completed a three-part questionnaire package which included Rosenberg's Self-Esteem Scale, the Adolescent Magic Questionnaire, and the Drug and Alcohol Assessment Scale. Results indicated that adolescent substance abuse and occult participation were significantly related. High and low occult participation groups were determined, and significant differences were found between the high versus low occult groups when compared on the primary variables of self-esteem and substance abuse. Significant differences were also noted when comparing the high versus low occult groups with various psychosocial developmental variables. Included is a discussion of the impact of occult participation on the psychosocial elements of adolescent self-esteem, self-concept, tolerance for deviance, and religious involvement.