Common impediments to good psychotherapy — or hell is other people

This paper discusses the thesis that the practice of psychotherapy, like other intense human relationships, involves a number of inherent difficulties that must be endured. These common impediments include 1) the identity and status of psychotherapy as a profession, 2) the requirement of a delicate balance in therapy between thought and emotion, 3) the necessity of a resolution to the patient's transferential rage while minimizing the therapist's tendency to avoid that rage, and 4) the therapist's desire and temptation to control and manipulate the patient. These four impediments are built-in barriers with which all therapists must live. Our task is to attack the more approachable, controllable problems in our impediments, such as limitations in our training models, frequent sell-out by psychotherapists to entrepreneurial profit-centered models of practice, and unclear guidelines about which patients should receive which psychotherapy and when.     

Attention within auditory word perception: insights from the phonemic restoration illusion

Phonemic restoration is a powerful auditory illusion that arises when a phoneme is removed from a word and replaced with noise, resulting in a percept that sounds like the intact word with a spurious bit of noise. It is hypothesized that the configurational properties of the word impair attention to the individual phonemes and thereby induce perceptual restoration of the missing phoneme. If so, this impairment might be unlearned if listeners can process individual phonemes within a word selectively. Subjects received training with the potentially restorable stimuli (972 trials with feedback); in addition, the presence or absence of an attentional cue, contained in a visual prime preceding each trial, was varied between groups of subjects. Cuing the identity and location of the critical phoneme of each test word allowed subjects to attend to the critical phoneme, thereby inhibiting the illusion, but only when the prime also identified the test word itself. When the prime provided only the identity or location of the critical phoneme, or only the identity of the word, subjects performed identically to those subjects for whom the prime contained no information at all about the test word. Furthermore, training did not produce any generalized learning about the types of stimuli used. A limited interactive model of auditory word perception is discussed in which attention operates through the lexical level.     

Irrationality profiles for anger and anxiety

A fundamental position in Rational-Emotive Therapy (RET) is that irrational belief systems cause emotional disturbance. This study adds to the body of recent research substantiating this position by showing significantly different profiles on the Jones Irrational Beliefs Test (IBT) (1968/1969) for a nonclinical population (N=446) differentiated according to low, medium, and high anxiety and low, medium, and high anger. The profile differences not only support the above fundamental position, but also offer some further evidence for the validity of the IBT.Paul J. Woods, Ph.D., co-editor of this journal, is an associate fellow of the Institute for Rational-Emotive Therapy, a professor of psychology at Hollins College, and is engaged in private practice in Roanoke, Virginia.Samuel K. Coggin is completing his Master's work at Hollins College and is employed as a psychologist at the Central Virginia Training Center, Lynchburg, Virginia.     

INCREASING HANDICAPPED PRESCHOOLERS' PEER SOCIAL INTERACTIONS: CROSS-SETTING AND COMPONENT ANALYSIS

The purposes of our study were: (a) to train a set of observationally determined social behaviors via peer initiation; (b) to determine if effects generalized across classroom settings and to directly intervene if generalization did not occur; and (c) to analyze components of the peer-initiation intervention. After baseline, nonhandicapped preschool children (confederates) were taught to direct social initiations to the three handicapped preschool-aged students. Teachers prompted the confederates to engage the students in social interaction when necessary and rewarded the confederates with tokens. Confederates' initiations to the students resulted in increased frequencies of positive social interaction. There was no generalization to other classroom settings, and the intervention was subsequently implemented in a second and third classroom. Next, the confederates' token reinforcement system was withdrawn, with no apparent deleterious effects on the confederates' or students' social interactions. When teachers substantially reduced their prompts to the confederates, students' social interactions decreased. Finally, reinstatement of teacher prompts resulted in increases in the confederates' social initiations and, consequently, the positive social interactions of the students.     

Comparative relationships of the Wechsler Adult Intelligence Scale—Revised (WAIS-R) and the Wechsler Adult Intelligence Scale (WAIS) to the Wechsler Memory Scale (WMS)

This study investigated whether the Wechsler Adult Intelligence Scale — Revised (WAIS-R) and Wechsler Adult Intelligence Scale (WAIS) demonstrate similar patterns of relationship with the Wechsler Memory Scale (WMS). Sixty VA patients were administered the WAIS-R and WMS and 60 completed the WAIS and WMS. The groups were comparable in terms of demographic variables. Pearson correlations were computed between the subtest and IQ scores from the intelligence scales and the scores from the WMS for each group. Comparison of the resulting correlations for the WAIS-R group with those of the WAIS subjects demonstrated only four significant differences, indicating that the WAIS-R and WAIS variables covary in a similar manner with the WMS scores. Following factor analysis of the test data for both groups, coefficients of congruence indicated a high degree of similarity between the two factor solutions. Essentially the same relationships emerged between intelligence variables and the WMS regardless of which scale was administered.     

More adaptation of speech by nonspeech

Three experiments tested Samuel and Newport's (1979) hypothesis that the perceptual system sorts its input on the basis of its spectral quality (periodic vs. aperiodic). In Experiment 1, repeated presentation of a shaped white-noise segment (aperiodic) produced a labeling shift on a /ja-za/ continuum (primarily aperiodic); two periodic adaptors produced no effect, supporting Samuel and Newport's hypothesis. The second experiment replicated these results and showed that the nonspeech adaptor produced almost as much adaptation as the test series' endpoint /za). In addition, using several mixtures of periodic and aperiodic adaptors indicated that the aperiodic component dominates adaptation effects for /ja-za/. A final experiment, using a similarity rating task, confirmed that subjects group /za/ with unvoiced fricatives rather than with other voiced consonants. The results thus indicate that the perceptual system is sensitive to whether the input is primarily periodic or aperiodic, regardless of whether it is speech or nonspeech.     

Legal schizophrenia and the mental health lawyer: Recent trends in civil commitment litigation

Mental disability law is among the most conflicted fields in American jurisprudence, whose essential adversarial structure has accentuated a natural degree of tension between the interests of the disabled and those of society at large, and created a largely needless division between legal rights and human needs. Practitioners in this field, whether lawyers or mental health services providers, exhibit the deleterious symptoms of this conflicted state of things which range from an indiscriminate hyperactivity to nearcatatonia. This overview of recent developments in commitment-related litigation traces the persisting conflicts over admission criteria, outpatient treatment alternatives, conditional release, transfer procedures, remedies for inappropriate commitment, and the scope of confidentiality rights. It draws a picture of practitioners who continue to be at the mercy of the law's contradictory pushes and pulls. While a degree of conflict in mental disability law is inevitable, the article suggests that by focusing on the best particular interests of the disabled client, practitioners can do social good and avoid the damage that results when other interests are allowed to dominate.     

Fear of AIDS: Its meaning and implications for clinical practice

Clinical reports have appeared about patients who present for mental health treatment with the major symptom of fearing that they have AIDS. The clinical reports of patients who fear AIDS are similar to those made many years ago by patients who feared syphilis. As with the syphilophobia of years ago, the AIDS group represents a divergent set of patients. Some can be described as the worried well who have realistic concerns because of a recent history of high risk behavior; others have unrealistic fears that are secondary to a major mental disorder such as hypochondriasis, depression, or schizophrenia. Suggestions are made to psychotherapists who encounter patients presenting with the problem of fearing AIDS.The views expressed here do not necessarily represent those of the Pennsylvania Psychological Association