A collaborative approach in the treatment of chronic pain

The impact of chronic pain on patients and their families can be devastating, with significant disruption and progressive deterioration of many life functions and roles. Typically, chronic pain patients have exhausted all standard medical treatment alternatives without finding relief from the pain. For chronic pain patients and their families, this leads to dependency on the health-care system which leaves patients and their families feeling helpless and hopeless in their struggle to survive their pain experiences. Assessment and treatment of chronic pain requires a comprehensive approach based on a multidimensional conceptualisation of pain that addresses cognitive, affective, behavioural, as well as sensory factors in the pain experience. A cognitive-behavioural treatment programme consisting of (a) a comprehensive multidimensional assessment, (b) a reconceptualisation aspect, (c) a skills acquisition phase, (d) a skills application, maintenance, and generalisation component, and (e) relapse prevention, is outlined. Emphasis is given to the important inter-related roles of the collaborative therapeutic relationship, reconceptualisation of the pain experience, and coping skills training, leading to self-management of life with pain as the ultimate treatment objective.     

A delay timer for presenting auditory and visual probes

A circuit designed to present auditory or visual probes is described. The circuit allows the probes to be delayed by a specified amount of time, and the volume (for auditory probes) or intensity (for visual probes) may also be adjusted. The circuit may be triggered by any device capable of emitting an electronic pulse-such as a computer or a tachistoscope.     

3-D graphics animation program for the Apple II

A graphics design program for creating point-light displays of transforming 3-D objects is presented. This program was written for an Apple II microcomputer interfaced to a Texas Instruments TMS 9918A video display processor. In contrast to other 3-D design programs, it uses individual point-lights undergoing circular trajectories as a design primitive. An editor enables the user to enter and edit specific motion parameters for defining the parallel projection of as many as 16 point-lights on the screen. These parameters are then used to calculate and store in an animation list the screen positions of each point-light for each frame. Number of frames to be displayed and display rate are user defined.     

PROVIDING A MORE APPROPRIATE EDUCATION FOR SEVERELY HANDICAPPED PERSONS: INCREASING AND VALIDATING FUNCTIONAL CLASSROOM TASKS

We evaluated a teacher training and supervision program for increasing the involvement of severely handicapped adolescents and adults in functional educational tasks. The program, consisting of a brief in-service followed by supervisory prompts and feedback, was accompanied by large increases in functional tasks in three classrooms. In addition, generalized increases occurred during nontargeted times in the classroom and the changes during both the targeted and nontargeted times were maintained over a 44–45 week period. In two subsequent experiments, surveys provided social validation for the criteria for functional versus nonfunctional tasks in that: (a) relevant individuals reliably categorized functional tasks as representing typical living, work, social, and leisure situations and (b) experienced clinicians consistently rated tasks previously categorized as functional as being more useful for severely handicapped persons than tasks categorized as nonfunctional. Results are discussed in terms of the relationship of functional classroom tasks in the overall provision of appropriate educational services for severely handicapped students.     

Self-serving Bias and Actor-Observer Differences In Organizations: An Empirical Analysis1

Self-serving attributional bias is the tendency for a subordinate to attribute personal (internal) cause for successful performance but to assign cause for failures to external factors. The actor-observed difference in attribution is the tendency for concerned observers (managers) of a subordinate's performance to attribute cause for the performance to factors internal to the subordinate, in direct opposition to the subordinate's external attribution for the same performance. This research investigated both phenomena. Twenty-four experienced managers served as manager/subjects in simulated appraisal situations. Subjects with prior work experience served as subordinate/subjects. Each manager participated in four separate simulated performance appraisals, under differing conditions of objective performance and work history, for a total of 96 interactions. The results revealed a strong self-serving bias on the part of subordinates. The results also strongly supported the notion of an actor-observer difference in performance attribution. Subordinates tended to attribute more externally and managers tended to attribute more internally (to the subordinate), regardless of performance level. The research also served to delineate and articulate the relationship between self-serving bias and actor-observer differences.     

Why a family perspective for pain?

Although it is well established that families have a strong influence on individuals' beliefs and behaviors related to health and illness, relatively little attention has been devoted to the family's role in the development, maintenance, and treatment of pain or to the impact of chronic pain in one family member upon other family members. A major source of information about pain and how to respond to pain symptoms is learned within the family setting. This article reviews ways in which pain conceptualizations are developed in the family and highlights the need to more carefully study health as well as dysfunctional family reactions to chronic pain. A case example is presented that details the far reaching consequences that chronic pain can have on family life. It is concluded that more careful research, particularly in terms of the operationalization of theoretical constructs and the reliable assessment of these constructs, is needed before any definitive statements can be made about the importance and characteristics of pain-family transactions.     

SUCCESSFUL USE OF THE NOCTURNAL URINE ALARM FOR DIURNAL ENURESIS

We report the effects of using a urine alarm, typically employed for nocturnal enuresis, to treat chronic diurnal enuresis in a 15-year-old female resident at Boys' Town. The results of an ABAB reversal design indicate that the alarm eliminated wetting in both treatment phases and that continence was maintained at 3- and 6-month follow-up.     

Group influence and the psychology of cultism within re-evaluation counselling: A critique

Re-evaluation counselling (often known as co-counselling, or simply RC) has recently been described as an ‘innovative’ form of therapy, despite the fact that it has existed for over forty years. It has also been suggested that it is, or is becoming, a psychotherapy ‘cult.’ This paper discusses the key theoretical ideas of re-evaluation counselling (RC) and assesses the extent to which some of these ideas could enable unscrupulous therapists to engineer artificial consent and impose their own belief systems on clients. RC's strong reliance on group based activities is also explored, and the extent to which this facilitates unthinking conformity is considered. Finally, guidelines are discussed which enable therapists and would-be clients to assess more clearly the potentially negative effects of involvement in groups such as RC.     

Multitrait-multimethod model of adolescent deviance,drug use,academic, and sexual behaviors

A multitrait-multimethod design was used to test Jessor and Jessor's (1977) problem behavior theory with a sample of adolescents, their parents, and peers. Behaviors included general deviance, drug use, low academic motivation, and precocious sexual behavior. While research has supported this theory, the reliance on self-report data for the majority of this work may threaten the validity of these findings. Results from hierarchical confirmatory factor analyses indicated that the convergent and discriminant validity of the seven behavior constructs was high and method effects were low. A two-factor second-order model, representing General Drug Use and Other Problem Behavior, accounted for a larger proportion of variance in the lower order factors compared to a single-factor model.This research was supported by Grant DA 03706 from the National Institute on Drug Abuse.