RELATIONSHIPS BETWEEN EXPERIMENTAL AND CLINICAL PSYCHOLOGY: THE CASE OF BEHAVIOR THERAPY

Behavior therapy is the outstanding example of the beneficial influence of experimental research on clinical practice. Initial applications of laboratory research to clinical disorders consisted primarily of the principles and procedures of operant and classical conditioning. The development and evaluation of the token economy and biofeedback methods are used to illustrate the contribution of operant conditioning, whereas the derivation and efficacy of exposure-based treatments for phobic and obsessive-compulsive disorders exemplify the utility of classical and avoidance conditioning concepts. As behavior therapy has matured and grown more clinically sophisticated, its theoretical and research bases have broadened to include areas such as vicarious learning and self-regulatory processes. Most recently, concepts from modern cognitive and social psychology (e.g., information processing, attribution theory) have begun to guide clinical applications. In turn, different therapeutic approaches have influenced the nature of laboratory research in some areas. Nonetheless, a gap still exists between experimental research and clinical practice. The solution to this perennial problem is not to make scientists of practitioners, but to recognize the unique contributions of basic researchers, clinical investigators, and practitioners, within a consistent framework that specifies the complex interrelationships among the different levels of analysis along the continuum of basic research to clinical practice. Such a framework is sketched-out together with some comments on the reasons for relative paucity of controlled clinical research in the U.S.A. and suggestions for bringing the influence of research findings to bear on practice.     

Order of Presentation and Verbal Recruitment Strategy Effectiveness1

This study examined the relative effectiveness of three different verbal recruitment strategies (opinion conformity, other enhancement, and self-enhancement) presented in different orders. Sixty undergraduates viewed three recruiters, each of whom used a different recruitment strategy to describe a hypothetical graduate program. Participants rated their impressions of each recruiter and then decided which program to attend. Results indicated that presentation order significantly affected participants' ratings of the opinion conforming and self-enhancing recruiters. Furthermore, although participants generally preferred the other enhancing and opinion conforming recruiters, this preference did not translate into a decision to attend the other enhancer's university. Implications for both the recruitment and impression management literatures are discussed.     

Affective exchanges between young autistic children and their mothers

This study examined autistic children's social behavior, affect, and use of gaze during naturalistic interactions with their mothers. Sixteen autistic children, 30 to 70 months of age, and 16 normal children, matched on receptive language, participated. Children and their mothers were videotaped during three situations: a free-play period, a more structured period during which communicative demand was made on the child, and a face-to-face interaction. In all three situations, autistic and normal children did not differ in the frequency or duration of gaze at mother's face. In the one condition (face-to-face interaction) during which affective expressions were coded, autistic and normal children also were not found to differ significantly in the frequency or duration of smiles displayed, and neither group displayed frowns. However, autistic children were much less likely than normal children to combine their smiles with eye contact in a single act that conveyed communicative intent. Autistic and normal children were not found to differ in the percentages of smiles they displayed to social versus nonsocial events. However, when autistic children's responses to mother's smiles specifically were examined, it was found that they were much less likely to smile in response to mother's smiles than were normal children. Finally, it was found that mothers o f autistic children displayed fewer smiles and were less likely to smile in response to their children's smiles, when compared with mothers o f normal children. These findings suggest that the autistic child's unusual affective behavior may negatively affect the behavior of others.We wish to thank the children and their mothers who participated in this study, and the staff at Division TEACCH at the University of North Carolina at Chapel Hill for their help in recruiting children for the study. Harriet Reingold generously allowed us to videotape the children in her infant observation laboratory at the University of North Carolina, Chapel Hill. Cathy Lord provided videotapes of some of the autistic children and their mothers. Mary Evers assisted in data collection. Kerry Hogan assisted in the coding of data; her help is gratefully acknowledged. The study was supported by a grant from the University of North Carolina at Chapel Hill.     

Stability of interests across ethnicity and gender: A longitudinal examination of grades 8 through 12

RIASEC interests were assessed in grades 8, 10, and 12 on a large national sample of 69,987 college bound students. Random samples of 1000 were drawn to represent each of the major US ethnic groups (African, Asian, Native, Mexican, Latino (non Mexican), Anglo, and Multiracial Americans) and interests were examined as they varied across time, ethnicity, and gender with respect to structure, mean changes, stability, clarity, and interest-occupational choice congruence. Results indicate that the structure of interests did not vary as a function of time, gender or ethnicity. The pattern of interests was fairly stable and similar across all ethnic groups and both genders. Congruence and clarity increased in 10th grade but both decreased in 12th grade suggesting a time of re-examination.     

Building and sustaining work engagement – a participatory action intervention to increase work engagement in nursing staff

This study evaluated whether a participatory action research intervention with nursing staff on acute care older people National Health Service wards in the United Kingdom was effective for increasing work engagement. Mediation analyses between job resources (social support, influence in decision-making), job demands, work-related needs (autonomy, competence, relatedness), and work engagement explored the presumed psychological mechanisms underlying the intervention. A non-randomized, matched control group, pretest, post-test design involved three intervention and five control wards. A significant decrease in relatedness, and a borderline significant decrease in competence, was observed in the intervention group compared to the control group, with no effect on work engagement (N = 45). Work-related needs mediated between resources and work engagement, supporting the job demands-resources model and self-determination theory as an underlying explanatory theory. Intervention implementation was difficult, highlighting the need for participant and organizational readiness for change, and strong management support. This is the first known study to apply participatory techniques to increase work engagement in nursing staff and explore the underlying explanatory psychological mechanisms, offering a novel means of taking work engagement research forward. Crucially, it highlights the challenges involved in intervention research and the importance of including evaluations of intervention implementation alongside statistical evaluations to avoid erroneous conclusions.     

Group Cognitive Behavior Therapy for Chronic Posttraumatic Stress Disorder: An Initial Randomized Pilot Study

Individuals with posttraumatic stress disorder (PTSD) related to a serious motor vehicle accident were randomly assigned to either group cognitive behavioral treatment (GCBT) or a minimum contact comparison group (MCC). Compared to the MCC participants (n = 16), individuals who completed GCBT (n = 17) showed significant reductions in PTSD symptoms, whether assessed using clinical interview or a self-report measure. Among treatment completers, 88.3% of GCBT participants did not satisfy criteria for PTSD at posttreatment assessment, relative to 31.3% of the MCC participants. Examination of anxiety, depression, and pain measures did not show a unique advantage of GCBT. Treatment-related gains were maintained over a 3-month follow-up interval. Patients reported satisfaction with GCBT, and attrition from this treatment was comparable with individually administered CBTs. Results are discussed in light of modifications necessitated by the group treatment format, with suggestions for future study of this group intervention.