Guided self-help versus pure self-help for perfectionism: a randomised controlled trial

Perfectionism is known to be a risk factor for the development and maintenance of obsessive-compulsive (OC) and depressive symptoms. The purpose of the present study was to test the effectiveness of a cognitive-behavioural self-help therapy for perfectionism, and to examine the effect of such treatment on OC and depressive symptomatology. The study compares the effectiveness of guided self-help (GSH, n=24) with pure self-help (PSH, n=25) therapy. Both GSH and PSH were found to be effective in reducing perfectionism, and also in reducing OC and depressive symptomatology. Overall, participants in the GSH condition experienced greater symptom improvement than participants in the PSH condition, and treatment gains for both groups were largely maintained at 3-month follow-up. Twenty percent of PSH participants experienced clinically significant increases in depressive symptoms over the treatment and follow-up period (compared to 0% in the GSH condition), suggesting that PSH may be a less suitable strategy than GSH in treating this population. Overall, the findings suggest that self-help for perfectionism is effective in reducing OC and depressive symptomatology in non-clinical individuals, with GSH being superior to PSH.     

An analogue study of the effects of Psychological Debriefing on eyewitness memory

Sixty-one participants from the community participated in a randomised controlled trial of group debriefing to assess the effect of this intervention upon memory for a stressful event. Participants were randomly allocated to one of three groups: debriefing; debriefing with an experimenter confederate present (who supplied three pieces of misinformation to the group regarding the stressful event); and a no-treatment control. All groups were shown a very stressful video and were again reviewed after 1 month. Members of the debriefing group where a confederate provided misinformation were more likely to recall this misinformation as fact than members of the other two groups. The debriefing group was also more accurate in their recall of peripheral content than the confederate group. Across all groups, participants were found to be more accurate at central rather than peripheral recall yet more confident for incorrect memories of the video than correct memories.     

Expressed emotion in families of children and adults with intellectual disabilities

Expressed emotion (EE) is a measure of the affective relationship between two people characterized by criticism, hostility, and emotionally over-involved attitudes. Outside of the field of intellectual disabilities, there has been considerable interest in EE as an environmental marker that explains variance in the severity and/or course of a number of psychiatric disorders. Researchers have also studied EE in parents and found strong associations with children's behavior problems. In this review, we focus on the data from 11 published studies of EE in families of children and adults with intellectual disabilities. We conclude that there is evidence for the presence of high EE in some families, and that this alone should concern researchers and clinicians and set an agenda for considerable future research effort. We also note a lack of attention to the measurement of EE in intellectual disability. In terms of the existing evidence base, we suggest that there is support for the hypothesis that behavior problems in children and adults with intellectual disabilities may be related to high EE in parents, and a small amount of data predicting over time support the putative causal effect of high EE on maintaining or exacerbating behavior problems. Given that EE is perhaps best conceptualized as the result of an interaction between caregivers and those cared for, there is a need to explore interventions that may help to remediate high EE within families. It is also important to understand from this position that EE may be a normative part of the experience of caring for someone under very stressful circumstances and not something for which families are blamed. Other future research priorities and some implications for practice are also discussed.     

Remembering the Pattern that Connects: Toward an Eco-Informed MFT

Gregory Bateson, who is regarded as one of the founders of the field of family therapy, warned about the dangers of chopping up the ecology (literally and metaphorically). Yet the ecosystem is showing signs of faltering under the pressure of human mistreatment, and increasingly people are manifesting symptoms associated with extreme disconnection from nature. Although family therapists have devoted little attention to the relationship between human and ecological planetary suffering, as systemically trained professionals MFTs are uniquely situated to see the big picture and to promote integrative healing between individual, familial, and environmental levels. This article explores some of the factors underpinning the field’s lack of attention to ecological issues and provides recommendations for how MFTs can remember the pattern that connects by cultivating a more eco-informed approach to training and clinical practice.     

Community-Based Interventions to Reduce Low Income, African American Women's Risk of Sexually Transmitted Diseases: A Randomized Controlled Trial of Three Theoretical Models

A community-based sample of disadvantaged African American women (n = 445) was recruited to participate in 1 of 3 theoretically driven experimental interventions based on either the theory of gender and power, social learning theory, or cognitive behavioral theory. Intervention outcomes were compared with a waiting list control condition. From baseline to postintervention, women in the experimental interventions showed differential change on cognitive indices (knowledge and attitudes) and skill acquisition (partner negotiation skills, correct condom application, lubricant selection, and information-provision to social networks) whereas control participants were unchanged. Women in the 3 experimental interventions also completed follow-up assessments for 1 year following the interventions. In all 3 experimental conditions, condom use increased relative to the control group and there were no differences between the experimental interventions. Women who participated in one of the theoretically grounded interventions continued to increase condom use over the following year. Women entering new relationships reported significantly more condom use than did women who remained in ongoing relationships. The findings suggest that intervention models that have proven effective for women who engage in high-risk behavior may be less effective for women in established relationships for whom risk is primarily derived from the extrarelationship behavior of their partners.     

Spouse abuse: An ecosystemic approach

This paper provides a perspective on spouse abuse from an ecosystemic approach suggested by second order cybernetics. An attempt is made to demonstrate the interactional basis for an understanding of spouse abuse and to suggest that the failure to use an ecosystemic perspective may result in therapists and other helpers inadvertently exacerbating the problem. Borrowing from the work of Keeney and Bateson, an analysis of the relational aspects of the problem of spouse abuse is provided which illustrates the similar nature of typical intervention strategies to the problem.The ideas discussed in this paper were developed while the author was a therapist at the Family Therapy Clinic at Texas Tech University. Appreciation is expressed to Monte Bobele, Bradford Keeney, and Thomas Conran for the helpful comments and ideas provided during the preparation of this paper.     

A comparison of on-the-scene coping mechanisms used by two culturally different groups

Five groups of participants from Mississippi (n = 101) completed a questionnaire based on 11 coping mechanisms used most often by Norwegian rescuers (Dyregrov & Mitchell, 1992). Eight significantly different strategies were endorsed by the Mississippians and the Norwegians. Mississippians used more altruistic, cognitive, and social coping mechanisms while the Norwegians tended to endorse emotional distancing and task oriented methods of coping. The strategy judged most important by both Mississippians and Norwegians was maintaining contract with other helpers. It is argued that differences in on-the-scene coping strategies used by rescue workers are based on cultural, social, and individual differences. Researchers concluded that data from one cultural group cannot necessarily be generalized to another group. An examination of differences between the jive groups of Mississippians has been published elsewhere (Holaday, Warren-Miller, Smith & Yost, in press).     

GENERALIZATION OF VERBAL CONDITIONING TO VERBAL AND NONVERBAL BEHAVIOR: GROUP THERAPY WITH CHRONIC PSYCHIATRIC PATIENTS1

Twelve chronic hospitalized female patients received token reinforcement contingent on two separate classes of verbalizations: (a) positive statements about optional activities available in the hospital setting, and (b) positive statements about people. Cross-class generalization of reinforced verbal responses about activities to overt behavior was tested by actual participation in activities; within-class generalization of verbal responses about people to verbalizations in another stimulus setting was assessed in a structured interview situation. A multiple baseline design with contingency reversals was employed to demonstrate experimental control of both classes of verbalizations in the group sessions. Positive statements about activities generalized to actual participation in activities, while generalization of positive statements about people to verbalization in the extra-group setting did not occur.     

Comparing Live and Video Observation to Assess Early Parent-child Interactions in the Home

Observation is the ‘gold standard’ for assessing parent-child behavior, however few studies have compared coding live, in real time, versus coding from videotapes in terms of their achievable levels of coder reliability within the field of parent programme research. This is important for practitioners and researchers for whom decisions might be influenced by time and financial constraints, but where outcomes may have real practical and clinical implications. Trained coders in the Dyadic Parent-Child Interaction Coding System Revised, coded 40 half-hour videotapes of 33 parent-toddler dyads interacting in the home on 29 items of dyadic behaviour. Four theorised composite variables were constructed. Videotaped data were compared to data drawn from the same interactions previously coded ‘live’ in the home. Correlations indicated significant agreement between the two modes at the item by item level (p?<?.001). Wilcoxon Rank tests revealed significant differences (p?<?.001) between the two modes. Eight items exceeded a ±30% change in median score suggesting clinically relevant differences. Although both methods achieved acceptable levels of inter-rater reliability, video coding achieved higher levels of agreement. Subtle differences exist between the two modes. Whilst neither mode proved superior it is suggested that they should not be used interchangeably.     

Exploring differences in youth and parent reports of antisociality among adolescent sexual and nonsexual offenders

This study examined the extent of, and explored several possible explanations for, the discrepancies found between adolescent and parent reports of conduct problems in adolescent sexual and nonsexual offenders. We found that adolescent sexual offenders scored lower on measures of conduct problems than did nonsexual offenders, whether on the basis of adolescent or parent report, though the difference was much larger for parent reports. Examining this discrepancy more closely, we found that parents of sexual offenders reported less antisocial behavior than did their sons, whereas parents of nonsexual offenders reported more antisocial behavior than did their sons. The same pattern of results was obtained for reports on impulsivity, but much less so with respect to antisocial personality traits such as narcissism and callousness. Measures of family functioning were generally not related to these parent-adolescent discrepancies in reports of conduct problems, but these discrepancies were positively correlated with parental reports of stress. The implications of these findings for the interpretation of research on adolescent sexual offenders and comparisons of sexual and nonsexual offenders are discussed.