Taking an individualized approach to the assessment of self-efficacy and the prediction of alcoholic relapse

The present study reports on a clinical instrument designed for assessing self-efficacy in alcoholics. In contrast to studies that construct general measures, it was proposed that taking an individualized approach to assessment might offer an effective methodology. Thirty-four alcoholics in an outpatient, behaviorally oriented treatment program participated as subjects. During therapy, an Individualized Self-Efficacy Survey (ISS) was developed for each subject. The ISS was developed by (a) administering the Drinking Patterns Questionnaire (DPQ) to identify important problem areas (e.g., work, children, marital) and specific drinking antecedents and (b) constructing a 15-item scale using each drinker's most important cues. The utility of having clients choose their own items was supported by finding a significant relationship between problem areas identified as important on the DPQ and the areas reported as surrounding relapse. ISS ratings were reflective of efficacy changes during treatment, while posttreatment ISS scores were predictive of subsequent relapse. Situation-specific prediction of relapse was not found. The advantages of this methodology for clinical use are discussed, while general directions for future research are suggested.     

Families and family therapy in Germany

The author describes some of the effects of decades of life under a dictatorship for East Germans and the effects on family life and family therapy of changes following the recent reunification of Germany. A case example illustrates some intergenerational family problems associated with the changes. Contrasts are drawn between East and West Germany and family therapy's present stage of development is depicted in both parts of the reunified country. Germany has approximately 10,000 trained family therapists, a minority of whom work in private practice. The largest amount of family and couples therapy is performed in agencies.Portions of this material were first presented in a poster session at the American Association for Marriage and Family Therapy annual conference in Miami Beach, 1992.     

The holocaust of first nation people: Residual effects on parenting and treatment implications

The residential school experience was devastating for many First Nation (Indian) people. The lingering effects of this era have been far reaching and remain painfully evident throughout Native communities. One of the more obvious areas directly affected has been parenting. This paper discusses current parenting difficulties of Native clients who were formerly in residential schools. A connection is made between the abuse experienced by these individuals and their parental struggles. Along with addressing various sociopolitical issues, a number of clinical interventions designed to promote the healing process of these victims and their families are provided and discussed.     

An investigation of the validity of the SPSI and SPSI-R in differentiating high-suicidal from depressed,low-suicidal college students

The present study examined the validity of the Social Problem-Solving Inventory (SPSI) and SPSI—Revised in differentiating 65 high-suicidal from 63 depressed, low-suicidal college students. Results from multivariate analyses indicated overall differences in problem-solving between these two groups as measured by the SPSI but not by the SPSI-R. Further examination of these differences revealed the high-suicidal group was different in problem-solving orientation, rather than problem-solving skills, compared to the depressed, low-suicidal group. However, when depression was statistically controlled in hierarchical regression analyses, none of the problem-solving measures predicted group membership. The superiority of the SPSI to the SPSI-R in differentiating these two groups appears to be accounted for by the elimination of 28 items in the revised version, many of which measure orientation to problem-solving. Also explored was the possibility that objective measures of problem-solving provide a better prediction of adjustment than do self-report measures.     

The response of day and night wetting children and children who wet only at night to retention control training and the enuresis alarm

Forty-five children with night wetting only (NW) and 30 children with day and night wetting (DNW) were randomly assigned to 2 treatment groups: alarm only and alarm preceded by 4 weeks of retention control training (R.C.T.). Fewer children became dry at night in the DNW group than the NW group and DNW children relapsed earlier following treatment. The enuresis alarm was far superior to R.C.T. in reducing night wetting in both enuretic groups. It also reduced day wetting in some of the DNW children. Children who became dry in the NW group did not show significant changes in functional bladder capacity. Although changes in functional bladder capacity were seen in the DNW children who became dry, changes were only noticeable once dryness had been achieved.     

Electrode placement,EMG feedback,and relaxation for tension headaches

Fifteen tension headache subjects were allocated to one of three groups: direct EMG feedback (from a site corresponding to the source of pain), indirect EMG feedback (from a site not corresponding to the source of the pain) and relaxation instructions. There were two base-line, six treatment and one post-treatment sessions. No significant differences were found between base-line and post-treatment EMG levels, for any of the groups; however, some significant reductions in levels were obtained within sessions. EMG levels recorded during headache attacks did not differ significantly from levels recorded during base-line. Frequency and intensity of headaches were significantly reduced, particularly in the relaxation group. At follow-up this improvement was maintained for subjects with forehead pain, but differences between the groups had disappeared.     

Treatment of obsessive-compulsive patients: The contribution of self-instructional training to the effectiveness of exposure

Fifteen obsessive-compulsive patients were given treatment consisting of ten sessions of gradual exposure in vivo. For half of the patients gradual exposure in vivo was preceded by self-instructional training.Treatment resulted in significant improvement on anxiety and avoidance scales, Leyton Obsessional Inventory, Self-rating Depression Scale and on ratings for anxious mood and depression. Neither the post-test nor the follow-ups 1 month and 6 months later indicated a difference between the effects of the two conditions. Self-instructional training did not enhance the effectiveness of gradual exposure in vivo.