The aftermath of heresy: a response to Pendery et al.'s (1982) critique of "Individualized Behavior Therapy for Alcoholics"

A point-by-point response is presented to Pendery et al.'s (1982) critique of the study “Individualized Behavior Therapy for Alcoholics (IBTA)”. Two independent, external investigations have critically examined the original records from the IBTA study. The IBTA study compared two different techniques for treating poor-prognosis, chronic alcoholic state hospital patients. It was found that a broad-spectrum behavioral treatment oriented to controlled drinking was a more effective treatment than was the standard hospital treatment program based on conventional wisdom. The Pendery et al. critique gave the appearance of being a refutation by presenting findings for only one group of Ss in a comparative study. In this response, it is shown that the experimental and control Ss were justifiably classified as gamma alcoholics, that Ss were randomly assigned to groups, and that the two groups were comparable in terms of pretreatment characteristics. Moreover, as regards the originally reported 2-yr treatment outcome findings, it is shown that Pendery et al, reported no specific events which were not already documented in the original study records which formed the basis for publications about the IBTA study. Finally, even in terms of long-term outcomes, i.e. mortality rates 10–11 yr after treatment, the experimentally-treated group (20% mortality) continued to fare better than the traditionally-treated group (30% mortality). Ironically, rather than Pendery et al.'s report being a refutation of the original published accounts of the IBTA study, it is concluded that the data reported by Pendery el al. actually strengthen the validity of the original publications. The attack on the IBTA study can be meaningfully viewed as a reflection of the scientific revolution presently underway in the alcohol field. The central impetus for conceptual change in the alcohol field, however, derives less from controlled-drinking research than from the lack of empirical support for conventional wisdom. Ideas are changing because the traditional view no longer inspires progress.     

Therapist-controlled exposure in vivo versus self-controlled exposure in vivo: A comparison with obsessive-compulsive patients

Fourteen obsessive-compulsive clients were given treatment consisting of ten sessions of gradual exposure in vivo With half the clients, the exposure in vivo was therapist-controlled; with the other half, the exposure in vivo was self-controlled.

The results of the posttest showed that both versions of the treatment resulted in a significant improvement on the in vivo measurement, anxiety and avoidance scales, Leyton Obsessional Inventory, Self-Rating Depression Scale and anxious mood. Neither the posttest nor the follow-ups one month and 3.5 months later indicated a difference between the effects of the two conditions. Self-controlled exposure in vivo proved to be as effective as therapist-controlled exposure in vivo, in spite of the fact that in the latter condition each treatment session lasted twice as long as in the former condition.     

从中西医学的竞争和渗透谈现代中医临床思维的变革

现代中医的临床思维正在发生着变革,一个以辨病为纲,辨证为目,辨病论治为经,辨证论治为纬的临床思维新模式,已经呼之欲出。这正是２１世纪中医学发展的必由之路,学术界必从唯物辩证法的角度来审视这场变革,并因其势而利导之。     

Within-modal and cross-modal reliabilities of two laterality tests

Sixteen right handers were given four tests of a dichotic listening recall task (concrete words) and a visual half-field recall task (letters). There was a significant right ear and right visual half-field superiority for the four test sessions, with improvement in recall scores over sessions. Pearson correlations for each ear on the four dichotic tests ranged from .74 to .90. Correlations on the visual half-field scores, however, were significant only after the first session. Analysis of stability in lateral preferences across modalities revealed stable and reliable performance, particularly in the last two testings, where 81.3% of the subjects had a right-sided asymmetry. Cross-modal correlations, however, were not significant. Implications regarding predictions of speech laterality are discussed in the light of these findings.     

Observational assessment systems use for basic and applied research

Three observational assessment systems, the Time-Sample Behavioral Checklist, the Staff-Resident Interaction Chronograph, and the Clinical Frequencies Recording System, are shown to have remarkable utility for a wide range of basic and applied research questions. The assessment systems have already been employed to measure independent and dependent variables in a number of treatment outcome and staff training studies and as measures in more basic studies of environmental history effects for chronic mental patients. Current and planned investigations employing the observational measures are outlined. These include psychometric studies of the instruments themselves, investigations of various parameters of ongoing treatment programs, and empirical validations of proposed nosological diagnostic schemas. Finally, several metamethodological issues germaine to observational assessment, in general, are noted, including the observation vs. interpretation debate and the role of precise observational measurement in applied research contexts.The research reported in this article was supported, in part, by Public Health Service Grants MH-15553 and MH-25464 from the National Institute of Mental Health, and by grants from The Joyce Foundation, Illinois Department of Mental Health and Developmental Disabilities, and the Purdue Research Foundation.Based on a paper presented at the 87th Annual Meeting of the American Psychological Association, New York City, September 1979, as part of a symposium New Assessment systems for residential treatment, management, research, and evaluation.     

Surf therapy for improving child and adolescent mental health: A pilot randomised control trial

The aim of this pilot randomised control trial (RCT) was to test, 1) feasibility and acceptability of a surf therapy program to improve symptoms of mental ill-health among children and adolescents, and 2) the design and procedures of an evaluative study. This pilot RCT compared a 6-week mentor-supported surf therapy program with a wait list control group, in Australian children and adolescents aged 8–18yrs (M age = 11.28, SD = 2.34; 15 females), who were help seeking for issues relating to their mental health. Exclusion criteria included if an individual was actively suicidal or experiencing a psychotic episode or being unavailable for program dates. The primary outcome was the feasibility and acceptability of the intervention and study design assessed via 11 pre-defined criteria. A secondary outcome was to investigate the effectiveness signal of the intervention on child indicators of depression and anxiety, assessed via the Revised Children’s Anxiety and Depression Scale-Short Form and the Strengths and Difficulties Questionnaire. Random allocation was computer generated and while it was not possible to blind participants, researchers collecting assessments were blinded to group allocation. Thirty-six youth were randomised (intervention = 18; wait list controls = 18), representing an 84% participation rate among eligible youth. Of the 11 a priori feasibility and acceptability criteria, 4 of 5 relating to the intervention, and 4 of 6 addressing the study design were fully met, with the unmet factors guiding program revision. At the completion of the intervention, children and adolescents receiving the intervention reported reductions in symptoms of depression (ES = 0.57), anxiety (ES = 0.43), emotional problems, (ES = 0.79), peer problems (ES = 0.56), hyperactivity/inattention (ES = 0.28), and overall difficulties (ES = 0.64). These reductions were not sustained 6-weeks after completion of the intervention. Surf therapy is an acceptable and feasible intervention for addressing symptoms of mental ill-health among children and adolescents. Preliminary evidence suggests that surf therapy improves symptoms of mental ill-health in the short-term but that these improvements were not sustained after the intervention is ceased.     

The Milan Approach,History, and Evolution

The two authors intend to underline the continuities and discontinuities that organize the Milan Approach, after the splitting from Selvini Palazzoli and Prata; they intend to tell the teachings of Luigi Boscolo and Gianfranco Cecchin from the beginning of training in 1978 till nowadays. After having spoken of some important stages in the work till the death of the two masters, the article underlines two major new aspects. 1. We speak about the corporeal turn: embodied experience as preconceptual know‐how from which concepts are structured. We speak about the connections between bodies and social issues that enact forms of knowledge and understanding. 2. In this period of war, violence, and tyranny, we speak about epistemology and ontology as complementary stances: the need to let others disclose themselves, by allowing them to speak their own terms of engagement. The therapeutic effort is one of deactivating the dangers of one’s own presuppositions and prejudices that limit one’s capacity to describe and make hypothesis. There are social ontologies, communities with strong moral intensity, historical and social realities that need therapists to take position, since they need to take side and be aware of the categories they utilize. Historical and social ontology deals with the continuous change of symptoms in connection to the continuous change of the social panorama in the context we live in. We live by the bodies we are.     

Phone follow up to families of COVID-19 patients who died at the hospital: families' grief reactions and clinical psychologists' roles

A proportion of persons affected by coronavirus disease-19 (COVID-19) die and do so in extraordinary circumstances. This can make grief management extremely challenging for families. The Clinical Psychology unit of an Italian hospital offered a bereavement follow-up call to such families. This study aimed to explore the families' experiences and needs collected during these calls, and the role that the psychologists played through the call. A total of 246 families were called over 3 months. Multiple qualitative methods included: (i) written reports of the calls with relatives of patients who died at the hospital for COVID-19; (ii) qualitative semi-structured interviews with psychologists involved in the calls; (iii) observation of psychologists' peer group discussions. A thematic analysis was conducted. Six themes emerged: without death rituals, solitary, unexpected, unfair, unsafe, coexisting with other stressors. Families' reactions were perceived by psychologists as close to a traumatic grief. Families' needs ranged from finding alternative rituals to giving meaning and expressing different emotions. The psychologists played both a social-institutional and a psychological-human role through the calls (e.g., they cured disrupted communication or validated feelings and choices). This study highlighted the potential of traumatic grief of families of COVID-19 victims, and provided indications for supporting them within the space of a short phone call.