Dietary Control of Rumination: Two Case Studies

Chronic rumination of 2 institutionalized men with profound mental retardation was treated using a dietary approach. In the first case, a peanut butter or honey supplement was given, whereby 2 spoonfuls of either food was added to every meal, with drinks moved to a later time. In the second case, food satiation together with a honey supplement was applied. In the first case, an ABABACA design was used. In the second case, the non-experimental AB design was applied. In both cases, rapid decrease in rumination was achieved. Anecdotal follow-up confirmed the permanency of the results.     

Reduced ADHD symptoms in adults with ADHD after structured skills training group: results from a randomized controlled trial

Objective

Feasibility, acceptability, and efficacy of a Dialectical Behavioral Therapy (DBT) -based method developed in Germany were evaluated in a Swedish outpatient psychiatric context.

Method

Fifty-one adults with ADHD on stable medical treatment or on no medication were randomized to the DBT-based skills training (n = 26) or a parallel loosely structured discussion group (n = 25). Self-rating scales were administered before randomization and after the treatment.

Results

Feasibility and participant satisfaction were good in both groups while skills training was perceived as more logical and effective for ADHD-related problems. The analyses of the individuals who completed the treatment and remained stable with regard to medication (n = 19 in skills training; n = 18 in control group) showed a significant reduction in ADHD symptoms in the skills training group, but not in the control group. No reduction of comorbidity was observed in any of the groups.

Conclusions

The treatment was feasible in an outpatient psychiatric context, well tolerated, and significantly reduced ADHD symptoms in on-treatment individuals who remained stable regarding medication status.     

Guidelines for classifying evidence-based treatments in couple and family therapy

Guidelines for Evidence-Based Treatments in Family Therapy are intended to help guide clinicians, researchers, and policy makers in identifying specific clinical interventions and treatment programs for couples and families that have scientifically based evidence to support their efficacy. In contrast to criteria, which simply identify treatments that "work" and have been employed in the evaluation of other psychotherapies, these guidelines propose a three-tiered levels-of-evidence-based model that moves from "evidence-informed," to "evidence-based," to "evidence-based and ready for dissemination and transportation within diverse community settings." Each level reflects an interaction between the specificity of the intervention, the strength and readth of the outcomes, and the quality of the studies that form the evidence. These guidelines uniquely promote a clinically based "matrix" approach in which the empirical support is evaluated according to various dimensions including strength of the outcomes, the applicability across cultural contexts, and demonstration of specific change mechanisms. The guidelines are offered not only as a basis for understanding the evidence for diverse clinical approaches in couple and family therapy within the systemic tradition of the field, but also as an alternative aspirational model for evaluating all psychotherapies.     

Facilitating relational empowerment in couple therapy

Couples in distressed relationships often get caught up in power struggles, "Power Over" interactions that are informed by both neurobiology (e.g., the fight-flight reaction) and by cultural assumptions (e.g., competition, individualism, and patriarchy). This article seeks to widen the discourse about power by highlighting "Power To" and "Power With." Power To includes the ability to self-regulate, to read and manage one's own emotions, and to have voice while respecting the other's voice. Power With reflects the couple's commitment to conurture the relationship through empathy, respect, and generosity. Power To and Power With are proposed to constitute relational empowerment, the ability to navigate one's inner world and the interpersonal realm. The neurobiology of both couples' reactivity and relational empowerment are considered. Techniques are offered to facilitate Power To and Power With, interventions that interrupt couples' cycles of reactivity and allow them to make more thoughtful choices. Emotion regulation and empathy are particularly important skills of relational empowerment, and examples are offered to increase these capacities in couple therapy. The therapeutic perspective offered in this article challenges cultural practices and assumptions that keep intimate partners polarized in power struggles, and explores how relational empowerment can foster an egalitarian, mutually respectful relationship.     

Developing the therapeutic relationship: from 'expert' professional to 'expert' person who stutters

This article looks back over the years and identifies some of the most influential thinkers, writers, and researchers who have had a profound effect on the way the therapy at the Michael Palin Centre for Stammering Children in London has evolved. It tracks the changes that have occurred in theoretical perspective, treatments offered, and the delivery of therapy. In particular this author is interested in the changing nature of the therapeutic relationship between professionals and people who stutter (PWS), and describes the way it has developed from the “expert professional” towards a more collaborative relationship that recognises the “expert patient”. It was inspired by a book written in 1902 by Mr Beasley, a person who stammered. After several unsuccessful attempts to find a ‘cure’ he found his own solution to his stuttering and then used what he had learned to help many others. Much of what he wrote was well ahead of his time and reminds us, the professionals, of the importance of listening to and taking account of the views of PWS in therapy and designing treatment that meets the needs of the individual. This article also looks briefly at evidence based practice (EBP) and the issues involved in measuring outcomes that reflect the complex and individual nature of the problem. Finally the importance of the research in developing the knowledge and skill base of clinicians as well as PWS is acknowledged and discussed and the way ahead signposted.Educational objectives: The reader will learn about (1) the early history and development of stuttering therapy, (2) the influence of a variety of psychotherapeutic approaches, (3) the relevance of designing therapy to meet the needs of the PWS, and (4) discuss the role of ‘common’ factors in EBP.     

Responding to rule violations or rule following: A comparison of two versions of the Good Behavior Game with kindergarten students

The purpose of this study was to examine the differential effects of 2 versions of the Good Behavior Game (Barrish, Saunders, & Wolf, 1969), allocating teacher attention to rule violations (GBG-response cost) and to rule following (GBG-reinforcement), on student and teacher behavior. The participants were 6 kindergarten students who were nominated as the 3 most disruptive students in each classroom. The study was conducted using single-case A/B/A/C/B/C reversal design with each teacher randomly assigned to either GBG-response cost or GBG-reinforcement condition for implementation in the first B phase. Results indicated that both versions were effective at reducing rule violations and that GBG-reinforcement consistently resulted in either comparable or lower levels of rule violations across classrooms and students. In addition, GBG-reinforcement was preferred by the teachers as a better fit to their classrooms. The implications of the findings to teachers and school psychologists in classroom settings are discussed.     

Gender Role Flexibility in Early Adolescence: Developmental Change in Attitudes, Self-perceptions, and Behaviors

Gender role flexibility has been conceptualized as a multi-dimensional construct that consists of attitudes, self-perceptions, and behaviors. The present study was designed to examine the developmental trajectory of gender role attitude flexibility, self-perception flexibility, and gender-typed behavioral flexibility during early adolescence. One hundred and thirty six male and female sixth grade students completed the Children’s Occupations, Activities, and Traits Scale (Liben & Bigler, 2002) during the fall and spring of their first 2 years of middle school and they kept monthly after-school activity diaries, which were coded for gender stereotypicality. Each component of flexibility exhibited a different pattern of developmental change consistent with the multi-dimensional view of gender role flexibility.     

Utilizing Staff Incentives to Increase School-Wide Praise

The authors evaluated whether an incentive raffle increased teachers' use of written praise and appropriate student behavior. Participants included 93 staff members and 755 students at an elementary school in Central Illinois. School staff received didactic instruction for the importance of using praise, and praise notes were measured on a weekly basis by praise type, staff member type, and student type. Results indicated that the faculty incentive produced medium effects for praise for students, but did not impact the number of office discipline referrals. Staff members reported praise notes to be an acceptable school-wide system for managing student behavior, but had mixed feelings regarding faculty receiving incentives for writing praise notes. Implications as well as future research are discussed.