Expectations of Psychotherapy Duration by Disorder: A Comparison Between Professional and Young Adult Expectations

Using more precise methodology, the current study investigated expectations of psychotherapy duration for specific disorders. Duration expectations were obtained for young adults and compared to those obtained from psychotherapists as reported by Lowry and Ross (Psychotherapy: Theory, Research, Practice, Training 34:272–277, 1997). Results revealed that expected duration for young adults by disorder was quite similar to the psychotherapists, where less severe psychological disorders and problems were expected to require shorter treatment durations than moderate and severe disorders and problems. For disorders and problems with which young adults were familiar, their expectations were essentially the same as psychotherapists. A meaningful difference was found for suicidal ideation, with young adults expecting significantly longer treatment duration.     

Deviations from Prescribed Prompting Procedures: Implications for Treatment Integrity

The acquisition of new skills may be hindered when teaching procedures vary from previously validated approaches or contain errors. In the present study, we compared the acquisition and maintenance of response chains taught using a perfectly implemented system of least prompts and a multiple verbal prompts procedure (i.e., addition of multiple verbal prompts and failure to follow through with more intrusive prompts). Four children, aged 6–9, participated in the study. An adapted alternating treatments design was used to compare the effectiveness and efficiency of learning during the system of least prompts and the alternative system of least prompts. Results were consistent with those obtained in previous studies in that the perfectly implemented and alternative prompting procedures were effective in teaching new skills for all participants. However, the perfectly implemented treatment required fewer trials to mastery for 4 of the 5 evaluations. Response chains taught under the multiple verbal prompts condition had poorer maintenance for 2 of the 5 evaluations. The results of the current study suggest that deviations from empirically identified teaching procedures may reduce the speed with which new skills are acquired.     

Utilizing Family Strengths and Resilience: Integrative Family and Systems Treatment with Children and Adolescents with Severe Emotional and Behavioral Problems

Community mental health agencies are consistently challenged to provide realistic and effective home-based family-centered treatment that meets local needs and can realistically fit within available budget and resource capabilities. Integrated Family and Systems Treatment (I-FAST) is developed based on existing evidence-based approaches for working with at-risk children, adolescents, and families and a strengths perspective. I-FAST identified 3 evidence-based, core treatment components and integrated them into a coherent treatment protocol; this is done in a way that builds on and is integrated with mental health agencies' existing expertise in home-based treatment. This is an intervention development study in which we conducted an initial feasibility trial of I-FAST for treating families with children at risk of out-of-home placement. The outcomes of the study provide initial empirical evidence that supports the effectiveness of I-FAST. Findings indicate that there were significant improvements in child behavior, significant increases in parental competency, and significant increases in the level of cohesion and adaptability in these families. All observed changes were significant from pre- to posttreatment with the families able to maintain these positive changes at 6-month follow-up. A more rigorous and robust research design, however, will be needed to establish definitive evidence of the effectiveness of I-FAST.     

Just How Effective are Antidepressant Medications? Results of a Major New Study

The STAR*D (Sequenced Treatment Alternatives to Relieve Depression) project was the largest and most extensive trial of antidepressants ever conducted. The study used state of- the-art methods to treat real patients coming to a hospital or psychiatric clinic for relief from depression. Because the first antidepressant is often ineffective for most patients, a sequence of drug treatments targeting various brain neurochemicals was carefully planned. This article will review the complex treatments and the various outcomes, including the frequency of relapse during twelve months of follow-up care.     

Traumatic stress and psychological adjustment in treatment-seeking women sexually abused in childhood: A follow-up

The objective of this study was to assess post-traumatic stress disorder (PTSD), psychological distress, and risk factors among women sexually abused in childhood (CSA) after six months in therapy. Thirty in-treatment CSA survivors reported their abuse history and filled out several questionnaires. Comparisons were made to a non-CSA in-treatment sample. Although, 50% of the CSA women still had PTSD, there was a remarkable decrease in PTSD symptoms (Cohen's d = 1.06). A considerable change in self-worth and in attachment styles was found. It was concluded that CSA survivors benefit much from 6 months of weekly treatment. However, it is recommended that treatment should continue for a still longer period.     

Personality change and personality as predictor of change in psychotherapy: A longitudinal study in a community mental health clinic

Research suggests that personality may change due to important life events, such as psychotherapy, and that personality and attitudes may predict treatment progress. Longitudinal data in a community mental health clinic showed positive changes in Emotional Stability, Hope, Gratitude, and Motivation during the course of psychotherapy. The static approach relating baseline personality and attitudes to treatment progress did not yield fruitful results. The dynamic approach was more effective, in which we treated personality and attitudes as malleable and used changes in these variables as predictors of progress. Treatment progress correlated with an increase in Emotional Stability. Positive changes in general life attitudes (Hope, Gratitude, Quality of Life) more so than therapy-specific attitudes (Motivation, Working Alliance) predicted symptom reduction.