Some developments in multivariate generalizability

This article is concerned with estimation of components of maximum generalizability in multifacet experimental designs involving multiple dependent measures. Within a Type II multivariate analysis of variance framework, components of maximum generalizability are defined as those composites of the dependent measures that maximize universe score variance for persons relative to observed score variance. The coefficient of maximum generalizability, expressed as a function of variance component matrices, is shown to equal the squared canonical correlation between true and observed scores. Emphasis is placed on estimation of variance component matrices, on the distinction between generalizability- and decision-studies, and on extension to multifacet designs involving crossed and nested facets. An example of a two-facet partially nested design is provided.Appreciation is expressed to the Office of Research in Medical Education, University of Texas Medical Branch, for permitting use of their data.     

Quality assurance in the clinical genetics setting—Report of a workshop

Participants in a panel discussion sponsored by thead hoc Quality Assurance Committee of the National Society of Genetic Counselors discuss early efforts to develop and implement quality assurance instruments at institutional, state, and regional levels. Uniform guidelines and self-assessment tools can help genetic counselors and clinical geneticists to provide the best possible care to individuals affected by genetic diseases. Further work will be needed to address aspects not covered here and to assure that guidelines allow for creative variation among professionals and centers. An interdisciplinary approach to such standard-setting is recommended.CGC     

Points of view analysis revisited: Fitting multidimensional structures to optimal distance components with cluster restrictions on the variables

Points of view analysis (PVA), proposed by Tucker and Messick in 1963, was one of the first methods to deal explicitly with individual differences in multidimensional scaling, but at some point was apparently superceded by the weighted Euclidean model, well-known as the Carroll and Chang INDSCAL model. This paper argues that the idea behind points of view analysis deserves new attention, especially as a technique to analyze group differences. A procedure is proposed that can be viewed as a streamlined, integrated version of the Tucker and Messick Process, which consisted of a number of separate steps. At the same time, our procedure can be regarded as a particularly constrained weighted Euclidean model. While fitting the model, two types of nonlinear data transformations are feasible, either for given dissimilarities, or for variables from which the dissimilarities are derived. Various applications are discussed, where the two types of transformation can be mixed in the same analysis; a quadratic assignment framework is used to evaluate the results.The research of the first author was supported by the Royal Netherlands Academy of Arts and Sciences (KNAW); the research of the second author by the Netherlands Organization for Scientific Research (NWO Grant 560-267-029). An earlier version of this paper was presented at the European Meeting of the Psychometric Society, Leuven, 1989. We wish to thank Willem J. Heiser for his stimulating comments to earlier versions of this paper, and we are grateful to the Editor and anonymous referees for their helpful suggestions.     

Supervisees' perspectives on the contribution of supervision to psychotherapy outcomes

Objective

The aim of this study was to examine supervisees' perspectives about the contribution of two predefined aspects of supervision, supervisory bond (SB) and didactic input of supervisor (DI), to their ascribed outcome of therapy.

Method

Supervisees anonymously assessed the SB, supervisors' DI and their contribution to therapy outcome. Assessment was quantitative and qualitative. The supervisory aspects were assessed using a questionnaire constructed for this study. Perceived contribution was evaluated by two scaled questions, and themes generated by an open question. Supervisees (n = 111) evaluated 16 supervisors and supervision’s contribution to psychotherapy outcomes of 111 clients.

Findings

Hierarchical regression showed that supervisees' age, supervisors' status and frequency of supervision accounted for 24% of the variance ascribed to outcome. SB and DI accounted for 51% of the variance. These values, which are higher than reported in the literature, may be attributed to the assessment of predefined aspects of supervision by the same assessor. Thematic analysis of the didactic input produced more themes than for the supervisory bond.

Conclusion

Sociodemographic variables and supervisory relationship variables determine supervisees' evaluations of supervision’s contribution to outcome.

Implications for practice

Training and supervision may benefit from information obtained from quantitative and qualitative measures regarding these and other predefined variables related to supervision. The in-depth look at views and experiences shared by supervisees may advance training, practice and research.     

Clinical Change Mechanisms in the Treatment of College Students With ADHD: Trajectories and Associations With Outcomes

The purpose of this study was to evaluate trajectories of response for the three theorized mechanisms of clinical change (knowledge, behavioral strategies, and adaptive thinking) associated with the Accessing Campus Connections and Empowering Student Success (ACCESS) intervention for college students with attention-deficit/hyperactivity disorder (ADHD) and their association with treatment outcomes. Participants included 250 college students comprehensively diagnosed with ADHD randomly assigned to ACCESS or to a delayed-treatment control who completed ratings at baseline, end of active treatment, and end of the maintenance phase of treatment (after two semesters). Growth mixture models (GMMs) were used to evaluate trajectories. Participants in ACCESS made significant gains in the use of behavioral strategies and trajectories were associated with large effect size improvements in measures of symptoms and functioning. Participants also made improvements in ADHD knowledge. However, only the knowledge trajectory with rapid improvement displayed significantly better outcomes. Only one trajectory group showed improvement in adaptive thinking with most ACCESS participants remaining stable across time. However, adaptive thinking trajectories were strongly related to both symptom and functional outcomes. ACCESS is associated with large gains in two of the three theorized clinical mechanisms of change, behavioral strategies and ADHD knowledge. Rapid improvement in behavioral strategies was associated with robust improvement in symptoms and functioning. Although improvements in the third mechanism, adaptive thinking, were small, they were strongly associated with outcomes demonstrating the importance of a cognitive-behavioral approach in treating college students with ADHD.     

Adolescents’ Change in Motivation as a Result of Buddhist Education: How Does It Make a Difference in Their Learning Outcomes?

Motivation significantly influences students’ learning outcomes. Changing their learning motivation improves their performance. This study used an exploratory sequential mixed methods approach, with the participation of 140 adolescents attending retreats at three Zen monasteries belonging to the Truc Lam (Bamboo Forest) Zen sect, to examine how they changed their motivation, what made them change, and how the change improved their learning outcomes. The study also evaluated the effect of gender and age on changes in motivation. The results indicated that many teenagers had changed from extrinsic to intrinsic motivation thanks to Dharma lessons, teacher support, and leisure activities. Compared to students who maintained their extrinsic motivation unchanged, they had better learning outcomes. Age, but not gender, had a considerable effect on changes in teenagers’ motivation. These findings provide more evidence for extending Buddhist education and conducting further research on young Buddhist learners’ motivation in various contexts.     

工作同盟和领悟对咨询效果的影响

为了解短程咨询中工作同盟和领悟对咨询效果的影响,以12个个案94次会谈为对象,考察工作同盟、领悟分别与会谈效果、治疗效果的关系,并考察二者共同作用于效果的方式。结果表明,咨访双方评定的工作同盟都可以正向预测会谈效果,但不能预测治疗效果;领悟与会谈有效性正相关,领悟正向预测治疗效果;咨询师评定的同盟的三个维度以领悟为中介影响其对会谈效果的评价。     

The Güttingen study of psychoanalytic therapy: First results

Results of a naturalistic study of the effectiveness of psychoanalytic therapy are reported. Outcome data are presented for a sample of N = 36 patients who were treated with psychoanalytic therapy. For a sample of n = 23 of these patients, data for 1-year follow-up are available at present. According to the results, psychoanalytic therapy yielded signifi cant improvements in symptoms (Symptom Checklist 90-R, SCL-90-R and rating of psychoanalysts), in interpersonal problems (Inventory of Interpersonal Problems, IIP), in quality of life (Questionnaire of Quality of Life, FLZ), in well-being (Questionnaire of Changes in Experience and Behaviour, VEV) and in target problems defi ned by the patients (Goal Attainment Scaling, GAS). Large effect sizes between 1.28 and 2.48 were found in symptoms (GSI of the SCL-90-R), interpersonal problems (IIP-total), quality of life (FLZ-total), well-being (VEV) and target problems (GAS). At 1-year follow-up, all improvements proved to be stable or even increased. The self-reported improvements in symptoms were corroborated by the ratings of the psychoanalysts. At the end of therapy, 77% of the patients showed clinically signifi cant improvements. In the 1-year follow-up group, this was true for 80%. Further results are presented and discussed.     

Total number of MMPI-2 clinical scale elevations predicts premature termination after controlling for intake symptom severity and personality disorder diagnosis

Premature termination of therapy by patients is a common phenomenon that can be deleterious to treatment outcome for patients and also negatively affect therapists, treatment centers, and research programs. Therefore, a method of identifying patients at risk for premature termination could have widespread benefits. This study investigated whether patients’ MMPI-2 profiles, including clinical scale elevations and Negative Treatment Indicator (TRT) scores, could predict premature termination in an outpatient sample, controlling for personality disorder diagnosis and symptom severity at intake. Results indicated that while TRT scores were not incrementally predictive of premature termination, the total number of clinical scale elevations was significantly incrementally predictive of dropout. Clinical implications are discussed.     

Helping and change without traditional therapy: Commonalities and opportunities

The therapeutic elements of four types of helping interactions (friends/family, religion, cinematherapy/bibliotherapy, and self-help groups), and their commonalities with traditional psychotherapy are explored. Empirical findings in these areas are discussed, along with suggestions for process and outcome research. Recommendations for the integration of self-help and paraprofessional counseling with professional therapy are presented.