团体咨询成员的相互共情及其与效果的关系——社会关系模型在团体咨询研究中的应用

研究旨在探讨团体成员的相互共情及其与团体效果的关系。共收集10个团体,53名成员的数据,运用社会关系模型分析。结果发现：1.成员自评相互共情得分较高,但互评相关不显著;2.共情水平与会谈效果正相关,与团体反治疗性因素负相关;3.被共情水平与不信任负相关;4.共情准确性与团体治疗性因素正相关。结论：成员自评相互共情水平较高,但互评不匹配。成员自评共情水平越高,会谈效果越好,受团体反治疗性因素阻碍更少。越被准确评估情绪效价的成员,从治疗性因素中获益更多。     

Relationship Between Homework Completion and Outcome in Cognitive Behaviour Therapy

Homework or between‐session learning has long been considered an essential aspect of effective cognitive behaviour therapy. However, it has received relatively less empirical attention than other components of cognitive behaviour therapy. In general, studies have found that homework completion is predictive of outcome in psychotherapy. However, the amount of homework completed by a patient represents only one aspect of this important therapeutic component. This study investigated both the quantity and the quality of homework completed during a 10‐week group cognitive and behavioural treatment program for anxious and depressed patients. It explored the relationship between various aspects of homework completion and outcomes on several different variables. A total of 94 patients were included in the analysis. It was found that both quantity and quality of homework completed predicted outcome on measures of depression, anxiety and quality of life at post‐treatment and at 1‐month follow‐up. The results were strongest for the amount of homework completed, suggesting that clinicians should encourage patients to complete homework even if the homework content is not entirely accurate. The results of this study highlight the importance of homework as a central part of effective cognitive and behavioural treatment.     

Homework Compliance Counts in Cognitive-Behavioral Therapy

Background: Prior research has demonstrated that there is some association between treatment engagement and treatment outcome in behavioral therapy for anxiety disorders. However, many of these investigations have been limited by weak measurement of treatment engagement variables, failure to control for potentially important baseline variables, and failure to consider various treatment engagement variables simultaneously. The purpose of the present study is to examine the relationship between two treatment engagement variables (treatment expectancy and homework compliance) and the extent to which they predict improvement from cognitive-behavioral therapy (CBT) for anxiety disorders. Methods: 84 adults with a DSM-IV-defined principal anxiety disorder took part in up to 12 sessions of CBT or acceptance and commitment therapy. Pre- and post-treatment disorder severity was assessed using clinical severity ratings from a semi-structured diagnostic interview. Participants made ratings of treatment expectancy after the first session. Homework compliance was assessed each session by the treating clinician. Results: Contrary to hypotheses, treatment expectancy and homework compliance were poorly correlated. Regression analyses revealed that homework compliance, but not treatment expectancy, predicted a significant portion of the variance in treatment outcome (10%). Conclusions: The present research suggests that although treatment expectation and homework compliance likely represent unique constructs of treatment engagement, homework compliance may be the more important treatment engagement variable for outcomes. The present research suggests that improvement of homework compliance has the potential to be a highly practical and effective way to improve clinical outcomes in CBT targeting anxiety disorders.     

Approaches to evaluation

This paper offers some informal thoughts about audit and research studies in a psychotherapy or counselling context, drawing on the author's background in a difficult area of evaluation: the outcomes of psychoanalytic psychotherapy for children and adolescents. Reasons for therapists' difficulties with the idea of evaluation studies are considered, and possible designs for feasible research projects are briefly discussed. Examples of different strategies within one area are given, to illustrate the way in which different approaches can be patched together to yield important findings, and to overcome the limitations of any one approach. the place of audit in relation to research is also briefly discussed.     

Ecstasy Use,Outcome Expectancies,and Sexual Risk Taking

Ecstasy has become one of the most widely used illicit drugs in Australia. This study investigated outcome expectancies as possible motivating and maintaining factors in ecstasy use and sexual risk‐taking behaviour. A sample of regular ecstasy users (N = 220) from Sydney and Canberra, Australia, was recruited for structured face‐to‐face interviews. They also completed an Ecstasy Expectancy Questionnaire. Seven of eight subscales significantly differentiated regular users from non‐users. Interestingly, light and heavier users held similar outcome expectancies, except that light users endorsed items on the sexual enhancement subscale more strongly than heavier users. Further investigation showed that the level of sexual risk taking observed in this sample was high, with the majority of participants reporting multiple partners, “casual” sexual encounters, sex under the influence of substances, and inconsistent condom use. Using logistic regression analyses, a key finding was that positive sex‐related ecstasy outcome expectancies were associated with involvement in disinhibited sexual behaviour under the influence of ecstasy. These effects persisted after statistically controlling for the frequency of ecstasy use. The findings suggest that sexual risk taking is related not only to the disinhibiting properties of ecstasy but also to beliefs that users hold about the effects of the drug.     

Output order reflects the cognitive accessibility of goals

Goal accessibility--the ease or speed with which a goal is activated--increases the likelihood that it will be acted on. The present studies validate output order as a measure of goal accessibility that can be applied to goal lists in both laboratory and naturalistic settings. In three studies, output order (the order in which goals are listed in a free-response format) was related to self-reported goal value but was not redundant with it. Furthermore, output order was affected by motivational priming whereas value was not, and order associated with typical student goals (e.g., achievement) compared with atypical goals (e.g., power). Output order is well suited to bring the study of accessibility to naturalistic studies of goals and goal pursuit.     

累积生态风险与青少年网络成瘾:心理需要满足和积极结果预期的中介作用

青少年网络成瘾与个体所处的生态背景密切相关。目前已有不少研究探讨家庭、学校、同伴背景中单个或少数风险因素对青少年网络成瘾的影响,但少有研究关注多个背景中生态风险因素的累积对青少年网络成瘾的影响及其心理机制。本研究基于累积风险模型和动机心理学理论,考察累积生态风险对青少年网络成瘾的影响及基本心理需要满足(个体在现实生活中需要被满足的情况)和积极结果预期(个体对网络使用诱因大小的判断)在其中的并行和/或链式中介作用。被试为5所中学的998名青少年。结构方程模型分析表明:(1)在控制了人口学变量后,累积生态风险对青少年网络成瘾具有显著的正向预测作用(呈"负加速模式")。(2)累积生态风险通过显著降低基本心理需要满足(表现出"梯度效应"),进而促进青少年网络成瘾。(3)累积生态风险通过显著提升积极结果预期(呈"负加速模式"),进而促进青少年网络成瘾。(4)累积生态风险对青少年网络成瘾的影响被基本心理需要满足和积极结果预期两条并行路径完全中介。上述结果表明,累积生态风险对青少年网络成瘾具有重要影响,且这种影响是通过需要和诱因两种动机力量一"推"一"拉"的合力来实现。     

Idiographic outcome analyses of the clinical significance of two interventions for patients with musculoskeletal pain

This study adopted a perspective of the individual to define domains of everyday life for the analysis of clinically meaningful change. The purpose was to compare the clinical significance of two interventions for patients with musculoskeletal pain, applying an idiographic outcome measure, The Patient Goal Priority Questionnaire, in combination with the Jacobson and Truax methodology [(1991). Clinical significance: A statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 67 (3), 300-307] for determination of clinical significance. The concurrent validity of the outcome variables behavioral performance, satisfaction with behavioral performance, and fulfilled pre-treatment expectations was also studied. Eighty-two patients, randomized to either individually tailored behavioral medicine treatment (experimental group) or physical exercise therapy (control group) were evaluated at baseline and 3 months post-treatment regarding behavioral treatment goals. The experimental intervention had high impact on participants' performance of their highest ranked everyday life activities, and resulted in larger proportions of clinically significant outcomes compared with controls. The concurrent validity of the outcomes was high for those reporting clinically significant changes, but more generally, there was a moderate agreement across outcome categories. The individual should be the unit for analyses of clinical significance to enhance the ecological validity of the construct. Further development of idiographic outcome measures is necessary, as is the inclusion in pain intervention research.