Evaluation of a sexual abuse prevention program for adults with mental retardation.

Programs to teach sexual abuse prevention skills to persons with mental retardation have rarely been evaluated empirically, and typical evaluations are limited to assessment of the participants' knowledge rather than their performance of specific skills. In the present study, 6 adult women with mental retardation were trained in sexual abuse prevention, and performance was assessed using four separate measures: pretests and posttests of knowledge, verbal report, role play, and naturalistic probes. All women learned the skills but failed to exhibit them to criterion during the probes. We discuss the implications for further training and assessment of sexual abuse prevention skills.     

Tracking Substance Abusers in Longitudinal Research: Understanding Follow-Up Contact Difficulty

Studies examining follow-up contact difficulty provide useful information for planning longitudinal studies and for assessing the validity of follow-up data. Contact difficulty was examined among 96 substance abusers following substance abuse treatment. Interview completion rates at the 3-month and 6-month follow-ups were 93 and 97%, respectively. The extent of contact efforts required to complete follow-up interviews varied substantially but tended to be greater at the 3-month follow-up than at the 6-month follow-up. Contact difficulty was related to reuse of substances at the 3-month and at the 6-month follow-ups with reusers requiring greater contact efforts than abstainers. None of the baseline individual and contextual variables examined significantly predicted level of contact effort at follow-ups. Attrition-related validity implications are discussed along with practical suggestions for planning tracking efforts.     

Behavioral Family Interventions for Improving Child-rearing: A Review of the Literature for Clinicians and Policy Makers

This paper reviews evidence that behavioral family interventions are effective at improving child-rearing in distressed families and families with children exhibiting disruptive behavior. Essential therapeutic strategies offered within a collaborative therapeutic process are identified. Exemplary materials for parents and clinicians are identified. Differences between behavioral family interventions and two popular press parenting approaches are highlighted, including the lack of empirical support for these widely used programs and the advice they offer which runs counter to behavioral approaches. Recommendations are offered for combining behavioral family interventions with other empirically supported approaches, promoting more widespread use of empirically supported treatments, such as behavioral family interventions, and the need for a public health perspective on family functioning, involving collaboration among clinicians, policy makers, and researchers.     

Tainted therapy and mistaken memory: Avoiding malpractice and preserving evidence with possible adult victims of childhood sexual abuse

Recent malpractice cases reflect increased liability for psychotherapists working with possible adult victims of childhood sexual abuse. These cases have related to recovery of past memory of abuse and the fashion in which the therapist managed the recovery and treatment. Ways in which therapists may harm clients by omission and commission are explored. The emerging lack of clarity between investigative and therapeutic interviews is discussed. False memory is considered in relationship to malpractice liability, standards of care, and attempts to preserve potential evidence. The author proposes written informed consent and investigative interviewing procedures for working with potential memory recovery cases. Formats for general informed consent to psychotherapy for patient record keeping of newly emergent material are appended.     

Sexual Identity Development: A Base for Work with Same-Sex Couple Partner Abuse

Literature review reveals that domestic violence occurs in same-sex relationships at approximately the same rate as it does in heterosexual relationships. There are a number of dimensions common to same-sex and heterosexual battering as well as significant differences. The differential impact of sexual identity development on same-sex violence has not been addressed in the literature. Unlike the situation with heterosexual couples, there is little in the literature addressing treatment guidelines for work with same-sex couples. This article highlights some of the differences between same-sex battering and heterosexual battering and suggests the need for additional research on the interaction between sexual identity development stages of same-sex partners and domestic violence.     

Couples Therapy for Drug Abusing Women in an Inpatient Setting: A Pilot Study

This article describes a pilot study to examine the usefulness of adding a couples therapy component to inpatient drug and alcohol treatment for women. The treatment model was modified from a 12-week integrative systems model that has been empirically supported in outpatient treatment settings. A team of student-therapists received intensive training and supervision in the modified version. This article discusses the ability of chemical dependency counselors to implement this model, includes pre and post treatment comparisons, and qualitative findings regarding the efficacy of the project. The treatment model promises to be usable, safe, and practical in inpatient settings, and merits a more thoroughgoing clinical trial.     

Does criminal offender treatment work?

In examining the effectiveness of offender treatment, this article attempts to integrate disparate bodies of knowledge. An overview of the effectiveness of offender treatment is presented. To put offender treatment into perspectives, the psychotherapy outcome literature for nonoffenders is briefly reviewed. The complexity of offender treatment is further explored by reviewing correlates and antecedents of criminality that include antisocial personality disorder, antisocial behavior in children, and substance abuse. Implications of the existing body of knowledge on future policy and more active involvement by psychologists are discussed.     

The Influence of Trauma Symptoms on the Therapeutic Alliance Across Treatment

The authors examined the influence of early phase dissociation, interpersonal problems, and retraumatization on the therapeutic alliance at early, middle, and later treatment phases. Participants were 84 female survivors of child abuse (ages 18 to 60 years, 53.6% Caucasian) who were receiving counseling at a university training clinic. Master’s- and doctoral-level students provided counseling using integrated relationship and trauma-based cognitive behavior therapy. Treatment followed a 3-phase model. The authors used structural equation models to test the hypothesis. In the early and later phases, fewer interpersonal problems significantly predicted a stronger alliance. In the middle phase, fewer interpersonal problems, less dissociation, and more revictimization significantly predicted a stronger alliance. Tasks, goals, and bond contributed significantly to the alliance in each of the 3 phases. Interpersonal problems were consistently the strongest predictor across the 3 phases, whereas tasks consistently made the greatest contribution to the therapeutic alliance across all 3 phases.