Treatment manuals: use in the treatment of bulimia nervosa

As psychology has moved toward emphasizing evidence-based practice, use of treatment manuals has extended from research trials into clinical practice. Minimal research has directly evaluated use of manuals in clinical practice. This survey of international eating disorder professionals examined use of manuals with 259 clinicians’ most recent client with bulimia nervosa. Although evidence-based manuals for bulimia nervosa exist, only 35.9% of clinicians reported using a manual. Clinicians were more likely to use a manual if they were younger; were treating an adult client; were clinical psychologists; were involved in research related to eating disorders; and endorsed a cognitive-behavioral orientation. Clinicians were less likely to use a manual if they provided eclectic psychotherapy that incorporated multiple psychotherapeutic approaches. We conclude that psychotherapy provided in clinical practice often does not align with the specific form validated in research trials, and “eclecticism” is at odds with efforts to disseminate manuals into clinical practice.     

Selective imitation of the passive construction through modeling

Six 4- to 5-yr-old subjects were exposed to five sessions in which an adult model used passive sentences to describe a set of modeling stimuli. Probe stimuli, which the subjects were asked to describe without benefit of modeling and without selective reinforcement were interspersed among modeling stimuli. A matched group of control subjects received probletrials but no modeling trials. Both groups of subjects were subsequently tested on their ability to comprehend active and passive sentence forms. Every subject in the experimental group produced passive sentences on probe trials even though there was considerable variability in the number of passives produced. No control subject produced passives. The modeling procedure increased the comprehension scores of the experimental group above those of the control group though the scores of both groups were above chance. The results were contrasted with earlier studies in which modeling was ineffective in producing passive usage and in which comprehension of the passive was not demonstrated by even older children.     

A COMPARISON OF PEER-DIRECTED AND TEACHER-DIRECTED EMPLOYMENT INTERVIEW TRAINING FOR MENTALLY RETARDED ADULTS

Interview skills deficits may limit employment prospects of mentally retarded adults. Although numerous papers highlight the importance of interview skills, few have validated effective strategies for use with mentally retarded persons. Further, there has been a lack of research contrasting rival interview skills training strategies. The present study was conducted with two mentally retarded young adults. It contrasted peer-directed instruction, in which both participants were equally deficient in the target skills, with teacher-directed instruction. Results of the investigation indicated that instruction, rehearsal, and feedback may be effective strategies regardless of who provides instruction. Comparisons of teacher-directed and peer-directed instruction indicated little or no difference in the effectiveness of the two procedures. However, the peer-directed procedure involved considerably less staff time than did the teacher-directed procedure.     

TEACHING SUPPORTED EMPLOYEES WITH SEVERE MENTAL RETARDATION TO SOLVE PROBLEMS

Two individuals with severe mental retardation, employed by a janitorial supply company, were taught to use self-instruction in combination with multiple exemplar training to solve work-related problems. Use of the combined strategy resulted in generalization of the effects of independent variables, as well as generalization to nontrained problems. Use of the strategy is discussed in terms of promoting independent performance among supported employees.     

Application of Problem Solving Therapy for Late-Life Anxiety

Cognitive behavioral therapy for anxiety has demonstrated lower efficacy in older compared with younger adults. Yet, few other evidence-based options for late-life anxiety have been examined. This case series aimed to demonstrate the application of Problem Solving Therapy (PST) to older adults with anxiety disorders building on PST’s strong empirical support for treating late-life depression. PST was implemented to treat three older primary-care patients diagnosed with anxiety disorders. We present treatment outcomes and discuss the feasibility and acceptability of using PST to treat these patients. Implications and lessons learned from these patients are discussed to inform further development of PST to better meet the needs of older patients suffering from late-life anxiety.     

The Gap Between Science and Practice: How Therapists Make Their Clinical Decisions

Recent surveys have found that many patients are not receiving empirically supported treatments and that therapists may not update their knowledge of research. Studies have found that therapists prefer to use their clinical experience rather than research findings to improve their practice, although cognitive behavioral (CB) practitioners have been found to use research more frequently than therapists of other theoretical orientations. The organization in which therapists work has been shown to impact attitudes toward working practices, but studies have not examined whether workplace requirements to use research affect therapists’ practice. Studies to date have mainly been conducted in North America. These findings may not be generalizable to the United Kingdom where there is a National Health Service (NHS), which requires the use of empirically supported treatments. The first part of this study aimed to investigate which factors were influential in therapists’ choice of theoretical orientation and to see whether CB practitioners differed from other therapists in the factors that influenced their choice of theoretical orientation. The second part tested whether therapists’ theoretical orientation or their workplace influenced the frequency with which they used research in their clinical decision-making. The final part investigated whether being a CB practitioner or working in the NHS was associated with having a favorable attitude toward research. An online survey was sent to 4,144 psychological therapists in England; 736 therapists responded (18.5%). Therapists reported that research had little influence over their choice of theoretical orientation and clinical decision-making compared to other factors, specifically clinical experience and supervision. CB practitioners and NHS therapists, regardless of their orientation, were significantly more likely to use research than other therapists and were more likely to have a positive attitude toward research.     

MUSLIM PERSPECTIVES ON STEM CELL RESEARCH AND CLONING

In Islam, the acquisition of knowledge is a form of worship. But human achievement must be exercised in conformity with God's will. Warnings against feelings of superiority often are coupled with the command to remain within the confines of God's laws and limits. Because of the fear of arrogance and disregard of the balance created by God, any new knowledge or discovery must be applied with careful consideration to maintaining balance in the creation. Knowledge must be applied to ascertain equity and justice for all of humanity. Research in Islam must be linked to the broad ethical base set forth in the Qur'an and the Sunnah. Whether embryonic stem cell research or cloning is ethically acceptable in Islam depends on the benefits derived from such applications. What is most important for the scholars is to adhere to the concepts of compassion, mercy, and benefit to everyone.