Manualizing psychotherapy: Aaron T. Beck and the origins of Cognitive Therapy of Depression

Abstract

This paper examines the origins of psychiatrist Aaron T. Beck’s 1979 Cognitive Therapy of Depression (CTOD). CTOD was the first psychotherapy manual designed to be used in a randomized controlled trial (RCT). Making psychotherapy amenable to the RCT design had been a ‘holy grail’ for leading American psychotherapy researchers since the late 1960s. Beck’s CTOD – which standardized his treatment so it could be compared with drug treatments in a clinical trial – delivered that holy grail, and ushered in the manualized treatment revolution. Manuals are now a sine qua non in psychotherapy research. In this paper, I explore some of the personal, political, and economic variables that made the idea of a manual irresistible to Beck and to those who first championed him.     

‘You have to treat the person,not the mouth only’: UK dentists’ perceptions of communication in patient consultations

Effective communication between patients and health professionals is a key component of patient-centred care. Although there is a large body of literature focusing on doctor-patient communication, there has been limited research related to dentist-patient communication, especially presented from the dentists’ perspective. The aim of our study was to explore UK dentists’ perceptions of communication in their consultations, and the factors they perceive may influence this. We conducted semi-structured interviews with eight dentists in UK dental NHS practices. Thematic analysis revealed three themes (‘Treating the whole person’, ‘Barriers to patient-centred communication’ and ‘Mutuality of communication’), which reflected the dentists’ perceptions of their own communication during consultations, the patients’ interaction skills, attitudes (and characteristics that may affect them), and external factors, such as time constraints, that can influence dentist-patients’ encounters. These in-depth accounts are valuable, in that we see what dentists perceive is important, obstructive and facilitative. They report using a patient-centred approach in their everyday dental practice; however this is often difficult due to factors such as time constraints. Although they emphasized that the patient has an active role to play in the communication process, it may be the case that they also need to play their part in facilitating this.     

Brief Behavioral Activation Treatment for Depressed Adolescents Delivered by Nonspecialist Clinicians: A Case Illustration

Behavioral activation (BA) can be as effective as cognitive-behavioral therapy for the treatment of depression in adults, but to date there is little research with adolescents. This is problematic given the recognized need to increase access to evidence-based interventions for depression in young people. We have developed a new adaptation of brief Behavioral Activation (Lejuez, Hopko, Acierno, Daughters, & Pagoto, 2011) specifically for young people: Brief BA for depressed adolescents. In this paper, we use a case example with session-by-session measurement to show how a nonspecialist clinician can deliver this intervention successfully. We discuss the key themes arising from this training case, challenges the clinician faced, and how these were managed through training and supervision.     

Traduction et adaptation du TEI-SF afin de documenter l’acceptabilité sociale de l’intervention comportementale intensive

Early intensive behavioral intervention is more widely used in large-scale community-based services in Autism Spectrum Disorder. There is an increased need to evaluate the social acceptability of these programs. The present study used a measure of social acceptability as part of a social validation procedure to evaluate a community-based EIBI offered in inclusive childcare, as well as two focused interventions associated with this program. To do so, the Treatment Evaluation Inventory Short-form (TEI-SF) questionnaire was adapted and translated to French. The validation results for the TEI-SF, as well as for the social acceptability of the EIBI programs and procedures, are presented. The results are the first evidence of the validity of the TEI-SF (adapted and translated to French), presenting scores of validity of intervention and a favourable perspective related to the early intensive behavioral intervention and opening the door to further research.     

The effect of driver improvement interventions on crash involvement; has it been under-estimated?

The available evidence suggests that driver improvement interventions (with the aim to increase driver safety, most often by education or training) do not work. The average effect calculated in several meta-analyses is close to, and not always possible to distinguish from, zero, despite total samples sizes of several hundred thousand drivers. However, it is possible that all studies included in these meta-analyses have under-estimated the effect, due to a methodological error; all crashes have been used as dependent variable, instead of only those that the targeted drivers have caused. This error is expected to have considerably deflated the effect sizes, but it is not known how large this effect could be.Using crash data for bus drivers in which culpability had been reliably established, a simple simulation was performed to determine the difference between using culpable and all crashes as an estimator of a safety effect. Using data for six years, calculations were made on single years. About ten percent of culpable crashes in each year were deleted to simulate a safety effect, where after the difference between the original and the simulated variable were calculated, using culpable only and all crashes in parallel. The effects using these two different kinds of datasets could then be compared and the under-estimation effect estimated.Culpable crashes, as compared to all crashes, yielded larger differences in means between time periods, and smaller standard deviations. In between-subjects comparisons resulted in 15–30 percent larger effects for culpable crashes. Within-subjects calculations yielded larger but not as systematic effects.The effect of driver improvement on crash involvement has been systematically under-estimated, as extremely few evaluation studies seem to have taken culpability for crashes into account. Therefore, new evaluations need to be undertaken, and/or old data re-analysed, to calculate a better estimate of the true effect of training and education in driving safety.     

Tisha B’Av, “Ghetto Day,” and producing “authentic” Jews at postwar Jewish summer camps

The postwar period brought sweeping changes for American Jews. Communal socioeconomic transitions and the aftermath of the Holocaust triggered intense anxieties among Jewish leaders regarding the preservation of so-called Jewish “authenticity,” and to an increased focus on the moulding of American Jewish youth. This article considers how Jewish summer camps used Tisha B’Av and secular, alternative memorial days, to lead campers toward various, ideologically imbued visions of Jewish authenticity. Through fostering an aura of tragedy in what was otherwise a world of play, songs, and enjoyment, Jewish educators used memorial days as transformative educational tools. Though camps’ ceremonies looked remarkably similar, often including a carefully crafted sombre atmosphere, dirges, and responsive readings, the message of the days proved malleable to different ideological perspectives. This article considers how Zionist, Yiddishist, Reform and Conservative camps came to use memorial days to produce “real,” “ideal,” or “authentic” Jews in accordance with their ideological visions in the decades immediately following the Holocaust.     

The supervisory alliance: Comparison of measures and implications for a supervision toolkit

Background Clinical supervision lies at the core of the professional development of clinicians providing services within a range of service settings. The supervisory alliance is regarded as the most important construct in effective supervision which underlies the importance of metrics to assess this construct. Aims materials and Method A cross‐sectional self‐report questionnaire design was used to examine clinical supervision constructs. The study used two scales measuring the supervisory alliance (SRQ and SWAI‐T), a scale measuring supervision satisfaction (SSQ) and a scale measuring disclosure (TDS). The questionnaires were administered to 127 clinical psychology trainees who were undertaking a practicum placement. Results Both scales measuring the alliance were positively correlated with satisfaction with supervision and disclosure, with similar sizes of correlation for each alliance scale. There was also a large, positive correlation between the two scales of measuring the alliance. Discussion Both scales were designed for use in supervision and are related to supervision outcome measures in the expected directions. Conclusion The SRQ has some distinct advantages over the SWAI‐T that lend the SRQ to be potentially more useful in clinical and research settings.     

政策执行偏差严重程度对公众地方政府责任判断的影响机制

为探讨地方政府政策执行偏差严重程度对公众地方政府责任判断的影响机制。采用问卷法对728名社会公众进行调查,结果显示：（1）公众地方政府有意性判断和公众地方政府可控归因中介了政策执行偏差严重程度与公众地方政府责任判断之间的关系。（2）政策执行偏差严重程度还通过公众地方政府有意性判断→公众地方政府可控归因的中介链作用于公众地方政府道德责任判断。并对研究的实践启示进行了讨论。     

上司地位知觉对下属默契的影响——反馈寻求行为和观点采择的作用

下属默契指的是下属与上司间不经言传而暗相投合的状态,它能潜移默化地提升下属绩效。因此,探讨下属默契的产生原因,对组织有着重要意义。鉴于此,本文以目标动机模型为理论基础,探讨了上司地位知觉对下属默契的影响及其内部机制。通过对186名企业员工的调查分析发现,上司地位知觉对下属默契有显著的正向影响;反馈寻求行为在此过程中起部分中介作用;此外,下属的观点采择能力调节了反馈寻求行为与下属默契间的正向关系。