Assessing therapeutic problem solving skills: Empirical analysis of a measuring operation

Employment of caregivers as trainers is an imperative in the training and treatment of mentally retarded persons. Besides being taught specific behavior modification skills, these paraprofessional trainers have to obtain a set of general skills in order to adjust their specific skills to new clients, situations, and behaviors across time. Empirical research on the characteristics of therapeutic problem-solving skills are scarce. This may be due to a reluctance of behavior researchers against including cognitive factors in the analysis of behavior influence. However, the development of basic knowledge on the existence of therapeutic problem-solving skills should be one of the primary research goals. This article describes the development and application of four scales assumed to be representative of an important set of general skills—therapeutic problem-solving skills. By means of these four scales 21 caregivers were evaluated before and after extensive training. A multifaceted measuring operation is employed with the main objective of empirically testing the dimensionality of problem-solving skills. Rater consistency and individual differences in change from pre- to post-training level are also uncovered. It is concluded that the four scales of therapeutic skills, largely reflect the same underlying concept of a rather general therapeutic problem-solving skill. Discussion of the findings also pointed to future research.     

Adolescent Self-Esteem and Cognitive Skills Training: A School-Based Intervention

We developed and evaluated a school-based psychosocial prevention program for adolescents, focusing on self-esteem, negative cognitive processes, and peer isolation. Fifty-one tenth-grade students between the ages of 13–16 were recruited and randomly allocated to one of three groups; Social Cognitive Training group (SCT), Attention Placebo Comparison Group (APC) and a Waitlist Control group (WL). A pre-post design using two types of measures: specific measures of the target skills (self-esteem, self-statements) and impact measures (quality of peer relationships, acceptability of intervention for adolescents and teachers) evaluated the effectiveness and social validity of the intervention. Multivariate Analyses of Variance showed significant improvements on measures of target skills for the SCT group in contrast to the comparison conditions on reported self-esteem, and self statements, however mixed results were found on the impact measures. While the SCT group was rated as highly acceptable and useful by both adolescents and teachers, student self report ratings of quality of peer relationships showed little change across the study period. We discussed our findings in terms of the effectiveness of group based cognitive interventions in developing adolescent self-esteem and social competence, and the ecological validity of implementing programs within naturalistic settings.     

Experiential Group Psychotherapy Supervision

Following a review of various traditional models of supervising group therapy, an experiential model of supervising group in a group setting is presented. The model stresses the group aspect of the supervisory process, encourages group interaction, here-and-now responses and associations, and employs concepts from both object relations and group-as-a-whole theory to understand what is taking place. The model's premise is that case material presented in a supervision group stimulates parallel material in supervisees, which is then used to elucidate what has taken place in the therapy group being presented. Excerpts from one supervisory group are used to illustrate major features of the model.     

Self-of-the-Therapist Work: A Balance Between Removing Restraints and Identifying Resources

The authors propose that self-of-the-therapist work is most productive when therapists and supervisors approach family of origin issues and historical life events in a balanced way and suggest that they move to an approach that ideally liberates restraints posed by self-of-the-therapist issues, while at the same time accesses resources available to therapists because of the same issues. This is a shift from the primarily restraint focus that has dominated self-of-the-therapist work. This paper also provides personal experiences of the authors, guidelines on how to create safety and balance, as well as practical examples of self-of-the-therapist exercises.     

Interpersonal Skills Training to Reduce Aggressive and Delinquent Behavior: Limited Evidence and the Need for an Evidence-Based System of Care

The prevention of aggressive and delinquent behavior during childhood and adolescence is one of the highest priorities for public health and crime prevention. The most common approach to preventing or treating these conduct problems has been to provide interpersonal skills training to the affected youth. This paper reviews all randomized controlled trials evaluating interpersonal skills training programs as an intervention to reduce conduct problems. Research shows that such programs have weak empirical support as isolated interventions. An alternative evidence-based system of care is described. Such a system would include behavioral parent training and behavioral classroom-based interventions for young children at risk of developing problems, as well as multisystemic family therapy or multidimensional treatment foster care for chronic delinquents. Within such a network of services, interpersonal skills training could play an important supportive role. Such a system holds the greatest promise for reducing the prevalence of aggressive and delinquent behavior in communities.     

Boundary Violations and the Psychoanalytic Training System

A number of features of psychoanalytic training contribute to boundary violations and their sequelae. Intergenerational transmission of sexual misconduct is well-known and often operates unconsciously in the generation inheriting the legacy. Idealization and loyalty are frequent components of collusion and cover-up when a senior member of an institute is sexually involved with a patient. Other factors include the unique features of the termination of training analysis, the compartmentalization required in analytic work, and the ambivalent attitude towards autonomy and consultation.     

Driving skills after whiplash

Previous studies have shown that some persons with longlasting problems after whiplash have changed eye movements. These changes have been related to disturbance of the posture control system. The question raised in the present study is whether such disturbances can influence daily life functions connected with balance, position and external movements, such as car driving. A group of 23 persons with disturbed eye movements due to whiplash injury, was tested in a driving simulator, together with a closely matched control group. The results revealed significant differences between the two groups with respect to response times to the traffic signs presented, identification of type of sign, as well as steering precision while the subjects’ attention was directed to the process of identifying the signs. Alternative explanations such as driving experience, pain, medication or malingering are at least partly controlled for, but cannot completely be ruled out. A distorted posture control system leading to disturbance of eye movements seems to be the most likely primary causative factor, but these disturbances are most certainly complexly determined. Reduced attention capacity is considered to be a mediating secondary factor. Registration of eye movements may be a useful diagnostic tool to evaluate driving skill after whiplash.     

Using the Michigan State University Family Therapy Questionnaire for Training

The development of the Michigan State University Family Therapy Questionnaire (MSU/FTQ) is described and a case example given of its use as a training tool. The MSU/FTQ is a relatively exhaustive list of 74 generic, structural, strategic, brief, and trans-generational family therapy interventions culled from the literature and translated into layperson's language. The marital and family therapy client uses it to provide feedback about the effectiveness of therapy by assessing those things theorists consider important about behavior maintenance and systemic change, indicating whether or not specific interventions occurred and their importance.     

Live Supervision in Family Therapy and Social Facilitation Effects: A Case Study with Physiological Measures

In this case study a family therapy trainee is treating a family during a live supervision session while wearing a blood-pressure monitor. The data are used to illustrate the paradox inherent in live supervision from a social facilitation theory standpoint: While the peer group is considered essential to the process of supervision by some models, the presence of observers and coactors is hypothesized to give rise to negative social facilitation effects which may inhibit the acquisition of complex skills and prolong the training phase of the professionalization process.     

Longitudinal Correlates of Arrest Status Among At-Risk Males

We examined the longitudinal adjustment, from grade 4 to grade 11, of a sample (n = 76) of boys judged to be at-risk for developing antisocial behavior patterns. We also examined subgroups of the sample differentiated by risk status and arrest records at grade 11. Antisocial behavior patterns exhibited by these boys demonstrated considerable stability over time. Differences were noted among high and lower-risk groups who were and were not arrested. In particular, measures of academic and social skills dimensions were related to better overall adjustment as indicated by lower arrest rates. Implications of these results for intervention are presented.