An evaluation of time-sample measures of behavior

Continuous and time-sample measures of the in-seat behavior of a secretary were obtained. Measurement error, i.e., the extent to which the sample measures deviated from the continuous measure, was a function of the frequency of the sample measurements and the criterion used to score an example of the behavior. If the behavior had to be exhibited throughout the observational interval (whole-interval time sampling), there was a consistent underestimate of the continuous measure. If the behavior had to be exhibited only briefly within the observational interval (partial-interval time sampling), there was a consistent overestimate of the continuous measure. And, if the behavior had to be exhibited at the end of the observational interval (momentary time sampling), overestimations and underestimations of the continuous measure occurred about equally often. As expected, the more frequently the sample measures were made the closer was the agreement between the sample and continuous measures. Two conclusions concerning measurement error in interval time sampling were made. The first was that the error will be a function of the mean time per response. The second is that this error will not be consistent across experimental conditions.     

Therapist training in video chat technology for use in an adaptive digital mental health intervention: Challenges,facilitators and implications for training models

Objective

This qualitative study investigated therapist training experiences, elements of skill acquisition, and barriers and facilitators associated with conducting assessments, and the delivery of low- and high-intensity therapist assistance delivered via video chat technology, adjunctive to a transdiagnostic digital mental health intervention programme for anxiety and depression.

Methodology

In total, 34 semistructured interviews were conducted with 20 therapists. Twenty interviews explored experiences of training to administer a clinical assessment tool, and 14 additional interviews explored training experiences of delivering low- and high-intensity therapist assistance via video chat technology.

Results

Reflexive thematic analysis identified three themes: video chat skill acquisition, competencies transferrable to video chat and video chat service quality. Training and supervision were identified as important to scaffold skill development, and therapists described surprise that their skill set was transferrable to video chat. The most cited barrier to the adoption of video chat was the management of risk and distress, along with environmental suitability. Frequently cited facilitators to the adoption of video chat included stable Internet connection, protocols and resources.

Conclusion

The benefits of video chat technology and digital mental health interventions can be maximised through the expansion and integration of training into existing teaching curricula. If therapists are familiarised and competent to deliver mental health services via the Internet, as well as in person, the future adoption of blended and stepped-care models is likely to be increased.     

The experiences of therapy from the perspectives of carers of people with dementia: An exploratory study

Design: Interviews were conducted with six carers of people with dementia about their experience of receiving counselling/psychotherapy. Interviews were conducted in the carer's own home, and data were analysed thematically using a narrative approach. Findings: Three themes were identified from the data: ‘Still doing the best I can’ (identified as losses and processes of personal growth); ‘Feeling connected and being understood’ (identified as attributes believed to be important within the therapeutic relationship); and ‘Wanting to share information’ (identified as sharing information with someone ‘neutral’). Carers placed emphasis on the age of the therapist and the amount of therapist self‐disclosure. Attending counselling and/or psychotherapy also helped the carer to find a ‘safe space’ to disclose and share concerns. Discussion: Carer loss and personal growth are explored, together with the importance of building therapeutic relationships and, for the therapist, seeking supervision when managing personal self‐disclosure. The theme of therapist self disclosure is explored together with the importance of therapists seeking supervision when managing personal self‐disclosure.     

Listening to Both Sides of the Therapeutic Dyad: Self-Disclosure of Gay Male Therapists and Reflections From Their Gay Male Clients

Clinicians vary as to their beliefs about the use of self-disclosure in psychotherapy depending on theoretical framework, experience level, and the problem focus. Given the limited number of studies examining therapeutic pairs (client and clinician), this study used qualitative methodology to interview gay male therapists and their gay male clients about how therapist self-disclosures affected their therapy. Results show that clients often felt aware of therapist self-disclosures, whether explicit or implicit, and believed the disclosures assisted them in feeling connected to their therapists and served to normalize the clients’ experiences. Limitations to the study are discussed.     

Fault Lines in the Great EST Debate

Three fault lines traverse inquiries into empirically supported therapies, along which pro and contra positions can be taken. First, failure to distinguish scientific from artistic properties of therapy has lead to neglect of pervasive personological and cultural variables that are implicated in this field of inquiry. Second, scientific anomalies result from focusing more on what ESTs are than on how they effect change. Psyche is portrayed as a humanistic Cartesian place-holder for an encroaching neuro-endocrinological and systemic understanding of human experiencing. Third, the EST movement is seen as a socio-political and business model, confounded with and eroding scientific objectives.     

Assessing and predicting supervisors' evaluations of psychotherapists – an empirical study

Objective: The aim of this study was to analyze the dimensions used by supervisors to evaluate trainee therapists and to detect how supervisors' assessments are influenced by features of the case and of the therapist.

Method: Data from 226 patients with diverse mental and social disorders who had been treated by 22 trainee therapists under the supervision of 12 supervisors were analyzed by factor- and regression analyses. Supervision was implemented as part of a psychotherapy training program. After treatment, each supervisor was asked to evaluate the trainee by using a list of 38 items proposed by Kanfer, Reinecker and Schmelzer (1996 Kanfer, FH, Reinecker, H and Schmelzer, D. 1996. Selbstmanagement-Therapie, Berlin: Springer.  [Google Scholar]). Case characteristics and therapists' features were assessed by questionnaires and checklists and related to the supervisors' evaluations.

Results: The statistical analyses indicated that supervisors could not easily integrate the multitude of relevant aspects into a differentiated schema of evaluation. A two-factor model best fitted the data. The two factors focus on specific aspects of therapeutic behavior. The evaluations were mainly related to the experience of the trainee therapist and to therapy outcome. For trainee therapists with more experience, the standards of comparison were set higher resulting in less positive evaluations.

Discussion: The results are discussed with reference to a process-oriented view of supervision and therapist evaluation. It was concluded that supervisors of behavior therapy seem to weight therapist-related and case-related information differently. However, the way supervisors integrate these types of information into evaluations of trainee therapists still remains rather vague.     

Therapists facing masks: A qualitative study of the nature of relationships between masks and relational depth

Background

Central to this research was exploring characteristics facilitating and disinhibiting meetings at relational depth to explore underlying driving factors of change. The overall aim was to explore relationships between masks and relational depth. Viewing masks as a characteristic sought to understand further the socio-cultural impacts of masks on client/patient care and decision-making to meet at depth. This research demonstrates immediate social and international context due to COVID-19.

Methods

A phenomenological methodology was utilised. The primary research vehicle was an examination of primary data from semi-structured interviews. Four therapists who had used masks within sessions (where both therapist and clients wore masks) provided data on meetings at relational depth.

Findings

Interpretative phenomenological analysis revealed four themes: ‘epicentre of aetiology’, ‘loss’, ‘masked-disinhibition’ and ‘disconnection paradox: depth through disconnection’. Findings suggest masks are a characteristic that can facilitate and inhibit meetings at depth—acknowledging common factors, including how therapists related to masks as an extended part of the client, and mutuality within disconnection to masks, not one another, was significant.

Conclusions

Findings suggest the exigent presence of masks could facilitate or inhibit meetings at depth, regulated by what masks represented to therapists/clients at moments of contact. Yet, when both therapist and client appeared mutually disconnected (to masks, not each other), they found moments of relational depth within the disconnection. Masks are suggested as a characteristic that can influence meetings at depth. Opportunities for depth seemed reliant on individual capabilities to offer depth, emphasising therapists' experiential awareness of their interoceptive process.     

Concurrent variable-ratio schedules: Implications for the generalized matching law

Rats' responses were reinforced on concurrent variable-ratio variable-ratio schedules in which responses on one lever incremented the ratio counter and responses on a second lever changed the schedule and correlated stimulus. The relative frequency of reinforcement was varied from .10 to .99. In one set of conditions, responding on the main lever incremented both ratio counters, but reinforcement required a response in the presence of the stimulus correlated with the ratio that had been completed. In a second set of conditions, responses on the main lever incremented only the ratio correlated with the stimulus that was currently present. When main-lever responses incremented both ratio counters, subjects distributed responding and time in a manner consistent with the generalized matching law. When responses on the main lever incremented only the schedule currently in effect, the rats responded almost exclusively on the schedule producing the higher frequency of reinforcement. These results extend the applicability of the generalized matching law to dependent ratio schedules.     

Internet-based self-help treatment for panic disorder: a randomized controlled trial comparing mandatory versus optional complementary psychological support

Panic disorder (PD) is one of the most common psychiatric disorders. Web-based self-help treatments for PD have had promising results. These online treatments seem to have larger effect sizes (ESs) when professional support is added. However, the amount of support or how it should be administered is not yet clear. The aim of this trial was to study two ways of administering psychological support provided by phone as a part of Internet-based self-help treatment for PD based on cognitive behavioral therapy. Seventy-seven participants diagnosed with PD were randomly assigned to one of three experimental conditions: a waiting list control group; a treatment group with non-scheduled psychological support; or a treatment group with scheduled psychological support. PD symptoms of participants who received treatment improved significantly compared to the control group (mean ES d = 1.18, p < .05). In addition, there were statistically and clinically significant differences between treatment groups (Mean difference = ?3.20, p = .005, 95% CI [?5.62, ?.79]). The scheduled group showed a larger ES, a lower dropout rate, and better adherence to treatment than the non-scheduled group. Scheduled support seems to be indicated for patients who seek Web-based treatment for PD, and their symptoms of panic, anxiety, and depression improve at post-treatment and six-month follow-up. In contrast, when support depends on patient demand, they receive less support and so, the therapeutic effect is poorer.