Homeopathic remedies as placebo alternatives — verification on the example of treatment of menopause-related vegetative and emotional disturbances

With the example of treatment of menopause-related vegetative and emotional disturbances, the author verifies the effectiveness of the use of Ignatia amara containing complex homeopathic remedies (IACCHR) as an alternative to placebo. Substantial improvement in psychological and psychosomatic symptoms was observed. Climacteric complaints diminished or disappeared completely in the majority of women (95.7% by patient evaluation and 96.2% by physician evaluation). Compared to standard pharmaceuticals, IACCHR treatment was tolerated better and lower risk of side effects was observed. The results obtained in this work indicate the significant therapeutic potential of this group of treatments, which is in line with the therapeutic effect of the placebo. Nevertheless, the showing of specific effects in pharmacological tests disqualifies the investigated treatments from use in a clinical trial in place of a placebo. An earlier version of this paper was presented at an international conference, “Placebo: Its Action and Place in Health Research Today,” held in Warsaw, Poland on 12–13 April, 2003.     

“Seeing Conversion Whole”: Testing a Model of Religious Conversion

Rambo (1993) theorized that religious conversion consists of a process involving seven dimensions, labeled context, crisis, quest, encounter, interaction, commitment, and consequences. To test the Rambo model, a new measure, the 97-item Adult Religious Conversion Experiences Questionnaire (ARCEQ), was developed, revised on the basis of feedback from a focus group, and administered by mail to 110 adult volunteers who self-identified as having experienced conversion. Reliability analysis of the subscales of the ARCEQ resulted in five (crisis, quest, encounter, commitment, and consequences) meeting the criterion ( > .80). A sixth (interaction) achieved a reliability of .76 and was retained, but the seventh (context) was dropped. Principal components factor analysis with Varimax rotation produced factors labeled Redemptive Love, Zealous Dedication, Dysphoric Need, Openness to Uncertainty, Extrinsic Crisis, and Experiential Learning, which could readily be interpreted in relation to Rambo's model. Subsidiary analyses showed a number of significant correlations between demographic characteristics of the sample and differences in religious conversion experience.     

Behavioral treatment of insomnia in older adults: an open clinical trial comparing two interventions

Fifty-five insomniacs, 60 years or above, participated in a behavioral treatment program, comparing two interventions (sleep hygiene+stimulus control vs sleep hygiene+relaxation tape). Half of the subjects were randomized to a waiting-list condition prior to treatment. No significant changes were observed during the waiting-list period. During the treatment period however, the subjects improved on several sleep parameters, and treatment gains were maintained at a 6-month follow-up. The effects of treatment were greater for nocturnal measures (e.g. sleep onset latency and total sleep time) as compared to daytime measures (e.g. life satisfaction, daytime alertness) and not-targeted behavior (medication use). There were no differences in treatment effects for the two interventions.     

Active-imaginal exposure: examination of a new behavioral treatment for cynophobia (dog phobia)

The aims of this study were to investigate exposure-based treatments for cynophobia (dog phobia) and to test a newly developed hybrid imaginal exposure treatment that we have named active imaginal exposure. The treatment introduces an in vivo coping component to imaginal exposure whereby the patient physically performs coping responses to an imagined feared stimulus. Eighty-two participants meeting DSM-IV criteria for specific phobia (animal subtype) were randomly assigned to one of three 30-min. treatments: (a) active-imaginal exposure (AI), (b) imaginal exposure alone (IE), or (c) graduated in vivo exposure (IV). Participants completed a behavioral approach test at pre, post, and four-week follow-up. Significant pre- to posttreatment improvement was observed in all three treatment conditions. Response rates at posttreatment were 51.9, 62.1, and 73.1% for the IE, AI, and IV groups respectively. Likewise, effect sizes at posttreatment were 0.76, 1.41, and 1.55 for the IE, AI, and IV groups respectively. Although in the predicted direction, the between group differences were not significant. A similar pattern of results was observed at follow-up. Further, safety behavior utilization during treatment was associated with less improvement--particularly in the two imaginal treatment conditions. Exposure treatments of dog phobia appear feasible and effective in reducing phobic fear and avoidance associated with dog phobia. Furthermore, preliminary evidence suggests that our active-imaginal exposure treatment may be a viable alternative to in vivo exposure.     

Training parents to implement pediatric feeding protocols

Four different multicomponent training packages were evaluated to increase the treatment integrity of parents implementing pediatric feeding protocols. In Study 1 we exposed 3 parents to a training package that consisted of written protocols (baseline), verbal instructions, therapist modeling, and rehearsal training. Results suggested that the package was successful in increasing treatment integrity of the feeding protocols to high levels. Study 2 investigated three different parent-training packages comprised of components used in Study 1. Two parents were exposed to written protocols, verbal instructions, and modeling; 2 parents were exposed to written protocols, verbal instructions, and rehearsal; and 2 parents were exposed to written protocols and verbal instructions. Results of Study 2 showed that each parent-training package produced very high treatment integrity. Follow-up data in the clinic and home for 5 participants suggested that the results were durable for up to 3 months. These results demonstrate a first step in the transfer and application of research findings into routine clinical practice because we evaluated several methods for training parents to implement behavioral feeding protocols, and we demonstrated that these methods resulted in high levels of treatment integrity in a controlled clinical setting.     

Sequential evaluation of behavioral treatments and methylphenidate dosage for children with attention deficit hyperactivity disorder

We used a sequential approach to evaluate the relative and combined effects of different types of behavioral treatments, as well as dosage of methylphenidate (MPH), on the disruptive behavior of 3 students who had been diagnosed with attention deficit hyperactivity disorder. Results showed that individualized behavioral treatments produced decreases in disruptive behavior equivalent to MPH for all 3 participants and demonstrated the need to evaluate behavioral treatments and medication dosage on an individual basis.     

Social Anxiety Disorder in Childhood and Adolescence: Current Status and Future Directions

This paper reviews the current status of research on the phenomenology, etiology, maintenance, assessment, and treatment of childhood and adolescent social anxiety disorder (SAD). Despite being one of the most prevalent disorders of childhood and adolescence, SAD paradoxically stands as one of the least recognized, researched, and treated pediatric disorders. The small treatment outcome literature provides preliminary support to the effectiveness of various forms of cognitive behavior therapy. The majority of studies to date, however, are limited by inadequate control conditions. Other findings include some support for the utility of parental involvement in treatment, significant advancements in outcome measures (e.g., normative comparisons, indices of naturalistic social functioning), and impressive durability of gains for the majority of treatments. Future directions are suggested, including experimental and naturalistic studies of developmental pathways and maintenance factors, the incorporation of positive psychology constructs (e.g., positive emotions, hope, self-control) in treatment and prevention, and the continued delineation of differences between child, adolescent, and adult manifestations of SAD.     

Does God Play Dice? A Response to Niels H. Gregersen, “The Idea of Creation and the Theory of Autopoietic Processes”

The idea that the Creator has a plan for creation is deeply rooted in the Christian notion of Providence. This notion seems to suggest that the history of creation must be the execution of the providential plan of God. Such an understanding of divine providence expects science to confirm that cosmic history is under supernatural guidance, that evolution is therefore oriented toward a goal—to bring forth human beings, for example. The problem is, however, that science finds evidence for neither supernatural guidance nor teleology in nature. To address this problem, I understand Niels H. Gregersen to suggest that God is involved in the creative process. The reason science cannot demonstrate God's supernatural guidance of evolution is that the Creator structures the process from within. Gregersen argues that God is involved in the process of creation by changing the overall probability pattern of evolving systems.
In my view, such a model of how God interacts with creation is supported neither by orthodox Christianity nor by modern science. After a critique of Gregersen's argument and a brief history of the relationship between Christianity and science, I shall suggest an alternative. It is that the freedom of creation to create itself is implicit in the fundamental dogma of Christianity that God is love.     

Psychotherapy Process Measure Research and the Evaluation of Psychotherapy Orientation: A Narrative Analysis

This article discusses the need for a systematic method that enables researchers to evaluate integrative therapy approaches using a range of therapy process measures. The Narrative System Process Coding (NPCS; Angus, Hardtke, & Levitt, 1996) is proposed as such a method, and is applied with the Experiencing Scale (Klein, Mathieu, Gendlin, & Keisler, 1970) and the Levels of Client Perceptual Processing (LCPP; Toukmanian, 1986) to three brief good outcome integrative therapy modalities to illustrate this need. The study found higher Experiencing Scale scores to be most strongly related to an experiential approach to therapy and to the NPCS internal narrative processes. Higher LCPP scores were most strongly related to the NPCS reflexive narrative process and to a perceptual-processing approach. The discussion initiates a discourse on the importance of explicating process measures' origins when comparing different therapy approaches in order to allow for the meaningful consolidation of process research findings.     

Course of Treatment During a Cohort-Based Inpatient Program for Posttraumatic Stress Disorder

This study examined one group of veterans with post-traumatic stress disorder (PTSD) over the course of a four month inpatient treatment program. The aim of the study was to examine treatment process factors that may contribute to the generally poor outcome reported in previous studies. Group members made weekly ratings in the domains of PTSD symptoms, morale, interpersonal relationships, and physical problems. Results contrasted with clinical assumptions usually made regarding the treatment process in these programs. Despite an appearance of cohesion among group members, variation of scores on functional domains was explained largely by individual differences. Progress through the program showed a strongly linear pattern, with no phase effects. Somatic complaints did not increase during the phase when traumatic material was explored. Degree of improvement or worsening was best predicted by level of PTSD symptoms at admission, indicating that more symptomatic veterans did worse in the program. Additional factors of race, combat exposure, childhood abuse, and application for disability had no effect on the process variables measured.