The effect of the two-chair dialogue intervention on self-compassion - adding an emotional evocative component to a basic Rogerian condition

Objective

How people relate to themselves when facing distress or failure influences general psychological well-being and vulnerability to psychological disorders. The aim of the present study was to explore the effect of an emotionally evocative intervention on self-compassion.

Methods

The data were retrieved from a larger study of Emotion-Focused Therapy (EFT) utilising a multiple baseline design comparing two treatment phases. The baseline phase consisted of 5, 7 or 9 therapy sessions where the therapist solely adhered to Rogerian relational conditions, as prescribed in EFT. A two-chair dialogue intervention was then added for five sessions. The sample consisted of 18 self-critical clients with clinically significant symptoms of depression and/or anxiety. The “Self-Compassion Scale” (SCS) was administered pre, mid and post therapy.

Results

The baseline phase did not lead to significant changes in self-compassion. However, the addition of the two-chair dialogue was associated with a significant increase in self-compassion. This increase was due to reductions in the negative subscales, especially the isolation subscale.

Conclusion

The emotionally evocative two-chair dialogue was associated with a significant change in self-to-self relating, compared to relational conditions alone. The two-chair dialogue, thus, seems to be a promising intervention for promoting healthier self-to-self relating.     

Principles versus procedures in making health care coverage decisions: addressing inevitable conflicts

It has been suggested that focusing on procedures when setting priorities for health care avoids the conflicts that arise when attempting to agree on principles. A prominent example of this approach is “accountability for reasonableness.” We will argue that the same problem arises with procedural accounts; reasonable people will disagree about central elements in the process. We consider the procedural condition of appeal process and three examples of conflicts over coverage decisions: a patients’ rights law in Norway, health technologies coverage recommendations in the UK, and care withheld by HMOs in the US. In each case a process is at the center of controversy, illustrating the difficulties in establishing procedures that are widely accepted as legitimate. Further work must be done in developing procedural frameworks. The opinions expressed are the authors’ own. They do not reflect any position or policy of the National Institutes of Health, US Public Health Service, or Department of Health and Human Services. This research was supported by the Intramural Research Program of the NIH Clinical Center.     

On use of student samples for scale construction

This research note responds to the question of whether a convenience sample of undergraduate students may be successfully utilized in concept development and in scale construction, and in what way the results are comparable to the findings of a representative national sample. The results of a Mokken analysis in both samples support the hypothesis that convenience samples have utility in concept development and in developing measures that can also be used in representative samples.     

The use of interval estimators as a basis for decision-making in medicine

Theoretical Medicine and Bioethics - Decision analysts sometimes use the results of clinical trials in order to evaluate treatment alternatives. I discuss some problems associated with this, and in...     

Scale development to measure attitudes toward unauthorized migration into a foreign country

This study reports on the development and cross-national utility of a Likert type scale measuring attitudes toward unauthorized migration into a foreign country in two samples from "migrant-sending" nations. In the first phase a pool of 86 attitude statements were administered to a sample of 505 undergraduate students in Bulgaria (22.5% male; M age = 23, SD = 4.8). Exploratory factor analysis resulted in six factors, and a reduction to 34 items. The results yielded an overall alpha of (0.92) and alpha for subscales ranging from 0.70 to 0.89. In the second phase the 34-item scale was administered in a survey of 180 undergraduates from Sofia University in Bulgaria (16.7% male, M age = 23, SD = 4.8), plus 150 undergraduates from Hanoi State University in Vietnam (14.7% male, M age = 19, SD = 1.8). Results yielded a 19-item scale with no gender differences, and satisfactory alpha coefficients for a Vietnamese and Bulgarian sample of 0.87 and 0.89 respectively. This scale, equally applicable in both samples, includes items that reflect salient topics of concept of attitudes towards unauthorized migration. An exploratory principal component analysis of the Bulgarian and Vietnamese version of the 19-item scale yielded three factors accounting for 54% and 47% of the variance respectively. A procrustes analysis indicates high conceptual equivalence in the two samples for factor 1 and 2, and moderate for factor 3. This study lends support to the idea that despite different cultural meanings there is a common meaning space in culturally diverse societies.     

The ‘borderzone zone’ controversy a study of theory structure in biomedicine

This paper gives an account of theory structure in the biomedical sciences with particular emphasis on cardiology. Rather than regarding theories as axiomatizable sets of statements (the so-called ‘received view’), theories are regarded as answers to questions which are accepted as legitimate and interesting by scientists within a field of investigation at a given time. This account of theory structure is used to distinguish between theories which are quite liable to be revised during the course of scientific investigation, here called theories within the field, and theories which are more securely established, here called theories of the field. These latter theories can also be regarded as patterns of reasoning which are applied again and again to answer the questions of the field. It is argued that the distinction proposed in this paper fits our intuitive understanding of what it means for a theory to be securely established within a field of research. Several examples are given which show the problems of justifying clinical intervention solely on the basis of theories within the field.     

On the Stability of Psychological Hardiness: A Three-Year Longitudinal Study

More than 30 years of research has established psychological hardiness as an important individual resiliency resource. One important question still remaining is whether psychological hardiness can be trained. The present study explored this question longitudinally within the context of a 3-year military academy training program. Cadets from 3 different Norwegian military academies (N = 293) completed hardiness questionnaires during the first week of their training, and then again at the end of each year, resulting in a total of 4 waves of data. Using hierarchical linear modeling, no statistically significant effect of time on hardiness scores was found. The nonsignificant growth parameter was examined further using Bayesian statistics as an indicator of the relative evidence for the null hypothesis of no change over time versus the alternative hypothesis of change. The resulting Bayes factor provided substantial support in our data for the null hypothesis of no hardiness development during the 3-year officer training programs.