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Biomedical subjects

D B Arnkoff

Publications and source records attributed to D B Arnkoff.

7 recordsLinked to original sources
PubMed2000

Two examples of strains in the therapeutic alliance in an integrative cognitive therapy.

Two case examples are presented to illustrate methods of recognizing and working with strains in the therapeutic alliance in an integrative cognitive therapy. I argue that developmental, personality, and therapy-readiness constructs are useful in understanding strains in the alliance and whether to confront such strains directly. Attachment theory was relevant to understanding the therapeutic alliance in the first case, when the client reacted to the possibility of termination in an insecure manner. Direct discussion of the alliance strain was useful in this case. The client in the second case was resistant to interpersonal influence. I did not address strains directly because the client would probably not have seen this work as relevant to his goals. In this case, a focus on strains could have weakened our alliance rather than strengthened it.

Adult↗
PubMed2000

Consumers' perspectives on helpful and hindering factors in mental health treatment.

We summarize the four papers in this issue by consumers evaluating their mental health treatment, focusing on aspects of their treatment that they collectively found helpful and hindering. These factors include the context of treatment, the therapy relationship, interventions used and issues addressed, helpful experiences outside the mental health system, and hindering views of mental illness and treatment. We then present comments by two clients in outpatient therapy on the same topic. Research on clients' perceptions of their outpatient psychotherapy is discussed in reference to these six consumer perspectives, and future directions for therapists and researchers are suggested.

Age Factors↗
PubMed1997

Questionnaire methods of cognitive self-statement assessment.

Questionnaire methods can be used to assess thoughts, which are cognitive products often referred to as self-statements, automatic thoughts, or internal dialogue. This review examines the nature of endorsement measures of self-statements and considers their advantages and disadvantages as well as scoring issues. A psychometric evaluation of self-statement questionnaires discusses the issues of reliability, content validity and scale development, criterion validity, construct validity, and clinical utility. Descriptions of and psychometric findings for over 2 dozen measures are summarized, including measures for depression, anxiety, eating disorders, pain, and applications with children and adolescents, and conclusions and future directions are suggested.

Awareness↗
PubMed1994

Validity issues in self-statement measures of social phobia and social anxiety.

Measures to assess internal dialogue or self-statements in socially phobic or anxious clients are now frequently used in clinical and research settings. Such cognitive assessment techniques are rarely considered, however, with regard to psychometric criteria. This article reviews the literature on self-statement assessment of social phobia and social anxiety from the perspective of content, criterion, convergent and discriminant validity. In general, most measures have shown good evidence of validity. Different scoring systems in addition to thought valence appear worthwhile, and multiple measures and assessment occasions should be considered.

Anxiety Disorders↗
PubMed1991

Cognitive-behavioral and pharmacological treatments of social phobia. A controlled study.

Sixty-five patients with social phobia were treated in a study that compared a cognitive-behavioral group treatment program with pharmacotherapy with alprazolam, phenelzine sulfate, or pill-placebo plus instructions for self-directed exposure to phobic stimuli. Statistically significant repeated-measures effects were shown on all measures, indicating that the treatments studied were associated with substantial improvements in patients with severe and chronic social phobia. Patients who were treated with phenelzine were rated by clinicians as more improved on a measure of work and social disability than patients who were treated with alprazolam or placebo (patients in the cognitive-behavior therapy group were not rated on this measure). Subjects showed positive cognitive changes from before to after treatment, and there were no differences between treatment groups on the cognitive measure. We discuss the implications of these findings within the context of demographic and clinical predictors of response.

Adolescent↗
PubMed1990

The psychosocial consequences of traumatic injury.

Long-term stress experienced by trauma patients was assessed for a sample of 137 patients treated at a large urban trauma center after suffering traumatic injuries resulting from motor vehicle/motorcycle accidents, falls, pedestrian accidents, and stabbing and gunshot wounds. Levels of psychological distress reported 3 to 39 months after the accident were considerable, but a measure of injury severity commonly used in critical care settings was not a good predictor of psychosocial outcome. The subjective impact of the accident and injury-related financial and employment problems were more important in predicting outcome than medical variables or time since injury. Family environment ratings were significantly worse for subjects with elevated levels of psychiatric symptoms. The results suggest that psychosocial interventions may benefit many of these individuals. Aspects to be considered in planning the intervention include projected functional disability, likely employment and financial problems, subjective perceptions of the accident and its implications, and family and social support.

Adaptation, Psychological↗