PubMed Health⌕ Search

Biomedical subjects

K N DeWitt

Publications and source records attributed to K N DeWitt.

8 recordsLinked to original sources
PubMed1985

A proposed method for measuring change beyond symptoms.

The initial report of the Patterns of Individual Change Scales battery presented the rationale, development, and conceptualization of this measurement package. Empirical data supported the reliability and validity of the scales as measures of patient characteristics that extended beyond the symptomatic domain. This article presents more extensive reliability and validity data. Ratings on two new samples were collected, and the interrater reliability coefficients for the scales were again of appreciable magnitude. Discriminant validity was examined, as was the factor structure of the battery. The results suggested that the scales tap three distinct sources of variance. Comparisons with symptom measures and case illustrations indicated that the measurement of changes in patients' functioning beyond symptoms is necessary and viable.

Adult↗
PubMed1984

Brief psychotherapy of bereavement reactions. The relationship of process to outcome.

We studied the relationship of dispositional and process variables with outcome in 52 bereaved patients given time-limited dynamic psychotherapy. Outcomes were generally favorable in symptom relief and improvement in relationship and occupational functioning. Patients' symptoms improved more than did their social and work functioning. Pretreatment levels of impairment or distress were significantly related to outcome, but most demographic and dispositional variables did not predict outcome. Process variables examined in relation to outcome--therapeutic alliance and actions by the therapist--were not significantly related to either type of outcome. When we considered the same process variables in interaction with two dispositional variables, motivation for dynamic therapy and developmental level of the self-concept, we found significant predictions of outcome. The major findings suggest that more exploratory actions were more suitable for highly motivated and/or better-organized patients and less suitable for patients with lower levels of motivation or organization of self-concept. More supportive actions were more suitable for patients at lower dispositional levels and less therapeutic for patients at higher levels.

Adjustment Disorders↗
PubMed1984

Three approaches to marital enrichment: toward optimal matching of participants and interventions.

Three approaches to marital enrichment were examined to determine if predictors of client gains could be identified empirically. Direct training of spousal communication skills by one of two male-female co-trainer teams, observation of videotaped simulations of direct training, and bibliotherapy with telephone contacts were the three approaches, and a wait-list control group was also evaluated. Clear predictive relationships emerged between initial indices of marital and family adjustment and prior experience with therapy, and client changes on self-report measures of marital and family adjustment. Different predictors and predictive relationships characterized each of the three different enrichment approaches, and prediction of outcome was more robust for these three trained groups than for the wait-list group. Changes in clients' communication behaviors were not well predicted, leading to the conclusion that attitudinal changes in marital enrichment programs may be facilitated by optimal matching of different clients with the appropriate type of intervention, but that behavior changes are more a function of systematic skills training for all clients.

Adult↗
PubMed1983

Judging change in psychotherapy. Reliability of clinical formulations.

Careful clinical formulation describing the dimensions of core neurotic conflicts is integral to the practice of psychodynamic psychotherapy. Therefore, a method for reliable and valid formulation is a necessary precursor for the empirical investigation of the impact of such therapy. Our study evaluated a method of outcome assessment based on clinical formulations. Results from 18 patients indicate that independently derived formulations of a central conflict do not agree and that these disagreements in formulation are reflected in disagreements in the change ratings that are based on them. Additional analyses suggested that symptomatic change represents the major component in outcome rating.

Adjustment Disorders↗
PubMed1981

Patterns of individual change scales.

Measurement of complex modifications in personal functioning is a necessary step to the relevant translation of psychotherapy research into clinical practice. Using an assessment strategy aimed toward decreasing subjective bias, we pursued an inductive clinical approach in constructing the Patterns of Individual Change Scales (PICS) battery. Designed for use with a bereaved population, each of the 13 scales has a unitary focus and hierarchy of functional levels across the domains of symptoms, social relations, and self-concept. Nine experienced clinical judges rated the scales after viewing videotaped evaluation interviews of 18 patients and 18 field subject. In general, the PICS had a suitable range for our borderline through normal population, reached acceptable levels of reliability, and could discriminate among subjects in clinically meaningful ways. Future analyses will consider issues of bias, validity, and generalization.

Adult↗
PubMed1978

The effectiveness of family therapy: a review of outcome research.

Outcome research was reviewed on the conjoint treatment of families that involved at least two generations. Results from studies without comparison groups show that conjoint family therapy has an impact that is similar, but not superior, to nonconjoint methods. Studies with comparison groups provide some evidence that conjoint treatment is superior to no treatment and to treatment with nonconjoint methods. Studies that examine the effect of factors (ie, patient, therapist, and technique) affecting the outcome of conjoint treatment show that variations in these factors do have an impact on the result. Identifying the proper criteria of change is important.

Adolescent↗