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Concurrent psychotherapy and behavior therapy. Treatment of psychoneurotic outpatients.

The feasibility and effects of treating psychoneurotic outpatients with concomitant but separate treatment programs of psychoanalytically oriented psychotherapy and behavior therapy was investigated in three cases, utilizing detailed clinical observations and questionnaire responses. The two treatment regimens appeared to have synergistic effects, and anticipated difficulties, such as a split therapeutic alliance, symptom substitution, or preciptious withdrawal from psychotherapy after symptom removal, did not occur. Although there was no evidence of symptom substitution after the behavioral removal of the "target symptom," both clinical observations and questionnaire responses indicated that successful behavior therapy had many unanticipated effects on the patient's nontarget behaviors and cognitions.

Adult↗

An outcome study of group therapy.

Outcome research in a group therapy program was conducted with therapists in training who had little prior experience with group therapy. Significantly greater improvement over an initial three-month period was found for treated patients when compared with control patients on a multivariate combination of five outcome criteria. Some, but not all, of the five separate criteria indicated such a difference. Only slight, nondifferentiating improvement was found for target symptoms. Significantly greater improvement over the three-month period on the multivariate combination was also found for treated patients who had begun therapy during the second year of the program when compared with treated patients who had begun therapy during the first year of the program. Finally, significant improvement over the three-month period on the multivariate combination was found for both treated and control patients.

Anxiety Disorders↗

A controlled evaluation of inpatient family intervention. I. Preliminary results of the six-month follow-up.

Although family intervention is practiced in most psychiatric hospitals, there are no adequately controlled studies of its efficacy. This study was designed to answer, in part, the following question: What is the relative efficacy of hospitalization with family intervention as compared with hospitalization without family intervention for patients with major psychiatric disorders who are in need of hospital treatment and for whom both treatments are judged clinically feasible? This is our first report, presenting preliminary data on six-month follow-up for the first three quarters of the total sample of 144 patients (80 with schizophrenic disorder and 64 with major affective disorder).

Adolescent↗

Impact of therapist interventions on early sessions of group therapy.

A methodology for studying the effect of therapist style on the process of group therapy was developed and applied to two early sessions in two different therapy groups. In general, the results supported the hypothesis that individually directed, confrontative interventions would lead to emotionally focused and immediate client responding. The results failed to confirm the hypothesis that relatively interpretive interventions would be the most productive. In fact, simple facilitations tended to produce higher mean focusing than all other types of interventions. Perhaps in very early sessions the most productive interventions are those designed simply to encourage patients to talk and interact. The decisive technique of a group therapist may be interpretation, which helps patients to comprehend the significance of personally relevant, emotionally charged interactions. However, in the fledgling group, the therapist may be most helpful by simply facilitating members' speaking up and interacting. Indeed, clarifications and interpretations may turn out to be the group therapist's most productive interventions, but perhaps not until after group cohesiveness is developed in early sessions.

Adolescent↗

The delayed impact of group therapists' interventions.

The direct and delayed impact of therapist interventions on 21 clients in three outpatient therapy groups was examined. Sessions one and five of each group were taped with every therapist intervention analyzed according to the Group Therapist Interventions Scale and every client utterance rated on the Experiencing Scale and categorized by the Group Immediacy Scale. It was hypothesized that therapists would have a delayed rather than direct influence on group process measures. When pairs of therapist-patient statements were examined; little immediate impact was evident. However, a profound delayed impact of group leaders was inferred from the finding that astherapist interventions became more forceful over the first five sessions, patients' level and immediacy of experiencing became more intense.

Adolescent↗

Internal multiplicity in emotion-focused psychotherapy.

Emotion-focused therapy regards the client's problems as indications that the inner dialogue among voices of the self has become fractious, often because one or more voices have developed emotion schemes that are based on maladaptive emotions. The goal of therapy is to transform such maladaptive emotions into more adaptive ones. The therapist's interventions focus on facilitating the client's process of dialogue among the voices of the self and guiding the client toward experiencing of adaptive emotions. These new experiences contribute to a dynamic shift in the relation among the voices. A case study illustrates how a male client's rage and hopelessness transformed into assertiveness and tenderness as the various voices learned to respect and help each other within the self.

Adaptation, Psychological↗

An activity therapy group with children in an in-patient psychiatric setting.

This article describes a short-term activity discussion therapy group for severely disturbed children in an inpatient psychiatric unit. Major themes of the sessions are reported as well as clinical vignettes that assist in clarifying techniques and demonstrating the efficacy of these techniques. Co-leaders include a resident psychiatrist, a nurse, and a mental health worker; supervision is provided by a social worker. The group described is on-going at the New York Hospital-Cornell Medical Center (Westchester Division) in the inpatient children's psychiatric unit. In summary, staff report that group members tolerate group activities better and exhibit more socially acceptable interactions.

Anger↗