M.A. (Psychology) / The overall aim of this study is to evaluate the effect that Human Modelling in a group therapeutic setting, has on the mental health or personal integration of prisoners. The General Systems Theory, principles of Cybernetics and Botes' (1987) integrated model of mental health are used as a meta theoretic point of departure. From the literature study it transpires that it is important to explain and treat the prisoner in totality in order to make treatment more effective. An attempt is thus made to formulate an integrated model for the explanation of the crime phenomenon by virtue of already existing models. Furthermore the personal functioning (intra- and interpersonal) - as index of mental health of the criminal is surveyed. A short comparison is done between the traits of a mentally healthy person (Botes, 1987) and the personal functioning of the criminal or prisoner. From this it appears that the criminal has certain deficiencies in this regard and hence cannot be described as an integrated person once the traits are unbalanced. He thus requires guidance towards a higher degree of personal integration, which should lead to a change in traits and accordingly balance is restored. From the literature study it is evident that treatment of prisoners is to a large extent unsuccessful. The reasons for this are pointed out. Human Modelling in a group therapeutic setting however, has the potential to lead the prisoner towards a higher degree of personal integration, due to it's metaphoric and synthetic nature, and to make treatment more successful. The potential that Human Modelling as a metaphor holds for the therapist and mental health of the prisoner, is pointed out and described...

Phobic and anxiety disorders are one of the most common, if not the most common and debilitating psychopathological conditions found among children and adolescents. As a result, a treatment research literature has accumulated showing the efficacy of cognitive behavioral treatment (CBT) for reducing anxiety disorders in youth. This dissertation study compared a CBT with parent and child (i.e., PCBT) and child group CBT (i.e., GCBT). These two treatment approaches were compared due to the recognition that a child’s context has an effect on the development, course, and outcome of childhood psychopathology and functional status. The specific aims of this dissertation were to examine treatment specificity and mediation effects of parent and peer contextual variables. The sample consisted of 183 youth and their mothers. Research questions were analyzed using analysis of variance for treatment outcome, and structural equation modeling, accounting for clustering effects, for treatment specificity and mediation effects. Results indicated that both PCBT and GCBT produced positive treatment outcomes across all indices of change (i.e., clinically significant improvement, anxiety symptom reduction) and across all informants (i.e., youths and parents) with no significant differences between treatment conditions. Results also showed partial treatment specific effects of positive peer relationships in GCBT. PCBT also showed partial treatment specific effects of parental psychological control. Mediation effects were only observed in GCBT; positive peer interactions mediated treatment response. The results support the use CBT with parents and peers for treating childhood anxiety. The findings’ implications are further discussed in terms of the need to conduct further meditational treatment outcome designs in order to continue to advance theory and research in child and anxiety treatment.

Despite a considerable progress in developing and testing psychosocial treatments to reduce youth anxiety disorders, much remains to learn about the relation between anxiety symptom reduction and change in youth functional impairment. The specific aims of this dissertation thus were to examine: (1) the relation between different levels of anxiety and youth functional impairment ratings; (2) incremental validity of the Children Global Assessment Scale (CGAS); (3) the mediating role of anxiety symptom reduction on youth functional impairment ratings; (4) the directionality of change between anxiety symptom reduction and youth functional impairment; (5) the moderating effects of youth age, sex, and ethnicity on the mediated relation between youth anxiety symptom reduction and change in functional impairment; and (6) an agreement (or lack thereof) between youths and their parents in their views of change in youth functional impairment vis-à-vis anxiety symptom reduction. The results were analyzed using archival data set acquired from 183 youths and their mothers. Research questions were tested using SPSS and structural equation modeling techniques in Mplus. The results supported the efficacy of psychosocial treatments to reduce the severity of youth anxiety symptoms and its associated functional impairment. Moreover, the results revealed that at posttreatment, youths who scored either low or medium on anxiety levels scored significantly lower on impairment, than youths who scored high on anxiety levels. Incremental validity of the CGAS was also revealed across all assessment points and informants in my sample. In addition, the results indicated the mediating role of anxiety symptom reduction with respect to change in youth functional impairment at posttest, regardless of the youth’s age, sex, and ethnicity. No significant findings were observed with regard to the bidirectionality and an informant disagreement vis-à-vis the relation between anxiety symptom reduction and change in functional impairment. The study’s main contributions and potential implications on theoretical, empirical, and clinical levels are further discussed. The emphasis is on the need to enhance existing evidence-based treatments and develop innovative treatment models that will not only reduce youth’s symptoms (such anxiety) but also evoke genuine and palpable improvements in lives of youths and their families.

The present study evaluates attentional training and behaviour rehearsal in treating musical performance anxiety and in modifying self-talk and perceptions of self-efficacy. Pianists who experienced extreme anxiety in. performing situations were randomly assigned to the following conditions: (l) attentional training (n = 19), (2) behaviour rehearsal (n = 16), (3) waiting list control (n = 18). Three therapy sessions were conducted over a three-week period with subjects in the first two conditions meeting in small groups for one and one-half to two hours. Subjects in the attentional training program were taught to become aware of their negative thoughts before, during, and after their performances and to substitute these negative thoughts with positive task-relevant self-statements. Cognitive recall from videotaped performances and cognitive-modeling slide-tape sequences facilitated this process. Subjects in the behaviour rehearsal program were given a rationale for the effectiveness of repeated performance before a small supportive audience in reducing performance anxiety. Both treatments required performances during therapy sessions and in home assignments. A multivariate analysis of covariance revealed no difference among the three groups at post-treatment on self-report, behavioural, or physiological measures. At a five-week follow-up, however, attentional training and behaviour rehearsal were more effective than the waiting list control condition in reducing visual signs of anxiety and improving the quality of playing. Attentional training was superior to behaviour rehearsal in reducing visual signs of anxiety. Two scales were developed to measure the cognitive mediational variables of self-talk and self-efficacy. At follow-up, both treatments were superior to no treatment in increasing positive and decreasing negative thinking surrounding performances. Attentional training was superior to the other two conditions in enhancing expectations of personal efficacy. Behaviour rehearsal did not surpass the attentional training treatment on any of the six dependent measures, at follow-up. These findings were discussed in relation to previous research on attentional training and behaviour rehearsal, and to the cognitive mediational processes common to both therapies. Issues such as modeling effects, expectancy effects, follow-up, home assignments, subject attrition, and implications for the musical community were also discussed. / Arts, Faculty of / Psychology, Department of / Graduate

This study investigated efficacy of an online, preventive intervention program, Children of Divorce-Coping with Divorce (CoD-CoD; Boring, 2011). It extends previous findings to a sample of eight youth from high-conflict families who recently initiated legal divorce proceedings. CoD-CoD is a cognitive-behavioral intervention that targets coping efficacy, coping strategies, and divorce-related cognitive appraisals. A multiple-baseline single case experimental design evaluated change in daily use of active and avoidant coping strategies and corresponding coping efficacy ratings. Individual patterns of change were inspected for the program’s putative mediator variables and overall mental health functioning. Results indicate that daily coping efficacy ratings increased for four participants and decreased for the three participants who reported the highest levels of exposure to interparental conflict. The majority of participants increased use of at least one type of active coping strategy and half decreased use of at least one type of avoidant coping strategy. There were no observed patterns of systematic change in divorce-related cognitive appraisals and changes in mental health functioning were mixed. An exploratory analysis found that youth were classified as "high-risk" on a psychometrically-sound risk index in 100% of cases with documentation of two or more conflict-indicative legal events in the family court file. The study findings are consistent with previous evidence of a moderated program effect on coping efficacy, although positive effects on youth-reported mental health functioning were not replicated. Findings are discussed within the context of a high-conflict sample with temporal proximity to the legal divorce and in light of study limitations. Research directions toward effectively connecting at-risk youth with evidence-based prevention services are detailed.

Research has shown that positive emotions are important to optimal health, functioning, and well-being, and contribute to resilience against psychological dysfunction. However, many clinical disorders, particularly anxiety and mood disorders, are associated with deficits in positive emotion that may contribute to symptoms and inhibit full recovery. Despite accumulating data identifying disturbances in positive emotion and positive emotion regulation in anxiety and depressive disorders, these deficits have received insufficient attention in treatment. The present study represents a preliminary evaluation of the feasibility and utility of a novel augmentation intervention for enhancing positive emotion in anxiety and depressive disorders. Nine patients with a range of principal anxiety disorders who had previously completed an initial course of cognitive-behavioral treatment at the Center for Anxiety and Related Disorders at Boston University (CARD) completed the study. The study utilized a single case experimental design, specifically a multiple baseline across participants design, with participants randomized to 2-, 4-, or 6-week baseline periods to control for the effect of time on outcome variables. Primary outcome variables were assessed weekly during the baseline and intervention phases to permit analysis of functional relationships between individual factors, specific treatment components, and therapeutic outcomes. Major assessments were conducted at baseline, pre-, post-treatment, and a 3-month follow-up. These included both self-report and independent evaluator-rated components. Results indicated that the intervention was effective in improving positive emotion regulation skills for 5 of the 9 of participants. The intervention was associated with significant improvements in anxiety and depressive symptoms, and preliminary effects sizes for pre- to follow-up changes in positive emotion regulation, symptoms, positive and negative emotion, functioning, quality of life, and well-being were moderate to large. Participants reported high acceptability and satisfaction with the study intervention. Qualitative feedback from participants highlighted several areas for improvement in the format and delivery of the intervention, such as increasing the number of sessions and providing a patient workbook, and these changes may increase the effectiveness of the intervention. Future research is needed to confirm the validity of these findings and evaluate the generalizability of these effects across patients and settings.

This study investigated the relative effectiveness of (1) modeling, (2) modeling plus behavior rehearsal, and (3) modeling, behavior rehearsal,_ and videotaped feedback in assertive training.. Twelve psychiatric outpatients were randomly assigned to three treatment groups, ,each of which received 5 hours of training. Four additional subjects served as a waiting .list control group. The dependent measures used were the Assertive Behavior Situation Test (ABST), a behavioral role-play test, and two additional paper and pencil measures (Constriction Scale and Fear of Negative Evaluation). Each of these measures was administered at pre- and post-test sessions. Split-plot 4.2 analyses of variance (Kirk, 1968) yielded a significant trial effect on both of the pencil and paper measures but not on the ABST. There were no significant group effects on any of the measures, nor were there any group X trial interactions. The implications of these results on previously reported assertive training research were briefly discussed.

Dialectical Behavior Therapy (DBT; Linehan, 1993) is an empirically supported, skills based, cognitive-behavioral therapy used to treat a myriad of symptoms including chronic suicidality and self-harm, emotion dysregulation, reactive aggression and other mood dependent behaviors. Because of its emphasis on self-regulation and a wide range of problem behaviors, DBT can be readily applied to sex offender treatment programming. In this workshop, participants will learn about DBT’s method of conceptualizing and addressing client problems, important strategies for engaging offenders in treatment using this approach, and DBT skills. Important updates from the most recent DBT skills manual will also be addressed. be discussed.

Dialectical Behavior Therapy (DBT; Linehan, 1993) is an empirically supported skills-based, cognitive-behavioral therapy originally developed for use with clients with borderline personality disorder and associated self-harm behavior. Its unique combination of individual therapy, skills group, in vivo skills coaching, and support for the therapists in the form of a weekly consultation team meeting, provide a comprehensive framework for treating difficult behaviors in a client population who do not demonstrate positive outcomes when participating in traditional psychotherapy practice. Multiple randomized control trials have demonstrated its effectiveness in reducing chronic suicidality and self-harm, particularly among those with personality pathology and substance abuse problems. Since its initial use, DBT has been applied to a myriad of treatment needs, including emotion dysregulation, reactive aggression, and other mood-dependent behavior. Recent evidence indicates that self-regulatory problems are quite common among sexual offenders (Stinson, Becker, & Sales, 2008; Stinson, Robbins, & Crow, 2011; Stinson, Sales, & Becker, 2008; Ward & Hudson, 2007), including difficulties with emotion regulation, violent and sexual aggression, interpersonal skills deficits, suicidality, and problems with substance use. Sex offenders benefit from DBT’s emphasis on self-monitoring, interpersonal and emotional skills development, and the use of a hierarchical treatment structure that addresses multiple behavioral problems and life concerns. Further, some sex offenders – particularly those who present with personality pathology or pronounced self-regulatory deficits – may be unable to meaningfully engage in sex offender specific treatment until they address more acute symptomatology. DBT presents an interesting new take on addressing complex emotional and behavioral problems in adolescent and adult sex offenders. Therapists using DBT benefit from a comprehensive and empirically-supported framework, as well as techniques specifically designed to protect clinicians from the burn-out so often associated with treating challenging and high-risk clients. But admittedly, for those unfamiliar with DBT, this novel way of conceptualizing and addressing sex offender clients can be difficult. The primary objective of this workshop is to introduce sex offender therapists to the tenets of DBT and facilitate the implementation of DBT principles and techniques in sex offender treatment. A secondary goal is to familiarize practiced DBT therapists with recent updates to the DBT skills manual.

Major depressive disorder (MDD) is characterized by reduced activation of the dorsolateral prefrontal cortex (DLPFC), a brain region involved in both emotion regulation and basic cognitive control processes. Recent studies have indicated that computerized interventions designed to activate the DLPFC can reduce depressive symptoms. The current study was a randomized controlled trial which extends this research to test whether one such program, called Cognitive Control Training (CCT), enhances depression treatment outcomes when used in adjunct to brief behavioral activation therapy for depression (BATD), an empirically-supported outpatient intervention. This study also explored whether the effects of BATD + CCT treatment on depression were mediated by changes in rumination and cognitive control. In a sample of thirty-four adults diagnosed with MDD, participants were randomly assigned to complete four sessions of either computerized CCT or a non-active computerized control task, concurrently with four sessions of BATD. Completion of the assigned computerized task took place immediately before each of the four BATD therapy sessions. Depression symptoms and proposed treatment mediators were assessed at baseline, mid-treatment, post-treatment, and four-week follow-up visits. I hypothesized that compared to the control group, participants receiving adjunctive CCT would demonstrate significantly reduced depressive symptoms. I also hypothesized that these effects would be mediated by changes in inhibitory control and set-shifting performance in the context of negative emotional material, as well as by changes in ruminative brooding. Results did not support these hypotheses. Depressive symptoms were reduced over time in both treatment conditions, with no significant difference between treatment conditions. Assignment to CCT was not associated with changes in the proposed mediators. Furthermore, exploratory analyses found minimal evidence that performance on inhibitory control and set-shifting tasks were related to baseline clinical characteristics (such as depression severity, rumination, or anxiety symptoms) or treatment outcomes. The results of this study support the potential for BATD as a brief, low-cost, flexible intervention for the treatment of depression and further show that CCT administered in adjunct to a 4-session BATD program does not add clinical benefit in the treatment of depression. This study and other recent research suggest that the effects of CCT may not be as robust as previously indicated, highlighting the need for continued investigation of the conditions under which CCT may be effective.