This research examined the structural properties of individual’s organizational change schemas. An organizational change schema is a particular sensemaking framework that contains knowledge about organizational change, including change attributes and relations among those attributes. Understanding the properties of these schemas is important because existing research suggests that the way individuals think about change influences their responses to it. Specifically, the present study investigated health care managers’ sensemaking regarding implementation of a quality initiative by examining: (1) the structure and content of organizational change schemas; (2) the extent to which schemas were shared by organizational members; and (3) the nature of the relationship between shared understanding and organizational inertia. A sample of 28 health care managers from a large hospital in the Northeastern U.S. completed the repertory grid, a method originating in cognitive psychology (Kelly, 1955). This method allowed organizational members to identify meaningful dimensions that distinguished between organizational change attributes while minimizing the imposition of the researcher’s frame of reference. The content and structure of members’ change schemas were also examined using a pre-designed instrument by Lau and Woodman (1995). Content analysis revealed that in their effort to make sense of organizational change, organizational members rely on a relatively small number of widely shared evaluative dimensions, and a larger number of essentially idiosyncratic dimensions. An analysis of change schemas by organizational level revealed important differences in the way top managers and middle managers make sense of change. The results of cluster analysis indicated that discrete shared organizational change schemas could be identified and meaningfully understood in terms of current and ideal orientations. Contrary to expectations, incongruence between members’ current and ideal change schemas did not give rise to negative emotions. However, incongruence between these schemas was positively related to resistance to change. Comparison of the two methods used in this study suggests that the preservation of the terms and dimensions people themselves use to describe organizational change represents an important consideration for future cognitive-based organizational change research. Implications for theory and practice as well as directions for future research are discussed.

No description available.

Thesis (PhD)--Stellenbosch University, 2000. / ENGLISH ABSTRACT: The objective of this study was to investigate and compare the effectiveness of a combined exposure and cognitive restructuring programme versus exposure only in the treatment of social phobia. The 44 participants in the study met the DSM-IV diagnostic criteria for social phobia at pre-treatment assessment, and presented mainly with general interactional social fears. They were allocated to a group which received a combined exposure and cognitive restructuring treatment (n = 15), a group treated with exposure only (n = 15), and a waiting-list control group (n = 14). For treatment purposes, both treatment groups were subdivided into two smaller groups of 7 and 8 participants each. The effects and differential effects of the treatments were compared in terms of four broad categories of variables: target phobia variables (anxiety/avoidance/escape in relation to a specific target phobia), social phobia variables (associated with the degree, nature, aspects and/or consequences of social phobia), cognitive variables (thought functionality, fear-of-negative-evaluation, and attentional bias), and severity of depression. Participants were individually assessed before treatment, immediately after treatment, and at follow-up after three months. Treatment were conducted by two co-therapists in 12 weekly group sessions of two hours each. Compared to a waiting-list control condition, both treated groups showed a significant improvement of the target phobia variables at post-treatment and, with the exception of target phobia anxiety for the exposure only condition, the significant effects were maintained at follow-up after three months. As for the social phobia variables, cognitive restructuring and exposure combined showed a significantly larger improvement compared to the waiting-list control condition on four of the variables (social phobia avoidance, social phobia observation anxiety, social phobia general symptomatology, and social phobia disturbance/disablement), and these significant effects were maintained at follow-up. The exposure only group showed significantly larger effects on only two variables (social phobia avoidance and social phobia disturbance/disablement) and only the effects on social phobia avoidance were maintained for the followup period of three months. With regard to the cognitive variables, the combined treatment led to significanly larger improvements in thought functionality compared to the waiting-list control condition and these effects were maintained at follow-up. No other significant differences between the effects of any of the treatments and the waiting-list control condition were demonstrated at post-treatment or at follow-up on any of the cognitive variables. Only the combined treatment resulted in significantly larger reductions in the severity of depression, The effects were maintained for the follow-up period of three months. Compared to the waiting-list control condition, the combined treatment resulted in improvement over a broader spectrum of social phobia symptomatology than exposure only at post-treatment and follow-up. The two treatments were also directly compared in terms of their effects on each of the dependent variables and the differences were largely insignificant at both post-treatment and follow-up. Only in terms of thought functionality tentative indications of a possible larger effect for the combined treatment were found. However, if this was the case, the differences were cancelled out at follow-up. It seems that both the combined treatment and exposure only were effective treatments for social phobia and that the combined treatment might have demonstrated slightly better results. These findings support the emerging view that the most important cognitive-behavioral treatments of social phobia do not differ greatly in terms of efficacy. It also offer support for the view of prominent researchers on social phobia outcome, namely that treatment effects are less dependent on procedural variations than on other critical elements, such as the length and frequency of treatment sessions, and exposure to the critical elements of patients' social fears. / AFRIKAANSE OPSOMMING: Die doel van hierdie studie was om die effektiwiteit van 'n gekombineerde blootstelling en kognitiewe herstruktureringsprogram teenoor blootstelling alleen in die behandeling van sosiale fobie te ondersoek en te vergelyk. Die 44 deelnemers aan die studie het voor behandeling aan die DSM-IV diagnostiese kriteria vir sosiale fobie voldoen en met oorwegend algemene interaksionele vrese gepresenteer. Hulle is verdeel in 'n groep wat met kognitiewe herstrukturering en blootstelling gekombineerd behandel is (n = 15), 'n groep wat slegs blootstelling ontvang het (n = 15), en 'n waglys-kontrolegroep (n = 14). Vir behandelingsdoeleindes is die behandelingsgroepe in twee subgroepe van onderskeidelik 7 en 8 deelnemers elk verdeel. Die effekte en differensiële effekte van die behandelings is in terme van die volgende vier breë kategorieë veranderlikes ondersoek: teikenfobie-veranderlikes (angslvermyding/ontsnapping ten opsigte van 'n spesifieke fobie), sosialefobie-veranderlikes (wat verband hou met die graad, aard, aspekte en/of gevolge van sosiale fobie), kognitiewe veranderlikes (gedagte-funksionaliteit, vrees-vir-negatiewe-evaluasie en aandagsverdraaiing), en graad van depressie. Deelnemers is individueel beoordeel voor behandeling, onmiddellik na afloop daarvan en na 'n 3- maande-opvolgperiode. Behandeling deur twee ko-terapeute het in 12 weeklikse groepsessies van twee uur elk geskied. In vergelyking met die waglys-kontrolekondisie, het beide behandelings tot 'n beduidende verbetering van die teikenfobie-veranderlikes by nameting gelei en, met uitsondering van teikenfobie-angs by die blootstellingsbehandeling, is die beduidende effekte vir 'n opvolgperiode van drie maande volgehou. Wat die sosialefobie-veranderlikes betref, het kognitiewe herstrukturering plus blootstelling 'n beduidend groter verbetering in vergelyking met die waglys-kontrolekondisie op vier veranderlikes (sosialefobievermyding, sosialefobie-observasie-angs, sosialefobie-algemenesimptomato/ogie, en sosialefobieongemak/ belemmering) tot gevolg gehad en is die beduidende effekte vir 'n opvolgperiode van drie maande volgehou. Daarenteen het die blootstellingsgroep slegs ten opsigte van twee veranderlikes (sosialefobie-vermyding en sosialefobie-ongemak/belemmering) tot beduidend groter effekte aanleiding gegee, waarvan die effekte net op een van die twee veranderlikes (sosialefobie-vermyding) vir 'n opvolgperiode van drie maande in stand gehou is. Ten opsigte van die kognitiewe veranderlikes, het kognitiewe herstrukturering plus blootstelling, in vergelyking met die waglys-kontrolekondisie, tot 'n beduidende verbetering van gedagte-funksionaliteit gelei wat vir 'n opvolgperiode van drie maande in stand gehou is. Geen ander beduidende verskille tussen die effekte van behandelings en die waglys-kontrolekondisie is vir enige van die ander kognitiewe veranderlikes by nameting of opvolg gedemonstreer nie. Slegs die gekombineerde behandeling het tot beduidend groter verlagings van die graad van depressie gelei wat vir 'n opvolgperiode van drie maande gehandhaaf is. In vergelyking met die waglys-kontrolekondisie, het die gekombineerde behandeling dus tot 'n beduidende verbetering oor 'n breër basis van sosialefobie-simptomatologie as blootstelling alleen by nameting en opvolg aanleiding gegee. Die twee behandelings is ook direk met mekaar in terme van effekte op elkeen van die afhanklike veranderlikes vergelyk en die verskille was by nameting en opvolg grootliks onbeduidend. Dit is slegs ten opsigte van gedagte-funksionaliteit dat daar tentatiewe aanduidings was dat die gekombineerde behandeling moontlik 'n beduidend groter verbeterende effek as blootstelling alleen kon gehad het, maar indien dit so was, was hierdie verskille by die opvolgmeting reeds uitgewis. Dit wil dus voorkom asof beide die gekombineerde behandeling en blootstelling alleen effektiewe behandelings vir sosiale fobie was en dat eersgenoemde dalk effens beter resultate kon gelewer het. Hierdie resultate ondersteun die standpunt wat tans besig is om op grond van navorsing te ontwikkel, naamlik dat daar nie betekenisvolle groot verskille in die effektiwiteit van die belangrikste kognitiefgedragsterapeutiese behandelings van sosiale fobie is nie. Dit bied ook steun vir die standpunt van prominente navorsers op die gebied van sosiale fobie uitkomsnavorsing dat behandelingseffek minder afhang van verskille in prosedure-variasies as van ander kritieke elemente, soos byvoorbeeld die lengte en frekwensie van die behandelingsessies en blootstelling aan die kritieke elemente van die sosiale vrese.

Thesis (DPhil) -- University of Stellenbosch, 2001. / ENGLISH ABSTRACT: Cognitive-behaviour therapy is criticised for focusing almost exclusively on strategic cognitive processing and for not attending sufficiently to non-verbal, automatic thoughts. Combining hypnosis with existing cognitive-behaviour therapy procedures is seen as a way of addressing this problem. The objective of the present study was therefore to investigate whether the effectiveness of a structured group cognitive behavioural therapy programme could be significantly improved if it is combined with hypnosis and whether such improvements will be maintained. This study, with a test-retest-follow-up design, involved 45 patients with a DSM-IV diagnosis of social phobia. Fifteen patients were treated with Heimberg's (1991) group cognitive-behaviour therapy for social phobia (the combined programme, consisting of cognitive restructuring and exposure treatment), while 16 patients were allocated to a waiting-list control condition. The effectiveness of the two treatments was assessed in terms of 13 dependent variables which were divided into the following broad categories: target phobia variables (anxiety/avoidance/escape with regard to a specific target phobia), social phobia variables (degree, nature, aspects and/or consequences of social phobia), cognitive variables (dysfunctional automatic thoughts, fear of negative evaluation and attentional bias), and severity of depression. Treatment was presented by two co-therapists in 12 \Neekly group sessions of 2 hours each. Patients were assessed in terms of the dependent variables before and after treatment and again at follow-up after 3 months. Compared to the waiting-list controls, patients in the combined treatment group (receiving cognitive restructuring and exposure) showed significant improvement at the end of treatment on all the target phobia variables, most of the social phobia variables (except for interaction anxiety and avoidance/distress), dysfunctional automatic thoughts and severity of depression. These improvements were maintained at follow-up. The combined treatment with hypnosis yielded similar results, when compared to the waiting-list control condition. In addition, this group also showed significant improvement in avoidance of and distress in social situations. A comparison of the two treatment conditions showed that they largely rendered similar results. However, the combined treatment with hypnosis yielded significantly greater improvement in terms of dysfunctional automatic thoughts compared to the treatment without hypnosis. Tentative indications were also found that adding hypnosis to the combined treatment fascilitated its ability to reduce avoidance behaviour in social phobia. The combined treatment with hypnosis did not, however, render greater change in attentional bias as reflected by the emotional Stroop task. / AFRIKAANSE OPSOMMING: 'n Belangrike beswaar teen die kognitiewe gedragsterapie is dat dit grootliks op strategiese kognitiewe prosessering fokus en dat daar nie genoegsaam aan nie-bewustelike, nie-verbale, outomatiese gedagtes aandag gegee word nie. Die kombinasie van hipnose met bestaande kognitiewegedragsterapeutiese prosedures word toenemend beskou as 'n manier om die probleem op te los. Die doel van hierdie studie was derhalwe om na te gaan of die effektiwiteit van 'n gestruktureerde groepkognitiewegedragsterapieprogram vir die behandeling van sosiale fobie beduidend verbeter kan word deur hipnose by die program te inkorporeer, en indien sodanige verbetering plaasgevind het, of dit oor 'n langer termyn gehandhaaf sou word. Die studie het 'n toets-hertoets-opvolgontwerp behels en 45 pasiënte met 'n DSM-lV-diagnose van sosiale fobie het daaraan deelgeneem. Vyftien pasiënte is met Heimberg (1991) se groepkognitiewegedragsterapie vir sosiale fobie (bestaande uit kognitiewe herstrukturering en blootstelling en ook die gekombineerde behandeling genoem) behandel, terwyl16 pasiënte dieselfde behandeling aangevul met hipnose ontvang het. Veertien pasiënte het 'n waglys-kontrolegroep gevorm. Vir behandelingsdoeleindes is die twee behandelingsgroepe in twee subgroepe van 7 of 8 deelnemers elk verdeel. Die uitwerking van die behandelings is in terme van 13 afhanklike veranderlikes wat in die volgende vier breë kategorieë verdeel is, ondersoek: teikenfobie-veranderlikes (angs/vermyding/ontsnapping ten opsigte van 'n spesifieke fobie), sosialefobie-veranderlikes (wat met die graad, aard, aspekte en/of gevolge van sosiale fobie verband hou), kognitiewe veranderlikes (gedagte-funksionaliteit, vrees-virnegatiewe- evaluasie deur ander en aandagsverdraaiing), en graad van depressie. Behandeling deur twee ko-terapeute het in 12 weeklikse groepsessies van 2 uur elk geskied. Pasiënte is voor behandeling, na afloop daarvan en na 'n opvolgperiode van 3 maande in terme van die afhanklike veranderlikes beoordeel. Die gekombineerde behandeling (bestaan uit kognitie-.ve herstrukturering en blootstelling) het, in vergelyking met die waglys-kontrolekondisie, aan die einde van behandeling tot 'n verbetering gelei van al die teikenfobie-veranderlikes, die meeste van die sosialefobie-veranderlikes (met uitsondering van sosialefobie-interaksie-angs en sosialefobie-vermyding/-ongemak), disfunksionele outomatiese gedagtes en graad van depressie. Hierdie verbeterings is gehandhaaf oor die opvolgperiode van 3 maande. In vergelyking met die waglys-kontrolekondisie het die gekombineerde behandeling met hipnose dieselfde resultate gele-.ver as die gekombineerde behandeling daarsonder. Addisioneel hiertoe het hierdie groep ook beduidend verbeter in terme van vermyding van en ongemak in sosiale-situasies. 'n Vergelyking van die effekte van die twee behandelingsprosedures het aangetoon dat hulle grootliks dieselfde resultate gel9lNer het. Die gekombineerde behandeling met hipnose het egter 'n groter verbeterende effek op disfunksionele outomatiese gedagtes gehad as die gekombineerde behandeling daarsonder. Aanduidings is ook gevind dat die byvoeging van hipnose by die gekombineerde behandeling 'n groter verbetering in vermydingsgedrag gefasiliteer het. Die gekombineerde behandeling met hipnose het egter nie 'n groter effek op aandagsverdraaiing as die behandeling daarsonder gehad nie.

The purpose of this study was to investigate whether biological variables could predict how older adults would respond to different types of treatment for depression. Fifty-six adults over the age of sixty-five, diagnosed with major depression (DSM III criteria) were assigned to one of four treatment conditions: group Cognitive Behavior Therapy with alprazolam or placebo medications, and minimal support therapy with alprazolam or placebo medication. Before and after treatment, REM latency and REM density were measured by polysomnograph in the sleep laboratory and the Dexamethasone Suppression Test (DST) was administered. Depression was measured by weekly by the Hamilton Depression rating Scale and the Beck Depression Inventory. Subjects presented with normal (i.e. nondepressed) values on REM latency and REM density. Thirty five percent of subjects were DST nonsuppressors, a similar percentage to that found in other studies of depressed subjects, but mean DST for the whole group was below the selected cutoff of 4 mcg/dl. The expected correlations among the biological variables and between these variables and baseline depression levels were not found. It was concluded, therefore, that depression in this group of subjects was not characterized by biological abnormalities. Multiple regression analyses of baseline variables and depression scores at mid and end of treatment and at followup indicated that initial depression levels and DST predicted later depression levels for subjects who received Cognitive Behavior Therapy, regardless of medication assignment. Low baseline DST levels were associated with good response to psychotherapy, confirming the findings of previous studies. Sleep variables were not predictive of response to treatment at any time point.

This study assessed the efficacy of the application of cognitive-behavioral self control therapy with a sample of psychiatrically impaired adolescents. Ten adolescent inpatients (5 male/5 female), residing within the Adolescent Unit of the State Hospital of a Southwestern state, were selected as subjects. Subjects ranged in age from 12 to 17 years and were paid volunteers. Subjects were assessed pretreatment for non self controlled behavior via the teacher rated Self Control Rating Scale (Kendall & Wilcox, 1979). This measure also served as the blocking variable utilized for random assignment to treatment or control group. Five adolescents were assigned to each group. Pretreatment measures of social perspective taking (Chandler Bystander Cartoons; Chandler, 1973) and social problem solving (Means-Ends Problem Solving test: Platt & Spivack, 1975) were taken additionally. All three measures were repeated at posttreatment and at 4 week follow-up. Treatment consisted of twelve 60-minute sessions held 3 times a week over the period of 4 weeks. The treatment consisted of a group application of Kendall's (1980) Cognitive-Behavioral Self Control therapy. The main treatment strategies included: (1) a problem solving approach, (2) self instructional training, (3) behavioral contingencies, (4) modeling, (5) affective education, and (6) role play exercises. The separate strategies were essentially interwoven. Except for the cognitive-behavioral self control training proper, subjects in both treatment and control groups were given similar tasks, task instructions, and performance feedback. Results found a range of behavioral self control skills distributed among the subjects but failed to support the hypothesis of associated poor social perspective taking and social problem solving skills. Treatment failed to improve teacher ratings of behavioral self control at posttreatment and at follow-up. Likewise, no significant improvement was found in social problem solving skills at posttreatment or follow-up, although a trend toward improvement was suggested. A significant improvement in social perspective taking skills was found in the treatment group at posttreatment. The improvement was maintained at 4 week follow-up. The results are interpreted as suggesting that cognitive-behavioral self control training can be useful in facilitating the further development and enhancement of previously inadequate cognitive capacities in psychiatrically impaired, non self controlled adolescents. Certain suggestions for enhancing the effectiveness and generalization of the treatment approach are discussed.

No description available.

D.Phil. / Please refer to full text to view abstract

Thesis (M.A. Rel.)--School of Theology, Anderson University, 1988. / Vita. Abstract. Includes bibliographical references (leaves 105-117).

Thesis (DClinPsychol)--Salomons Centre. BLDSC no. DX230085.