The purpose of the present study was to attempt to use the principles of behavior therapy and group psychotherapy to enhance social adjustment of the geriatric patients in an institutional environment. There are several factors positively related to satisfactory adjustment to old age such as educational level, marital status, employment history, religion, health, and membership in groups.

This paper examines the role that group psychotherapy plays in promoting the development of identity in adolescents who are diagnosed with Attention Deficit Disorder with Hyperactivity (ADHD). Negotiating identity issues is the central task of adolescence (Erikson, 1950). It is also one of the most difficult periods for ADHD adolescents because of their innate and learned sensitivities to the experience of shame. Shame is the feeling we have when we evaluate ourselves using the standards of valued others and of society and determine that we do not meet those standards (Lewis, 1992). Group psychotherapy thus becomes the treatment of choice for adolescents diagnosed with ADHD because the process of group psychotherapy addresses the issues of identity and shame in a way that individual therapy is unable.

Introduction: Defensive functioning may play an important role in the development and treatment of binge-eating disorder (BED). The Defense Mechanism Rating Scale (DMRS) is a widely used observer rating measure of defensive functioning. However, there is little research on defensive functioning and the DMRS in BED. This dissertation includes three studies on defensive functioning in individuals with BED. Study one assessed the validity and reliability of the DMRS when used to rate Adult Attachment Interview (AAI) transcripts, and compared defensive functioning between women with and without BED. Study two compared change in defensive functioning in women with BED who received Group Psychodynamic-Interpersonal Psychotherapy (GPIP) versus those in a waitlist no treatment control condition. Study three assessed the impact of other group therapy members’ defensive functioning on an individual group member’s treatment outcomes (i.e., binge-eating frequency and interpersonal functioning). Thus, the overall goals of this dissertation were to better understand the role of defensive functioning in BED, the degree to which defensive functioning changes due to group therapy, and the impact in the context of the therapy group’s defensive functioning on individual outcomes. Method: Participants with for this study were recruited from three previous investigations. Two clinical trials of group psychotherapy provided data of individuals with BED: (1) a randomized trial (N = 85) in which participants were assigned to GPIP (n = 35) or a waitlist control (n = 50), and (2) an uncontrolled study in which all participants with BED (N = 101) received GPIP. A total of 17 therapy groups were formed across both studies, with each group consisting of five to 11 members. In addition, a third study provided data from two comparison groups without BED: women who were overweight/obese (body mass index [BMI] > 27 kg/m2; n = 47) and women who were normal weight (BMI = 20 to 25 kg/m2; n = 49). Participants with BED completed a battery of questionnaires and the AAI at two time-points (i.e., pre-treatment/pre-waitlist and six months post-treatment/post-waitlist). Participants without BED completed the same battery of questionnaires and the AAI at one time-point and did not receive treatment. All AAI audio recordings were transcribed and used to code defensive functioning. Results: In study one, the DMRS coded from AAI transcripts demonstrated acceptable inter-rater reliability; good convergent validity, as it was significantly correlated with other related constructs (i.e., interpersonal functioning, reflective functioning, and attachment insecurity); and acceptable predictive validity, as women with BED had significantly lower defensive functioning than normal weight women without BED. In study two, those who received GPIP had significantly greater improvements in defensive functioning from pre-treatment to six months post-treatment compared to the waitlist control group. Follow-up analyses revealed that the average number of High Adaptive defenses significantly increased from pre-treatment to six months post-treatment in the GPIP condition, but not in the waitlist control condition; and significantly more participants assigned to the waitlist control condition deteriorated in their defensive functioning from pre-waitlist to six months post-waitlist than those assigned to GPIP. In study three, individual defensive functioning scores at pre-treatment were not significantly associated with either treatment outcome (i.e., binge-eating frequency or interpersonal distress) at six months post-treatment. However, other group members’ mean defensive functioning scores at pre-treatment were significantly associated with individual interpersonal distress, but not binge-eating frequency, at six months post-treatment. Discussion: Overall, this dissertation lends further support to the role of defensive functioning in the maintenance and treatment of BED. Individuals with BED tend to use less adaptive defensive functioning, but this can be improved through GPIP. Further, context of the therapy group in terms of defensive functioning is particularly important for improving treatment outcomes in individuals with BED. These findings should be replicated across more diverse samples and other types of group psychotherapy. Group therapists can help their patients with BED confront their maladaptive defense mechanisms and binge-eating by tackling their interpersonal distress, and placing sufficient emphasis on the group’s composition in terms of defensive functioning.

No description available.

Prior research in individual therapy has provided evidence that therapists are poor predictors of client outcome without the aid of objective measures and often misjudge clients' perceptions of the therapeutic relationship. The focus of the current research was to conduct a similar study in a group setting. Therapists from a university counseling center and a state psychiatric hospital were recruited to test their accuracy in predicting client outcome, quality of therapeutic relationship and their own use of empirically supported group interventions. Results indicated that therapists are poor predictors of all three, providing support for the implementation of measure-based feedback systems to inform therapists about key information that may affect the effectiveness of group psychotherapy.

No description available.

Thesis (Ph. D.)--University of Texas at Austin, 1998. / Vita. Includes bibliographical references (leaves 281-292).

Group psychotherapy with borderline patients is an activity that is fraught with ominous apprehension and it is perhaps for this reason that little research has been done in the field. The aim of the present studies was to map out the area and to test some basic hypotheses about patient and therapist behaviour during the therapy process. Two therapy groups of carefully diagnosed clinical borderline patients were studied by means of video-technique during a therapy process of 20 months. Special technical arrangements and ethical agreements were elaborated for the research. Outcome data was collected concerning the patients’ self-image, symptom-level and personality structure. A follow-up was done 2-3 years after therapy on functional level, capacity for work, medication and need of further treatment. As expected a high drop-out rate occurred. Within a year 40% of the patients had left, and within 20 months 60%. Drop-out was not found possible to predict before the period of therapy commenced but early drop-outs were generally younger and in a more acute state of distress than late drop-outs. In order to study the therapy process two major perspectives were elaborated and operationalized: 1) classification of focus and depth of therapists’ interventions and 2) relational capacity of the patient (Borderline Relatedness). In contrast to remainers, late drop-outs were found most sensitive to disturbances in the frame of therapy (group instability) and were considered prone to interact malignantly with the therapists, eventually leading to drop-out. As to outcome and follow-up, late drop-outs were characterized by the poorest outcome all over, while early drop-outs and remainers were generally more stabilized although the early drop-outs seemed more dependent on medication for their functioning. By means of a principal components analysis the large amount of outcome data was condensed to two important factors: 1) symptom and functional level and 2) direction of anger. Thus, it was found that an important feature of a positive outcome was the ability to function at work and in social life and to direct anger outwards, not just towards oneself, thus protecting and idealizing important others, as was often the case with these patients before treatment. Taken together, the results point to the need for more precise and sensitive diagnostic methods and outcome criteria both to predict and to evaluate therapeutic outcome. To minimize drop-out and negative therapeutic reaction the research speaks in favor of further studying the therapist-patient interaction during the group therapy process and to evaluate the relative importance of therapist interventions and non-specific curative factors. / <p>Diss. (sammanfattning) Umeå : Umeå universitet, 1989, härtill 4 uppsatser.</p> / digitalisering@umu.se

Thesis (Ph. D.)--University of Texas at Austin, 1998. / Vita. Includes bibliographical references (leaves 281-292). Available also in a digital version from Dissertation Abstracts.

Thesis (Ph. D.)--University of Missouri-Columbia, 1996. / Typescript. Vita. Includes bibliographical references (leaves 86-97). Also available on the Internet.