The purposes of this survey were (1) to determine the nature of the case load of speech clinicians in Texas public school speech and hearing therapy programs, (2) to determine the type and condition of facilities in which the therapy described in item one above is being conducted, (3) to ascertain what the speech and hearing clinicians of the state believed to be essential for the effective practice of therapy, and (4) to find out what the clinicians believed to be special problems in their present facilities.

This study examined the use of group Adlerian play therapy (AdPT) as an 8-week intervention to treat children, ages 8-13, displaying emotional and/or behavioral difficulties. The study looked at the effects of the intervention on the parent reports of child externalizing behaviors and parenting stress, and the children’s reports of self-esteem (Social Competence, Behavioral Conduct, and Global Self-Worth). The study included two phases. Phase 1 was a randomized control trial (RCT), which allowed for comparison of treatment to the waitlist-control as between group effects, pre- and post-intervention. Group comparisons could not be tested due to an inadequate sample size of children. Phase 2 involved the waitlist group completing the same 8-week therapy intervention and looking at all participants as a single sample over time, using three time points: pre-intervention, post-intervention, and one-month follow-up. Results from Phase 2 demonstrated tentative support for group AdPT. Additional analyses were conducted in Phase 2 examining differences between the two age groups, 8-10 and 11-13, and the mediating effect of Adverse Childhood Experiences (ACEs) on the effectiveness of the intervention. While the analyses suggest that group AdPT is effective for younger and older children, the small number of older children (n = 7) limits the ability to draw definitive conclusions. Children with moderate levels of ACEs showed non-significant trends in improved externalizing behaviors and self-esteem compared to children with lower and higher ACEs. Implications for future research, practice and policy are discussed.

Solution-focused therapy is one of the models of brief family therapy that has come into prominence during the 1980s and 90s. Whereas earlier forms of family therapy concentrated on problems and the behaviors that maintained them, solution-focused therapy places its emphasis on "exceptions" to the problem--times when it is not happening--and seeks to elaborate on and amplify these exceptions. A solution-focused therapy model has been used with individuals, couples, and groups of individuals, but a search of the relevant literature revealed no information on its use with couples' groups. The purpose of this study was to develop a solution-focused treatment plan for a couples ' group and to test its effectiveness. A single-case research design was used with a multiple baseline assessment strategy across subjects. Participants' improvement on measures of overall marital satisfaction and specific goal achievement was considered in evaluation of effectiveness. Five couples completed the program. Marital satisfaction was measured using the Revised Dyadic Adjustment Scale (RDAS) and the Kansas Marital Satisfaction Scale (KMS) . On both measures 7 of the 10 participants showed improvement between baseline and intervention scores. Two participants showed little change in scores and 1 subject recorded a decline in score. A self-report goal sheet utilizing a 0-10 scale was used to record progress toward individual and couple goals. Eight participants reported progress, 1 no change, and 1 a decline on both types of goals. The results of this study lend support to the supposition of positive out comes from solution-focused couples ' group work and suggest the need for further study.

<p>Ett nytt sätt att behandla panikångest i form av gruppterapi med KBT redovisas ur ett patientperspektiv. Gruppterapeutisk historia och beståndsdelar i KBT tas upp liksom skamkänslor, ”compliance” och ”holding”. Fem kvinnor och tre män ur olika terapigrupper och med olika bakgrund intervjuades om sina upplevelser. Deltagarnas förväntningar, erfarenheter av gruppsammansättning och gruppdynamik samt gruppens bidrag till personliga förändringar och insikter studerades. Materialet bearbetades genom begreppskategorisering. Farhågor och förväntningar på andra deltagare dominerade hos deltagarna inför terapin. Under terapins gång hade andra deltagare motiverat och uppvärderat varandras behandlingsarbete samt visat på att individen inte var ensam om sitt tillstånd. Ingen var helt fri från panikångest efter behandling men har kunnat återerövra delar av sitt liv. Alla planerade någon form av behandlingsfortsättning.</p>

Ett nytt sätt att behandla panikångest i form av gruppterapi med KBT redovisas ur ett patientperspektiv. Gruppterapeutisk historia och beståndsdelar i KBT tas upp liksom skamkänslor, ”compliance” och ”holding”. Fem kvinnor och tre män ur olika terapigrupper och med olika bakgrund intervjuades om sina upplevelser. Deltagarnas förväntningar, erfarenheter av gruppsammansättning och gruppdynamik samt gruppens bidrag till personliga förändringar och insikter studerades. Materialet bearbetades genom begreppskategorisering. Farhågor och förväntningar på andra deltagare dominerade hos deltagarna inför terapin. Under terapins gång hade andra deltagare motiverat och uppvärderat varandras behandlingsarbete samt visat på att individen inte var ensam om sitt tillstånd. Ingen var helt fri från panikångest efter behandling men har kunnat återerövra delar av sitt liv. Alla planerade någon form av behandlingsfortsättning.

No description available.

Group psychotherapy is the most widely utilized treatment modality for convicted sex offenders, and the therapeutic alliance is considered a fundamental concept in virtually all applications of psychotherapy. However, empirical examination of how the therapeutic alliance impacts upon treatment effectiveness for sex offenders has been neglected. In a prospective design, a sample of 95 consecutive admissions to an inpatient treatment program for convicted adult male sex offenders was studied with regard to their experience of the therapeutic alliance with treatment staff, with their copatients, and with the overall treatment program. Patients of the Phoenix Program (Alberta Hospital Edmonton) rated their sense of alliance at monthly intervals. The therapists who worked with them (n = 21) also completed monthly evaluations of their own emotional responses toward these same patients. Pre- to post-treatment comparisons on personality tests, interpersonal distress, and interpersonal functioning showed a number of statistically significant changes consistent with treatment goals. Patients self-report over time in treatment showed a gradual, consistent increase of large effect size on all three alliance targets. Sex offenders in this sample were able to experience positive alliance with therapists and peers and the sense of alliance was shown to grow stronger over time. Staff ratings revealed that positive and negative affect increased as patients time in treatment increased. Significant associations between patient-rated alliance and outcome were found to be positive and in desired directions. The growth rate in alliance toward therapists was positively and significantly associated with the growth rate of conflict within oneself among female therapists. Male therapists also reported significant growth in conflict within oneself but this was independent of patient-rated alliance growth rates. Thus, female therapists experienced heightened affect in the face of greater patient alliance, while male therapists also experienced heightened affect but for reasons unrelated to patient alliance. There was virtually no reduction in negative affect toward patients despite moderate increases in positive affect toward patients. This study represents an important endorsement of a treatment model that seeks to improve general adjustment and ameliorate risk factors associated with recidivism, via positive changes in interpersonal relationships. / Psychiatry

Interventions targeting processes that commonly maintain different psychological disorders have demonstrated promising effectiveness data. However, very few studies have examined brief transdiagnostic groups. Qualitative explorations of the acceptability of both transdiagnostic and brief groups are also very limited. A brief transdiagnostic group, the Take Control Course (TCC), has been developed for clients with common mental health problems in primary care services. This thesis examined the effectiveness and acceptability of the TCC, which is a 6-session transdiagnostic group intervention. The TCC is explicitly theory-driven and targets mechanisms of psychological change specified by Perceptual Control Theory (PCT). Three papers are presented within this thesis that examined: i) the empirical and conceptual background of the TCC; ii) whether the TCC was non-inferior compared to an active control (individual low-intensity Cognitive Behavioural Therapy, CBT); iii) whether the TCC was acceptable to participants using qualitative examination of participants’ experience of the TCC and perceptions of what contributed to psychological change (or lack of change). The thesis comprises: i) a narrative review; ii) a non-inferiority RCT; iii) a qualitative interview study using Thematic Analysis. The thesis utilised mixed methods in order to understand the TCC from multiple perspectives. The overall programme of research that the thesis is part of is strongly informed by the Medical Research Council (MRC) framework for developing and evaluating complex interventions. Although the MRC guidelines stress the utility of randomised experimental designs in evaluating an intervention, they also recognise the contribution that qualitative methodologies make to such evaluations. The narrative review outlined how the development of a transdiagnostic intervention, which targets specific transdiagnostic processes, could provide an efficient way of promoting psychological change. It explicitly detailed how the theoretical basis informed intervention components. Within the RCT, intention-to-treat analyses at 6-month follow-up found that the TCC was non-inferior to individual low-intensity CBT on anxiety and depression outcomes, functioning and an idiosyncratic problem measure. 156 clients were randomised. Secondary, per-protocol analyses, found inconclusive evidence of non-inferiority. This was the first randomised trial providing evidence for the non-inferiority of a brief transdiagnostic group compared to established individual therapy. The qualitative study of 12 in-depth interviews indicated that the flexible group format of the TCC was appreciated, as participants felt able to engage at their own pace and adapt components. Greater clarity regarding what was within participants’ control reduced distress and enabled effective pursuit of valued goals. This was the first qualitative study of participant experience of a brief transdiagnostic group. Findings indicated that TCC was acceptable and non-inferior to an established CBT intervention. This adds to the evidence base for transdiagnostic interventions.

Bipolar disorder (BPD) is associated with negative health outcomes and high relapse rates and group psychoeducation (PE) is recognised as an effective intervention when used in conjunction with pharmacological treatment. Unhealthy beliefs and attitudes have not been measured or related to outcomes in group PE and the mechanism for how PE exerts its effect are unidentified. Aims: (a). An adapted group psychoeducation intervention will change (improve) unhealthy personal beliefs about illness and attitudes towards medication when compared to a treatment as usual group. (b). Changes in unhealthy personal beliefs and attitudes will be maintained overtime (a 12 month follow up period). (c). People who subsequently relapse compared to those who do not relapse, will have less improvement in their unhealthy personal beliefs about illness and attitudes towards medication from PE. (d). An evaluation of the efficacy of psychoeducation in a systematic review for bipolar disorder in preventing relapse and other outcomes will identify factors that relate to clinical outcomes. Methods: A 10 session PE intervention was adapted and 38 participants with bipolar disorder I or II (using DSM-IV criteria) were recruited from a Specialist Affective Disorders Service. A waiting list assessment time was used as a parallel group control and a longitudinal study took place over a 12 month follow up period in all participants once they had received the intervention. A mirror image study reviewed case notes to identify relapse 12 month pre versus post intervention. Assessments measuring, beliefs and attitudes, mood symptoms and satisfaction where carried out, 8 weeks prior to intervention (waiting list), pre intervention, and 6 and 12 months post intervention. Results Summary: The waiting list control comparison showed significant improvement in attitudes measured by the Personal Beliefs about Illness Questionnaire (PBIQ) and Drug attitude Inventory (DAI) and symptoms and functioning. Beliefs on all domains of the PBIQ improved significantly (p<0.001) as did attitudes toward medication (p<0.001) there were also small but significant improvements in mood symptoms. In all participants (n=38) improvements were maintained over the 12 month follow up period. Nine people relapsed in the 12 months after the intervention compared with 22 before (p<0.002) and relapsers improved significantly less than non-relapsers following PE on the PBIQ (p=0.012) and the DAI (p=0.046). Conclusions: A group PE intervention reduced unhealthy personal beliefs and attitudes, both manic and depressive relapse and improved functioning. Improvements are maintained over time except adherence which remained unchanged. The amount of improvement in the PBIQ and DAI is related to relapse with non relapsers improving more than relapsers. The systematic review provides reasonable evidence that psychoeducation is at least modestly effective in preventing relapse in bipolar disorder, with the strongest evidence for reducing overall and manic relapse.

The purpose of this study was to develop a manualized therapy group for wives or significant others of veterans with posttraumatic stress disorder and to evaluate its effectiveness in reducing wives' psychological symptoms. A second aim of the study was to determine if women's involvement in the wives group resulted in decreases in their husbands' PTSD symptoms. Women recruited for the study were administered pre-test measures during a screening session. They then participated in a 9-session manualized therapy group designed by the researcher that included psychoeducational, process, and support components. Examples of group topics included psychoeducation regarding PTSD, assertiveness and communication, intimacy, self-care, and stress management. After completing the group sessions, participants were asked to complete post-test measures. Other factors explored in this study included marital satisfaction, perceived social support, general satisfaction with the group, and demographic variables. Results indicated that wives who participated in the group treatment exhibited significant decreases in secondary stress symptoms and increases in marital satisfaction from pre-test to post-test. The majority of participants also reported high levels of satisfaction with the group process. Therefore, it appears that the group protocol presented in this study could be a useful tool in the treatment of wives of veterans with PTSD. The results of this study have potential implications regarding the clinical treatment of families of veterans with PTSD and the development of future programs within the VA system.