En France les chercheurs se sont encore peu intéressés à l’évolution des auteurs d’infractions sexuelles en psychothérapie de groupe alors que les thérapeutes proposent fréquemment cette modalité thérapeutique à ces patients. Notre objectif est d’approfondir les connaissances sur cette population hétérogène et sur son évolution clinique suite à deux ans de thérapie groupale. Nous avons également cherché à mieux comprendre les changements observés. Vingt-huit auteurs d’infractions sexuelles ont participé à la première phase de notre étude et deux ans plus tard dix-sept ont effectué le retest. Nous avons fait le choix de recueillir des données issues des patients, des thérapeutes et du chercheur et de nous baser sur une approche quantitative et qualitative. Nos résultats révèlent des profils et des évolutions cliniques diverses. Des changements cliniques ont été repérés : une amélioration de la centration sur soi, de la perception de la réalité et des relations interpersonnelles ; une évolution des profils d’attachement narratifs vers davantage de cohérence, de réflexivité et d’authenticité ; un développement des capacités de mentalisation. Par contre, d’autres dimensions n’évoluent pas significativement notamment le fonctionnement défensif global ainsi que les troubles de la personnalité et certains patients restent stables entre T1 et T2. Notre recherche montre donc que les auteurs d’infractions sexuelles présentent des changements cliniques mais souligne la complexité de cette évolution. Cette étude permet de mieux comprendre les processus de changement et permet ainsi d’améliorer les prises en charge proposées. / In France, researchers have barely investigated the evolution of sexual offenders receiving group therapy whereas therapists regularly recommend this therapeutic modality to these patients. Our aim is to get better knowledge of this mixed population and their clinical evolution after two years of group therapy. We also focused on understanding better the observed changes. 28 sexual offenders took the first phase of our study and 17 of them took a re-test two years later. We decided to collect data from patients, therapists and the researcher, on a quantity and quality based approach. Our results show different profiles and clinical evolutions. Clinical changes appearing are: improvement in self-esteem, in perception of reality and in interpersonal relationships ; evolution of narrative attachment methods towards more coherence, reflexivity and authenticity ; development of mentalisation abilities. However, other dimensions don’t show substantial improvement, particularly global defense functioning and personality disorders and some of the patients remain stable between T1 and T2. Therefore, our study shows that sexual offenders go through clinical changes but emphasizes the complexity of this evolution. This study helps provide a better understanding of the process of change and therefore helps improve exisiting therapeutic modalities.

Sandtray therapy, a modality of play therapy, has been used in a variety of ways as the treatment intervention with different theoretical approaches; however, there is a very limited amount of empirical research. The purpose of this research is to examine the effectiveness of group sandtray therapy at school with preadolescents identified with behavioral difficulties. This is a pretest-posttest control group design. Participants in the experimental group received sandtray therapy in group for ten weeks, and participants in the wait-list control group received no treatment intervention. The researcher compared two groups to examine the overall effectiveness of sandtray therapy as determined by the scores of the Child Behavior Checklist-Teacher Report Form (CBC-TRF), Parent Report Form (BASC-PRF), and Self Report of Personality (BASC-SRP). Based on teachers' reports, statistically significant difference existed between the two groups in terms of preadolescents' overall behaviors, externalizing behavior problems, and internalizing behavior problems after the ten week treatment intervention. The effect sizes were medium (d= .52-.59). According to parents' reports, a statistically significant difference was found regarding preadolescents' externalizing behavior problems, and the effect size was medium (d=.63). No statistically significant differences were found regarding preadolescents' total behaviors and internalizing behavior problems based on BASC-PRF. The effect sizes arranged from medium to small (d=.55 and .35, respectively). In terms of the total behavior on BASE-SRP, no statistical significant difference was found and the effect was small (d=.18). A case example was included to illustrate the process and effect of group sandtray therapy. Based on the results of this study, it is determined that group sandtray can be an effective treatment intervention for preadolescents identified with behavioral problems. The primary contribution of this study is to present empirical support for the effectiveness of using sandtray therapy.

The purposes of this study were: 1) to determine the measurement dimensions assayed by the EPIC Self-Assessment Scales; 2) to provide information necessary to'determine whether revision of the EPIC Self-Assessment Scales would be desirable, and if so, what items need revision or deletion to obtain optimum dimensional structure; and 3) to provide information relevant to possible further research using the EPIC Self-Assessment Scales. On the basis of the results, four dominant and two subsidiary factors were concluded to be the measurement dimensions assayed by the EPIC Scales. Those were identified as Self-Assurance, Physical Appearance/Physical Shape, Emotional Lability, and Verbal Competence; subsidiary factors were Social/Interpersonal Attitude and Social Behavior/Sociability. It was also concluded that revision of the Scales be undertaken, deleting the 29 bipolar scale items which did not exhibit loadings of .500 or higher on any of the six factors. It was recommended that the revised Scales include additional bipolar scale items taken from the semantic differential literature, and that the instructions to subjects be revised. Further research to establish the reliability and validity of the revised instrument was also recommended.

The problem with which this investigation was concerned is that of treating agoraphobia with cognitive-behavioral group therapy and cognitive-behavioral group therapy combined with the drug alprazolam (Xanax). The purpose of the research was twofold. The first goal was to determine the relative effectiveness of the two treatment conditions on phobic behavior, anxiety, and depression. A second goal was to analyze the results and make recommendations concerning each of these modalities available to agoraphobics, their families, and to treatment specialists. The research design of this study was a randomized, pretest-posttest, experimental group design. The sample (N = 15) consisted of Group I (N = 7), who received behavioral-cognitive group therapy combined with the medication alprazolam, and Group II (N = 8), who received behavioral-cognitive group therapy only. The treatment included 15, 2-hour weekly group sessions, with the addition of a brief medication evaluation prior to each group meeting for Group I. During these sessions, the subjects received information about agoraphobia in the form of brief didactic segments, treatment materials, homework assignments, group interaction, and various forms of desensitization. Based on the findings of this study, the following conclusions were drawn: 1. Multidimensional behavioral-cognitive group therapy can significantly reduce phobic avoidance, anxiety, and depression associated with agoraphobia; and 2. Multidimensional behavioral-cognitive group therapy in combination with administration of alprazolam, can significantly reduce phobic avoidance and anxiety associated with agoraphobia.

The present study explored whether use of Spanish language sayings, or dichos, improved group climate within multi-ethnic chronic pain groups. Use of this form of figurative language fits within psychological theory identifying use of metaphor as a means of promoting change and creating new meaning. Further, metaphor use is consistent with the broader aims of experiential therapy. Group climate was measured by group members' self reports using the Group Climate Questionnaire-Short Form. A pilot study involving Latino Americans in medical and non-medical contexts aided in categorizing dichos as high versus low-relevance. It was anticipated that clients would rate high-relevance sessions as involving greater engagement, and less conflict and avoidance than low-relevance groups. Participants were recruited from four multidisciplinary pain management clinics offering similar programs. Once every four to six weeks, group leaders were provided with a list of either high or low-relevance dichos, and were blind to the existence of dichos categories. Three hierarchical regression analyses were employed to determine whether dichos relevance, characterized as low, mixed or highly relevant, contributed to variance in group conflict, avoidance and engagement. Dichos familiarity was the last variable entered into the regression equation, with gender, ethnicity and acculturation score entered in sequential fashion. Consistent with predictions, low-relevance groups yielded higher conflict scores than all groups combined. Also, high-relevance groups predicted lower avoidance when compared to all groups. In contrast to hypotheses, high-relevance groups predicted lower ratings of group engagement when compared to all groups. Post-hoc analysis indicated the mixed-relevance groups yielded significantly higher engagement scores than the low and high-relevance groups. Implications of these findings are discussed in relation to impact on approaches to group therapy with Latino American clients, and within the chronic pain population. Limitations of the study and recommendations for future research are offered.

Background: Word retrieval deficits are a common, pervasive feature of aphasia. Semantic feature analysis (SFA) is a popular treatment technique for word retrieval impairment. Preliminary evidence of its use in small aphasia-group settings suggests improved word retrieval in discourse-based tasks with improvements in communicative informativeness (Antonucci, 2009; Falconer & Antonucci, 2012). Objective: The aim of this study was to investigate the training of SFA within discourse during a small (two-member) aphasia group treatment to ascertain if gains would be made in word retrieval abilities and communicative informativeness. Method: Two female participants with chronic aphasia, aged seventy seven and sixty eight, participated weekly in group treatment for five consecutive weeks where stimuli were used to elicit increasingly naturalistic discourse. A multiple-baseline design was used and a case series analysis conducted. Baseline measures, treatment data and data from the six week follow-up (SWFU) session were analysed using the protocols developed by Nicholas and Brookshire (1993) and Mayer and Murray (2003). Results: Both participants demonstrated certain modest gains in overall communicative informativeness but these were not maintained at the SWFU session. Gains in informativeness ranged from 12% to 13.4% for participants, which agree with improvements in other studies (Antonucci, 2009; Boyle & Coelho, 1995; Falconer & Antonucci, 2012). P2 (presented with anomic aphasia) performed better than P1 (presented with Broca’s aphasia and a component of apraxia of speech [AOS]) with regards to communicative informativeness (%CIUs) and had greater access to semantic knowledge (i.e. could access lexical forms at an improved rate). Conclusion: The small group setting may offer advantages to facilitate communication skills and increase participation in everyday conversation. Further research is needed to identify benefits for individuals with differing aphasia types and severity, optimal intensity and frequency of group treatment and the role of peer support during group interaction. Key Words Aphasia, stroke rehabilitation, word retrieval, semantic feature analysis, connected speech, discourse, group therapy, communicative informativeness, functional communication. / Dissertation (MA)--University of Pretoria, 2016. / Speech-Language Pathology and Audiology / MA / Unrestricted

In routine outcome monitoring (ROM), the rate and timing of treatment failure alerts has been related to the success of feedback in past randomized clinical trials. In a recent OQ-45 feedback study, Burlingame and colleagues (2018) found that the rates and timing of not-on-track (NOT) progress alerts in group treatment were different than those reported for individual treatment. Using data from 58 different therapy groups and 374 patients, NOT progress alerts occurred at 186% of the rate reported by Shimokawa et al. (2010) when they examined over 6,000 patients receiving individual therapy at the same clinics. Another significant difference was found on the timing of the first NOT progress alerts with group treatment's first alerts occurring two sessions later than individual treatment. The goal of the current study was to use de-identified archival OQ-45 data from patients receiving group and individual treatment at a comparable clinic to determine if these rate and timing differences were replicable. Data from individual therapy (N = 5,493) and group therapy (N = 146) patients' OQ-45 scores show that the present study duplicated the significant difference found in the rate of NOT alerts between these formats. Relative risk of alerting as NOT at least once in group therapy was calculated to be 1.43 compared to individual therapy (group patients are 143% more likely to alert than individual patients). On the other hand, the present study did not find a significant difference in the timing of first alerts between formats. The implication of these results are significant when considering ROM in group therapy. Patients participating in group therapy are much more likely to flag as not-on-track later during the course of treatment when compared to patients in individual therapy.

Therapeutic alliance, cohesion, and group climate are all important relationship components of group therapy which have been shown to predict client outcome. Yet, due to discrepancies in how these are defined and measured in the literature, how these three constructs differentially predict outcome is not yet fully understood. For instance, most studies only assess a single construct and often do so with outcome assessed from a pre-post perspective rather than continuously. The present study is an archival analysis on Group Questionnaire (GQ) positive bond and Outcome Questionnaire-45 (OQ-45) data that aims to elucidate the predictive relationship of therapeutic alliance, group cohesion, and climate with client outcome in group therapy. Furthermore, this study is intended to clarify past discrepancies by studying alliance, cohesion, and group climate simultaneously, as well as address limitations of previous studies by exploring the relationship with outcome over the life of a group using continuous data. Results demonstrate that symptom improvement on the OQ-45 total score has a positive relationship with each of the GQ positive bond constructs (i.e., alliance, cohesion, and climate). This relationship was significant regarding session-to-session fluctuations on a given client's scores, as well as regarding differences between clients in their personal averages across sessions. However, when linear growth trajectories are considered that take session to session change in the three relationship constructs and outcome, only alliance emerges as a significant predictor of improvement. In other words, alliance, climate, cohesion all predict outcome when time is ignored; however, only alliance significantly predicts outcome when change over time is taken into account. These results highlight the importance of the client-therapist relationship to outcome in group therapy setting, mirroring some past research findings.

The present study investigated (a) the effects of group therapy ix on values and behavioral adjustment of hospitalized psychiatric patients, and (b) differential effects of directive versus non-directive group therapy in effecting desired therapy outcomes. Thirty subjects selected from among patients at Wyoming State Hospital were matched on age and sex and then randomly assigned to two experimental groups and one control group. Experimental group I received directive group therapy, experimental group II received non-directive group therapy and the control group participated in recreational activities. Both experimental groups and the control group participated in 12 weekly sessions, which were structured according to the respective objectives, mode of leadership style and/or activity intended for each group. All subjects were administered the Rokeach Value Survey prior to, and following the 12 group sessions. Each subject was also rated on the MACC Behavioral Adjustment Scale by two independent raters (hospital ward attendants) both before and after the experimental period. Porter's (1950, pp. 180-182) "counseling categories" were used to measure directiveness and non-directiveness of the group therapy leaders. Pretest comparisons among the experimental and control groups showed the groups to be essentially comparable (not significantly different) either in median rankings of values on the Rokeach Value Survey or in ward attendant ratings of the subjects on the MACC Behavioral Adjustment Scale. Posttest comparisons on the same variables (i.e., value rankings and ratings of behavior) indicated significant differences among the experimental and control groups on two of the 18 instrumental values of the Rokeach Value Survey, but no differences on any of Rokeach's 18 terminal values. Posttest changes over pretest value rankings occurred as much in the control group as in the experimental groups and the direction of changes varied with each group. Thus, no definitive benefits of one type of group procedure over another occurred. Further, the limited number of values for which posttest differences were observed between the experimental and control groups were well within the amount of normal change that could be expected from chance probabilities alone. It was therefore concluded that these particular changes in value rankings were essentially negligible and thus not attributable to either of the treatment modalities. Possible effects of group therapy in general, as well as any differential effects of directive versus non-directive group therapy were also studied in terms of behavioral ratings of subjects by hospital ward attendants. Statistically significant results on this variable clearly supported the value of both therapy groups over the control group for effecting positive changes in post-treatment behavioral ratings of the study's hospitalized subjects. However, the results did not demonstrate sufficient differences between the two experimental groups to conclude superiority of one leadership style over the other. A descriptive analysis of individual movement (direction and amount of change) from pretest to posttest ratings of behavioral adjustment was presented, and posttest differences between subjects subgrouped according to psychiatric diagnosis and number of psychiatric hospitalizations were discussed in terms of clinical rather than statistical inferences. The results of the study were discussed in reference to previous research related to human values, and Rokeach's viewpoint with regard to personal values and value changes was considered in light of the findings of the present study. Some possible implications of the study results were suggested, with particular reference to some of the unique characteristics of the study sample, including differing psychiatric diagnoses and chronicity of subgroups of the subjects, and a possible lack of motivation on the part of some subjects for participation in therapy groups. Several delimitations of the study were discussed, and recommendations for further research of this nature were offered.

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