Explanatory style change in supportive-expressive dynamic therapy.

Change in explanatory style (measured by the Attributional Style Questionnaire [ASQ]) has often been considered specific to cognitive therapy (CT). We used data from 59 patients who had received supportive-expressive (SE) dynamic therapy after meeting DSM-III-R criteria for a depressive spectrum disorder and who had completed the ASQ at intake and termination of treatment. We found that depressive symptoms decreased significantly and that explanatory style became more optimistic over the course of treatment.

Relationships between God and people in the Bible, part III: When the other is an outsider.

This study considers intergroup attitudes in the Bible and compares relationships between God or Jesus and (a) Torah non-Israelites; (b) New Testament people who were not followers of Jesus; and (c) New Testament people who were not Jewish. Torah non-Israelites belonged to an out-group with respect to the Hebrew Torah, New Testament people who were not followers of Jesus belonged to an out-group with respect to the Christian New Testament, and New Testament people who were not Jewish were an in-group with respect to Christians. Results were that God or Jesus' relationships were very negative with people in the Torah who were non-Israelites and with people in the New Testament who were not followers, while relationships were positive with people in the New Testament who were not Jewish.

Computer-supported monitoring of patient treatment response.

The use of information technology (IT) for the purpose of improving psychotherapy outcomes in the context of routine clinical practice is described. IT efforts from two research programs, one in Germany and the other in the United States, are based on evidence that not all patients who enter treatment have a positive outcome and that continuous monitoring of patient treatment response with immediate feedback to therapists can be used to increase the likelihood of success for the poorly responding client. Such monitoring and feedback can best be accomplished by IT methodologies.

Clinical significance methods: a comparison of statistical techniques.

Clinically significant change refers to meaningful change in individual patient functioning during psychotherapy. Following the operational definition of clinically significant change offered by Jacobson, Follette, and Revenstorf (1984), several alternatives have been proposed because they were thought to be either more accurate or more sensitive to detecting meaningful change. In this study, we compared five methods using a sample of 386 outpatients who underwent treatment in routine clinical practice.

Relationships between God and people in the Bible, Part II: The New Testament, with comparisons with the Torah.

IN AN EARLIER study on the first five books of the Bible, the Torah or Pentateuch, relationships between God and people were assessed with the use of a clinical-quantitative method, the core conflictual relationship theme (CCRT) method. Here, the study is extended to God or Jesus's relationships with people in the New Testament, to obtain the first description of those relationships based on an established measure of relationships. In the New Testament, many different kinds of relationship themes were observed, with benevolent and positive themes as the most frequent.

Relationships between God and people in the Bible: a core conflictual relationship theme study of the Pentateuch/Torah.

The most widely known images of God are from the Bible. An important characteristic of these images is their portrayal of God's interactions with people. Although there have been many religious and literary discussions of God's relationships with people in the Bible, no systematic psychological assessment has been reported.

Remission, recovery, relapse, and recurrence in eating disorders: conceptualization and illustration of a validation strategy.

In a consensus-building process a group of experts from 19 European countries (COST Action B6) adapted the terms partial and full remission, relapse, recovery, and recurrence according to principles described by Frank et al. for depression. The empirical validity of the operationalizations was illustrated by longitudinal data on the post treatment course of 233 anorectic and 422 bulimic patients (diagnosed according to DSM-IIIR) from the German Project TR-EAT.

Is psychotherapy more effective when therapists disclose information about themselves?

Theorists have long debated the wisdom of therapists disclosing personal information during psychotherapy. Some observers have argued that such therapist self-disclosure impedes treatment, whereas others have suggested that it enhances the effectiveness of therapy. To test these competing positions, therapists at a university counseling center were instructed to increase the number of self-disclosures they made during treatment of one client and refrain from making self-disclosures during treatment of another client.

Norms, normality, and clinical significant change: implications for the evaluation of treatment outcomes for eating disorders.

Objective: The implications of the use of national norms of the Eating Disorders Inventory (EDI) are investigated.

Method: A German version of the EDI was administered to a representative national sample (n = 650), a repeatedly measured community sample (n = 207), and a national inpatient sample with primary diagnoses of anorexia or bulimia nervosa (n = 959). Resulting scale distributions were compared with those of North American samples of the handbook.

The factor structure of the working alliance inventory in cognitive-behavioral therapy.

Studies of the therapeutic alliance in cognitive-behavioral therapy (CBT) have varied in their results, necessitating a deeper understanding of this construct. Through an exploratory factor analysis of the alliance in CBT, as measured by the Working Alliance Inventory (shortened, observer-rated version), the authors found a two-factor structure of alliance that challenges the commonly accepted one general factor of alliance. The results suggest that the relationship between therapist and client (Relationship) may be largely independent of the client's agreement with and confidence in the therapist and CBT (Agreement/ Confidence), necessitating independent measures of these two factors, not one measure of a general alliance factor.

Supportive techniques: are they found in different therapies?

Therapists of different persuasions use various techniques. Although many of these techniques are specific to their theory of treatment, others are practiced in common among different forms of psychotherapy. Many of these common techniques have been previously described, but supportive techniques have been largely ignored.

Computer-assisted feedback-driven quality management for psychotherapy: the Stuttgart-Heidelberg model.

The authors present the Stuttgart-Heidelberg Model for quality management of psychotherapy. The system is characterized as an active internal approach with external support from researchers. Problem-solving activities are initiated and maintained by computer-assisted feedback on possible treatment shortcomings.

Alliance predicts patients' outcome beyond in-treatment change in symptoms.

The authors examined the relations among therapeutic alliance, outcome, and early-in-treatment symptomatic improvement in a group of 86 patients with generalized anxiety disorders, chronic depression, or avoidant or obsessive-compulsive personality disorder who received supportive-expressive dynamic psychotherapy. Although alliance at Sessions 5 and 10, but not at Session 2, was associated with prior change in depression, alliance at all sessions significantly predicted subsequent change in depression when prior change in depression was partialed out. The results are discussed in terms of the causal role of the alliance in therapeutic outcome.

The Revised Helping Alliance Questionnaire (HAq-II) : Psychometric Properties.

The concept of the therapeutic alliance and its operationalization have received much attention in recent years. One of the early self-report measures of the therapeutic alliance was the Helping Alliance questionnaire (HAq-I). This scale was recently revised to exclude the items that explicitly reflect improvement.

To use or to refuse cocaine--the deciding factors.

Two types of narratives were obtained from 35 cocaine-addicted patients: narratives about using cocaine and narratives about not using cocaine. The most prevalent factors in using cocaine were (a) having enough money, (b) wish to end physical/emotional pain, and (c) wish/decision to use. The factors in narratives about not using cocaine were (a) patient arranged conditions to be nonstimulating for using cocaine, (b) recognition of bad consequences, and (c) wish/decision not to use.

Efficacy of short-term dynamic psychotherapy : past, present, and future.

The author outlines the history of brief dynamic psychotherapy, describes some of its characteristics, and addresses methodological requirements for assessing the efficacy of psychotherapy. Review of two major meta-analyses suggests that manual-based brief dynamic psychotherapy by trained therapists is likely to be as effective as other forms of psychotherapy and more effective than no treatment. More studies are needed that 1) compare brief dynamic psychotherapy with other forms of treatment for specific psychiatric disorders; 2) use theory-specific measures of outcome in addition to measures of symptoms; and 3) compare brief dynamic psychotherapy with long-term psychotherapy.

Diagnosis of narcissistic self-esteem regulation in patients with factitious illness (Munchausen syndrome).

A quantitative taxonomy for the identification of patients with narcissistic pathology and with borderline personality disorders based on test results is presented. The quantitative identification of these subgroups was produced using a Q-factor analysis. Based on the correlation of the subjects by means of the 241 questions from the narcissistic inventory of Deneke and Müller [27], three subgroups could be defined.

An empirical evaluation of three components of the tetrahedron model of clinical judgment.

The tetrahedron model of clinical judgment (Rock, Bransford, Maisto, and Morey, Clin. Psychol. Rev.

Effects of communication content on speech behavior of depressives.

Depressed patients were interviewed at two different severity levels in the course of their illness about both problematic and neutral topics, and their speech behavior was analyzed in terms of speech activity and silences. Lowered speech activity and increased silences occurred at higher severity levels and also during problematic communication content, suggesting the mediation of cognitive factors as postulated by Beck's cognitive model of depression.

Cyclical psychodynamics and the triangle of insight: an integration.

This paper attempts to integrate a recent dynamic conceptualization of patients' problems known as "cyclical maladaptive pattern" (Strupp and Binder 1984) with a more traditional model, the "triangle of insight" (Menninger 1958). The integration is offered as an effort to illustrate the theoretical continuity of the two models. The integrated model also serves as a useful step toward improved specification of the principles and procedures implicit in the creation of a comprehensive psychodynamic formulation, potentially enhancing research, training, and the clinical practice of psychodynamic psychotherapy.