Interpretation and the Therapeutic Relationship: An Attempt at Integration

The term integrative psychotherapy can have a range of meanings. It can refer to integration between therapeutic approaches grounded in different theoretical frameworks as exemplified in Wachtel’s (Psychoanalysis and behavior therapy: toward an integration. Basic Books, New York, 1977) Psychoanalysis and Behavior Therapy. Many therapists informally practice this sort of integration when, in response to problems and issues presented by the patient, they intuitively borrow from a variety of approaches in their clinical work. Therapeutic integration can also refer to attempts at integration within a single broad therapeutic approach such as psychoanalytic or psychodynamic. This is the direction I will take in this article. My goal in this paper is to contribute to the possibility of integration among different theoretical approaches within psychoanalysis in a delimited area. The delimited area that I will focus on is the tension between an emphasis on interpretation and insight versus an emphasis on the therapeutic relationship as the primary agent of therapeutic change. Rather than an “either-or” position, I will show that integrating theories about both aspects of this process leads to a richer, more complex picture of what happens in psychodynamically-informed therapy.     

Potential Selective Responding in a Parent Questionnaire Study of Post-Institutionalized Children

This study assesses selective responding in a single wave of data collection and a four-wave study. Participants were 121 parents of post-institutionalized children, identified as “never responders,” “previous responders,” or “wave 4 responders.” Parents evaluated their adopted child's family, school, peer, and behavioral adjustment. Children (47% male) were 2 to 20 years old (M = 10.79, SD = 4.59) and adopted between 5 and 54 months of age (M = 15.49, SD = 9.94). Within a single wave of data collection, no evidence suggested that selective responding contributes much bias. Over a multi-wave study, however, results may under-represent adjustment difficulties.     

Positive and negative affect: A maximum-likelihood approach

Using the LISREL maximum-likelihood program, the relation between Bradburn's positive affect and negative affect scales is examined for three age groups of adults. It is found that (a) unequal item loadings fit significantly better than equal item loadings; (b) the best-fitting loadings for the elderly are significantly different from those of the non-elderly; (c) the positive and negative affect scales are substantially correlated and (d) correlations with related variables are stronger when positive and negative affect scales are formed by maximum-likelihood loadings rather than by unit loadings. Given the widespread use of Bradburn's scales, implications of these results for subjective well-being are discussed.     

Treatment of incarcerated, sexually-abused adolescent females: an outcome study

This study examined the psychosocial functioning of 100 adolescent females (ages 12-17) sentenced to secure care in a southeastern state and the impact of gender-specific, cognitive-behavioral therapy (CBT) intervention on the psychosocial functioning of subjects who reported a history of sexual abuse. The Multidimensional Adolescent Assessment Scale (MAAS) was used to assess psychosocial functioning. Pre-test scores on the MAAS revealed significantly higher scores on 12 of 16 dimensions of psychosocial functioning and higher rates of serious criminal behavior for youth who subsequently disclosed sexual abuse histories as compared to those without such histories. At post-test, statistically significant improvements in psychosocial functioning were observed on 14 of 16 MAAS subscales for those who received the CBT intervention. Thus, incarcerated female adolescents who reported a history of sexual abuse demonstrated more impairment in their functioning as compared to those without a reported history of sexual abuse and responded positively to gender-specific, CBT-based intervention.     

Modeling the Effects of Expressed Emotion,Psychiatric Symptomology,and Marital Quality Levels on Male and Female Verbal Aggression

Previous research has linked expressed emotion (EE) levels and psychiatric symptomology, whereas other empirical efforts have examined the relationship between EE and marital relationship variables. Still other research has linked psychological conditions with acts of aggression, and the impact of marital issues within this domain of inquiry also has been explored. The study presented here examined the combined effects of EE, marital quality, and psychiatric symptomology on displays of verbal aggression by both relationship partners. Both husbands' and wives' reports of marital quality were predictive of both husbands' and wives' verbal aggression levels; here, reports of lower marital quality were associated with higher levels of verbal aggression. Additionally, husbands' and wives' reports of psychological symptomology in self and partner were important paths to marital quality, as were husbands' and wives' reports of EE levels. Further, some evidence was generated that supports the mediating role of marital quality with regard to EE and psychological symptomology. However, the overall fit indices of the models tested in this empirical effort were modest. Limitations that concern the instruments utilized in the present study are discussed in this regard.     

FAMILY SYSTEMS THERAPY AFTER OPERATIONS DESERT STORM WITH EUROPEAN-THEATER VETERANS

We describe a quasi-experimental trial of time-limited family therapy with veterans and families of veterans who served in Europe, outside the war zone, during Operation Desert Storm (ODS). Family systems therapy was provided both to individuals and conjointly to couples or families during the acute postwar readjustment period. The intervention adapted strategies from structural, strategic, intergenerational, and behavioral family therapies in a brief-treatment protocol for systemic stressor resolution. Veterans given family system therapy were able to resume functional levels of psychosocial adjustment and reduce the risk of long-term (Chronic or delayed) psychosocial impairment. Based on these preliminary findings, controlled evaluation of family systems therapy appears warranted for indi-     

On a multiple endpoints testing problem

In a clinical trial comparing drug with placebo, where there are multiple primary endpoints, we consider testing problems where an efficacious drug effect can be claimed only if statistical significance is demonstrated at the nominal level for all endpoints. Under the assumption that the data are multivariate normal, the multiple endpoint-testing problem is formulated. The usual testing procedure involves testing each endpoint separately at the same significance level using two-sample t-tests, and claiming drug efficacy only if each t-statistic is significant. In this paper we investigate properties of this procedure. We show that it is identical to both an intersection union test and the likelihood ratio test. A simple expression for the p-value is given. The level and power function are studied; it is shown that the test may be conservative and that it is biased. Computable bounds for the power function are established.