Workshop 1 Title: Using Code-a-text to Analyse Psychotherapy Texts Authors



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Address for Correspondence:


John S. Lyons, Ph.D.

Director, Mental Health Services and Policy Program

Northwestern University Medical School

303 E. Chicago Avenue, Ward 9-200

Chicago, IL 60611 USA
ABSTRACT

This study reports on the first three stages of a project to develop a decision support tool for ensuring that families of children and adolescents with developmental disabilities receive the counseling and psychotherapeutic support services they need. There is ample evidence that parenting a child with significant developmental or intellectual difficulties is challenging, these challenges can become overwhelming when parenting capacity is impaired. Current systems of care for persons with developmental disabilities attend to the intellectual, developmental, and physical needs of the disabled but often ignore the needs of caregivers. This can be particularly challenging for parents of children with developmental disabilities who often must balance parenting responsibilities with jobs and other roles.

In order to improve the match between these needs and services, the State of Texas has undertaken a project to develop a decision support tool that identifies the needs and strengths of children and their families. In this paper we present the initial development of this tool, which is entitled the Child and Adolescent Needs and Strengths for developmental disabilities (CANS-DD). Developed from focus groups of families and professionals, the CANS-DD has 45 items covering six domains including Functioning, Risk Behaviors, Co-Morbidities, Care Intensity & Organization, Caregiver Capacity, and Strengths. It is these later two domains that are novel to this measurement approach and the focus of the present poster. After an iterative developmental process in which drafts of the instrument were shared with stakeholders and feedback was incorporated, initial reliability and validity testing was undertaken. Using six different raters, inter-rater reliability of the overall measure was adequate with a kappa of 0.71. Internal consistency of the total measure was 0.75. The Caregiver Capacity domain had an alpha of 0.78. The Strengths domain had an alpha of 0.70. In a study of 133 children and adolescents in care, both the Caregiver Capacity and Strengths were related to the presence of Risk Behaviors and Co-morbidities and to out-of-home placements. Single parents had lower levels of Caregiver Capacity and Strengths than two parent families. Additional details of the validity study will be provided. Implications for service planning and service delivery also will be discussed.
Poster Session B
Title: Attachment Styles in Romantic Relationships of Clients with Anxiety Disorders
Author: Markos Maragkos
Address for Correspondence:
Markos Maragkos

Department of Clinical Psychology

University of Munich

Leopoldstr. 13

D-80802 Munich

Germany


Phone: +498921805179

Fax: + 498921805196

Email: maragkos@psy.uni-muenchen.de
ABSTRACT
The main purpose of this study was to investigate the adult attachment styles in romantic relationships within a sample of clients (N=30) with anxiety disorders (PD(A), Social Phobia).
The following questionnaires were administered to both the clients and their significant others: SCL-90_R, Attachment Style Questionnaire by Ina Grau, Styles of Conflict Inventory. We hypothesized a complementary attachment style which was confirmed by our results.
A majority of clients show a dependent attachment style most of their significant others were characterized by an avoidant attachment style. Implications for the therapy were discussed.
Poster Session B
Title: Changing Objects: The Effects of Group Therapy on Addicts' Attachment to Drug of Choice
Authors: Tina Rich, Colleen M. Sandor
Address for Correspondence
Tina Rich

Cornerstone Counseling Center

660 South 200 East #308

Salt Lake City, Utah 84111

USA

Fax: (801) 359-3244



e-mail - 75374.331@Compuserve.com
ABSTRACT
The proposed presentation will present data from an ongoing study of drug addicts in early recovery who are participating in an Intensive Outpatient Treatment (IOT) program in a community mental health facility. The clients attend group therapy four nights a week, two hours a night for a minimum of 6 weeks.
Previous research has shown that addicts have a well articulated, coherent relationship with their drug of choice. The present study tests the hypothesis that attachment to therapy group predicts change in addicts' attachment to their drug of choice. The Structural Analysis of Social Behavior (SASB) Intrex was used to measure addicts' relationship with drug of choice and with therapy group on admission and after six weeks of intensive Outpatient Treatment. Change in relationship with drug of choice was examined as a predictor of change in drug-using behavior and adaptive function. The association of SASB Intrex change measures with pre-treatment psychiatric symptom report and personality structure was also explored.
Poster Session B
Title: Group Psychotherapy for Depression: Comparison of Outcome and Active Mechanism Specificity in Two Protocols for Treatment of Depression
Authors: Russell J. Roberts and Tracy A. Ludlow
Address for Correspondence:
Russell Roberts

School of Psychology

Griffith University, Gold Coast Campus

Queensland, Australia 9726.

Email: r.roberts@mailbox.gu.edu.au

Fax: 61-7-55948291



ABSTRACT

Both Cognitive Behavioral Therapy and Interpersonal Therapy have been demonstrated effective in the treatment of depression. Recent multi-site studies of psychotherapy for depression have indicated gender differences in treatment outcome. However the design of these studies could not differentiate a true effect of sex-specificity in treatment response from the artefact of intra-group processes. In this study 36 males and 36 females were matched then randomly assigned to either a Cognitive-Behavioral, Interpersonal Psychotherapy or a wait-list control condition. The study utilised a 3 by 2 matched pairs design with gender and treatment type the independent variables. Measures of mood, interpersonal problems, anhedonia, self esteem and sex-role identity were taken both pre and post treatment. Post treatment measures showed a clear advantage of both Cognitive Behavioral Therapy and Interpersonal Therapy over wait list control. Further, the results indicated a strong gender X treatment interaction effect. Implications of these results for treatment selection and programming are discussed.





Poster Session B
Title: Contrasting Models for Estimating the Trajectory of Cost-Effectiveness Change in a Clinical Trial Contrasting Structural Ecosystemic Treatment with Structural Family Therapy and Treatment-as-Usual for Drug Abusing Minority Youth.
Authors: Frederick L. Newman, Daniel Feaster, Robert Williams, & Jose Szapocznik.
Address for Correspondence:

Frederick L Newman, Ph.D., HSA/SPM, AC-I, Room 278A,

Florida International University-North Campus,

3000 NE 151st Street, North Miami, FL 33138 USA

FAX: 305-919-5848 email: newmanf@fiu.edu
ABSTRACT
The primary aim of the clinical trial is to compare the cost-effectiveness of Structural Ecosystems Therapy (SET) relative to Structural Family Therapy (FAM) and Community Control (CC) for drug abusing problem-behavior minority youth. It is hypothesized that scores in: a) drug use, and b) conduct, delinquent, and other antisocial behaviors will change at a faster rate yielding a better outcome for SET than for FAM, and for FAM than for CC. It is also hypothesized that initial added costs of the SET intervention relative to FAM, and of FAM relative to CC will be off-set by the reduction in costs to the health, mental health/substance abuse (MH/SA), and juvenile justice systems within 12 months after standard SET, FAM, or CC interventions are expected to end. It is predicted that behavioral changes of the youth in SET, relative to FAM, and of FAM relative to CC, will be accompanied or followed by decreases in the costs of health, Mental Health/Substance Abuse, and Juvenile Justice services outside of the study.

The presentation focuses on contrasting methods of analyses that address the concerns of several perspectives: a) societal; b) state executive and state agency level policy makers, and c) psychotherapy researchers. The analytic techniques applied to investigate the cost-effectiveness differences among the three interventions over time include multivariate repeated measures analyses, and growth curve analysis employing Structural Equations and Hierarchical Linear Modeling. The paper contrasts these analytic approaches in terms of how well they tests hypotheses concerning the trajectories of change in a) family interactions, b) in how the family interacts with other segments of the community (e.g., with the youth’s peers, the school, extra-intervention Mental Health/Substance Abuse services, and the Juvenile Justice system), and c) the costs to the Health, Mental Health/Substance Abuse, and Juvenile Justice systems over time.


Poster Session B
Title: Evolution of the Salamanca Data Bank
Authors: Manuela Redero Sanchez, Silvia Rodriguez Oliva, and Alejandro Avila Espada
Address for Correspondence:
Manuela Redero Sanchez

Unidad de Investigacion en Psicologia Clinica y Psicoterapia

Dpto. de Personalidad, Evaluacion y Trataminentios Psicologicos

Facultad de psicologia. Univesidad de Salamanca

Avda. de la Merced 109-131. 370005

Salamanca, Spain



ABSTRACT
Until recently there has not been a comprehensive bank of cases and text (transcriptions of psychotherapy sessions) in Spain. Now, different professionals have access to such a bank for their research work. Our objective has been to create a cases and text bank similar to one previously developed at Ulm University (Germany) but also improving it on several characteristics. After one year of work, we have collected three types of text.


1. Sessions of psychoanalytic psychotherapy: 246

241 adults, 15 adolescents


2. Fragments of single psychotherapy sessions: 2
3. Thematic Apperception Test protocols: 145

100 from individual administration, 45 from collective administration


All of these materials are in their original language (Spanish). The present study attempts to analyze a collection of the first clinical interviews of patients with several mental disorders: phobias, personality disorders, neuroses, etc. Our objective is to structure the thematic content. In the future, we expect to increase the number of cases and text in the bank in a way that facilitates the work of many researchers. It will be open to all who are interested in collaborating with us in our studies.

Poster Session B
Title: Development of a Core Battery for the Assessment of Anxiety, Affective, and Personality Disorders in an Outpatient Training Clinic
Author: David M. Todd
Address for Correspondence:
David M. Todd
Department of Psychology
University of Massachusetts
Amherst, MA 01002
USA
ABSTRACT
One of the general recommendations of the 1994 conference on core battery was to "take into account settings in which research is conducted" (Strupp, Horowitz, and Lambert, 1997). Faculty and students at the University of Massachusetts have been engaged in the design of a core assessment battery for the clinical psychology program training clinic, the Psychological Services Center (PSC). A series of program meetings was held, drawing heavily on reports and recommendations of the 1994 conference, including consideration to "universal", "general", and "specific" levels of assessment.
An early proposal in this process was to focus on affective, anxiety, and personality disorders, the areas that were addressed in depth in the 1994 conference. The rationale for maintaining this focus was that these are common diagnoses in outpatient clinics; that comorbidity between these forms of disorder is high; that there is evidence that comorbidity, especially when it involves personality disorder, may have strong implications for treatment and training; and that there was significant faculty interest in each of these areas.
Complementing this work of the 1994 conference, which emphasized the evaluation of instruments within each of the diagnostic categories, we have concentrated on the creation of an integrated core battery for our clinic. We are particularly interested in the utility of this battery for the selection and assignment of cases, treatment planning, and therapist training and supervision, as well as outcome assessment. The rationale, process, and results of these discussions are summarized to provide one example of a core battery developed for this type of setting, and remaining issues are described.
Poster Session B
Title: Dialectic-Behavioral Psychotherapy (DBT) in Clinical Practice - An Evaluation
Authors: Brigit Steinbrenner, Martina Schonauer-Cejpek, Rudolf Hirsch

Address for Correspondence:
Martina Schonauer-Cejpek

Universitatsklinik fur Psychiatrie Graz

Auenbruggerplatz 22

A-8036 Graz, Austria


ABSTRACT
This study examined psychotherapeutic benefits of using DBT- concepts in combination with individualistic psychotherapy in borderline-patients.

Regarding Marsha Linehan, dialectic-behavioral psychotherapy (DBT) is a very specific way to treat patients with borderline-personality disorders using a multimodal psychotherapy model combining techniques of various therapeutic schools. In follow-up studies (Archives of general Psychiatry 1991, 1993) Marsha Linehan showed that using this model of group psychotherapy leads to a reduction of self-injuring (parasuicidal gestures, drug- and substance abuse, eating disorders) and internal stress as well as improvement of life quality. DBT-concept is always a combination of skill training in groups and individual therapy.

At the University Hospital for Psychiatry in Graz, this concept has been advanced and evaluated (this advanced concept is discussed in the surroundings of another poster).

The Gunderson DIB-R semi-structured interview was used for diagnostic purposes. All patients received complete information regarding their disorder. Personal concepts for treatment were worked out together and build in a therapy contract, which was signed by both patient and psychiatrist. Six females and one male patient were included in the program. During the year of attendance of the psychotherapeutic group, every three months the patients were examined by using the Munchner Lebensqualitat Dimensionsliste (MLDL) and other questionnaires concerning their state of health. Intervision-groups (individual psychotherapists, psychiatrists and other medical staff) were used to correlate observations of individual psychotherapists with subjective declaration of patients. In the group, patients should learn/improve capacities that help change patterns towards attitudes, feelings, dispositions, which might lead to problems and emotional burdens in their lives.

The results of this evaluation are to be shown in this poster.
Poster Session B
Title: Dialectical Behavior Therapy for Treatment of Concurrent Borderline Personality Disorder and Substance Use Disorders: A Pilot Study
Authors: Shelley McMain and Lorne Korman
Address for Correspondence:
Shelley McMain

Centre for Addiction and Mental Health

Addiction Research Foundation Division

33 Russell Street

Toronto, Ontario M5T 1R8

Canada
ABSTRACT


To date, little attention has been directed toward the development of specialized treatment services for clients diagnosed with borderline personality disorder and co-occurring substance use disorders. In recent years, Linehan (1983; 1991; 1994) provided initial support for the effectiveness of Dialectical Behaviour Therapy (DBT) for individuals with borderline personality disorder (BPD). Linehan has extended her evaluation of DBT to the treatment of individuals with concurrent BPD and substance use disorders. The results of these studies have yet to be published. The current study was designed to evaluate the efficacy of DBT with individuals diagnosed with BPD and co-occurring substance use disorders. The study was intended to provide an objective evaluation of the effects of DBT by clinicians and researchers who are independent of the Linehan research group. The specific aims were to test the efficacy of DBT to a treatment-as-usual condition in a sample of 24 individuals diagnosed with BPD and substance use disorders. Subjects were randomly assigned to a DBT pilot treatment condition (N= 12) or to a treatment-as-usual condition (n= 12). Outcomes targeted include reductions in frequency and severity of substance use, suicidal behaviours, symptom distress, interpersonal behaviour, treatment retention and number of days hospitalized The main outcome assessment battery is to be administered at pre-, 4-month, 8-month and 12-month treatment points. Preliminary findings pertaining to the outcome of the first four months of treatment, will be discussed.

Poster Session B
Title: Effectiveness of Affect Arousal in Treatment of Depression–An Exploration of Client Outcomes Using Voice Therapy
Author: Benny R. Martin
Address for Correspondence:
Benny Martin

Graduate School of Education

University of California at Santa Barbara

Santa Barbara, CA 93106-9490

Fax: 805-893-7594

Email: bmartin@education.ucsb.edu


ABSTRACT
This pilot study examined the effects of Voice Therapy, an experiential-process approach, upon depression in an alternating treatments design using four subjects. It is the first application of this therapy model on a clinical population. All subjects had a diagnoses including moderate-to-severe depressive symptoms.

Voice therapy utilizes the here-and-now experience to increase arousal of affect to stimulate insights in the subjects with the goal of reducing depressive symptomatology. voice therapy arises out of a combination of the process experiential approach along with psychodynamic, separation, and object relations theories and derives its name from the technique of prompting the client to "voice" self-criticisms in the second person, i.e., "you" statements. This therapy assumes that self-punishing and self-nurturing thoughts can combine to produce self-destructive behaviors in clients and are due to early family dynamics and accompanying sociocultural and historical environmental issues. It is believed that prompting clients to greater affect arousal leads to release of anxiety-laden material, which in turn allows the client to gain insight into their own dynamics. It is suggested that after identification of such insights that strategies can be developed to restructure a client's self-definitions to be more positive.

In the present study, voice therapy techniques were employed in a modified A-B-A-B design which alternated sessions incorporating voice therapy techniques with sessions featuring no voice therapy techniques. The purpose of the research was to determine if limited application of voice therapy produced any clinically meaningful differences in the subjects. The Beck Depression Inventory was used to assess client outcomes, and qualitative comparisons of the data were conducted using graphs. The preliminary results showed differentiating factors which warrant further study.
Poster Session B
Title: Emotional Episodes in Attachment Narratives of Eating Disorder Patients
Authors: Sandra Vilarinho, Isabel Soares & Paulo P. P. Machado
Address for Correspondence:
Paulo P. P. Machado

Universidade do Minho, Departamento de Psicologia

Campus Gualtar

4700 Braga, Portugal

Tel# +351 53 604241

Fax# +351 53 678987

e mail: pmachado@iep.uminho.pt
ABSTRACT
Our study aims to examine the emotional content of attachment narratives of eating disorder patients. This study was conducted within a larger project   the European Collaboration on Effective Treatment of Eating Disorders (COST B6). Forty patients were assessed using the COST B6 protocol that includes Patient Questionnaire (PQB), SCL 90 R, EDI, and FPI. The Adult Attachment Interview was also administered and interview transcripts were rated with the Attachment Q sort developed by Roger Kobak. Protocols were also rated for Emotional Episodes (Korman, & Greenberg, 1991). Results will be discussed in light of attachment theory, patterns of emotional regulation, and patterns of symptom expression of eating disorders.

Poster Session B
Title: EUROVIHTA - A Program to Improve Life Quality and Adaptation of People with HIV/AIDS
Authors: Luis Carlos Escobar Pinzón, Julia Bock, Dieter Riemer, Martin Hautzinger
Address for Correspondence:
Martin Hautzinger

Department of Psychology, Eberhard-Karls-University

Reutlinger Str. 12

D - 72072 Tuebingen

Germany

ABSTRACT
Based on therapeutic experience with self-help groups of national and regional Aids-support-organizations in Spain and Germany, a group intervention program was developed. The program integrates knowledge of psychoneuroimmunology, coping and stress regulation, and psychotherapy research, to improve the quality of life for people with HIV/Aids. It consists of six modules: relaxation, group dynamic techniques, behaviour and cognitive oriented elements, problem solving skills to improve and use personal resources, and crisis management. It is currently evaluated with the Project EUROVIHTA in five countries.
The program is made up of 16 sessions with each two hours following a very similar structure. The trainer has specific topics to present during each session, but should leave enough room for group discussion and exchange about the participants’ own experiences. The trainer is responsible in cooperation with the participants for the agenda, for scheduling time and for structuring the problem-solving oriented process. Preliminary experience with the program is promising and fits in with meta-analytic results of similar approaches with clients.
We’ll present first results of the evaluation of 120 subjects treated in this investigation.
Poster Session B
Title: Existential Loneliness Questionnaire: Background, Development and Preliminary Findings
Authors: Aviva Mayers, Sick Toon Khoo, Martin Svartberg, Gerd Inger Ringdal
Address for Correspondence:

Aviva Mayers

Norwegian Centre for Child Research

University of Trondheim

N-7055 Dragroll, Norway
ABSTRACT
This poster describes the background, development and preliminary findings of the existential loneliness questionnaire (ELQ-P) which was designed by the first author to test for the presence of existential loneliness in parents infected with the HIV virus.

Empirical research on loneliness has focused almost exclusively on a condition determined by either (1) circumstances (state) or (2) personality differences (trait). A third category, existential loneliness which has been cited in the literature has generated relatively little discussion and no empirical testing. It is a universal but often dormant feeling present in all of us. However, following such universal experiences as separation from a loved one or an emotional loss, the feeling that we are alone and helpless in the world may be triggered. Most people for much of their lives defend against such feelings with denial based but adaptive strategies such as suppression, repression, displacement, or belief in one's omnipotence, that detoxify death and the feelings of anxiety and loneliness that accompany this. Certain conditions, however, may strip one of such defenses. This may be the case with for example, persons suffering a terminal illness especially at a young age, possibly facing the death. of their children in addition to their own or that of partners and friends, or transmitting a deadly gene or virus to their partners or offspring. In view of the above, HIV+ parents seemed an ideal one on which to test out this concept.


The instrument is a 41 item 6 point Likert type scale which was administered to 51 HIV+ parents in New York City. The UCLA Loneliness Scale, the Beck Depression Inventory, the Hopelessness Scale, and the Purpose in Life Scale were also administered in conjunction with the Existential Loneliness Scale (ELQ-P). The purposes of this study were (1) to describe the development of the ELQ-P (2) to evaluate its psychometric properties with special emphasis on item performance and item selection using Mokken's (1971) nonparametric latent trait model for unidimensional scaling (3) to delineate the boundaries of the construct of existential loneliness by examining the relationship between ELQ-P on the one hand and measures of loneliness, depression, hopelessness and purpose in life on the other. The relationship of AIDS symptomatology to existential loneliness were also explored. The treatment implications of the ELQ-P for this and other populations will be discussed.

Poster Session B
Title: Focus on Therapeutic Alliance: The Psychometric Properties of Six Measures Across Three Treatments
Authors: John Cecero, Lisa Fenton, Charla Nich, Tami Frankforter, and Kathleen Carroll
Address for Correspondence:
John Cecero

Department of Psychology

Fordham University

113 W. 60th Street

New York, New York 10023

USA
ABSTRACT


This study compared the psychometric properties of six measures of therapeutic alliance (California Psychotherapy Alliance Scales; Penn Helping Alliance Rating Scale; Vanderbilt Therapeutic Alliance Scale; and the Working Alliance Inventory - therapist, client, and rater versions) in a sample of substance dependent individuals participating in a randomized clinical trial of three psychotherapies.
Internal consistency, factor structure, interrater reliability by rater and by instrument, and intercorrelations among the instruments were evaluated.
Results supported the construct validity of the therapeutic alliance and indicated that all six measures had acceptable reliabilities. Correlations between observer and participant measures were comparatively low. Reliabilities did vary, however, by treatment condition, and this new finding invites future research into matching alliance instruments to specific treatments.


Poster Session B
Title: Group Psychotherapy: A Single Case Process/Outcome Study
Author: K. Roy MacKenzie
Address for Correspondence:

K. Roy MacKenzie

201-1600 Howe Street

Vancouver, BC, Canada V6Z 2L9

Tel:604 822 7669; Fax: 604 669 8873

E-mail: rmack@interchange.ubc.ca


ABSTRACT
The group psychotherapy research literature has grown in parallel with that of individual psychotherapy but with a lag of about a decade. There is a small literature dealing with process/outcome dimensions. However, many of these studies examine training groups or student groups, and few deal with actual patient populations. This poster describes the findings in a time-limited anti-depression group of 18 sessions.

The Anti-depression Interpersonal Group is designed for patients who have experienced repeated episodes of major depression and may have a history of significant dysthymia as well. The focus of the group is on the connections between depression and interpersonal relationships: an adaptation of Interpersonal Psychotherapy (IPT) for the group format. An intensive but semi-structured approach to the current nature of important relationships is used. Group interaction is emphasized and affective responses facilitated. The focus remains on current and future problems, and extended discussion of topics related to past experiences is not encouraged (with the exception of delayed grief reactions). Medications are not managed within the group. The group meets weekly for 90 minutes for 18 sessions.

The change measures consist of the Outcome Questionnaire (OQ-45), Inventory of Interpersonal Problems (IIP) administered at intake, mid-point, termination and follow-up, and Beck Depression Inventory (BDI) at monthly intervals. A Client Satisfaction Questionnaire is completed at termination and follow-up.

Process measures consist of the 12-item Group Climate Questionnaire (GCQ) and the 12 item California Group-Psychotherapy Alliance Scale (CALPAS). These are administered at the end of each group session. The GCQ asks for a description of the entire group, while the CALPAS asks for the individual member's experience in the group. The results will be portrayed in a series of figures focused on the following aspects of the group:

(1) Mean session GCQ scores and group development

(2) Mean session CALPAS scores and group development

(3) Correlation between individual CALPAS scores and outcome

(4) Correlation between individual GCQ scores and outcome

(5) Critical events and shifts in GCQ and CALPAS ratings

(6) Variations in member process profiles on subscales of the GCQ and CALPAS


Poster Session B
Title: How About the Relation Between the Brief Symptom Inventory BSI and the Symptom Check List SCL90R in Assessing Symptoms?
Authors: Sven Rabung, Isa Sammet, Henning Schauenburg
Address for Correspondence:

Sven Rabung

Department of Psychosomatics and Psychotherapy

University of Göttingen

Von-Siebold-Str. 5

37075 Göttingen, Germany

e-mail: srabung@gwdg.de
ABSTRACT
Background and purpose of study: The Symptom Check List SCL90R (Derogatis 1977) is a widely accepted instrument for assessing patients’ symptoms. It is often applied in pre-post-studies to evaluate symptom reduction. If frequent assessments are necessary as in process studies, it is essential to apply short instruments to maintain patients’ compliance. The 53-item short version of the SCL90R is the Brief Symptom Inventory BSI (also known as SCL53, Derogatis 1993). It assesses the same dimensions of symptoms: somatization, obsessive-compulsiveness, interpersonal sensitivity, depression, anxiety, anger-hostility, phobic anxiety, paranoid ideation, and psychoticism. For reasons of practicability, the BSI is often used to monitor the course of symptom change. Intending to bring those process results and outcome results assessed by SCL90R together, it is essential to know about the interrelations between the two instruments. It was the purpose of this study to investigate them.

Design of study: 55 in-patients with mixed neurotic and personality disorders, treated in our Department of Psychosomatics and Psychotherapy for 6 to 17 weeks, were given the BSI weekly to assess symptom development. Additionally they completed the SCL90R in the first and in the last week of treatment to analyze pre-post-effects in symptom change.

Pre-treatment scores of both instruments were tested on interrelations respectively differences. Correspondingly, pre-post-effect sizes of symptom reduction were calculated for both inventories and tested on differences.

Results: Pre-measures of SCL90R and BSI differed significantly in most of the symptom dimensions. Accordingly, effect sizes of symptom reduction assessed by the SCL90R were found to be significantly higher than those assessed by the BSI.

The poster will present these results and discuss them taking the different settings of application (pre-post vs. weekly) into account.
Poster Session B
Title: I’m a Teenage Mother!: A Challenge for Prevention
Authors: Barbara Figueiredo, Raquel Matos, Rute Matos, Rute Magarinho, Elizabete Loureiro, Fillpa Batista, Carla Martins, Clara Marques, Ines Jongenelen and Isabel Soares
Address for Correspondence:
Barbara Figueiredo

Universidade do Minho, Instituto de Educacao e Psicolgia

Campus de Gualtar

4719 Braga, Portugal

Tel: +351 53 604240 1 5

Fax: +351 53 678987

Email: bbfl@iep.uminho.pt
ABSTRACT
Adolescent motherhood is considered a risk condition into the psychological well-being of the mother and the infant. Taking this in account a prevention program for adolescent mothers was developed and evaluated.
The study compares a group of 15 adolescent mothers submitted to a prevention program entitled “I’m a Teenage Mother!” with a group of adolescent mothers that didn’t participate in the prevention program, attending both at the Maternidade Julio Dinis (Porto).
The prevention program was conducted during the 3rd trimester of pregnancy and the first three months of postpartum in group sessions coordinated by a multidisciplinary team, including social workers, nurses, obstetricians, paediatricians ans psychologists.
In terms of results the adolescent mothers included in the prevention program are compared, three months after childbirth. Differences between these 2 groups are examined in terms of mother’s mental health status, quality of the home environment and the child care, quality of martial relationship, mother’s family support in child care, mother’s attitudes toward motherhood and the infant and postnatal adaptation. The infants of the adolescent mothers who were submitted at the prevention program are also compared in terms of behavioral difficulties, temperament and early signals of psychopathology.
Poster Session B
Title: Influence of Trainee Personality on Short- and Long-Term Effects of Training in Empathic Communication
Authors: Per Nerdrum, Per Høglend
Address for Correspondence:

Per Nerdrum

Graduate School of Social Work and Social Research

Oslo College Pilestredet 52

N-0167 Oslo Norway

Email per.nerdrum@oks.hioslo.no


ABSTRACT

For experienced lecturers of communication skills, it seems obvious that trainee personality influences the effects of training in empathic communication. Empirical research, however, has more or less disregarded this factor when investigating effects of such programs.


To investigate the impact of trainee personality on both short-term and long-term effects of a training program in empathic communication, we implemented a quasi-experimental study with two groups of students of social work. The level of empathic communication was measured from analogue data in both groups before training (T1), after the training period in the program group (T2) and at follow-up (T3) 18 months after training. Personality characteristics hypothesised to influence effects of training (neuroticism, extraversion and latent empathy) were assessed at T1. The program group participated in a 50-hour communication skills training course in addition to ordinary concept training, while the control group participated in social work concept training only. In the follow-up period, the groups received similar field practice.
Only one of the three personality characteristics hypothesised to influence effects of training of empathic communication did so. In interaction with presence or absence of training, Hogan Empathy Scale (HES), measuring latent empathy, had a fairly large (9 %) and significant influence on the short-term effects of training. This indicates that the level of latent empathy influenced post-test level in the program group, but not in the control group. HES influenced long-term effects of training in the same way, but to an even larger extent (12 %). Extraversion, and neuroticism did not influence training effects. Hogan Empathy Scale measures a combination of personal self-confidence in social situations, and openness, curiosity and non-judgmental attitude towards others.
Poster Session B
Title: Integrated Group Therapy for Patients with Bipolar Disorder and Substance Use Disorder: Outcome Results and Treatment Themes
Authors: Roger Weiss, Lisa Najavits, and Shelly Greenfield
Address for Correspondence:

Roger Weiss

McLean Hospital

115 Mill Street

Belmont, MA 02478

USA
ABSTRACT

Our research group has developed and pilot tested a 20-session manualized group therapy (Integrated Group Therapy, or IGT) for patients with coexisting bipolar disorder and substance use disorder. During this study, conducted under the auspices of the National Institute on Drug Abuse Behavioral Therapies Development project, 21 patients participated in the treatment; three different iterations of the therapy were conducted. Outcomes amount the patients receiving IGT were compared with those of 24 patients with the same diagnostic characteristics who received monthly assessment but no group therapy ("non-IGT"). Patients in the IGT cohort had significantly better outcomes on days of drug use, the drug composite score on the Addiction Severity Index, and consecutive months of abstinence.

A major goal of the therapy, which was based largely on cognitive-behavioral relapse prevention principles, was to identify behavior and thought patterns that were common to the recovery processes in both bipolar disorder and substance use disorder, and to contrast these with behavioral and thought patterns typical of the relapse processes for each disorder. In this regard, several key themes emerged during IGT. These included the following:

1. "It matters what you do" ( it matters if you get out of bed in the morning instead of pulling the covers over your head, it matters if you decide to get drunk today rather than abstaining from alcohol) vs. "May as well" thinking ( 'I may as well get high, I may as well skip my medication today; it doesn't matter').

2. "Snapshot" (I like the feeling I get after one or two drinks; I like the feeling of being a little hypomanic) vs. "Video" ('If I think through what will happen after the first two drinks, I realize that this will be followed by many more drinks and destructive consequences. Slight hypomania will be followed by severe mania and an inevitable nightmarish depression') thinking.


Results of the study and a review of central themes will be discussed.

Poster Session B
Title: Internalization of the Therapist in Long-Term Psychodynamic Treatment of Chronic Schizophrenia
Authors: Elizabeth A. Skowron and Donna L. Horn
Address for Correspondance:
Elizabeth A. Skowron

Department of Counseling Psychology,

University of Wisconsin

Milwaukee, Wisconsin 53201-0413

USA
ABSTRACT
The purpose of this study was to investigate the process of psychotherapy transfer in the long-term treatment of chronic schizophrenia in order to elucidate the mechanisms by which patients work through the loss of a previous therapist and consolidate gains in functioning through work with a transfer therapist. We hypothesized that a patient’s capacity to internalize aspects of the previous therapist lies at the core of successful therapy transfers and terminations. Internalization involves the patient taking in aspects of the therapist which serve to strengthen ego functioning (i.e., adaptive coping skills), and it is thought to serve a central role in the treatment of schizophrenic and other chronic mental illnesses (Barber & Crits-Cristoph, 1995; Orlinsky & Geller, 1993; Kernberg, 1972).
Twenty-four of 51 sessions conducted during a weekly, year-long psychotherapy were transcribed and subjected to intensive analysis using the Structural Analysis of Social Behavior (Benjamin, 1979) and the Therapist Representation Inventory (Geller, Cooley, & Hartley, 1981). Analysis of initial interpersonal-intrapsychic complementarity between (a) transfer therapist and patient and (b) previous therapist and patient, and observed changes over the course of treatment were used to construct a conceptual model of internalization as an event in psychotherapy of schizophrenia. The pattern of therapist interventions and client performance in successful vs. unsuccessful events is described. Implications for training are discussed.

Poster Session B
Title: Interrelational Aspects of Body Image and its Changes in a Dream Series: A Case Study
Author: Alfredo Lhullier
Address for Correspondence:
Dr. Alfredo Lhullier

Catholic University of Pelotas, Brazil

Pontifical Catholic University of Rio Grande do Sul, Brazil

Sen. Mendonca 301/405

96015 200/Pelotas RS

BRAZIL


email: lhullier@atlas.ucpel.tche.br or lhullier@voyager.com.br
ABSTRACT

Many methods have been developed to measure interrelational shifts and changes in psychotherapy patients. One of them, the CCRT (Luborsky & Crits Christoph), has been systematically found to be a reliable method of research for these aspects. This method has a quantitative part, related to frequency of some contents, and a part of content analysis of the narratives (relationship episodes). When analyzing small samples of narratives, like dreams, it is possible to emphasize the qualitative aspect of the method to study their variations, which could be important to the current study. Using the structure of CCRT (wish, response from other, response from self) and its standard categories in a content analysis methodology (qualitative approach) applied to a dream series of a successful analysis (Patient Eric Y, from Ulm Databank) the author examines the changes in the interrelational aspects related to body image. This correlation is considered as a possible indicator to process research in psychotherapy patients with body image distress.



Poster Session B
Title: Intra- and Interpersonal Characteristics in Anxiety Disorders
Authors: Achim Wentzel, Markos Maragkos, Willi Butollo

Address for Correspondence:
Dr. Achim Wentzel

Department of Clinical Psychology and Psychotherapy

Ludwig-Maximilians-University Munich

Leopoldstr. 13

D – 80802 Munich

Germany


e-mail: wentzel@psy.uni-muenchen.de
ABSTRACT
It is widely held that anxiety disorders represent a complex clinical syndrome. Comprehensive views of this syndrome are mostly based on clinical observations. However, empirical evidence is scarce. In this study, we analysed videotaped group-therapies for intra- and interpersonal characteristics (e.g. ego boundaries, emotions, introjects) in patients with anxiety disorders by using a newly developed rating system. We used the therapeutic work as a diagnostic tool, since psychological functioning often becomes evident only in the therapeutical process.
Here, data concerning the following categories is presented: coping with loss, emotional coping, self-support, need for control, enmeshment with parents, negative organisation of experience, introjects, and interactive styles. In all these categories, dysfunctional patterns of clinical and therapeutical importance were found. Interestingly, characteristics specific for distinct anxiety disorders have been observed.
Poster Session B
Title: Metacognitive Variations During the Psychotherapy of a Borderline Patient: An Analysis of Transcripts of a Whole Tape-Recorded Psychotherapy, According to the Scale for the Evaluation of the Metacognitive Function.
Authors: Antonino Carcione, Giancarlo Dimaggio, Maurizio Falcone, Giuseppe Nicolò, Michele Procacci, Giuseppe Ruggeri, Antonio Semerari.
Address for Correspondence
Antonio Semerari

III Centro di Psicoterapia Cognitiva

Via Ravenna 9/c 00161 Roma

e-mail: terzocentro@iol.it

Tel/Fax 06/44233878
ABSTRACT
Our hypothesis was that the psychotherapeutic change, i.e. the patient improved thanks to the psychotherapy, was promoted by some change in the patient’s Metacognitive skills. At the beginning of therapy the patient lacked ability in several aspects of Metacognition: he was unable to integrate emotions, thoughts and schemes into coherent narratives, was partially unable to assume a not-egocentric point of view, and finally was unable to master his problematic state. At the end of the therapy the patient showed a global improvement of the Metacognitive function and in particular an increase in the Mastery subscale, that is to say that the patient was more capable to operate on the relational and psychological conditions of his suffering.


Poster Session B
Title: Methodological Issues in the Use of Self-Report Questionnaires in Psychotherapy Outcome Research
Author: John McLeod
Address for Correspondence:

John McLeod

School of Social and Health Sciences, University of Abertay Dundee Marketgait House, Marketgait, Dundee, Scotland

ABSTRACT

Although many psychotherapy outcome studies carried out in the 1950s were characterized by the use of different types of change measures, in recent years the trend appears to have been to rely mainly on data collected through self-report questionnaires. The use of these methods does not seem to have taken account of the development of theory and research in personality psychology and psychometrics. The aim of this paper is to highlight some methodological issues associated with the application of self-report questionnaires in this field. These issues are:

(i) the process of questionnaire construction embody a set of validity and reliability criteria originally developed in the context of personnel selection. These criteria are not wholly compatible with the goals of therapy outcome research;

(ii) the way that a person responds to a questionnaire has been shown to be influenced by social desirability, impression management and self-deception. This creates particular problems in the context of outcome research;

(iii) research into the process of answering a questionnaire item suggests that in responding the person activates cognitive schema relevant to the domain of behaviour being assessed. Therapeutic interventions may produce change in these schema without necessarily changing the pattern of behaviour;

(iv) psychometric self-report questionnaires are likely to be insensitive to qualitative change;

(v) the domain of trait-like personal information being accessed by self-report questionnaires does not reflect important aspects of therapeutic impact.

The nature of these issues is briefly illustrated through consideration of the kinds of predictions about questionnaire response processes that might be derived from one well-known theory of therapeutic change - Stiles' assimilation model. In conclusion, it is argued that, in the absence of further research into these methodological issues, reliance on self-report questionnaires may represent a limiting factor in relation to the growth of knowledge about therapeutic outcomes. On practical, theoretical and policy grounds a more differentiated approach to research on outcomes is called for.



Poster Session B
Title: Methods and Techniques of Body Movement Psychotherapy in the Treatment of Somatizations
Author: María E. Moneta
Address for Correspondence:
Dept. of Psychiatry, Faculty of Medicine,

University of Chile, Las Hualtatas 6321, Vitacura,

Santiago, 6681631 Chile

e mail: mmoneta@machi.med.uchile.cl


ABSTRACT
The use of techniques seeking the contact with oneself through the body, via its movement and expression, is an effective therapeutic way to make manifest the feelings of anxiety at a somatic level. The use of verbalizations in the trained experience of the "felt body" and of the movements elicited is an important component during the therapeutic process. Through it the patient learns to transform his bodily experience in images and thoughts. This constitutes a learning that leads to a change in the unconscious body image and to a different relation with the body.
Stages of the therapeutical process and techniques used in body movement therapy working with groups of chronically somatizing patients are described. The group process in this type of approach is undergoing characteristic episodes: 1) Exploration, 2) Discovery 3) Acknowledgment 4) Connection and 5) Integration. The use of language or verbalization processes during movement therapy can support the orientation of the patients toward their own bodies. Quantity and quality of verbalizations are a function of the patient group, the working style of the therapist and the underlying therapeutical theory.

Poster Session B
Title: Narrative Psychotherapy with Adolescents: An Alternative Model of Identity Construction
Author: Miguel Goncalves
Address for Correspondence:
Miguel Goncalves

Department of Psychology

University of Minho

4700 Braga

Portugal

ABSTRACT
In this paper we present a model of narrative therapy with adolescents. Departing from re-authoring approach of White and Epston (1990) we suggest the use of therapeutic externalization of dysfunctional identities and the internalization of the preferred ones. We briefly present the re-authoring model and then described the process of identifying unique identities.

Poster Session B
Title: Predictive Models in Support of Adaptive and Selective Indication in Psychotherapy
Author: Wolfgang Lutz, Zoran Martinovich, Kenneth I. Howard
Address for Correspondence:

Wolfgang Lutz, Ph.D.

Department of Psychology, Northwestern University

2029 Sheridan Road

Evanston, IL. 60208-2710

USA
ABSTRACT


Random coefficient regression models can be used to model the influence of initial clinical characteristics on individual patient’s course of improvement over time. Given that method, it is possible to model the course of treatment for individual cases and for different outcome dimensions (well-being, symptoms, functioning) once initial information for a patient is available. In this presentation an extension of that profiling method will be presented, where patients process information will be included in the model to improve the original predictions during the course of treatment for an individual patient and to support adaptive clinical decisions.
Going a step further and using individual treatment-response predictions, a clustering model will be presented, which allows the definition of relatively homogeneous outcome clusters in terms of their predicted and observed courses of treatment. Using this clustering approach, probability estimates can be given to support treatment decisions; furthermore this method allows a single therapist to evaluate his or her caseload and to search for areas, where further training could be helpful. Extensions and specifications for using the method for different diagnostic groups will be discussed.
Poster Session B
Title: Protean Targets or Treatment Equivalence: Toward Target Validation
Authors: Robert L. Russell and Cara Lanza
Address for Correspondence:
Loyola University Chicago

Department of Psychology-DH 624

Att.: Robert L. Russell

6525 N. Sheridan Rd.

Chicago, IL 60626

email: rrussel@luc.edu


ABSTRACT
There has been a large body of meta-analytic data, in both the child and adult areas, which supports the worrisome conclusion that different treatments all have about the same level of efficacy for the "same" problem. Several authors have provided critical commentary as to why and how this finding may be misleading and derived from shortcomings in the research studies on which it is based. In this paper, we focus on one such shortcoming, namely the protean character of the supposed targets for intervention. Current practice often proceeds as if targets are adequately specified when identified at the syndromal level, when in fact within syndrome variability is alarmingly large - at the symptom level, the severity level, etiological level, pathogenic level, and at the level of the developmental pathway. Most treatments have relatively the same level of effectiveness because they each match up with only a small proportion of appropriate targets. Discovering the differential effectiveness of treatments first requires the arduous task of identifying and validating specific targets for intervention. We suggest criteria that can be used to validate targets, and indicate how such validation can lead to improved cycles of process-outcome studies. Application of our suggestive cycle will better identify matches between targets and interventions, through the use of comparative and dismantling paradigms of research.
Poster Session B
Title: Psychological Adjustment of Russian Speaking Immigrants to the U.S.: Comparison to a Non Immigrant Russian Speaking Sample
Authors: Katerine Osatuke and Mia W. Biran
Address for Correspondence:
Katerine Osatuke

Department of Psychology, Miami University

Oxford, OH 45056, USA

Email: osatukk@muohio.edu


ABSTRACT
It is a common conclusion in the literature on immigration that immigrants are at an increased risk for stress, adjustment problems, and psychological dysfunctions. This conclusion is always drawn from comparing immigrants to native populations of hosting countries. However, a comparison of immigrants to their own countrymen may provide a more valid baseline for evaluating their adjustment. This study compared Russian speaking immigrants to non immigrant Russian speaking sample on 12 commonly used self report measures of adjustment, personality, and stress levels. The immigrants were less stressed and better adjusted than the non immigrants. Correlation analyses of the scores are presented, and implications for therapy with immigrants

are discussed.



Poster Session B
Title: PTSD After War in Bosnia: Implications for Diagnostics
Authors: Rita Rosner, Steve Powell, Willi Butollo
Address for Correspondence:
Dr. Rita Rosner

Department of Clinical Psychology and Psychotherapy

Ludwig-Maximilians-University Munich

Leopoldstr. 13

D – 80802 Munich, Germany

e-mail: rosner@psy.uni-muenchen.de


ABSTRACT
Background: The goal of this study was to estimate the extent of Posttraumatic Stress Disorder in the general population and in specific samples of clients in psychological or medical treatment in Bosnia-Herzegovina. Data on the lifetime prevalence of traumatic events, conditional probabilities for the development of PTSD and the point prevalence for PTSD were obtained.
Sample and Methods: 329 people surviving the siege of Sarajevo were assessed with a wide range of PTSD related measures (PSS-SR, IES, BDI, STAI). The subsamples consisted of a random sample (N=116), a sample of individuals in psychological treatment (N= 114) and a sample in medical treatment (N= 99).
Results: While virtually all individuals survived at least one traumatic experience, only 21.4 % of individuals in the random sample developed PTSD according to DSM-IV criteria. The rates in the other samples were 34 % in medical treatment and 44.2 % in psychological treatment. Based on observations made during the assessment and on the conditional probabilities for specific traumatic events, the hypothesis is put forward that the strict use of DSM-IV criteria leads to a substantial underestimation of traumatisation. Subjects usually report the loss of a family member as the most upsetting event, while intrusive symptoms are usually related to a different traumatic event. Therefore we conclude that in the case of multiple traumatisations the validity of the DSM-IV criteria suffers. Implications for treatment will be discussed.
Poster Session B
Title: Race, Culture, and the Therapeutic Relationship: Preliminary Investigations

Author: Adil Qureshi
Address for Correspondence:

Adil Qureshi

Department of Counselor Education and Counseling Psychology

Western Michigan University

Kalamazoo, MI 49008

USA
ABSTRACT

This study examines psychotherapy process in the context of both race and culture. In recent years investigators have indicated that the psychotherapy process is of considerable importance in the context of what is termed cross-cultural or multicultural counseling or psychotherapy. Despite the interest in the area, there have been minimal empirical investigations of the pertinent issues and dynamics in the cross-cultural or multicultural context. The investigation will proceed by interviewing clients in an effort to identify basic themes pertinent to psychotherapy process in the context of race and culture.

Since the early 1980s, multicultural researchers have developed a framework for what are termed multicultural counseling competencies. Although there has been a great deal of interest in the area, few investigations have attempted to empirically validate the basic structure of these competencies. This paper is an effort to contribute to scholarship in this area. A basic assumption underlying the study is that multicultural therapist competencies must be discovered inductively; a qualitative investigation will allow themes to emerge relatively free of bias, be it of the investigator or of existing theory. The position taken in the paper is that the emergent process related themes are central to the notion of multicultural competencies; the themes inform issues pertaining to the therapeutic relationship and also to the therapist’s overall responsiveness to the client.

Subjects are interviewed in a relatively loosely structured format. Because these are preliminary investigations, the goal is to allow the research participants to speak freely about their experiences in psychotherapy and about how race and culture may affect the process (although not necessarily the content).

The themes are then be explored in the context of existing investigations of the therapeutic relationship, and philosophical hermeneutics is proposed as a conceptual framework for both the therapeutic relationship and therapist competencies for effective work with clients of different cultural and/or racial backgrounds.




Poster Session B
Title: Substance Abuse and Psychiatric Disorders (Dual Diagnosis) – One Year After Discharge From Compulsory Care
Author: Håkan Larsson
Address for Correspondence:

Håkan Larsson



Department of Applied Psychology Umeå University,901 87UMEÅ.

Ph: + 46-90-786 78 37 Fax: + 46-90-786 66 92

E-mail: hakan.larsson@apsy.umu.se
ABSTRACT
The aim of this study is to examine, first, the effectiveness of treatment among the clients, and second we are interested in the clients opinions about the treatment they have received, especially the compulsory care according to the Care of alcoholics and drug abusers (certain cases) act. Third we want to examine the influence of early experiences of relations to significant others and how these relations in its turn have an impact on the clients possibilities to benefit from the treatment they have been offered. The empirical data in this report comes from interviews made with 31 clients who are dually diagnosed, i.e. they suffer from both substance abuse problems and psychiatric disorders. The interviews were made one year after discharge from compulsory care according to the Care of alcoholics and drug abusers act. The clients answered two questionnaires that were carried through as interviews, TSR, Treatment Service Review (McLellan, 1992) and EEQ, Early Experience Questionnaire (Henry, 1996).

The clients were treated in two different settings (homes) which were compared (14 clients from Frösö treatment home and 17 from Hessleby treatment home). The results showed that the two groups of clients had experienced very few days with problems during the year except for psychological, emotional problems. They have also answered that they have had few contacts with professionals except for their psychological and emotional problems. The interviewer ratings of the clients problems are similar to those made by the clients, i.e. they are quite low, except for psychological problems which are considered to be most serious. The results from the clients descriptions of their early experiences to important others (EEQ) showed that in relation to the mother, the clients feared that she should ignore and neglect and they wished that she should help and protect. There are differences between the two groups concerning the image of the father. The clients from Frösö treatment home rate their father as they rate their mother, i.e. they fear that he will ignore and neglect and wish that he should help and protect. They have also rated that they fear that he will attack and reject and wish that he should nurture and comfort. The clients from Hessleby treatment home fear that he will belittle and blame and wish that he should affirm and understand. When it comes to how the parents acted towards the clients when they were children the results shows that the image of the mother is more clearly positive at Hessleby. The image of the father is more vague for both groups, but it is more positive for the clients from Hessleby treatment home.

Unfortunately we once again have to demonstrate that these clients with “dual diagnosis” end up in a remote land of nowhere, where no first-rate quality service can be obtained. The Social Services consider that these clients do not belong to their responsibility because of their psychological problems, and the psychiatric sector does not want them because of their substance abuse problems. What the psychiatric care can offer is a short time detoxification. The serious consequence of this result is a situation where these clients “only” receive substance abuse treatment or no treatment at all. Or first compulsory care, according to the Care of alcoholics and drug abusers act, then nothing, and then once again compulsory care. Over and over again in a permanent merry-go-round, because the substance abuse is more a result of the psychiatric disorder in stead of the contrary. Several of the former compulsory clients are coping with their situation pretty well. We can see some common patterns among those clients who do not immediately relapse into active substance abuse. It is evident that those clients who are coming out to some form of planned aftercare, have some reasonable living, and have contact with a committed social worker have much more possibilities to live a “normal” life. For those on the other hand who are discharged to nothing, who are alone and without support, who do not have a good contact with the social services and who do not have somewhere to live, for them the road back to the slough is not very far.
Poster Session B
Title: Supervisor Style and Its Relationship to the Supervisory Working Alliance, Supervisor Self Disclosure and Supervision Evaluation Method
Authors: Jessica A. Walker, Nicholas Ladany, Deborah S. Melincoff
Address for Correspondence:
Jessica A. Walker

Lehigh University

Counseling Psychology Program

111 Research Drive

Bethlehem, Pennsylvania 18015 4794

USA
ABSTRACT


Supervisors tend to work with their trainees from a variety of approaches and roles. Friedlander and Ward(1984) highlight three interrelated styles that supervisors use when approaching supervision and responding to trainees. Supervisors adopting an attractive style tend to be warm and friendly; supervisors adopting an interpersonally related style tend to be invested and therapeutic; and, supervisors who adopt a task oriented style tend to be focused and goal oriented. The purpose of this investigation was to extend the empirical understanding of supervisory style in relation to supervision variables, specifically the supervisory working alliance (Bordin, 1983), supervisor self disclosure, and supervision evaluation method. Data from 136 psychotherapy supervisors demonstrated a significant relationship between supervisory style and the supervisory working alliance. Specifically, supervisors who engaged in more attractive and interpersonally sensitive styles were perceived to have a stronger supervisory working alliance. In addition, supervisors who engaged in a more attractive and interpersonally sensitive style were more likely to self disclose to their trainees. Further, supervisors who were more task oriented and interpersonally sensitive tended to utilize live observation as a trainee evaluation method. Finally, supervisors who were more likely to use videotaping as an evaluation method were perceived to have a stronger supervisory working alliance with their trainee. Limitations and implications for psychotherapy supervision theory, research and practice are addressed.

Poster Session B
Title: Telephone Administered Cognitive Behavioral Therapy for the Treatment of Depression in Multiple Sclerosis
Authors: David C. Mohr, Anne C. Boudewyn, Peter Marietta
Address for Correspondence:
David C. Mohr, Ph.D.

UCSF/Mt. Zion Multiple Sclerosis Center

1600 Divisadero St.

San Francisco, CA 94115-1642 USA

Telephone: (415) 885-3783

Email: dmohr@itsa.ucsf.edu


ABSTRACT
Many patients with chronic illnesses experience depression, but, due to physical impairments, are unable to attend regularly scheduled outpatient psychotherapy appointments. One option, which previously has not be examined empirically, is to administer psychotherapy over the telephone. This study examined the efficacy of eight weeks of telephone administered cognitive behavioral therapy (CBT) in treating depression in multiple sclerosis (MS) patients.
All participants were patients in Kaiser Permanente Medical Care Group of Northern California, USA and had confirmed diagnoses of multiple sclerosis (MS). Thirty-two patients, who scored at least 15 on the POMS Depression-Dejection scale, were randomly assigned to either the telephone CBT or to a standard of care (SoC) control group. The telephone CBT group received a patient workbook entitled "Coping with MS." This workbook covered the basics of CBT (e.g. activity scheduling and cognitive restructuring), as well as interventions for common impairments in MS including fatigue management, pain management, and coping with cognitive impairment. Patients received eight 50-minute sessions. The patient workbook helped provide focus both during sessions and for homework between sessions. Therapists were advanced graduate students who were supervised weekly by the first author. The SoC group received the standard care offered by Kaiser Permanente.
Depression in patients receiving telephone CBT group was significantly reduced over the eight weeks as compared to patients receiving SoC (p = .01). The implications of this study will be discussed.
Poster Session B
Title: The Alliance-Outcome Relationship in Patients with PTSD and Substance Abuse
Authors: Lisa Najavits, Rebecca Lurz, Rima Saad, Amy Dierberger, Roger Weiss
Address for Correspondence:
Lisa Najavits, PhD

McLean Hospital

115 Mill St.

Belmont, MA 02478 USA

Lnajavits@hms.harvard.edu

ABSTRACT
While the therapeutic alliance is a robust predictor of outcome for psychotherapy in general, its predictive power for “difficult” populations is less clear. Specifically, research on the alliance in dually-diagnosed populations shows very mixed results thus far. As part of a randomized controlled outcome study on women with posttraumatic stress disorder and substance dependence, 22 outpatients and 4 therapists completed the Helping Alliance questionnaire-II (Luborksy et al., 1996) at sessions 3 and 12 of a 24-session group treatment. The treatment, Seeking Safety (Najavits, in press), is a manualized cognitive-behavioral group psychotherapy designed to treat both disorders at the same time to help patients achieve safety in their lives. Results for both sessions 3 and 12 indicate that the alliance was moderately strong as rated by both patients and therapists (mean ranges 4.0-4.7). The patient and therapist alliance were not significantly correlated at session 3, but were strongly correlated at session 12 (r=.79). Further analysis of results will be conducted to determine the association between the alliance data and outcomes on PTSD, substance abuse, psychiatric symptoms, and functioning measures.

Poster Session B
Title: The Approach to Explication of the Transformation of the Dialogical Sequences in Group Analytic Psychotherapy
Authors: Alexander Maslov, Olga Maslova, Marina Smirnova
Address for Correspondence:
Alexander Maslov

P.O.Box 54

193024

St. Petersburg



Russia

e mail: mao74@AM2849.spb.edu


ABSTRACT
This study examined the constructions of the psychotherapeutic conversations in two forms of the group therapy: a short term experiential intensive group work and a long term group analytic psychotherapy. These therapeutic forms both are analytically oriented evocative and focuses on free floating group discussion in order to facilitate emotional and dynamic changes, combining aspects of the group analytic and experiential approaches.
The Dialogical Sequences Analysis was employed to identify markers (or shifters) of Inner Voices (and Internal Objects) and their transformations and also to assimilate the problematic experiences by members of groups.
This study is a trial to find some formal signs of appearance of new Voices (and Inner Persons) in utterances of clients and some changes in clients's present experiences. Another task was to examine the connections between Metaphoric and Dialogical Sequences in client's and therapist's speeches to determine how semiosis differed in short term and long term group psychotherapy.

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