摘要:

The importance of psychological treatments in forthcoming national health care plans has been deempha‐sized in federally sponsored clinical practice guidelines published to date, and questioned by certain policymakers and consumer groups. Many critics impugn the clinical efficacy and effectiveness of psychological treatment compared to drug treatments. This article reviews evidence suggesting that psychological interventions from a variety of theoretical perspectives have demonstrated effectiveness for a wide range of disorders—either alone or, in some cases, in combination with medications. In most cases these treatments are more effective and often longer lasting than credible alternative psychological interventions serving as “psychological placebos.” Political and public relations issues, as well as problems with dissemination, must be overcome if the public is to benefit fully from powerful and effective psychological interventions in any national health ca

ISSN:0969-5893    

DOI:10.1111/j.1468-2850.1994.tb00014.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

This article describes the popularity of eclecticism among clinical psychologists and related professional groups over the past 35 years and the more recent growth and development of the Integration movement in psychotherapy. Although these two emphases share a common view or value system of not restricting one's psychotherapy to only one theoretical orientation, they also appear to differ in important ways. Some of these differences are discussed as well as problems in research and training.

ISSN:0969-5893    

DOI:10.1111/j.1468-2850.1994.tb00015.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

This article reviews the role of nonspecific treatment factors in cognitive‐behavior therapy (CBT) for depression. An analysis of relevant studies reveals that the majority of symptomatic improvement in CBT occurs prior to the formal introduction of cognitive restructuring techniques. This suggests that other, likely nonspecific, treatment factors play a large role in mediating clinical improvement. Nonspecific factors are hypothesized to ameliorate patients’ feelings of hopelessness at the beginning of treatment, a process that catalyzes improvement across other depressive symptoms. Reviewed evidence supports a mediation role for the hopelessness construct in CBT. Two nonspecific factors, the treatment rationale and the assignment of homework, appear integral to early symptomatic improvement. The role of cognitive techniques is discussed in light of these findi

ISSN:0969-5893    

DOI:10.1111/j.1468-2850.1994.tb00016.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

We explore the complex interplay of clinical discovery and controlled evaluation, demonstrating how experience in the applied arena provides Invaluable insights and ideas about the complexity of the human condition and of ways to intervene effectively. Case studies have features that earn them a firm place in psychological research, and to ignore their potential contributions is to limit severely the kind of knowledge that can be generated by more systematic modes of inquiry. Some limitations of group designs in comparative therapy research are also reviewed, again highlighting the importance of Idiographic analyses of single cases. Innovation and creative advancement are most readily nurtured via immersion in clinical/applied work, but at the same time the'nature of that work is inevitably shaped by theories and hypotheses that clinicians bring into the applied setting. These abstractions are themselves influenced by the clinician's interpretations of data, which interpretations are molded by theoretical and metatheoretical preconceptions. In this complex and interactive fashion, clinical innovation is part of a nonlinear network of forces that includes personal biases, professional allegiances, epistemological assumptions, theoretical preferences, and familiarity with and use of certain bodies of data.

ISSN:0969-5893    

DOI:10.1111/j.1468-2850.1994.tb00017.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

A balanced approach to the detection of malingering and defensiveness in the neuropsychological assessment of mild traumatic brain injury (MTBI) is suggested, while genuine neurobehavioral and psychopathological sequelae are documented. The absence of neuroradio‐loglcal evidence and heavy reliance on patient report and neuropsychological test data make malingering and defensiveness issues that are critical in forensic contexts and for the credibility of neuropsychology. Deficiencies in interview data collection and the relative strengths and weaknesses of the MMPI (Minnesota Muttiphasic Personality Inventory) are reviewed. The potential independence of malingering and defensiveness and of MMPI and neuropsychological data are noted. The equivocal research on malingering is reviewed, with particular emphasis on assessment of memory deficits as one of the most common complaints in MTBI. Arguably, malingering is more similar to than different from other diagnoses, but it has not been so treated in clinical practice. The need for developing sophisticated malingering probes is acknowledged, but the quest for a single malingering test is criticized and preference given to approaches that rely on evaluating data patterns indicating malingerin

ISSN:0969-5893    

DOI:10.1111/j.1468-2850.1994.tb00018.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Theoretical and empirical arguments are presented for the systematic integration and study of group dynamic processes in cognitive‐behavioral groups. Such “hybrid groups” explicitly utilize group cohesion, group developmental stages, and multilevel interventions with the hope of offering cognitive therapy through a group rather than simply in a group setting. Potential advantages of the hybrid model include enhanced active learning, modeling, motivation, skill generalization, and relapse prevention. Further evidence and recommendations are presented regarding hybrid group structure, composition, therapist role, limitations, and directions for future res

ISSN:0969-5893    

DOI:10.1111/j.1468-2850.1994.tb00019.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

The Hamilton Rating Scale for Depression (HRSD) has emerged as a standard in the study of depression. However, despite its extensive use and the assumption that it is a single measure, integration of data produced in studies utilising the HRSD is difficult for several reasons. After a review of 688 relevant articles, tt was determined that approximately 42% contained referencing errors resulting in confusion over which administration procedures were actually implemented. Since its introduction, several alternate versions of the scale have emerged and alternate scoring methods, ad hoc revisions, or derivative versions of the scale have been applied. These and related problems with the HRSD are detailed along with suggestions for reducing the ambiguities that result from its continued use in depression research.

ISSN:0969-5893    

DOI:10.1111/j.1468-2850.1994.tb00020.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

ISSN:0969-5893    

DOI:10.1111/j.1468-2850.1994.tb00021.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY