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Biomedical subjects

L E Beutler

Publications and source records attributed to L E Beutler.

At least 19 recordsLinked to original sources
PubMed2000

Vicarious emotional experience and emotional expression in group psychotherapy.

Emotional arousal is a key concept in most theories of change. To be able to understand the role of emotional expression better, two treatments, cognitive therapy (CT) and focused expressive psychotherapy (FEP; a manualized form of Gestalt therapy), with opposite process assumptions about the expression of emotions were compared. Additionally vicarious emotional experience in the sense of an underlying emotional contagion was examined. Clients suffering from major depression were rated for the expression of emotion in three randomly selected sessions of a 20-session treatment course. While the types of emotions generally experienced by CT clients and FEP clients did not differ significantly, differences in the subgroups of active and observing-group members were found. This indicated that the process assumptions made by the respective treatments were only valid for the actively participating clients and not for the observing group members. Emotional contagion as a process was not supported.

Adult↗
PubMed1999

Emotion recognition in psychotherapy: impact of therapist level of experience and emotional awareness.

Accurately identifying another person's emotional state is an ability that may be necessary for a psychotherapist to empathize with a patient and that may be required for obtaining valid and reliable psychotherapy process ratings in research. Accuracy of identifying emotions and of rating emotional intensity expressed by a patient was studied in a comparison of 36 experienced therapists and 36 undergraduate psychology students who intended to become psychotherapists. Representative segments of a psychotherapy session were presented in one of three ways to tease apart the relative importance of verbal and nonverbal cues in making accurate ratings. Accuracy was judged against ratings supplied by two experienced and prestigious clinicians based on the same therapy sample. Results indicated that although therapists were more accurate than nontherapists in identifying emotions, they did not differ in the accuracy of rating emotional intensity. Moreover, accuracy of ratings was found to be less reliant on verbal cues among psychotherapists than among nontherapists. Finally, levels of participants' personal awareness of their own emotions had a positive impact on the accuracy of identifying specific emotions but not on the accuracy of rating their intensity.

Adult↗
PubMed1999

Psychotherapy research: basic or applied?

Borkovec and Miranda (1996) have argued that the "greatest progress in the development of increasingly useful interventions" (p. 14) will come from redefining comparative trials research on psychotherapy outcome as basic research. They foresee that such a reconceptualization will lead to the increased use of dismantling, parametric, and additive research strategies and that it will result in increasing collaboration with other basic researchers. The assumption that a redefinition will stimulate increased collaboration and specificity of causal mechanisms is questioned as are the assumptions that randomization, group comparison designs, and within therapist designs will lead inherently to more valid assessments of cause-effect relationships. Analyses of a randomized clinical trials study is used to illustrate how clinical research can be guided by theory to tease out causal relationships, within therapy, and within patient factors. Ultimately, a combination of research paradigms, including N = 1, clinical utility, and controlled research, will best provide answers to important questions of change mechanisms and treatment effectiveness. A simple reconceptualization, however, is not necessary to make this happen and belies the complexity and overlap of the problems to be addressed.

Humans↗
PubMed1999

Manualizing flexibility: the training of eclectic therapists.

Manualized training has become the standard for psychotherapy research and is rapidly becoming adopted in clinical and counseling psychology training programs. However, it is still unclear whether manualization improves outcomes, and there is evidence that manualized training reduces nonspecific therapist qualities and attenuates clinical judgment. Prescriptive and integrative models of psychotherapy are designed to increase therapist flexibility. This article describes some current and anticipated efforts to teach therapists to flexibly use therapeutic procedures without losing some of the advantages of manualization.

Humans↗
PubMed1999

Making assessment relevant to treatment planning: the STS Clinician Rating Form. Systemic Treatment Selection.

This article reports on the development of a computerized, clinician-based method of assessing patient variables that contribute to differential assignment of psychotherapy models. In the current health care environment, omnibus personality tests and current state measures are both expensive and insensitive to most of the empirically defined patient characteristics that have been identified as indicators of different treatment qualities. Moreover, reliance on patient self-report introduces a variety of distortions and limits predictive studies and follow-up assessments to those who are cooperative. These factors limit the usefulness of the currently available procedures. Aptitude-Treatment-Interaction (ATI) research has revealed differential effects of manualized cognitive, interpersonal, and insight-oriented treatments as a function on a select number of relatively specific personality and symptom qualities. A cost- and time-efficient method of measuring these dimensions could increase the power of treatment by identifying in advance those that are likely to be most effective for a given patient. The STS (Systematic Treatment Selection) Clinician Rating Form is a relatively brief, clinician-based measure of a variety of patient dimensions, including subjective distress, various aspects of coping style, and resistance traits. Current data reveal good interrater reliability and adequate levels of discriminant and convergent validity.

Adult↗
PubMed1998

Clinical utility research: an introduction.

Clinical utility research is concerned with how one develops knowledge that can be directly used for improving clinical practice. Some have referred to this domain as "effectiveness" research, but clinical utility implies much more than clinical effectiveness. It also addresses issues of access, transferability, sample specificity, and the uniqueness of each human condition. This special series of papers describe several research programs that have been conducted in applied settings and that illustrate research on clinical utility. These descriptions are modestly representative of the wide applicability of research methods that address the uniqueness of each setting and population and the nature of findings that can be used to guide clinical practice. The papers bridge cultures, countries, settings, and problems. They illustrate some of the advantages of, and some of the knowledge to be gained from conducting controlled research in settings that are devoted to clinical service.

Cultural Characteristics↗
PubMed1998

Identifying empirically supported treatments: what if we didn't?

The conclusion of the Division 12 Task Force's report on empirically supported treatments raises 3 questions: (a) Is it desirable for the profession to specify what treatments are effective? (b) Do the criteria, either selected by the Task Force or modified by others, represent a reasonable way of identifying effective treatments? (c) Would different and less controversial conclusions have been reached if the criteria used were broadened to include naturalistic and quasi-experimental studies? It is concluded that the Task Force's selection of criteria, particularly as modified by D. L. Chambless and S. D. Hollon (1998), was a reasonable response to these pressures. Findings from studies using less stringent and controlled research designs suggest that the proposals may have resulted in less palatable conclusions than those offered in its original report.

Empiricism↗
PubMed1996

Introduction to the special section on the contribution of psychotherapy and pharmacotherapy research to national mental health care.

This special section represents a coordinated publication of the Journal of Consulting and Clinical Psychology and the Archives of General Psychiatry. These 2 journals have typically focused on somewhat different areas of research and have been read by different audiences. In an effort to achieve cross-fertilization of the disciplines of psychiatry and clinical psychology, this coordinated publication provides a current view of research both in psychopharmacology and psychotherapy as applied to major depression, anxiety disorders, alcohol abuse, and drug abuse. To further the aims of informing the diverse readership in areas to which they are often not exposed in the separate journals, the Journal of Consulting and Clinical Psychology is publishing in this section, articles that address biomedical and psychopharmacological research, and the Archives of General Psychiatry is publishing a coordinated set of articles on psychotherapy and behavior therapy. Collectively, the series contained in these 2 journals is designed both to foster knowledge and to enhance communication among psychiatrists and psychologists.

Drug Therapy↗
PubMed1996

The dilemma of factitious demographic distinctions in psychological research.

Terms such as race, sex and age are assumed to reflect biological characteristics and distinctions. In psychological research, these terms are often treated as if they were a reflection of a meaningful set of psychological constructs. A review of articles in 3 prominent journals over a 30-year period reveals that these supposed biological identifiers are not used consistently and lack empirical and conceptual validity. An analysis of those articles shows that, over time, the term race has given way to the use of the more general and psychologically relevant term ethnicity, sex and gender have been used interchangeably, and the psychological constructs underlying or supposedly reflected in age are seldom discussed. It is proposed that psychosocial researchers and editors adopt a consistent definition of these terms and that research include an effort to identify the underlying concepts that the investigators assume to be reflected in these distinctions whenever these labels are used to report research findings.

Clinical Trials as Topic↗
PubMed1995

Bridging scientist and practitioner perspectives in clinical psychology.

Literature suggests that a complex and often hostile relationship exists between the science and practice of clinical psychology. Contributors to this conflict of viewpoints are reconsidered within the proposition that there are different roads to discovery and that there may be good reasons to keep the science and practice of clinical psychology somewhat separate. Results of a national survey of 325 psychologists are reviewed that support the view that psychological practitioners value research and consider their practices to be augmented by scientific findings. However, they are in need of vehicles of communication that will help them translate scientific findings into practice. Results suggest that practitioners do more to understand scientific findings than scientists do to understand the problems that face clinical practitioners. Ways to facilitate communication between and among these groups are considered.

Communication↗
PubMed1995

Introduction to the special section: the case for training in the provision of psychological therapy.

Recent trends, such as the national health care initiative, have brought into focus the importance of identifying the qualifications of those who provide mental health services. This special section explores the research evidence for the value of professional training among those who provide psychological therapy. The set of articles describe what is known about the relationship to therapeutic efficacy of professional training, training in ethnic diversity, and clinical supervision. These articles suggest that professional training enhances clinical efficacy, especially if type of training, setting of practice, and nature of patient problems are considered. They also suggest that supervision and specific training in ethnic diversity enhance knowledge and sensitivity among psychotherapists. It is anticipated that this special section will promote a dialogue about these conclusions.

Education, Graduate↗
PubMed1994

Patterns of symptomatic recovery in psychotherapy.

Using the psychotherapy dosage model in which effect was probability of recovery, this study compared treatment response rates for psychological symptoms. Symptom checklists were administered to 854 psychotherapy outpatients at intake and during treatment. Sixty-two symptoms were grouped into 3 classes on the basis of probit analysis results. Chronic distress symptoms demonstrated the fastest average response rate, whereas characterological symptoms demonstrated the slowest. Acute distress symptoms showed the highest average percentage of patients recovered across doses. A typical outpatient needed about a year of psychotherapy to have a 75% chance of symptomatic recovery. The model holds promise for establishing guidelines for the financing of psychotherapy.

Adolescent↗
PubMed1994

The intensification and resolution of blocked affect in an experiential psychotherapy.

Focused Expressive Psychotherapy is a Gestalt-based method of psychotherapy which is designed to facilitate the resolution of constricted emotion in patients. This form of therapy is described as a five-step process. The present article addresses the steps of that process which relate specifically to the intensification and resolution of emotions. The importance and rationale for intensification are discussed and related to the concept of restructured schematic memories. Markers of resolution are identified as changes in 'benchmarks', changes in patient behaviour or attitude, and/or a reevaluated stance towards past events. We conclude by citing one of our recent research efforts that demonstrates a relationship between the intensification of emotion and positive therapy outcome.

Adaptation, Psychological↗