Social skills training in unipolar nonpsychotic depression.
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Biomedical subjects
Publications and source records attributed to M Hersen.
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The effects of social-skills training consisting of instructions, feedback, behavior rehearsal, and modelling were examined in a multiple-baseline analysis in four unassertive children. The treatment was effective in that the behaviors selected for modification changed markedly. The effects of treatment generalized from trained to untrained items (interpersonal situations requiring assertive responding) and gains were maintained at the two-and four-week followup probe sessions. In addition, overall assertiveness in all subjects increased from baseline assessment to the conclusion of treatment and into followup.
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The use of the token economy in institutional settings is examined in light of historical, political, deprivation, ethical, and generalization issues. The major points may be summarized as follows. a) The token economy may be viewed as a palliative measure to prevent the incredibly regressive effects of institutionalization. b) To achieve control in token programs in many "total institutions," an artificial state of deprivation must be achieved. c) Generalization of behaviors into the natural environment following the patient's stay in a token economy program should not be taken for granted. d) What the patient learns in a token economic system may not be what the token economy's program director probably intends.
Social-skills training was applied to two male chronic schizophrenics. Component behaviors of social skill requiring modification were identified for each patient by rating videotapes of role-played interactions. Training involved instructions and feedback for one subject and instructions, feedback, and modelling for the second. Target behaviors were treated sequentially and cumulatively in a multiple-baseline format. Training was applied for both positive and negative assertion and for situation involving males and females. The results were positive for all behaviors for both patients. Follow-ups at 2, 4, 6, and 8 weeks after training indicated that most effects were maintained at near-treatment levels.
One of the major areas of disagreement between therapists working within the psychodynamic and behavioral frameworks involves the issues of symptom substitution and symptom return, the psychodynamicists holding that treatment of symptoms alone cannot result in permanent improvement, and the behavioral therapists arguing that it can. However, a reexamination of the data indicates that psychoanalysts base their conclusions primarily on cases of hysterical neurosis whereas the behaviorists base their conclusions primarily on the treatment of phobia. Heeding the call of the recent American Psychiatric Association Task Force on Behavior Therapy (1973), in this paper we seek to reconcile the apparently contradictory data, illustrating our arguments with case reports. Moreover, we will attempt to obtain a greater degree of rapprochement and cross-fertilization between the dynamic and behavioral schools of thought.
The effects of phenothiazines and social skills training on a severely withdrawn schizophrenic were examined. Regulation of phenothiazine levels had the result that the patient became more receptive to behavioral interventions. Specific application of a token economy program effected a marked improvement in the assertive training was employed to improve the patient's repertoire of ininterpersonal responses. Prior to actual hospital discharge the patient was faded back into his natural environment during a job retraining phase at Goodwill Industries. Specific data on the patient's improved social functioning are presented in a multiple baseline analysis. Follow-up data document the patient's successful adaptation of his natural enviroment.
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