The concept of dependence as developed by Birtchnell: a critical evaluation.

Birtchnell (1988) appeals for an accurate definition of dependence. Such accuracy would help with measurement, prevention and treatment of depression. He describes dependence as a developmental deficiency. In so doing, he presupposes a psychodynamic trait-based, and gender-related development model, but does not acknowledge its influence on his thinking. Birtchnell's analysis has three types of problem. The reasoning may be questioned because of faulty inferential leaps, undue reliance on the concept of 'maturity', the use of a tautology, ('The dependent person is...dependent'), internal contradictions, and a questionable analogy between children's and adults' behaviour. Secondly, he appears to suggest that there is empirical evidence to support his theoretical approach, but he does not provide explicit evidence. He draws conclusions about causal links and neglects alternative interpretations, especially the transactional interpersonal element in social relationships. Finally, the analysis is potentially weakened by what may be described as an androcentric bias and relies upon a 'medical model' of psychological disorder, which fails to consider the impact of social influences on the expression of emotion. The author argues that it is at present premature and inappropriate to define dependence, but appeals for methods of research which would be more helpful in understanding it.

Group anxiety management: effectiveness, perceived helpfulness and follow-up.

An evaluation was conducted on out-patient cognitive-behavioural anxiety management groups. Twenty-nine clients assessed before and after the group and at three-month follow-up showed significant improvement on self-report measures. A further follow-up on 21 clients, conducted by an independent assessor at an average of 11 months, showed greater improvement with time. Clients also rated how helpful they had found non-specific therapeutic factors, and specific anxiety management techniques. 'Universality' was the most helpful non-specific factor, and 'the explanation of anxiety' was the most helpful technique.

Anxiety management groups in clinical practice.

Anxiety symptoms are commonly reported both in patients and in the general population. There is also increasing concern being expressed over the widespread use of prescribed anxiolytics. This has encouraged the development of psychological interventions for both specific and generalised anxiety. In this paper, 29 patients, most of whom suffered from generalised or free-floating anxiety, were treated in small groups as part of a staff training programme. Their treatment was standardised, and consisted of progressive muscular relaxation, cognitive therapy and an educational input as to the nature of anxiety. Two measures, the Spielberger Trait Scale and an individualised problem rating scale were completed before and after the group and at three months follow-up. All but one of the results was statistically significant. The implications of these results are discussed.