The orthogonal-oblique bi-level model of the Outcome Questionnaire (OQ-45.2): Polish adaptation based on factor analysis.

UNLABELLED: AIM : The aim of this project was to conduct the cross-cultural factorial validation of the Outcome Questionnaire (OQ-45.2) using the Polish population. METHODS: Data were obtained from day-patients (n = 211), inpatients (n = 234), outpatients (n = 137) and non-patients (n = 426). Statistical analyses included: parallel analysis, exploratory factor analysis, confirmatory factor analysis, correlation analysis, criterion equivalence, clinical significance and reliable change index, and test-retest. RESULTS: Statistical analyses provided the strongest support for the bi-level model of the total score, five orthogonal (subscales specific for the Polish OQ, i.e. Social Conflicts and Addictive Behaviors; and original yet modified subscales, i.e. Symptom Distress, Interpersonal Relations, and Social Role), and two oblique factors (Somatization and Anxiety, Social Role 2). The psychometric properties of the Polish OQ were found to be adequate and similar to the original American OQ and its international adaptations. Specific for the Polish OQ cut-off scores for clinical significance were established. The role of cultural differences and the passage of time in the process of the cross-cultural validation were elaborated upon. CONCLUSIONS: The Polish version of the OQ 45-2 has been recognized as an instrument adequately measuring general functioning as well as specific areas of functioning of the individual (i.e. interpersonal relations; social role performance; social conflicts; symptom distress; somatization and anxiety; addictive behaviors). Results of this factorial analysis seem to be valuable for both clinicians using the OQ-45.2 and for creators of any psychotherapy outcome measure.

Effects of providing patient progress feedback and clinical support tools to psychotherapists in an inpatient eating disorders treatment program: a randomized controlled study.

Research on the effects of progress feedback and clinician problem-solving tools on patient outcome has been limited to a few clinical problems and settings (Shimokawa, Lambert, & Smart, 2010). Although these interventions work well in outpatient settings their effects so far have not been investigated with eating-disordered patients or in inpatient care. In this study, the effect of providing feedback interventions was investigated in a randomized clinical trial involving 133 females diagnosed with anorexia nervosa, bulimia nervosa, or eating disorders not otherwise specified. Comparisons were made between the outcomes of patients randomly assigned to either treatment-as-usual (TAU) or an experimental condition (Fb) within therapists (the same therapists provided both treatments). Patients in the Fb condition more frequently experienced clinically significant change than those who had TAU (52.95% vs. 28.6%). Similar trends were noted within diagnostic groups. In terms of pre to post change in mental health functioning, large effect sizes favored Fb over TAU. Patients' BMI improved substantially in both TAU and the feedback condition. The effects of feedback were consistent with past research on these approaches although the effect size was smaller in this study. Suggestions for further research are delineated.

Providing patient progress information and clinical support tools to therapists: effects on patients at risk of treatment failure.

The current study examined the effects of providing treatment progress information and problem-solving tools to both patients and therapists during the course of psychotherapy. Three hundred and seventy patients were randomly assigned to one of two treatment groups: treatment-as-usual, or an experimental condition based on the use of patient/therapist feedback and clinical decision-support tools. Patients in the feedback condition were significantly more improved at termination than the patients in the treatment-as-usual condition. Treatment effects were not a consequence of different amounts of psychotherapy received by experimental and control clients. These findings are consistent with past research on these approaches although the effect size was smaller in this study. Not all therapists were aided by the feedback intervention.

Effectiveness of group psychotherapy for adult outpatients traumatized by abuse, neglect, and/or pregnancy loss: a multiple-site, pre-post-follow-up, naturalistic study.

The New Experience for Survivors of Trauma (NEST) is a group psychotherapy intervention for clients traumatized by consequences of abuse, neglect, and pregnancy loss. This multiple site study is the first investigation of its effectiveness. Ninety outpatients from a naturalistic setting completed the Symptom Checklist and the Sense of Coherence questionnaire at baseline, end of treatment, and one-year follow-up. Effectiveness was tested with statistical significance, effect size, and clinical significance. Clients from the total sample as well as from the abortion subsample showed improvement at the end of treatment and at follow-up. Lack of a control group is balanced to some extent by the high ecological validity. The findings suggest that the NEST treatment may be beneficial for traumatized clients and call for further research.

Follow-up psychotherapy outcome of patients with dependent, avoidant and obsessive-compulsive personality disorders: A meta-analytic review.

Assessing the number of patients who maintain their gains after the completion of therapy has been of interest to psychotherapy outcome researchers. The current study examines evidence related to the maintenance of treatment gains in individuals diagnosed with Cluster C personality disorders. Fifteen studies, published between 1982 and 2006, met the criteria for inclusion. The effect size standardized mean difference statistic was applied. In the majority of cases, most of the improvement occurred between pretreatment and posttreatment. However, social skills training often produced effect sizes that were larger for posttreatment follow-up. The study indicates that therapy gains are usually maintained at follow-up for Cluster C clients treated with cognitive-behavioral and psychodynamic approaches as well as social skills training. Uncertainty remains whether DPD, AVPD or OCPD patients benefited most from therapy.

[Motivational factors and the psychotherapeutic change]. / Czynniki motywacyjne a wynik psychoterapii.

AIM: The purpose of the study was to investigate the stability of motivation to psychotherapy and the relationship between motivation and clinical improvement. METHODS: The data were collected from 274 patients. As the key questionnaire, we used the Questionnaire of Motivation, measuring four factors: helplessness, activity, sense of wrong, sense of threat. Three other questionnaires were applied: Hopkins Symptoms Check List, Adjective Check List, Sense of Coherence. RESULTS: Motivation was found an important, but not a dominant factor influencing the psychotherapy outcome. Motivation showed the strongest influence on symptom level at the time of admission to the clinic. The personality variables had stronger influence at the end of the treatment. Helplessness, sense of wrong and sense of threat showed a steady decline both during the waiting list period and during the therapy. The level of activity factor rosed significantly during the treatment, parallel to the clinical improvement. The helplessness motivational factor was predominant at both pre-treatment occasions. CONCLUSIONS: The ability to being active was an important predictor ofpsychotherapeutic change. The role of helplessness at the beginning of the treatment may be considered as powerlessness in the face of intensity of symptoms.

[The outcome of inpatient psychotherapy and previous psychotherapy duration]. / Wyniki psychoterapii w warunkach stacjonarnych a czas trwania wczesniejszej psychoterapii.

AIM: The previous psychotherapy duration was the main independent variable. METHOD: 301 patients successively reporting for inpatient treatment in the Clinic of Neurotic Disorders received questionnaires. 274 patients completed the treatment and returned all the tests and were divided into three groups: a) those without previous psychotherapy, b) those with the experience of previous short-term therapy, c) those with previous long-term psychotherapy. The following tools were used: Hopkins Symptom Checklist, Sense of Coherence, Questionnaire of Motivation, and Adjective Check List. RESULT: Previous psychotherapy duration discriminates symptoms, coherence, motivational factors, personality aspects, both in the beginning of psychotherapy and at the time of discharge from the hospital.

[The eclectic individual psychotherapy of a dysthymic patient--case study]. / Eklektyczna psychoterapia indywidualna pacjentki z dystymia--opis przypadku.

The article describes the case of eclectic individual psychotherapy of a dysthymic patient. The therapeutic process integrated elements of the following psychotherapeutic approaches: psychodynamic, behavioural-cognitive, systemic, interpersonal, existential and Gestalt. The paper discusses history of treatment, diagnosis of dysthymia, indications for psychotherapy, course of the sessions. Anamnesis, factors contributing to the disorder, triggers and factors sustaining the symptoms, personality factors were also analysed. Therapeutic goals and applied techniques are presented.

[Motivational factors in psychotherapy of eating disorders]. / Czynniki motywacyjne w psychoterapii zaburzen odzywiania sie.

AIM: We examined changes in general psychopathology during psychotherapy of patients with eating disorders. We were also interested in distinguishing motivational characteristics of completers and dropouts with anorexia and bulimia nervosa. METHOD: All subjects completed two self-descriptive measures: Motivational Inventory and Hopkins Symptoms Checklist (HSCL-72). Questionnaires were completed three times: during the qualification visit, at admission and two weeks before discharge. RESULTS: It was observed that general psychopathology among patients with anorexia nervosa and bulimia nervosa decreased. Comparing to completers with bulimia nervosa completers with anorexia nervosa had a higher level of activity factor before the treatment. Dropouts with anorexia nervosa differed from completers in decreased level of threat factor and activity factor. Completers with bulimia contrasted markedly with statistically meaningful decrease of the Body Mass Index. CONCLUSIONS: The efficacy of cognitive-behavioural-social psychotherapy of patients with eating disorders seems to be confirmed by large decrease of general psychopathology. Dropouts with anorexia seem to have poorer insight concerned with lower need of health activity.

[Child abuse, neglect and pregnancy losses--combination and its psychological sequel]. / Przemoc, zaniedbanie w dziecinstwie oraz straty ciazy--ich wzajemne powiazania oraz psychologiczne konsekwencje tych powiazan.

The authors surveyed the literature focused on childhood mistreatment and pregnancy loss. They present definitions and classifications of child abuse (emotional, verbal, physical, sexual), child neglect (physical, emotional-intellectual) and pregnancy losses (especially miscarriage and abortion). In the second part of the paper a correlation between abuse and pregnancy loss is displayed as well as a correlation between child abuse and neglect. The different kinds of pregnancy losses are viewed as similar in aspect of psychological sequel, though their intensity and particular character depends on the mother's contribution to the loss of her child. In the last part, the consequences of the above correlation are discussed. The clinical observations suggest, that abuse and neglect experienced in childhood increases the probability of pregnancy loss in adulthood. On the other hand, the loss of on unborn child is one of the factors causing child abuse and neglect.

[Group therapy for people damaged by child abuse, neglect and pregnancy loss combination]. / Terapia grupowa IIPLCARR dla osób doswiadczajacych nastepstw przemocy, zaniedbania i straty ciazy.

The authors reviewed the literature focused on groups for people damaged by childhood mistreatment and pregnancy loss. They also presented II-PLCARR therapy designed for those who suffer from a sequel of abuse, neglect and pregnancy loss combination. Time limited group therapy for people damaged by abuse, neglect and pregnancy loss was designed at the Institute of Pregnancy Loss Child Abuse Research and Recovery, Victoria, Canada. The phases of the program include e.g.: realising mistreatment and damage; realising excuses, denial and resistance; training of assertion; resisting manipulation; accepting partial responsibility; facing guilt, mourning the loss of childhood; passing through despair; dead babies rehumanization and mourning; reconciliation with victims, observers and perpetrators; negotiation of realistic expectations; attenuations of unnecessary pair bonding; learning to love; celebration; good good-byes. The study of IIPLCARR therapy effectiveness is displayed as well.