RESUMO
OBJECTIVE: The Suitability for Short-Term Cognitive Therapy (SSCT) rating procedure has predicted outcome in depressed and anxious patients. This study examines its relevance in assessing patients with psychosis. METHOD: Outpatients with psychosis (n=56), depression (n=93), and anxiety (n=264) received cognitive- behavioral therapy in a university hospital teaching unit (mean number of sessions=16, SD=11). Demographic, clinical, and suitability variables were assessed as potential predictors of dropout and success as measured by the Reliable Change Index. RESULTS: Despite lower suitability scores in the psychosis group, dropout and success rates were similar across groups, although the magnitude of symptom reduction was less in the psychosis group. Across diagnoses, dropout was predicted by unemployment and by reluctance to take personal responsibility for change. In the psychosis group only, dropout was predicted by hostility. Success of completed therapy was predicted by higher baseline agoraphobic anxiety and "responsibility for change" scores. CONCLUSION: Attention to hostility early in therapy may reduce dropout in psychotic patients. Fostering acceptance of responsibility for change may improve both treatment retention and success across diagnoses. Agoraphobic fear is associated with success, possibly reflecting the effectiveness of behavioral interventions in psychosis and anxiety alike.
Assuntos
Transtornos de Ansiedade/terapia , Terapia Cognitivo-Comportamental , Transtorno Depressivo Maior/terapia , Transtornos Psicóticos/terapia , Assistência Ambulatorial/métodos , Assistência Ambulatorial/psicologia , Transtornos de Ansiedade/psicologia , Terapia Cognitivo-Comportamental/métodos , Transtorno Depressivo Maior/psicologia , Transtorno Distímico/psicologia , Transtorno Distímico/terapia , Feminino , Humanos , Entrevista Psicológica , Masculino , Transtorno Obsessivo-Compulsivo/psicologia , Transtorno Obsessivo-Compulsivo/terapia , Transtorno de Pânico/psicologia , Transtorno de Pânico/terapia , Pacientes Desistentes do Tratamento , Transtornos Fóbicos/psicologia , Transtornos Fóbicos/terapia , Psicoterapia Breve/métodos , Transtornos de Estresse Pós-Traumáticos/psicologia , Transtornos de Estresse Pós-Traumáticos/terapia , Resultado do TratamentoRESUMO
The effectiveness of a social skills training group for adolescents with Asperger syndrome and high-functioning autism (AS/HFA) was evaluated. Parents of six groups of adolescents (n = 46, 61% male, mean age 14.6) completed questionnaires immediately before and after the 12-week group. Parents and adolescents were surveyed regarding their experience with the group. Significant pre- to post-treatment gains were found on measures of both social competence and problem behaviors associated with AS/HFA. Effect sizes ranged from .34 to .72. Adolescents reported more perceived skill improvements than did parents. Parent-reported improvement suggests that social skills learned in group sessions generalize to settings outside the treatment group. Larger, controlled studies of social skills training groups would be valuable.
