Identification of patients at risk for nonresponse and negative outcome in psychotherapy.

Mohr, David C.; Beutler, Larry E.; Engle, David M.; Shoham-Salomon, Varda; Bergan, John J.; Kaszniak, Alfred W.; Yost, Elizabeth B.

doi:10.1037/0022-006x.58.5.622

Cited by 63 publications

(62 citation statements)

References 23 publications

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“…They may have more room for improvement in key outcome variables, preventing a ceiling effect that may exist in comparison groups. 33 Further, we found that that interpersonal sensitivity was positively associated with the CASF scale, suggesting that men with significant interpersonal sensitivity are more likely to see sexual dysfunction as threatening to a core sense of male identity. With sexual dysfunction, this identity becomes threatened, and an individual's coping resources may be strained or overwhelmed.…”

Section: Discussionmentioning

confidence: 62%

Promoting recovery of sexual functioning after radical prostatectomy with group-based stress management: The role of interpersonal sensitivity

Molton

Siegel²,

Penedo

et al. 2008

Journal of Psychosomatic Research

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Objective-Treatment for localized carcinoma of the prostate (PCa) is frequently associated with decrements in sexual functioning and satisfaction. Given the highly interpersonal nature of these decrements, interpersonal problems (such as interpersonal sensitivity) may affect recovery of sexual functioning after PCa treatment by interfering with physician and partner communication and through distorted cognitions surrounding sexual dysfunction. The objective of the present study was to determine the effect of interpersonal sensitivity on several treatment indicators, including response to a group based psychosocial intervention.Methods-Participants were 101 older men recovering from radical prostatectomy and were enrolled in a randomized controlled trial of a 10-wk group-based cognitive behavioral stress management (CBSM) intervention. Measures included the Inventory of Interpersonal Problems (IIP) and the Sexual Functioning subscale of the UCLA quality of life measure.Results-At baseline, interpersonal sensitivity was related to a belief linking sexual dysfunction to core male identity (r = .29, p < .05). Using hierarchical regression, we found that (a) the CBSM intervention was effective in promoting sexual recovery in all participants and that (b) this effect was moderated by interpersonal sensitivity, such that individuals with higher levels of interpersonal sensitivity made larger improvements in sexual functioning in response to CBSM.Conclusions-CBSM was effective for improving sexual function after radical prostatectomy. Individuals with higher levels of interpersonal sensitivity were more likely to perceive sexual dysfunction as a threat to masculine identity and made larger gains in the CBSM intervention. Results and relevance to the older male cancer patient are discussed from the perspective of interpersonal theory.

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Section: Discussionmentioning

confidence: 62%

Promoting recovery of sexual functioning after radical prostatectomy with group-based stress management: The role of interpersonal sensitivity

Molton

Siegel²,

Penedo

et al. 2008

Journal of Psychosomatic Research

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“…Two RCTs revealed that clients exposed to expressive-experiential therapies exhibited higher rates of deterioration than did those in either no-treatment (Beutler, Frank, Schieber, Calvert, & Gaines, 1984) or alternative-treatment conditions (Mohr et al, 1990). Because the latter study did not contain a no-treatment control group, however, conclusions regarding therapy-induced deterioration must be viewed cautiously.…”

Section: Expressive-experiential Psychotherapiesmentioning

confidence: 95%

Psychological Treatments That Cause Harm

Lilienfeld

2007

Perspect Psychol Sci

775

612

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The phrase primum non nocere (“first, do no harm”) is a well-accepted credo of the medical and mental health professions. Although emerging data indicate that several psychological treatments may produce harm in significant numbers of individuals, psychologists have until recently paid little attention to the problem of hazardous treatments. I critically evaluate and update earlier conclusions regarding deterioration effects in psychotherapy, outline methodological obstacles standing in the way of identifying potentially harmful therapies (PHTs), provide a provisional list of PHTs, discuss the implications of PHTs for clinical science and practice, and delineate fruitful areas for further research on PHTs. A heightened emphasis on PHTs should narrow the scientist-practitioner gap and safeguard mental health consumers against harm. Moreover, the literature on PHTs may provide insight into underlying mechanisms of change that cut across many domains of psychotherapy. The field of psychology should prioritize its efforts toward identifying PHTs and place greater emphasis on potentially dangerous than on empirically supported therapies.

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“…However, we do have some information on the rate of negative outcomes in minimal-contact bibliotherapy for depression. Mohr et al (1990) found that a relatively high rate (19%) of depressed participants in a self-directed treatment condition had at least a one-point increase on the HRSD at posttreatment. Based on this finding, Mohr (1995) suggested special caution in the use of self-administered treatments.…”

Section: Negative Outcomesmentioning

confidence: 97%

Self‐administered treatments for depression: A review

2003

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Although there are numerous self-help books for depression, relatively few have been empirically tested. However, those that have been used in clinical trials have fared well, with an average effect size roughly equivalent to the average effect size obtained in psychotherapy studies. Computer-based treatments are being developed and appear promising as an alternative to bibliotherapy for those interested in self-administered treatments. This article provides a summary of the depression bibliotherapy literature and discusses several remaining questions such as effectiveness versus efficacy, practice applications, ethics, and future research.

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Identification of patients at risk for nonresponse and negative outcome in psychotherapy.

Cited by 63 publications

References 23 publications

Promoting recovery of sexual functioning after radical prostatectomy with group-based stress management: The role of interpersonal sensitivity

Promoting recovery of sexual functioning after radical prostatectomy with group-based stress management: The role of interpersonal sensitivity

Psychological Treatments That Cause Harm

Self‐administered treatments for depression: A review

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