Annette Demby

A Short Form of the Inventory of Interpersonal Problems Circumples Scales

The 127-item Inventory of Interpersonal Problems (IIP) has proven useful in capturing clinically important aspects of clients interpersonal functioning. Alden, Wiggins, and Pincus constructed a 64-item circumplex form of the IIP (IIP-C). We found that an even shorter form was needed for situations involving the screening of patients in a brief time. We, therefore, constructed a 32-item short circumplex form (IIP-SC). This form was found to exhibit excellent internal consistency reliability and strong test-retest correlations in three outpatient samples. It was found to correlate highly with the longer forms of the IIP and to show similar treatment responsiveness to them. The IIP-SC has also been demonstrated to correspond closely to the circumplex model of interpersonal behavior. The IIP-SC is, thus, an adequate substitute for the complete IIP in settings where brevity is important.

Efficacy of a brief psychosocial intervention for symptoms of stress and distress among patients in primary care.

Psychosocial problems and symptoms of emotional distress play a prominent role in patients reporting to primary care settings. Interpersonal counseling (IPC) was developed as a brief psychosocial intervention for patients with stress and distress to be administered by nurse practitioners in a primary care setting. The results of a pilot study indicate more rapid reduction of symptoms and improvement in emotional sysmptoms and psychosocial functioning in the IPC group than in a comparison group with initially elevated scores on the General Health Questionnaire. The priorities for further testing are discussed, and possible implications for service delivery are explored.

Preliminary Findings on a New Instrument to Measure Cohesion in Group Psychotherapy

ABSTRACTThis article describes the development of a new process scale to measure cohesiveness in group psychotherapy. This scale, The Harvard Community Health Plan Group Cohesiveness Scale (HCHP-GCS), can be used by trained clinical raters viewing half-hour videotaped segments of psychotherapy groups. Early evidence indicates that these ratings can be made in a reliable manner and that there appears to be a strong relationship between ratings of cohesion and patient ratings of outcome in the group.

Time-limited group psychotherapy for patients with personality disorders: outcomes and dropouts.

This study reports on the time-limited (18-month long) group therapy of 49 outpatients, most of whom were diagnosed with DSM-III-R, Axis II personality disorders (American Psychiatric Association, 1987). Although many patients did not complete the full course of treatment, those who did experienced many areas of change. Completers reported substantial changes in self-esteem, symptomatology, and diagnosability on Axis II. This type of group treatment appears to be a promising mode of intervention for those with personality disorders.

Comparative Outcome in Time-Limited Individual and Group Psychotherapy

ABSTRACTIn this randomized clinical trial, we compared time-limited group psychotherapy and time-limited individual psychotherapy. Ninety-eight nonpsychotic psychiatric outpatients participated. There were five therapists, all highly experienced with brief therapies. Significant improvement and maintenance of improvement occurred in both treatments. Although both treatments were quite beneficial on a number of our subjective measures, there was a clear preference by patients for the individual therapy. Recommendations are offered for improving the acceptability of group treatment approaches.

The Relationship Between Main Actor Behaviors and Treatment Outcome in Group Psychotherapy

The therapeutic process of 89 members in time-limited group psychotherapy was investigated using a group modification of the Vanderbilt Psychotherapy Process Scale (GRP-VPPS) applied to the most focused on member, or Main Actor, in each 30-minute group segment. The means of each patients GRP-VPPS scores during those segments in which he or she was Main Actor were subjected to Principal Component Analysis, resulting in three factors: Therapeutic Participation, Negative Reaction and Ease of Self-Expression. Exploration of the relation of process to outcome found that Therapeutic Participation was positively related to therapeutic benefit as judged by patients, therapists, and independent raters. Negative reaction was negatively related to change on two scales, while ease of self-expression was negatively related to improvement in self-esteem. For several outcome variables there was an interaction indicating that more resistant behavior was related to better outcome for patients who were main actor only a f...

Short-term group psychotherapy: Who succeeds, who fails?

Group psychotherapy literature is unclear about what patient characteristics contribute to better and poorer outcome. This study examined pre-group therapy patient characteristics and their relationship to short-term group therapy outcome. A battery of outcome measurements was administered to 192 short-term group therapy patients before, after, and 4–6 months after their group experience. Three distinct outcome groups are defined: dropouts, low changers and high changers. Characteristics of each group are discussed. Aside from the traditionally important variables such as age and education, this study indicates that interpersonal variables (interpersonal sensitivity, distance/closeness to others, primary involvement with family) may be potentially important areas to pursue in screening and preparing patients for a group.

Patient activity and outcome in group psychotherapy : new findings

The relation of patient verbal activity to pretherapy symptom status and outcome was examined for ninety patients in time-limited group psychotherapy. For each half-hour segment the most verbally active member, or main actor (MA), was identified. Verbal activity was measured by counting the number of times each patient was MA during the course of the group. Outcome was assessed by administering a battery of instruments pre- and posttherapy and by obtaining direct ratings of patient benefit from the patient, therapist, and an independent rater: the number of times MA was found to be significantly correlated with four pretherapy measures, indicating that the most disturbed patients were most active in these groups; the number of times MA was also correlated with patient and therapist benefit ratings, indicating that therapists and patients themselves agreed that those who spoke the most benefited the most. However, partial correlations between number of times MA and other outcome measures did not produce any significant relationships. Thus, it does not appear that patient verbal activity is related to outcome, as measured by objective instruments.

The stress of marital separation: Intervention in a health maintenance organization.

&NA; Relationships between life stress and illness form the basis of much current thinking and practice in psychosomatic medicine. This study examines a particular life stress, marital separation, in a controlled, prospective design. Participants are 237 Health Maintenance Organization [HMO] subscribers followed over a two‐year period. Marital separation was experienced by 117 of these participants early in the two‐year study period. A stratified random half of these separated individuals participated in a short‐term psychoeducational group intervention, “Seminars for the Separated.” Measures of psychosocial adjustment and medical utilization were analyzed to describe correlates of experiencing marital separation and to evaluate the intervention. Statistically significant increases in medical utilization by people experiencing marital separation were observed in comparisons with married control subjects. Much of this increased utilization is in the year surrounding the actual separation and is accounted for by mental health visits. Effects of the intervention were not evident until controls for baseline levels of medical utilization were introduced. Even then, intervention effects were slight. Methodological problems and implications for further study are presented.

Outcome in short-term group psychotherapy

This study examines the effectiveness of planned dynamic short-term group psychotherapy in a health maintenance organization setting. The groups, conducted by experienced short-term psychodynamically trained therapists, focused on common life-stage issues. A pretest/posttest design was employed; group participants completed a battery of self-report measures before, after, and 4–6 months after treatment. Group participants made statistically (and clinically) significant positive changes on the majority of change measures. They saw themselves as improved on target problems, became far less symptomatic, and reported considerable growth in interpersonal functioning.