Brad A. Alford

Cognitive therapy of schizophrenia: Theory and empirical status

The empirical status of cognitive approaches to schizophrenia is presented. A review of outcome studies identifies patient characteristics, describes treatment components, delineates outcome and follow-up status (if available), and considers commonalties among therapy components. A “clinical section,” synthesized largely from the successful outcome studies, presents cognitive therapy principles and strategies adapted to treatment of schizophrenia. Theoretical issues, such as ecological validity and the necessity to target both disordered cognitive content and processing, are briefly addressed. Finally, eight “burning questions” or issues for future research are suggested.

BRIEF FOCUSED COGNITIVE THERAPY OF PANIC DISORDER

back regarding physiological functioning can produce a major spontaneous panic attack. In this study, a patient diagnosed as panic disorder was provided false feedback that her heart rate had suddenly accelerated, and a panic attack resulted. While the hypothesized specific ideational content (catastrophic misinterpretation) was not measured in this study (Margraf et al., 1987), the observed effects of information distortion are consistent with the cognitive model (Beck, Emery, & Greenberg, 1985).

Integration of scientific criteria into the psychotherapy integration movement

Psychotherapy integration has recently received considerable attention among behavior therapists. Although the wisdom of ecumenicism has been questioned, behavior therapy has often been credited with flexibility and modification of practice based on experimental and clinical research. From this perspective, the two central criteria for psychotherapy integration are inclusion of proven therapeutic elements and exclusion of unproven ones. Rationales for the importance of both criteria are discussed, and an analogy to the development of modern medicine is suggested. Formal acceptance of the proposed criteria would place psychotherapy integration in a proactive position to censor fee-for-service clinical practice not grounded in basic clinical or experimental research.

Behavioral design of a positive verbal community: A preliminary experimental analysis

Behaviorists have theorized (and experimental analyses suggest) the potential clinical application of verbal behavior modification. This study evaluated therapeutic effects of behavioral intervention to modify the intact verbal community. The setting was an adolescent operant treatment center for behavioral disorders. All residents within the center, 16 females and 22 males, participated in the study. A within subjects experimental design compared effects of a positive verbal community (PVC) plus the ongoing operant treatment program to the operant program alone. Conceptually, these were dual-level and single-level operant programs, respectively. Dependent measures included rates of positive goal-relevant verbalizations of residents, and clinical measures of self-control and psychiatric symptoms. Preliminary evidence supported the feasibility of the PVC as a potential novel therapeutic intervention.

Brief Cognitive Psychotherapy of Panic Disorder

In the clinical treatment of panic disorder, the standard course of cognitive therapy has been shown to be an effective alternative to psychopharmacotherapy (Beck & Greenberg, 1988). Further, outcome studies have shown response to treatment to often be quite rapid, with reported panic attacks significantly reduced-and sometimes eliminated altogether-after only a few sessions (Sokol, Beck, Greenberg, Berchick, & Wright, 1989). Consistent with these findings, brief, focused cognitive psychotherapy may be the treatment of choice for certain uncomplicated panic disorder cases where agoraphobia is not severe (Alford, Beck, Freeman, & Wright, 1990).