Gerald C. Davison

Psychology Should List Empirically Supported Principles of Change (ESPs) and Not Credential Trademarked Therapies or Other Treatment Packages

Current systems for listing empirically supported therapies (ESTs) provide recognition to treatment packages, many of them proprietary and trademarked, without regard to the principles of change believed to account for their effectiveness. Our position is that any authoritative body representing the science and profession of psychology should work solely toward the identification of empirically supported principles of change (ESPs). As challenging as it is to take this approach, a system that lists ESPs will keep a focus on issues central to the science and practice of psychology while also insulating the profession from undue entrepreneurial influences.

Articulated thoughts during simulated situations: A paradigm for studying cognition in emotion and behavior

In spite of the widespread belief of cognitive behavior therapists and researchers that irrational thinking underlies much human psychological suffering, there is little if any direct evidence bearing on the assumption that people think in particular ways when confronted with stressful situations. A paradigm is proposed that appears capable of providing information about peoples articulated thoughts as they occur in highly structured, experimenter-controlled situations. The results from an initial experiment indicate the utility of the paradigm in collecting data on how people think under both stressful and neutral conditions. The paradigm seems to offer great flexibility in examining thought processes under a wide range of conditions of interest to psychopathologists and cognitive researchers.

Being Bolder With the Boulder Model: The Challenge of Education and Training in Empirically Supported Treatments

A number of factors interfere with the realization of the scientist-practitioner model of training in applied psychology. Resistance to empirically supported treatments (ESTs) may arise from both academic faculty and internship supervisors who have an investment in approaches of longer standing but with less empirical justification. A possible problem with ESTs, however, is that they typically derive from studies that use treatment manuals, which, originally developed to define the independent variables in psychotherapy research, have become central in graduate training. Because manuals can constrain clinician behavior and because they are almost always associated with categorically defined diagnostic categories, one can lose sight of the idiographic analysis of single cases. Reliance on manualized treatment can discourage functional analysis of the complexities of individual cases. Achieving some synthesis of this dialectic poses a significant challenge to the continuing development of the science and profession of applied psychology.

Processes of fear-reduction in systematic desensitization: Cognitive and social reinforcement factors in humans

Systematic desensitization (SD) is a technique which usually takes place in a social context and involves the use of imagery and possibly other symbolic/cognitive processes as well. Research and theory bearing on these two sets of uniquely human variables are critically reviewed. The main conclusions are as follows: (a) a conceptualization of SD as a procedure which is effective via the induction of counterphobic cognitions has failed to find replicable support and is, furthermore, questionable on a priori grounds because of the doubtful relevance of attribution theory to the alteration of severe, long-standing phobias; (b) expectation of gain can produce increments in beneficial effects arising from SD but does not appear to account for all improvement; (c) deliberately induced self-instructions may increase the efficacy of SD and may, furthermore, be operating in uncontrolled but important ways in the procedure as currently practiced; (d) the word “cognitive” is used in both a descriptive and an explanatory sense in the literature, threatening even more obfuscation than already exists; (e) experiments designed to determine the role of the desensitizer as a social reinforcer for increased (imaginal) approach behavior are either inappropriate in conception, confounded in design, or productive of inconclusive results; and (f) stimulus-response formulations are proposed not to be ipso facto incapable of usefully conceptualizing and manipulating covert processes, including imagery.

Bystanders' Perceptions of Perpetrators and Victims of Hate Crime An Investigation Using the Person Perception Paradigm

This study used the person perception vignette method to examine whether people perceive hate crime victims as more culpable than non-hate crime victims. In a between-participants design, participants were randomly assigned to read a vignette depicting a nonhate crime or a comparable hate crime motivated by the perpetrators hatred for either the victims race, sexual orientation, or religion. Results showed that participants assigned more blame to the victim in the non-hate crime condition compared to the victims in each of the three hate crime conditions. In addition, they perceived the perpetrators as more guilty in each of the three hate crime conditions compared to the non-hate crime condition. In addition, people with prejudiced attitudes perceived both hate crime and non-hate crime victims as more culpable and both hate crime and non-hate crime perpetrators as less culpable than did unprejudiced people.

Relaxation, Reduction in Angry Articulated Thoughts, and Improvements in Borderline Hypertension and Heart Rate

An intensive 7-week relaxation therapy was evaluated in a sample of unmedicated borderline hypertensive men. All subjects were provided state-of-the-art medical information regarding changes known to affect hypertension favorably, e.g., lower salt intake and regular exercise. In addition, relaxation subjects were trained in muscle relaxation that entailed audiotaped home practice. As predicted, relaxation combined with hygiene lowered blood pressure more than did hygiene alone. Neither treatment favorably affected a paper-and-pencil measure of anger but relaxation did lower anger-hostility on a new cognitive assessment procedure, Articulated Thoughts in Simulated Situations (ATSS). Moreover, ATSS anger-hostility reduction was correlated with blood pressure or heart rate reductions, for all subjects and especially for those in the Relaxation condition. This represents the first clinically demonstrated link between change in a cognitive variable and change in cardiovascular activity. Finally, results were especially strong in subjects high in norepinephrine, suggesting its importance in essential hypertension.

LOBELINE AND REDUCTION OF CIGARETTE SMOKING

An empirical and logical analysis of research employing lobeline sulfate in reducing cigarette smoking raises serious doubts as to the utility of this chemical “nicotine substitute.” An experiment is also described in which predominantly college-aged volunteers desiring to stop smoking were given either specially prepared troches containing 0.5 mg. lobeline or placebos in a double-blind design. Neither during treatment nor during an immediately following post-treatment period did the drug achieve greater gains than the placebo. Correlational and other analyses of psychological data suggest that the local throat irritation commonly regarded as a side-effect of lobeline lozenges actually plays a central role in discouraging smoking in those persons motivated to continue sucking the lozenges. Suggestions are also offered as to procedures that might prove useful in maintaining treatment gains, whether drug-produced or part of the familiar placebo effect.

Cognitive bias in the articulated thoughts of depressed and nondepressed psychiatric patients

Becks cognitive theory of depression postulates several types of cognitive bias among depressed patients. Empirical studies supporting this hypothesis have usually used questionnaire “endorsement” measures of cognition, which may suggest responses to subjects. We used the articulated thoughts during simulated situations (ATSS) method of cognitive assessment in comparing cognitive processes of 15 outpatients with major depression with those of 15 nondepressed psychiatric outpatients in three simulated situations. Depressed patients exceeded nondepressed patients in cognitive bias only in the negative (not the neutral or positive) simulated situation. Discussion centered on the possible utility of ATSS for research on cognition in stressful situations.

A social learning therapy programme with an autistic child

Abstract Undergraduates were trained in a predominantly operant conditioning therapy aimed at acquiring a measure of control over the behaviour of an autistic child in the setting of a day-care centre. Objective measures of therapist-control prior to therapy showed that the workers initially had no influence whatever on the child. Post-measures indicated that both therapists had achieved a markedly greater degree of control. Controls for mere familiarity and for generalization to workers other than the therapists led to the conclusion that, during the programme, the child had become significantly more responsive to adults in general. The case study material, gleaned from the daily reports by means of which the author monitored the treatment, demonstrated many specific instances of behaviour-change, including the apparent desensitization of various fears. In view of the fact that the treatment setting was far from ideal for this approach, the positive results were regarded as strong support for the suitability of operant conditioning techniques for manipulating psychotic behaviour in children.

Behavior therapy and homosexuality: A critical perspective

Inadequate behavioral assessment in formulating appropriate therapeuticstrategies characterizes much of the behavior modification literature on the treatment of homosexual behavior. Homosexuality has been too narrowly conceptualized, and improved treatment approaches must more accurately reflect its diverse and complex sources. The rationale for the predominant use of aversive techniques in the behavior therapy treatment of homosexuality is critically examined, and a more expanded therapeutic regimen deriving from social learning theory suggested. The ethics of these behavior change programs and the choice of therapeutic goals are discussed.