L. Michael Ascher

Paradoxical intention and insomnia: an experimental investigation

Abstract A study by Turner and Ascher (1978) compared the efficacy of progressive relaxation, stimulus control, and paradoxical intention in ameliorating sleep onset insomnia. Results indicated that the three were equally effective. The present study is a partial replication of Turner and Ascher (1978) and focuses on the use of paradoxical intention in reducing sleep difficulties. Twenty-five individuals complaining of sleep discomfort were randomly assigned to three groups: paradoxical intention, placebo control, no treatment control. Clients in the paradoxical intention group were instructed to remain awake while lying in bed in a darkened room. The complete rationale for such a prescription was provided. Those in the placebo group received a pseudo systematic desensitization program. Results indicated that subjects exposed to the paradoxical intention procedure reported significant improvement on several measures of sleep behavior when compared with reports of subjects in either placebo or no-treatment control groups.

Employing paradoxical intention in the treatment of agoraphobia

Abstract The present study assessed the efficacy of paradoxical intention in ameliorating the travel restriction of agoraphobics. A combined score indicating proximity to two difficult target locations represented the dependent variable. A multiple baseline across subjects was used with each of two groups of five clients. This was accomplished by sequentially staggering introduction of treatment. At the conclusion of baseline phase. Group A received 6 weeks of gradual exposure followed by paradoxical intention to criterion. Group B received paradoxical intention to criterion immediately after baseline. Results indicated that paradoxical intention produced greater movement toward targets for clients in Group B when compared both with their baseline and with the performance of Group A following an equal period of gradual exposure.

Therapist factor in the treatment of insomnia.

Abstract This quasi-experiment attempted to replicate the finding of Turner and Ascher (1979) in contrasting progressive relaxation, stimulus control and paradoxical intention therapies for the treatment of insomnia using clinicians-in-training as therapists. Progressive relaxation and stimulus control were again shown to be effective, paradoxical intention instructions were not. A significant therapist effect was found which is discrepant with previous findings in the field.

Coping styles, paradox, and the cold pressor task

The study investigated how coping style differences affected performance on the cold pressor task. Reactions of “monitors” (individuals who prefer having information about stressors) and “blunters” (individuals who avoid cues connected with stressors) were compared, using different instructional sets. The study also assessed the effectiveness of paradoxical intention compared to more traditional cognitive strategies. Monitors and blunters were identified using Millers recently developed Behavioral Style Scale. All instructional sets improved performance in comparison to a control condition, and individuals generally did better when an instructional set supported their preferred coping style. Paradoxical intention did not show any decided advantage over other strategies. The desirability of designing stress management programs to fit individual coping style patterns is discussed.

Paradoxical intention in the treatment of agoraphobia and other anxiety disorders

Following a description of the paradoxical intention procedure and a brief review of the general behavioral literature relevant to this technique, the authors focus on the role of paradoxical treatment programs for agoraphobic clients. The cognitive and exposure components of paradoxical intention are discussed and the procedure is compared and contrasted with other cognitive behavioral methods on one hand, and with flooding on the other. Finally, the authors provide several ideas for future research.

An experimental study of covert extinction

Abstract A 2×3 study, using performance on a pseudo concept formation task as the dependent variable, tested the efficacy of covert extinction (CE). Groups received either CE instructions, overt extinction (OE) instructions, or no instructions, and either reinforcement or no reinforcement. The data revealed no significant difference between the unreinforced CE and OE groups, but did indicate significant differences between these groups and the unreinforced group receiving no instructions. Parallel results were obtained for the three similar reinforced groups. The conclusion, based on these data, was that CE was effective in facilitating the course of extinction whether or not the environment continued to provide reinforcement for the specific response.

Enhancing effectiveness of paradoxical intention in treating travel restriction in agoraphobia

Techniques ancillary to paradoxical intention were employed to reduce anxiety and depression in agoraphobic clients. It was suggested that such enhancement would produce greater improvement in terms of increased travel capabilities during the initial portion of therapy than would be the case for individuals receiving component treatment. Three groups, each containing five agoraphobic clients, were provided with the enhanced paradoxical intention procedure, the paradoxical intention alone, or the enhancement package alone. Following the fourth session, subjects in the enhanced paradoxical intention group were performing significantly better than subjects in the two remaining groups.

THE ROLE OF HYPNOSIS IN BEHAVIOR THERAPY

Hypnosis has been employed by proponents of many psychotherapeutic approaches in an effort to facilitate the effectiveness of their therapy. As might be expected, it has been most closely associated with those psychotherapeutic systems whose characteristics are most relevant to, and best complimented by, the hypothesized properties of hypnosis. Consideration of the characteristics or the definition of hypnosis, by those interested in this psychotherapy-hypnosis association, is, of course, influenced by their relevant theoretical conceptions. In the majority of cases, it is the traditional view of hypnosis that is espoused, i.e., the “trance state” position. A theme central to this view is the assumption that an individual experiences an “altered state of consciousness” as a consequence to the administration of a hypnotic induction procedure. It then follows that the properties of the “trance” are enlisted to enhance aspects of a specific relevant therapeutic system. For example, Wolberg uses hypnosis within a psychoanalytic context to facilitate efforts in uncovering difficult unconscious material; another use of hypnosis for Wolberg is the dissolution of defensive blocks that the patient might employ in order to impede therapy. Whether hypnosis actually facilitates the course of psychoanalytic psychotherapy is difficult to determine, since psychoanalytic psychotherapy itself eludes efforts to operationalize its significant components and adequately measure therapeutic outcome. The situation with hypnosis and behavior therapy is slightly different. While the traditional view of hypnosis dominates even in the behavioral context, behavior therapy is more available to objective testing and thus to the assessment of the effectiveness of such ancillary variables as hypnosis. The present paper examines the role of hypnosis in behavior therapy, First, the traditional “state” conception of hypnosis will be described along with its implications for behavior therapy. This will be followed by a critical review of the logical and empirical basis of the trance state in behavior therapy. Finally, the “nonstate” conception of hypnosis will be briefly described and its potential contributions for behavior therapy outlined.

Guided behavior rehearsal

Abstract Guided behavior rehearsal is a method for training individuals with a general lack of interpersonal skills. Central to the program is the peer model (a non-professional trained guide) who has facility in the area in which the patient has the most difficulty. The guide models appropriate behavior of the patient in the relevant troublesome social situations. The entire program centers on the desensitization paradigm, utilizing in vivo desensitization and imaginal desensitization, together with modeling, positive reinforcement, behavior rehearsal and assertive training. Office sessions with the therapist are interspersed among those with the model.

Assessment of behavior theraphy institutes-I

Abstract This article presents a statement of goals for behavior therapy institutes and outlines methods for realizing them. A program for the evaluation of the attainment of these goals in future institutes is proposed.