Effectiveness of a social relations intervention program for aggressive and nonaggressive, rejected children

A sample of 52 Black aggressive, rejected and nonaggressive, rejected children were randomly assigned to receive a social relations intervention or to be in a nonintervention control group. The school-based intervention for fourth-grade children focused on positive social skill training and cognitive-behavioral strategies to promote deliberate, nonimpulsive problem solving. At both the post-treatment and the 1-year follow-up assessments, the social relations intervention was found to be effective only with the aggressive, rejected children. Implications for the importance of assessing subtypes of rejected children are discussed.

Comparative effectiveness of social problem-solving therapy and reminiscence therapy as treatments for depression in older adults

Compared the effects of 2 psychotherapies based on divergent conceptualizations of depression in later life. Seventy-five older adults diagnosed with major depressive disorder were assigned randomly to problem-solving therapy (PST), reminiscence therapy (RT), or a waiting-list control (WLC) condition. Participants in PST and RT were provided with 12 weekly sessions of group treatment. Dependent measures, taken at baseline, posttreatment, and 3-month follow-up, included self-report and observer-based assessments of depressive symptomatology. At posttreatment, both the PST and the RT conditions produced significant reductions in depressive symptoms, compared with the WLC group, and PST participants experienced significantly less depression than RT subjects. Moreover, a significantly greater proportion of participants in PST versus RT demonstrated sufficient positive change to warrant classification of their depression as improved or in remission at the posttreatment and follow-up evaluations.

Parent training and social skills training for children with attention-deficit hyperactivity disorder: how can they be combined for greater effectiveness?

Attention-deficit hyperactive disorder (ADHD) is a chronic and treatment-refractory syndrome affecting academic, social and emotional adjustment in children. Stimulant medication is the treatment of choice and is often paired with psychosocial treatment. However, no single treatment modality alleviates the symptoms or improves the negative peer status of these children in their social ecology over the long term. This article reviews two psychosocial treatments used for ADHD, parent training and social skills training and suggests ways that these two components may be combined for greater effectiveness by encouraging the parent to: 1. learn more about the importance of developing social competence and positive peer status; 2. use incidental teaching and self-evaluation strategies; 3. become strategic organizers of the child's social life; and 4. become case managers to facilitate more consistency between the significant adults in the child's social environment.

Treatment of social behavior in autism through the modification of pivotal social skills

We examined acquisition of individual social communicative behaviors and generalization across other social behaviors in 2 children with autism. The results of a multiple baseline design showed that the children's treated social behaviors improved rapidly and that there were generalized changes in untreated social behaviors. These improvements were accompanied by increases in subjective ratings of the overall appropriateness of the children's social interactions. The results suggest the possibility of identifying pivotal response classes of social communicative behavior that may facilitate the understanding of social behavior in autism as well as improve peer interactions, social integration, and social development.

[Social therapy with psychiatrically disordered dyssocial adolescents]

This paper presents different aspects of social therapy with dissocial adolescents on a specialized inpatient psychiatric unit. Social therapy works through individual therapy but even more through the therapeutic milieu on the ward. The therapy process is divided in the resistance, the working through and the resolution phase. Social therapy aims on the one side at the compensation of deficits in everyday life. Interchange with staff promotes on the other side corrective social experiences, that finally function as a model for all human relationships of the adolescent. When social therapy succeeds, the adolescent doesn't need his acting-out behavior any longer and may concentrate on his age-specific problems.

[Rehabilitative success of a social therapy sailing project]

This article wants to present figures about subsequent development of adolescents age fourteen to eighteen with behavioural disorders, who underwent a social therapeutic and educational treatment during a sailing tour, backed by German Federal Youth Welfare Act. 114 adolescents were investigated. The figures describe where they came from, their characteristics before and after the project and the drop outs. Finally a follow up study of 61 of the adolescents in the program can be presented. As a result it could be shown, that the adolescents were very unsufficiently described, that they were treated without success in other institutions before, and that they grew up under bad conditions. A fifth of them left the eight months program after three months. Within an average investigation time of three Years and two months more than half of the adolescents showed an improvement in at least one of the following criteria: further education, better social adaption, decrease of delinquency and further need of care in a psychiatric or educational institution.

[Multidisciplinary assistance in a case of conduct disorder. A three-year project]

Conduct disorders are common. They concern many people inside and outside the health service. They are often a cause of despair in individuals, in the family and among professionals. This article describes the situation of a young boy. In 1985 everybody was about to give up and said there was nothing more that could be done for him. In this situation a municipal multidisciplinary team, with a three-year programme of treatment was organized. The purpose was to find out if it was possible to create new meanings in his surroundings, to give him a new start. The result is promising.

Psychological treatments for negative symptoms

Psychological training programmes for patients presenting with negative symptoms have developed from an environmentally based approach (the token economy) through interactive programmes (social and life skills training) to programmes which focus directly on facilitating and enhancing the cognitive skills of the individual patient (self-instructional training and problem-solving). It is clear that this sequence of research has generated a range of approaches which are probably undervalued in the management of patients suffering from negative symptoms. Problems remain with respect to the generalisation of some procedures but it seems likely that these problems may be overcome by tailoring treatments to the particular cognitive deficits of different groups of patients. This will obviously require a detailed analysis of the structure of negative symptoms and the deficits associated with them. The distinction between difficulties in initiating behavior and difficulties in organising behaviour may prove to be particularly important in this respect.

[Intensive psychosensorial stimulation of malnourished children. I. Effects on psychomotor development and physical growth]

Children under 18 months of age, with primary moderate and severe malnutrition, were treated by a multiprofessional team with an ambulatory system. The prospective effect of intensive psychosensorial stimulation over psychomotor development and physical growth was studied. Control (41 children) and experimental (55 children) groups were compared when the program started and successively followed up after 6 and 12 months. The experimental group were given intensive psychosensorial stimulation at home by their mothers. They were trained and periodically inspected by nurses. Both groups were matched by age, sex and birthweight. They all came from very poor families. Mean age when the program started was 10.4 months. Weight for age, weight for height, height for age (Standard NCHS), serum albumin, serum iron, transferrin saturation, TIBC were evaluated. Psychomotor development was evaluated with Rodríguez S. (EEDP) and Brunet Lezine scales. Both groups had similar increment in weight for age, weight for height, serum iron and transferrin saturation. No change was observed in height for age, serum albumin and TIBC. Psychomotor development improved more in the experimental group (p less than 0.01), coming to normal range in most children in that group. To conclude, intensive psychosensorial stimulation in malnourished children is not shown to improve physical growth but does improve psychomotor development (malnutrition, psychomotor development, physical growth, psychosensorial stimulation).

Group sociotherapy: a psychoeducative model for schizophrenic patients and their families

The clinical and research community have identified critical issues in educating schizophrenic patients and their families about schizophrenia. A review of the literature, a comprehensive alternative model, and descriptive modules inherent in an effective group sociotherapy program are offered for schizophrenic patients in remission and for their families. The model provides advantages for monitoring patients on an outpatient basis and has applicability to mental health clinic, day hospital, and day treatment center programs.

Psychoanalytic principles in psychosocial rehabilitation

Major mental symptomology in schizophrenic patients is alleviated when isolation and withdrawal are replaced by improved object relationships. This can best be accomplished through the enhancement of social, emotional, and environmental support systems. Psychosocial rehabilitation, that is, the establishment of a corrective living situation for emotionally isolated individuals, is a dynamic process. Staff in psychosocial centers are presented with unusual challenges and opportunities for helping people. Freudian psychoanalytic theory helps explain the causation of major mental symptomatology in schizophrenics as well as the mechanisms for the alleviation of those symptoms. It is postulated that the basic defect is exaggerated narcissistic libido and deficient cathexis of libido onto objects, which is accompanied by dammed-up libido. Like a festering boil, the dammed-up libido continues to exert noxious and deleterious effects, ultimately by way of chemical and neuronal pathways presently not well understood. The release of the dammed-up libido through improved object relationships is accompanied by lessening symptomatology and improved functioning. Indiscriminate and prolonged utilization of psychotropic medication is antitherapeutic in that it prevents delabeling, interferes with the resocialization process, and inhibits ego growth and development.

'Psychosocial' interventions with families and their effects on the course of schizophrenia: a review

Recent interest in the way social factors influence the course of schizophrenia has led to attempts to monitor and manipulate these factors. The work on the Expressed Emotion of the relative has been especially influential in this area. A number of studies have now been conducted in which a psychosocial intervention has been employed in an attempt to prevent relapse after discharge from hospital. These studies are reviewed with an emphasis on their methodological adequacy and on the nature of the intervention used. Recent studies have demonstrated a positive result for psychosocial interventions used in combination with neuroleptic medication. However, analysis of these studies does not allow us to conclude that we can identify the 'active ingredients' in these psychosocial treatment regimes. Although there is cause for optimism, further investigation is required.

[Short trips by chronic psychiatric patients as effective sociotherapeutic measures]

The article reports on experience gained with short excursions (day trips and brief holidays) for chronic psychiatric patients. Such trips have a beneficial effect on the patients' mental status and improve the image of in-patient psychiatric treatment. To the patients, this form of sociotherapeutic activity represents an enrichment in the overall therapeutic scheme at psychiatric sanatoria.

The peer-managed small group versus the rehabilitation model of treatment of chronic patients

The Fairweather small-group model, developed some 20 years ago, has been proven to be an effective form of treatment for chronic patients who have spent long years in institutions. However, there have been no recent evaluations of how small-group programs work compared with contemporary rehabilitation programs and how effective they are with the "new chronic patient" recently described in the literature. In a study of such patients at the Florida Mental Health Institute in 1977, the authors compared matched patients in a small-group program and a rehabilitation therapy program on measures of self-concept, perception of kind and degree of help received, and recidivism rate. They found that patients in the small-group program spent significantly less time in treatment. Moreover, the small-group program was effective in reducing recidivism over an 18-month period and was less expensive than the rehabilitation therapy program.

[Sociotherapy in the psychogeriatric nursing home. Possibilities for a psychogeriatric sociotherapy]

Terms as sociotherapy, environment therapy and the therapeutical environment have their origin in psychiatry and from there influenced various other treatment settings. The basic philosophy however is still the same: people live and are treated in social organizations which have an influence on their feeling of well-being and chances on recovery. Depending on the specific characteristics, each treatment setting has developed different ways of interpreting and practicing this philosophy. One of the ways of defining the psychogeriatric interpretation of sociotherapy is the analysis of the behavior of the nurse in a psychogeriatric nursing-home, with a sociotherapeutic treatment philosophy, in relation to the patients. Evaluation of behavior in terms of its sociotherapeutic characteristics is not necessarily equivalent to sociotherapeutic behavior. It however gives a clearer view of the way a philosophy is practiced and the conditions under which this is done.