Empirically Supported Treatments

Background Procedures that reduce errors while learning a repertoire play an important role in Applied Behavior Analysis for people with autism due to the detrimental effects that excessive exposure to error may have on learning. Previous studies have investigated the effects of correction procedures that require active student response after a trial with error. Some intervention manuals recommend against reinforcing responses after correction to prevent the establishment of prompt dependence. This study directly investigated the effect of reinforcement after an active-response correction procedure during tact training in four children with autism. An echoic-to-tact training procedure was used to train tacts. A “no reinforcement after correction” (NRC) condition was compared to a “reinforcement after correction” (RC) condition, using an adapted alternated treatments design. Results All participants needed less correction trials in RC than in NRC, and considering all 26 sessions in w...

Objective: Nonsuicidal self-injury (NSSI), the deliberate, self-inflicted damage of bodily tissue without the intent to die, is associated with various negative outcomes. Although basic and epidemiologic research on NSSI has increased during the last 2 decades, literature on effective interventions targeting NSSI is still emerging. Here, we present a comprehensive, systematic review of existing psychological and pharmacological treatments designed specifically for NSSI, or including outcome assessments examining change in NSSI.
Method: We conducted a systematic search of PsycINFO, MEDLINE, and ERIC databases to retrieve relevant articles that met inclusion criteria; specifically, uncontrolled and controlled trials that 1) presented quantitative outcome data on NSSI, and 2) clearly differentiated NSSI from suicidal self-injury (SSI). Consistent with the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, definition of NSSI, we excluded studies examining populations with developmental or intellectual disabilities, or with psychotic disorders.
Results: Several interventions appear to hold promise for reducing NSSI, including dialectical behaviour therapy, emotion regulation group therapy, manual-assisted cognitive therapy, dynamic deconstructive psychotherapy, atypical antipsychotics (aripiprazole), naltrexone, and selective serotonin reuptake inhibitors (with or without cognitive-behavioural therapy). Nevertheless, there remains a paucity of well-controlled studies investigating treatment efficacy for NSSI.
Conclusions: Structured psychotherapeutic approaches focusing on collaborative therapeutic relationships, motivation for change, and directly addressing NSSI behaviours seem to be most effective in reducing NSSI. Medications targeting the serotonergic, dopaminergic and opioid systems also have demonstrated some benefits. Future studies employing controlled designs as well as a clear delineation of NSSI and SSI will improve knowledge regarding treatment effects.

Background: Procedures that reduce errors while learning a repertoire play an important role in Applied Behavior Analysis for people with autism due to the detrimental effects that excessive exposure to error may have on learning. Previous studies have investigated the effects of correction procedures that require active student response after a trial with error. Some intervention manuals recommend against reinforcing responses after correction to prevent the establishment of prompt dependence. This study directly investigated the effect of reinforcement after an active-response correction procedure during tact training in four children with autism. An echoic-to-tact training procedure was used to train tacts. A "no reinforcement after correction" (NRC) condition was compared to a "reinforcement after correction" (RC) condition, using an adapted alternated treatments design. Results: All participants needed less correction trials in RC than in NRC, and considering all 26 sessions in which both training procedures were implemented, participants' performance was higher with RC than without in 17 sessions and was the same in 3 sessions. Conclusions: We discuss the effectiveness of reinforcing correct responding after an active-response correction procedure, the absence of prompt dependence, and the implications of better correction procedures for applied settings.

Purpose. The purpose of this paper is to better understand the relationship between substance abuse counselors' personal recovery status, self-schemas, and willingness to use empirically supported treatments for substance use disorders. Methods. A phenomenological qualitative study enrolled 12 practicing substance abuse counselors. Results. Within this sample, recovering counselors tended to see those who suffer from addiction as qualitatively different from those who do not and hence themselves as similar to their patients, while nonrecover-ing counselors tended to see patients as experiencing a specific variety of the same basic human struggles everyone experiences, and hence also felt able to relate to their patients' struggles. Discussion. Since empirically supported treatments may fit more or less neatly within one or the other of these viewpoints, this finding suggests that coun-selors' recovery status and corresponding self-schemas may be related to counselor willingness to learn and practice specific treatments.

Background Procedures that reduce errors while learning a repertoire play an important role in Applied Behavior Analysis for people with autism due to the detrimental effects that excessive exposure to error may have on learning. Previous studies have investigated the effects of correction procedures that require active student response after a trial with error. Some intervention manuals recommend against reinforcing responses after correction to prevent the establishment of prompt dependence. This study directly investigated the effect of reinforcement after an active-response correction procedure during tact training in four children with autism. An echoic-to-tact training procedure was used to train tacts. A “no reinforcement after correction” (NRC) condition was compared to a “reinforcement after correction” (RC) condition, using an adapted alternated treatments design. Results All participants needed less correction trials in RC than in NRC, and considering all 26 sessions in w...

Psychotherapeutic practice, while it can and has benefited greatly from scientific research, rests on many other secure epistemic foundations.  In the present article, this thesis is argued in two stages.  First, a scale of justified belief is developed.  Drawing upon mainstream epistemological thinking, this scale rates the generally acknowledged degree of certainty attributed to propositions yielded by different sources of knowledge, and thus the confidence with which we may believe and act upon them.  Second, an analysis of the degree to which each of these knowledge sources enters into the practice of psychotherapy is developed.  In the end, what is proffered here is a view of psychotherapy as an activity whose judgments and decisions rest on multiple secure foundations.

In her book Uneasy Virtue, Julia Driver presents an account of motive or trait utilitarianism, one that has been taken as “the most detailed and thoroughly defended recent formulation” of consequential virtue ethics. On Driver's account character traits are morally virtuous if and only if they generally lead to good consequences for society. Various commentators have taken Driver to task over this account of virtue, which she terms “pure evaluational externalism.” They object that, on Driver's account of virtue, it could turn out that traits traditionally understood as pernicious are actually virtuous. While many writers have speculated about the forms new ‘virtues’ might take in a hypothetical world, I will argue that at least one trait that is seemingly pernicious but would have to be counted as virtuous by Driver already exists.

Psychotherapeutic practice, while it has benefited greatly from scientific research, rests on many further secure epistemic foundations. In the present article, this thesis is argued in two stages. First, a brief review of some elementary epistemological findings is presented. In this review, the generally acknowledged degree of certainty attributed to different knowledge sources, and thus the confidence with which we may believe and act upon them, are recounted. Second, an extended analysis of the ways in which each of these knowledge sources enter into the practice of psychotherapy is developed. In the end, what is proffered here is a demonstration that well conducted psychotherapy is an activity whose judgments and decisions rest on many secure foundations.

This paper outlines the epistemological and theoretical formation of narrative therapy and implications for its evaluation. Two authoritative paradigms of psychotherapy evaluation have emerged in psychology since the mid1990s. The Clinical Division of the American Psychological Association established the empirically supported treatment (EST) movement. A more inclusive but medically emulative model of evidence based practice in psychology (EBPP) then emerged. Some therapies such as narrative therapy do not share the theoretical commitments of these paradigms. Narrative therapy is an approach that values a non-expert based, collaborative, political and contextual stance to practice that is critical of normalising practices of medical objectification and reductionism. Post-positivist theoretical influences constitute narrative therapy as a practice that values the social production and multiplicity of meaning. This paper problematises a conflictual relationship (a differend) between t...

Chapter 6 describes the rationale for adapting empirically supported treatments before applying them. It argues that interventions should be adapted to meet the client's developmental level, to demonstrate cultural sensitivity, and to meet contextual constraints (in a host environment). It suggests that treatment fidelity should be parameter around adaptations so that core elements are retained.