Group psychotherapy, a special activity program, and group structure in the treatment of chronic schizophrenics.

Abstract

Activity programs and group psychotherapy frequently have been used in the treatment of the chronic patient. Evaluations of these procedures, unfortunately, often have suffered from poor definition and choice of procedure, and inadequate design. This paper reports an experimental study of these therapies in combination with the effect of group homogeneity.The use of activity programs in neuropsychiatric hospitals received its major impetus from Myerson's "total push" method in the treatment of chronic NP hospital patients (Myerson, 1939). Many authors since have reported varying degrees of success with this treatment method and progressive variations upon it (e.g., Cohen, 1959;Murray & Cohen, 1959;Pace, 1957;Peters, 1955). Patients in such programs usually have been assigned to a group and given or offered a relatively specific "job." Responsibility for performance typically rests with the supervisor or therapist and slightly, if at all, with the patient members. Generally this approach might be thought of as a systematized attempt to increase drive level by stimulation and encouragement. Scher (19S7a, 1957b) extended this concept considerably with his emphasis upon the "task orientation" of the patient. When response to the task was demanded rather than

Another dodo bird verdict? revisiting the comparative effectiveness of professional and paraprofessional therapists

“…There is a concern that patients with minor psychopathology or schizophrenia are unresponsive to treatment, thereby preventing professional superiority from emerging. However, this concern is not borne out, as studies find that patients who have high levels of psychological health obtain greater benefits from psychotherapy (Luborsky, 1988), and four of the studies favouring paraprofessionals (Anker and Walsh, 1961;Poser, 1966;Ellsworth, 1968;Mosher et af., 19751, and one of the studies favouring professionals (Sheldon, 1964), showed positive treatment effects for schizophrenic patients.…”

Psychometric instability of measures in novel settings: Use of psychiatric rating scales in nursing homes

“…Two raters were used by Lentz et al (1971) with the NOSIE-30 and ISMF, by Lorr and Vestre (1968) with the PIP, and by Ellsworth and Clayton (1959) and Anker and Walsh (1961) with the MACC. The present use of three raters, therefore, would increase the chances of obtaining a high reliability compared to that of the research just cited.…”

The nonprofessional as a psychotherapeutic agent

“…The ability of nonprofessionals to change the behavior of adult inpatients has been reported in 12 of the 13 studies that were reviewed (Anker & Walsh, 1961;Appelby, 1963;Beck, Kantor, & Gelineau, 1963;Bucktey, Muench, & Sjoberg, 1970;Carkhuff & Truax, 1965, Gelineau & Evans, 1970Greenblatt & Kantor, 1962;Hartlage, 1970;Holzberg, Knapp, & Turner, 1967;Poser, 1966;Rappaport, Chinsky, & Cowen, 1971;Sines, Silver, & Lucero, 1961;Verinis, 1970). Eight of these studies employed a control group.…”

“…If the results of the controlled studies are examined together, it is evident that nonprofessionals have been able to alter many indices of psychological dysfunction in adult inpatients, such as: overt behavior (Appelby, 1963;Carkhuff & Truax, 1965;Verinis, 1970); the results of psychological tests (Buckley, Muench, & Sjoberg, 1970;Holzberg, Knapp, & Turner, 1967;Rappaport, Chinsky, & Cowen, 1971); perceptual and motor coordination tasks (Poser, 1966;Rappaport, Chinsky, & Cowen, 1971); and discharge rate (Carkhuff & Truax, 1965). Although five studies (Anker & Walsh, 1961;Beck, Kantor, & Gelineau, 1963;Gelineau & Evans, 1970;Greenblatt &Kantor, 1962;Hartlage, 1970) did not employ a no-treatment control group, they produced additional evidence of the nonprofessional's ability to change the behavior of adult inpatients. These studies found that nonprofessionals were able to change the overt behavior of adult inpatients (Hartlage, 1970;Anker & Walsh, 1961) and the self-concept of the patients (Hartlage, 1970), as well as to increase their discharge rate (Beck, Kantor & Gelineau, 1963;Gelineau & Evans, 1970;Greenblatt & Kantor, 1962).…”

“…Although five studies (Anker & Walsh, 1961;Beck, Kantor, & Gelineau, 1963;Gelineau & Evans, 1970;Greenblatt &Kantor, 1962;Hartlage, 1970) did not employ a no-treatment control group, they produced additional evidence of the nonprofessional's ability to change the behavior of adult inpatients. These studies found that nonprofessionals were able to change the overt behavior of adult inpatients (Hartlage, 1970;Anker & Walsh, 1961) and the self-concept of the patients (Hartlage, 1970), as well as to increase their discharge rate (Beck, Kantor & Gelineau, 1963;Gelineau & Evans, 1970;Greenblatt & Kantor, 1962). It is evident, from both controlled and uncontrolled studies, that nonprofessionals are able to significantly change the behavior of adult inpatients.…”