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This introductory paper for the Special Series on Post-traumatic Stress Disorder (PTSD) provides an overview of the psychological literature on chronic PTSD. We describe the symptoms of PTSD, the common associated features of the disorder, and common themes in the clinical presentation of traumatized individuals. Epidemiological studies are reviewed that reveal the widespread occurrence of potentially traumatizing events and the prevalence of PTSD among traumatized populations. We next provide an overview of psychological assessment procedures. This is followed by a description of three psychological theories of PTSD that have received a good deal of attention along with their implications for treatment. Two of the most widely applied treatments of PTSD are next reviewed in some detail: direct therapeutic exposure therapy and stress management approaches. Finally, we introduce the six papers that follow in the series in the context of a brief discussion of directions for future research in the field of chronic PTSD. [ABSTRACT FROM AUTHOR]

This paper proposes a new strategy for bridging the gap between psychotherapy process research and practice. Constructs covering the full spectrum of potential change mechanisms are derived from a general theory of human functioning (Grawe's Consistency Theory) and operationalized by Therapy Spectrum Analysis (TSA), a measure of the realization of therapeutic change mechanisms within individual therapy sessions. Using the data generated by TSA, we conducted an exploratory search for meaningful patterns of process and session-outcome variables using Answer Tree as a context-sensitive method of data analysis. Results show that process-activated resources of the patients, in particular their responsiveness to interventions and motivation are especially predictive of the session productivity experienced. Further analyses were conducted to uncover how the patients' participation can be promoted and results translate into guidelines for the session-to-session decisions by clinicians. Copyright © 2003 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

The present paper reviews what is currently known about sexual abuse and the treatment of the offenders. Sexual offending is primarily committed by males and as many as 50% of females and 33% of males are sexually victimized in some way during their life. While some of these acts involve minimally intrusive behaviours (e.g. exhibitionists), many involve forced vaginal or anal intercourse and varying degrees of associated physical violence and deliberate humiliation of the victim. The effects on the victim can be severe and long-lasting. Current theories of the aetiology of these behaviours incorporate biological and developmental factors occurring within a socio-cultural context that fails to discourage sexual abuse. Experience is said to create a vulnerability that in some men finds expression in sexually abusive behaviour. Appropriate assessment targets the issues that are addressed in treatment, including: cognitive distortions, sexual behaviours and attitudes, social functioning and substance abuse. In addition, treatment also attempts to generate a set of relapse prevention plans for each offender. While some reports have not found benefits for treatment, the majority of acceptable studies have demonstrated clear reductions in re-offending among treated sexual offenders. Copyright © 2000 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Clients with Obsessive Compulsive Personality Disorder (OCPD) take normally positive characteristics such as conscientiousness and attention to detail to such an extreme that these characteristics become seriously dysfunctional. This disorder has received only limited attention from cognitive-behavioural investigators and the one empirical investigation of the treatment of individuals with OCPD found that simply inducing these individuals to engage in treatment was difficult. This paper presents a cognitive-behavioural conceptualization of OCPD and uses a detailed case example to illustrate an approach to intervention which shows promise for providing an effective approach to intervention. [ABSTRACT FROM AUTHOR]

This paper describes a programme for inpatients with severe personality disorders as well as acute exacerbation of Axis II pathology. The goal of the programme was to quickly stabilize participants with respect to self-injurious behaviour and return them to the community. The programme consisted of frequent coordinated cognitive group therapy sessions with supporting written and audiovisual materials. The groups were open-ended and heterogenous, and employed educational and experiential-affective components. An extended group case example is presented in order to illustrate the operation of the programme. The range of typical participants is described, including their diagnoses, treatment plans, and homework assignments. Some comments on the personal and professional difficulties encountered by therapists working with this population ate described as well as some suggestions for alleviating those difficulties. [ABSTRACT FROM AUTHOR]

Contemporary cognitive-behavioural approaches to conceptualizing and treating personality disorders are summarized and examined. The initial evidence regarding the effectiveness of these treatment approaches consisted primarily of clinical anecdotes but a growing body of empirical evidence regarding the efficacy of cognitive-behavioural treatment for clients with personality disorders has developed in recent years. The available empirical literature is reviewed and is discussed in terms of its implications for clinical practice. [ABSTRACT FROM AUTHOR]

In an Emotion-focused approach emotion is seen as foundational in the construction of the self and is a key determinant of self-organization. As well as having emotion people also live in a constant process of making sense of our emotions. Personal meaning is seen as emerging by the self-organization and explication of one's own emotional experience and optimal adaptation involves an integration of reason and emotion. In this framework therapists are viewed as Emotion coaches who work to enhance emotion-focused coping by helping people become aware of, accept and make sense of their emotional experience. Emotion coaching in therapy is based on two phases: Arriving and Leaving. A major premise is that one cannot leave a place until one has arrived at it. Three major empirically-supported principles of Emotion Awareness, Emotion Regulation and Emotion Transformation that guide emotion coaching are discussed. Copyright © 2004 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

The particular importance of examining the issue of the effectiveness of treatment for problem drinking is based on: (a) the history of a separation of science and practice in the alcohol field; (b) an era of increased accountability for the results of clinical practice. Consideration of the complexities involved in deciding whether treatment makes a difference is followed by an examination of the relative merits of empirical and non-empirical evaluative approaches. Barriers to using knowledge effectively (therapist and cultural) are identified along with the use of knowledge destruction tactics. It is concluded that the most realistic alternative is an empirical approach that uses a wide range of methodologies to bridge the scientist–practitioner divide. © 1998 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Four unselected patients with drug-resistant delusional disorder were individually treated with eight sessions of cognitive therapy plus a booster session every month up to 1 year. All patients improved on a global measure of delusional severity (the GSDS), and showed a marked reduction in belief conviction. Related psychopathology as measured on the Comprehensive Psychopathological Rating Scale (CPRS) also markedly improved and all the gains were maintained at 1-year follow-up. Improved compliance with medication was achieved with half of the patients, and contributed to the improvement gained. [ABSTRACT FROM AUTHOR]

Conceptual and clinical problems arise in the treatment of patients with personality disorders, including three clinical problems: establishing and maintaining a therapeutic relationship with these patients is often difficult, empirically-validated treatments for personality disorders are generally not available, and personality-disordered patients typically have multiple presenting problems. We describe a case formulation model for conceptualizing and treating multiple-problem patients, and outline how it addresses these difficulties arising in the treatment of patients with personality disorders. [ABSTRACT FROM AUTHOR]

This study describes a survey of 496 NHS clinical psychologists (65% return rate obtained) looking at professional activities, job-related stress, views on personal therapy, and details of personal therapy experiences. Forty-one percent reported having had experience of personal therapy, a figure lower than in any of the published American samples. Seventy-eight percent said they were moderately or very stressed by the job. Those with experience of personal therapy had higher scores on the GHQ-28 and higher self-reported scores for stress of the job and stress of doing psychotherapy. More psychologists with a psychodynamic orientation had experience of personal therapy than would have been expected by chance. Psychodynamic therapists chose psychodynamic or psychoanalytic therapists, but cognitive-behavioural therapists chose therapists of orientations other than their own. Reasons for undertaking and ending therapy, the rated outcome of therapy, and means of findin8 a therapist are reported. Outcome of therapy was generally positive, with 17% of the sample reporting unsatisfactory results. The results are discussed in the light of published studies and in the context of work-related stress among clinical psychologists. [ABSTRACT FROM AUTHOR]