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The treatment of phobic states by desensitization is tedious and not always completely successful (Marks, 1969). Recently newer methods claiming improvement in speed and efficacy have been introduced, such as flooding or implosion (for example, Boulougouris et al., 1971) and prolonged exposure (Watson et al., 1971). An approach based on respiratory control which seems to be as effective as other methods and even more rapid in action is described in this short paper.

Ten adult patients with long-standing specific phobias were treated by prolonged continuous exposure to their phobic objects in fantasy and reality without avoidance. All patients were greatly helped by four to five hours' treatment in two or three sessions, and all improved more after practice than after imaginal sessions. The treatment method is more economical and efficient than other methods described so far.

A new technique is described for the treatment of phobic patients which may be more effective than other available methods to date. Three out of four patients treated by implosion (flooding) became almost symptom-free after a mean of 14 sessions and remained so over six-and-a-half months' follow-up. The mechanism of action of the method is not yet clear.

Summary.-An "electively mute" 12-yr.-old boy was successfully treated using positive reinforcement procedures. Visual feedback from the volume-level meter of a tape recorder was used to help in inducing sounds and to aid in raising speech volume. Various ocher techniques were employed to increase the rate of speech and to generalize it to a variety of environmental situations. The phrase "elective mutism" was first used to describe "children who are silent amongall but a small circle of intimates" (Tramer, 1934). The condition is generally thought to be intractable to treatment and often persists for many years (Reed, 1963). There are numerous papers dealing with the teaching of speech to autistic and schizophrenic children or to children who have never spoken or who have been slow to develop speech (e.g., Black & Moss, 1967; Hewett, 1965; Lovaas, Berberich, Perloff, & Schaeffer, 1966). In contrast, the electively mute child has often developed extensive speech. However, he will only emit words under a highly specific and restricted set of discriminative stimuli. Even when he does speak, his verbal rate is often very low. Behavioral research with elective mutism has not been reported widely. Reid, Hawkins, Keutzer, McNeal, Phelps, Reid, and Mees ( 1967) treated a 6-yr.old in a "marathon behavior modification" session. Straughan ( 1965 ) used an operant approach with a 13-yr.-old; however, it appears that this S was not electively mute. Under the reported baseline conditions he emitted almost 14 words an hour. The presentation in the present paper describes several techniques applied in a severe case of elective rnutism. The techniques appear to have relevance for treatment programs where the goals include increasing the rate of speech, generalizing it to a wide variety of environmental situations, and increasing speech volume. METHOD

Sltmn2ary.-This paper cities several areas which have received little attention in the literature on behavior therapy. It is suggested that these areas are important from the standpoint of practicing and evaluating a behavior rherapeutic approach to maladaptive behavior. The issues include diagnosing, dealing with more realistic response classes, getting objective measures of additiona1 relevant variables, selecting appropriate behavioral modification techniques for rhe particular case, exploring stimulus conditions leading to the maladaptive behavior, and reporting the carry-over of behavioral changes produced in the experimental environment to the natural environment. In spite of the growing literature on methods and applications of behavior therapy, few papers evaluate this work in light of actual therapeutic demands. Despite the many studies demonstrating the utility of the approach and its potential benefit, there are a number of important issues that have as yet received too little discussion in the literature. These iss~les are discussed in this paper. Although many well-traincd therapists are aware of these issues and each point has received some mention in the literature, in general they have been neglected. Further, while chis paper is written in the context of behavior therapy, it is believed that each point has bearing on other therapies as well. A variety of behavior modification techniques derived from the operant and classical conditioning literature have been described (Bachrach, 1962; Eysenck, 1964; Grossberg, 1964; Kalish, 1966; Rachman, 1963; Truax, 1966; U11man & Krasner, 1965; Wolpe, 1958; Wolpe & Lazarus, 1966). If behavioral change is the goal of therapy, these procedures are important. Techniques include shaping, reinforcing. extinction, desensitization, negative practice, escape and avoidance training, stimulus control, role-taking, and others. Their advantage lies in their being based on principles supported by considerable evidence from st~tdy of both animals and humans. This past research and specific techniques give the behavior therapist a valuable framework and practical armamentarium for approaching a situation in which his aim is to alter behavior (Bandura, 1961). An advantage of this work is that it is relatively precise and objective. Its operational natiue permits the reader to know precisely what behavior is under smdy and what the therapist does in his efforts to modify the behavior. While having a framework of functioning is desirable, this frame of reference should not be too limiting. Rather than viewing therapy as plugging maladaptive behavior into a single model, the therapist should be attuned, as the ex

This symposium and the papers that compose it reflect the fact that the study of culture and achievement motivation has truly ‘‘come of age.’’ Gone are the days when a few hearty souls from Europe, Great Britain, the United States, and Australia, as well as a few others imbedded in the research traditions largely associated with ‘‘Western oriented centres of knowledge’’ stood as the primary source for prompting and guiding research on the nature and nurture of motivation. Equally, if not more, important is that studies of culture and motivation are increasingly conducted under the purview of a multicultural community of scholars. Certainly, this represents an exciting development, and the papers that compose this symposium are interesting as they provide fresh perspectives on motivation as it emerges in contexts and cultures not often portrayed in the motivation literature in the so-called ‘‘Western world.’’ While the scholars who have contributed to this symposium reflect an awareness of the research traditions of the past, they also exhibit special insights into the uniqueness of the varied cultures they have studied, the meanings of motivation that are associated with these cultures and the varied impact of these meanings on ways of acting and thinking. Certainly, this all speaks well for the level of scholarship evident in these papers. It also holds out the promise that the study of culture and motivation is neither dormant nor outmoded. Permit me, however, to raise an issue that I am regularly inclined to raise with the motivation research community in the United States. From the outset, the study of achievement motivation

The following paper presents theoretical, empirical, and ethical rationales for the training of parents as behavior therapists for their own children. Thirty-four studies, ranging from single case studies to reports on large-scale, multi-family training programs, are critically reviewed, with primary emphasis on the nature and extent of parental involvement and responsibility, and on the level of methodological sophistication. Related papers are cited when appropriate. Further research and areas needing theoretical clarification are suggested, in relation to the future and expansion of this type of therapeutic intervention. In addition the implications of such an approach for both a “systems” model of child therapy and a prevention-oriented model of mental health services are discussed.

This paper makes no claim to be an exhaustive discussion of influential variables in the reciprocal inhibition treatment of phobias. Had it been, it would have also mentioned, at length and in detail, such considerations as lack of faith in the method, insufficient motivation to get well, obsessive-compulsive neurosis, the number of conditioning sessions, and the duration and intensity of phobias, all of which apparently play a role in the final outcome4. The paper concentrates on other of the more important or intriguing limiting factors, as follows: the non-utilization of hypnosis, deficiencies in visualization and relaxation, the presence of free-floating anxiety, severe environmental stress, and the amount of secondary gain. The improvement rate in 26 phobic patients immediately after desensitization therapy was 42%. Follow-up, 16 months to three years later, showed a decline in the improvement rate to 31%. Considering the well-recognized and enormous difficulty in successfully treating phobic patients, one should not be too hasty in condemning these results. The rather meager therapeutic achievement merely points up the complexity of factors intervening between stimulus and response, mainly in the person of the patient, that “black box” of almost infinite variegation. In this respect, conditioning therapy faces the same difficulties as any other and in the field of symptom removal probably does better than most. Reciprocal inhibition treatment is a worthwhile addition to the psychiatrist's armamentarium and should be used wherever indications and expectations warrant it.

This paper is an extension of an earlier article by the authors concerning procedures for conditioning language behavior in linquistically divergent children. Specifically, this paper deals with the role and importance of response generalization in the development of syntax. The results suggest that the conditioning method used was effective in obtaining the necessary generalization.

In recent years interest has attached to the fact that experiences allied to those described by patients during acute schizophrenic illnesses can be induced in normal people by the use of certain drugs, sometimes called “hallucinogens”. In so far as these drugs have caused hallucinations, however, they have induced predominantly visual hallucinations, whereas in schizophrenia the outstanding hallucinations are auditory ones, of voices—often making remarks in the third person singular, sometimes making apparently senseless or absurd remarks. In this paper, attention is drawn to means whereby non-schizophrenic persons can be caused to experience hallucinatory and illusory voices by primarily psychological and not pharmacological techniques. These techniques are also applicable to normal volunteers, but this paper will deal with first experiences of them during the treatment of some sexual deviants and alcohol addicts.

IT HAS been pointed out that much of psychiatric nursing education is concerned with familiarizing the student with the work done by other members of the therapeutic team.(l) Yet, of all the groups concerned with the care of the sick the psychiatric nurse spends the longest periods of professional time in the patient’s presence. t2) Undoubtedly the neglected essence of effective psychiatric nursing is based on developed expertize in therapeutic interpersonal relationships. w However there is a danger that this ill defined central function of the clinical nurse will become subservient to the professional interventions of the other caring agencies. Because of this it is important that the nursing profession develops specific clinical roles related to but independent of the professional roles of other members of the clinical team. Although the present argument centres on schizophrenia there is ample evidence of the nurse’s effective roles in the treatment of other psychiatric disorders e.g. neurotic disorders c3) and alcoholism. t4) This paper concerns itself with two specific therapeutic interventions a nurse may make in the treatment of schizophrenia, both in the hospital and community.

The new behavior technologies raise obvious ethical and legal questions, particularly when employed in institutional contexts. This paper offers a conceptual framework for the discussion of legal interventions designed to prevent Orwellian abuses of the new technologies, without preventing legitimate therapeutic applications.

Summary Associated with the rapid growth of behavior modification as a major treatment strategy has been the use of behavioral assessment procedures. These procedures differ in method, theory, and goals from those used in traditional clinical practice. This paper surveys and critically examines the major methods of behavioral assessment, and offers recommendations to enhance their validity. The behavioral assessment methods reviewed include: observation, self-report, survey schedules, assessment for systematic desensitization, physiological measures, and assessment by operant conditioning.

The use of aversive stimuli with the retardate is controversial. This paper describes the successful application of electrical stimulation to eliminate self-abusive behavior. It is presented as an advocacy for a form of treatment which has its rightful place in our armamentarium and can be of benefit to many severely-profoundly retardates. To deny them this benefit is considered unethical, inhumane, unfair and absolutely wrong.

This paper describes the results of a clinical trial of a new method, intensive group therapy, devised explicitly to incorporate the principal advantages of three traditionally separate techniques: the intensive five-day-a-week format of psychoanalysis; the real-life quality of group therapy, which promotes social-interaction analysis and modification; and the punishment/reinforcement techniques of behavior therapy. The eight patients treated in the group all had had extensive but largely unsuccessful therapy; during the first 18 months of intensive group therapy seven of the eight made appreciable therapeutic gains.

This paper describes a successful operant conditioning program using a variety of reinforcers which were individualized for 5 hospitalized female anorexia nervosa patients, resulting in rapid weight gain to premorbid levels. The patients studied met the following criteria: a) weight loss greater tha

Exposed a total of 121 5-14 yr old boys with histories of high and low exposure to TV (and the violence therein) to a moderately violent film. Measures of autonomic response (skin conductance and blood volume pulse amplitude) were taken before and during their exposure to the violent film. Over both measures and in another replicated study, the high TV exposure Ss were significantly less aroused autonomically. This suggests a limited but still definite and measurable desensitization to filmed violence. Since the Ss had had either no exposure or no recent exposure to the particular film, results suggest the possibility of a generalizing effect for the desensitization that occurred. VioLit summary: OBJECTIVE: The purpose of this study by Cline et al. was to examine, via measurement of physiological responses, whether children can become desensitized to violence. METHODOLOGY: For their first study, the authors employed a quasi-experimental cross-sectional design with a sample of 80 male children between the ages of 5 and 12. Subjects were divided into two groups, based upon the amount of television they had watched in the previous two years. The high-television-exposure group had watched 25 hours or more television per week in that period, while the low-television-exposure subjects had watched fewer than 4 hours of television per week. Forty children for each group were recruited via newspaper advertisements, and subjects were compared for social class levels and father's education. Autonomic arousal was measured with a physiography whilst subjects were shown a 14 minute film containing three segments. The first consisted of a nonviolent ski film, the second was a chase scene and the third showed a brutal boxing match. This third segment had an equal amount of nonviolent material in between the violent scenes, so that each subject could act as his own control. Arousal was measured from before the films began until the end of the experiment, with measurement involving blood volume pulse amplitude to access heart response rates and changes. The second part of the research involved the use of 41 boys between the ages of 7 and 14 years, with one group of 20 high-television-exposure subjects and one group of 21 low-television-exposure individuals. The procedure of the study was identical to that in the first phase, except that subjects viewed the films in high-low pairs instead of alone. Skin conductance was also measured in this study, with levels of skin charge being measured if above 500 ohms. FINDINGS/DISCUSSION: The authors initially investigated whether there existed any demographic differences between the high-exposure and the low- exposure groups. Significant differences were found between the two groups of subjects for both measures, with low-exposure subjects coming from families in which the father had higher occupational status and more education. When comparing base levels of autonomic responses prior to viewing the films, however, no significant differences were found between the two groups. The authors suggested that although there existed some difference in socio- economic status between the subjects, this difference should not have systematically affected their autonomic responses to the violent films. When comparing the two groups on automonic responses before the film and after the nonviolent film, no significant differences were found. However, this was not the case for responses to the violent films. Subjects in the low-television-exposure group exhibited significantly higher levels of autonomic arousal, and therefore emotional arousal, than did boys in the high-television-exposure group. Even during the nonviolent parts of the boxing match, low-exposure boys were more aroused, although not significantly so, than their high-exposure counterparts. The authors concluded that a desensitization effect or an habituation effect to violence in general might develop in those subjects who watch greater amounts of television than their low-exposure peers. AUTHORS' RECOMMENDATIONS: The authors suggested that, based upon the findings of their studies, further research be conducted using a greater variety of stimulus films. EVALUATION: The authors present an interesting glimpse into the effects of desensitization upon the young television viewer. However, the small sample size, coupled with the use of only one violent film and only two measures of physiological response, suggest that the results be viewed with some caution. No mention was made in the paper as to the difference, if any, between the groups viewing the films alone and those experiencing the study in pairs. Other demographic variables, such as ethnicity, could have been included, and the effects of desensitization upon females were not considered. No discussion was presented about the implications of the findings, which could have been very interesting. Overall, the study provides an interesting although brief and non-detailed examination of the effects of high and low exposure to television in children. (CSPV Abstract - Copyright © 1992-2007 by the Center for the Study and Prevention of Violence, Institute of Behavioral Science, Regents of the University of Colorado) KW - Desensitization KW - Exposure to Violence KW - Child Male KW - Juvenile Male KW - Middle Childhood KW - Late Childhood KW - Early Adolescence KW - Media Violence Effects KW - Television Viewing KW - Television Violence (25 refs.) Language: en

This paper compares the progress of 25 retarded children who attended an experimental summer camp based on principles of behavior modification, with a matched group of 15 retarded children who did not attend camp. The campers showed significantly greater progress than did controls in predetermined target areas, suggesting that a camping experience may have beneficial effects, and that a program of behavior modification may provide even further benefits.

This paper discusses behavior principles and techniques of behavior modification which may have implications for utilization in classrooms for exceptional children. Procedures for selection and application of consequences which accelerate or increase the frequency of appropriate behavior, and those which decelerate or decrease the frequency of inappropriate behavior are described. Disadvantages and dangers inherent in random, haphazard application of these principles are cited.

This paper deals with the problems involved in the treatment of complex neurotic conditions. A seventh feature is added to Wolpe's list of the six features that make a neurosis complex. The use of Lysergic Acid Diethylamide (LSD 25) in the treatment of such difficult cases is discussed and three cases are presented.

Difficulties in defining and measuring “depression” operationally have led behavior therapists largely to ignore the subject. This paper describes several operational factors which lend themselves to more objective assessment and therapeutic maneuvers. Within this context, S-R analyses can presumably lead to effective and specific treatment procedures. Three treatment techniques are described, and one method (time projection with positive reinforcement) is described in considerable detail.

This paper describes the use of observation of the patient's interaction with his spouse and children in his own home as a part of the assessment and treatment of depression. Home observations are conducted during the beginning, middle, and ending phases of treatment. Interactions are coded in terms of the behaviors emitted by the patient and the social consequences of his behavior. The home observations are used to define treatment goals and to measure behavior change. In addition, home observations have beneficial consequences in that they (a) immediately focus the therapist-patient interaction on behavioral and interpersonal problems, and (6) provide a way of involving a significant part of the patient's environment in the treatment process. Some preliminary data are presented which are consistent with the hypothesis that a low rate of positive reinforcement is a critical antecedent condition for the occurrence of depressed behaviors. This is one of a series of reports describing the treatment of depression2 from a behavioral point of view (Lewinsohn & Atwood, 1969; Lewinsohn & Shaw, 1969; Lewinsohn, Weinstein, & Alper, 1970). The major assumptions underlying the approach are (a) a low rate of positive reinforcement acts as an eliciting stimulus for some depressive behaviors such as verbal statements of dysphoria, fatigue, and other somatic symptoms; (b) a low rate of positive reinforcement constitutes a sufficient explanation for other parts of the depressive syndrome such as the low rate of activity and verbal behavior. For the latter, the depressed person is considered to be on a prolonged extinction schedule; (c) the social environment provides reinforcement in the form of sympathy, interest, and concern which strengthens and maintains depressive behaviors; (d) a number of different environmental events (e.g.