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This article reviews the research on couple therapy over the last decade. The research shows that couple therapy positively impacts 70% of couples receiving treatment. The effectiveness rates of couple therapy are comparable to the effectiveness rates of individual therapies and vastly superior to control groups not receiving treatment. The relationship between couple distress and individual disorders such as depression and anxiety has become well established over the past decade. Research also indicates that couple therapy clearly has an important role in the treatment of many disorders. Findings over the decade have been especially promising for integrative behavioral couples therapy and emotion-focused therapy, which are two evidence-based treatments for couples. Research has also begun to identify moderators and mediators of change in couple therapy. Finally, a new and exciting line of research has focused on delineating the principles of change in couple therapy that transcends approach.

Cognitive processing therapy (CPT) for posttraumatic stress disorder (PTSD) has been shown to reduce symptoms of PTSD in a veteran population. This study explored patterns of self-reported symptom change during CPT. Veterans (N = 60) with PTSD were randomized to receive CPT immediately or after 10 weeks. We hypothesized that those treated immediately would evidence initial symptom stability followed by decline compared with those who waited, whose PTSD symptoms would remain stable. The best model fit based on deviance statistics and Bayesian information criteria comparisons was one in which participants treated immediately showed more rapid initial decline followed by a slower rate of PTSD symptom improvement relative to those who waited, who showed a stable level of symptomatology. Findings suggest that CPT produces quick and maintained improvements in veterans. The effect sizes for change between those who received CPT immediately and those who waited were approximately medium sized. Implications of findings are discussed.

Background: Considerable progress has been made toward the development of evidence-based treatments for a wide range of psychological disorders; however, little is known about the mechanisms through which these treatments actually lead to clinical change. Although the use of traditional randomized controlled treatment designs and tests of statistical mediation have significantly advanced understanding of psychological treatments, they are insufficient to test mechanisms of change. Method: This article outlines the conceptual and methodological requirements for evaluating mechanisms of change, highlights the importance of such a focus, and offers specific recommendations for research aimed at elucidating change mechanisms. Results and Conclusions: Conceptualizing and conducting studies that test mechanisms of change requires substantial modifications to traditional research designs, but doing so will significantly enhance scientific understanding as well as the efficiency and effectiveness of clinical interventions.

The main goal of this study was to offer data about the efficacy of virtual reality exposure (VRE) in the treatment of panic disorder with or without agoraphobia (PDA). The study was a between-subject design with three experimental conditions (VRE group, in vivo exposure [IVE] group and waiting-list [WL] group) and repeated measures (pre-treatment, post treatment and 12 month follow-up). The treatment programmes lasted 9 weekly sessions. Thirty-seven patients meeting DSM-IV criteria for PDA participated in this study. The improvement achieved using virtual exposure was superior to a WL condition and similar to that achieved using IVE. Our results support the efficacy of VRE in the treatment of PDA at short and long term. The advantages of VRE for the treatment of PDA regarding cost-benefit issues are described. Copyright © 2007 John Wiley & Sons, Ltd.

The effectiveness of a guided compliance procedure to reduce noncompliance among typically developing preschool children was evaluated. After baseline data on compliance to common demands were collected, a parent, instructional assistant, or graduate research assistant implemented the guided compliance procedure, which involved the delivery of progressively more intrusive prompts contingent upon noncompliance. The effects of the procedure were examined using a nonconcurrent multiple baseline design across participants. The results suggest that the procedure was effective for four of the six children who participated. Copyright © 2006 John Wiley & Sons, Ltd.

This article describes a novel form of the classic changing criterion design called the range-bound changing criterion design. The article illustrates the new design by reporting results from the first study to use this simple variation of the changing criterion design. The article also identifies other interventions, target behaviors, and contexts for which the range-bound changing criterion design is useful, as well as guidelines and rationales for using this new design. Copyright © 2005 John Wiley & Sons, Ltd.

We report a case in which a Self-Injurious Behavior Inhibiting System (SIBIS) device and a conditioned punisher were utilized to decrease and maintain suppression of severe head hitting/banging in a preschool child. After an experimental evaluation conducted at the hospital, SIBIS was implemented at home. The originality of this particular SIBIS case study is that programmed and systematic effort at establishing conditioned punishment was included in the intervention. Results indicate that a zero-level response was rapidly reached, and that the conditioned punisher (i.e. verbal prompt + movement towards the place where SIBIS was kept) was sufficient to maintain treatment effects. Continuous assessment after treatment and formal observation session at 7 months follow-up revealed that SIBIS could be removed from the natural environment of the child while maintaining a therapeutic effect. These results were interpreted as the effects of the explicit pairing between the delivery of electric stimulations and previously neutral stimuli, which were initially ineffective to elicit any response, or to suppress SIB. Close and extended monitoring during and after treatment failed to reveal the presence of negative side effects associated with SIBIS, whereas a number of positive effects were observed. Copyright © 2004 John Wiley & Sons, Ltd.

Children with disabilities pose unique challenges for occupational therapists when the value of therapy programmes and the child's individual progress are being evaluated. Children whose development is atypical may make progress through a course of intervention and/or maturation, yet standardised tests frequently used by occupational therapists are often not sensitive enough to detect these changes. In this current climate of economic rationalism and accountability, providing documentary evidence of occupational therapy programme benefits is essential. This paper addresses the utility of goal attainment scaling for objectively and systematically documenting the outcomes of occupational therapy intervention. Goal attainment scaling provides a direct, reliable and accurate method of assessing treatment-induced client change. The process of goal attainment scaling is described and the literature on goal attainment scaling in paediatrics is reviewed. It is concluded that goal attainment scaling is a useful clinical process and measure of therapy programme outcomes for children with disabilities.

Despite the growing literature on empirically supported therapies, these interventions are rarely used in clinical settings. Although researchers lament the poor transfer of techniques from controlled trials to clinics, little has been written to guide the adaptation of manualised treatments for real-life clinical practice. The goal of this paper is to provide suggestions for the clinical use of research-tested treatments, with specific examples from the treatment of child depressive disorders. Strategies for applying manuals flexibly, adapting treatments to address comorbidity, attending to individual differences, and overcoming training obstacles are highlighted.

The authors are involved in an ongoing trial comparing the efficacy of cognitive behavioural therapy for patients with bulimia nervosa delivered via telemedicine versus delivered via an on-site therapist. The overall purpose of the study is to see if psychotherapy can be delivered effectively via telemedicine, and if such administration is acceptable to patients. This trial evolved out of growing concerns that manual-based psychotherapies for various psychiatric conditions are not widely available, particularly to people in rural areas. Some of the practical aspects of delivering psychotherapy via telemedicine are discussed. Copyright © 2003 John Wiley & Sons, Ltd and Eating Disorders Association.

A meta-analysis of 40 primary prevention studies provided an encouraging assessment of past efforts and clear challenges for the future.