Effectiveness of cognitive–behavioral treatments in reducing Type A behavior among university faculty: One year later.

Conducted 6-mo and 1-yr follow-up evaluations of a study in which the effectiveness of cognitive–behavior modification (CBM) and cognitive–behavior modification plus assertion training (CBM/AT) treatments were compared with a minimal treatment (MT) control in reducing Type A (coronary prone) behavior and related characteristics among 31 university faculty members. Ss completed a battery of measures, including the Jenkins Activity Survey, a Type A self-rating scale, and the Manifest Hostility Scale. At both follow-ups, CBM and CBM/AT groups continued to report significantly less Type A behavior and Type A irrational beliefs than controls. Also, CBM and CBM/AT groups reported significantly less speed and impatience behavior at both follow-ups than did the control group, differences that were not found at posttreatment. No significant differences among groups were found for hard-driving/competitive, trait anger, or hostility levels, with the exception that CBM Ss reported significantly less hostility at the 1-yr follow-up than did MT Ss. Results support the long-term effectiveness of brief cognitive–behavioral treatments in reducing Type A behavior. (9 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Transfer of assertion-training effects to roommates of program participants.

Investigated the effects of assertion training (AT) on 36 college freshmen and on the behavior of 33 roommates who did not themselves receive AT. Ss, each of whom shared a dormitory room with a roommate, were randomly assigned to 1 of 3 treatment conditions: an AT group, a discussion-oriented group, or a no-treatment control group. Covariance analysis of posttreatment measures of assertiveness (College Self-Expression Scale, Tennessee Self-Concept Scale, Social Avoidance and Distress Scale) revealed that the AT group, but not the discussion group, was significantly more assertive than the control group. The AT group, but not the discussion group, was also significantly less socially anxious than the control group. Roommates of Ss who received AT obtained significantly higher assertiveness scores than roommates of Ss in either of the other 2 groups. Possible mechanisms for the generalization of the effects of AT to roommates and clinical implications are discussed. (12 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A comparison of cognitive-behavioral therapy and relaxation training for the treatment of depression in adolescents.

30 moderately depressed high school students were randomly assigned to either cognitive-behavioral treatment, relaxation training, or a wait-list control condition. Treatment Ss met in small groups for 10 50-min sessions over 5 wks in a high school setting. Outcome measures included a modified Beck Depression Inventory, the Rosenberg Self-Esteem Scale, and the State-Trait Anxiety Inventory. The cognitive-behavioral and relaxation training groups were superior to the wait-list control group in the reduction of depressive symptoms at both posttest and 5-wk follow-up assessments. There was no significant difference between active treatments in their effectiveness for reducing depression. Ss in the cognitive-behavioral and relaxation training conditions went from moderate levels of depression at pretest to nondepressed levels at posttest, and they maintained these levels at follow-up. Improvements in anxiety and academic self-concept were also demonstrated by the active treatments. Findings demonstrate that these short-term group-administered therapies are effective in significantly decreasing depression in adolescents. (48 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive-behavioral self-control therapy for children: A components analysis.

27 non-self-controlled 8–12 yr olds (as measured by the Self-Control Rating Scale) were randomly assigned to a cognitive-behavioral treatment, a behavioral treatment, or an attention-control condition. Ss were administered the Peabody Picture Vocabulary Test, Matching Familiar Figures Test, Piers-Harris Children's Self-Concept Scale, and Wide Range Achievement Test. All Ss received 12 sessions of individual therapist contact focusing on psychoeducational, play, and interpersonal tasks and situations, with the cognitive-behavioral treatment including self-instructional training via modeling and behavioral contingencies and the behavioral treatment involving modeling and contingencies. The cognitive-behavioral intervention improved teachers' blind ratings of self-control, and both the cognitive-behavioral and behavioral treatments improved teachers' blind ratings of hyperactivity. Several performance measures (cognitive style, academic achievement) showed improvements for the cognitive-behavioral and behavioral conditions, whereas only the cognitive-behavioral treatment improved children's self-concept. Normative comparisons and 10-wk follow-up provided additional support for the efficacy of the cognitive-behavioral treatment; 1-yr follow-up did not show significant differences across conditions. (35 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

EMG biofeedback training of Type A and Type B behavior pattern subjects.

Assessed the relative efficacy of EMG biofeedback training to reduce tension levels in Ss characterized either by the presence of the coronary-prone behavior pattern (Type A) or by its absence (Type B). 55 college students, classified as Type A or B on the basis of Jenkins Activity Survey (Form T) scores, were randomly assigned to either a biofeedback or a control group. Ss met for 6 training sessions, then returned for a 7th session to perform without biofeedback a series of easy (4-digit recall) and difficult (7-digit recall) tasks. Biofeedback Ss attained a greater degree of relaxation during training than did control Ss, regardless of A/B status. Also, biofeedback Ss maintained greater relaxation during task performance than did control Ss. Across groups, Type A's performed significantly better than Type B's on difficult tasks, and although Type A biofeedback Ss had EMG levels as high as Type B controls for the actual duration of performance tasks, they maintained significantly lower EMG levels than either group prior to, between, and after performance tasks. (22 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Assertiveness, territoriality, and personal space behavior as a function of group assertion training.

42 18-40 yr old females who requested services from a university counseling center were employed to examine changes in assertiveness, territoriality, and personal space as a function of group assertion training. Ss were assigned to either a treatment (assertion training) group or to a control (waiting list) group. The following outcomes were hypothesized: (a) Ss who participated in the assertion training treatment program would increase their assertive behavior significantly more than controls. (b) Treatment Ss would exhibit smaller personal space zones than would controls. (c) Treatment Ss would use more space on a drawing task than would controls. Data collected from a battery of measures, including the Rathus Assertiveness Schedule, the College Self-Expression Scale, and the Assertive Behavior Situation Test, provided strong support for the 1st and 3rd hypothesis and partial support for the 2nd hypothesis. Implications of the findings for counseling and for the use of ethological constructs are discussed. (23 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effectiveness of booster sessions in the maintenance and enhancement of treatment gains following assertion training.

46 unassertive Ss were randomly assigned to assertion training (AT) or waiting-list control conditions. Ss receiving AT showed significantly greater improvements from pretreatment to posttreatment on 8 out of 10 questionnaire measures of assertiveness and 3 out of 5 direct behavioral observation measures compared with the waiting-list group. 27 Ss who had completed the AT program were then randomly assigned to 1 of 3 booster conditions, namely, monthly AT boosters (ATB), monthly attention placebo boosters (APB) or no boosters (NB). At the 3-mo follow-up there was minimal difference between booster conditions. By the 6-mo follow-up the results favored the ATB condition. Although the APB procedure was effective in preventing the relapse shown by the NB Ss, the ATB group actually showed further improvements on some measures of assertiveness during the 6-mo follow-up period. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Assertiveness training for disabled adults in wheelchairs: Self-report, role-play, and activity pattern outcomes.

34 physically disabled adults participated in an 11-wk assertiveness training (AT) program. Ss were randomly assigned to either AT or a waiting-list (WL) condition. Each was asked to complete 3 self-report measures, a role-play test, and a social and recreational activity diary. The AT Ss showed significant improvements on both self-reported assertiveness and role-play performance from pre- to posttreatment, whereas WL controls showed no changes on these measures. No significant changes in frequency of social or recreational activities were found at posttest for either AT or control Ss. A mixed pattern of results was shown at 6-mo follow-up. Posttest gains were maintained across all self-report measures of assertiveness and acceptance of disability, whereas role-play performance approached baseline levels at 6-mo follow-up. Overall results support the use of AT in enhancing perceived social efficacy and interpersonal skill of physically disabled adults in wheelchairs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Conceptual level matching and effects of assertion training.

36 unassertive women (aged 20–52 yrs), assessed through Quick Test scores as high or low on conceptual level (CL), were randomly assigned to high-structure-behavioral or low-structure-cognitive forms of assertion training (AT). Low-CL Ss who received the "matched," high-structure AT were expected to make greater gains in assertiveness and to report more satisfaction with counseling than were Ss who received the "mismatched," low-structure AT. High-CL Ss in the matched, low-structure condition were expected to gain more benefit from AT and to express more satisfaction with counseling than were high-CL Ss in the mismatched, high-structure condition. After 4 2-hr sessions of AT, low-CL Ss in the matched condition showed more improvement in assertiveness of verbal responses and evaluated the counselor as more expert and trustworthy than did low-CL Ss in mismatched condition. No matching effects were found with high-CL Ss. (38 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Assertion training with handicapped persons.

Investigated the effects of assertion training in 9 handicapped college students and 5 handicapped discharged rehabilitative medicare outpatients. Ss were matched on self-reported assertiveness and were assigned to 1 of 2 groups: (a) treatment Ss who received assertion training, and (b) waiting-list-control Ss who received no treatment for 5 wks and then received assertion training. Behavioral role playing, self-report, and activity budget pre- and posttest measures revealed that assertion-training Ss reported significantly greater gains in assertive behavior and showed greater improvement in performance on 7 criterion measures than did control Ss. 18 criterion measures did not show any differences between treatment and control groups. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive and behavioral therapy for musical-performance anxiety.

Compared the efficiency of cognitive-behavioral therapy, emphasizing self-instruction and attention-focusing techniques, with behavior rehearsal and with a waiting-list control in the treatment of debilitating musical-performance anxiety. Ss were 53 pianists (aged 12–53 yrs old) who experienced extreme anxiety in performing situations. Therapy sessions were conducted over a 3-wk period; Ss met 3 times in small groups for 1?–2 hrs and also completed homework assignments. Self-report (e.g., Subjective Stress Scale, Expectations of Personal Efficacy Scale for Musicians), behavioral, and physiological indexes of anxiety were collected at baseline, treatment termination, and follow-up intervals. Multivariate analyses indicated that both the cognitive-behavioral therapy and behavior-rehearsal programs were effective in reducing musical-performance anxiety in comparison to the control condition at the follow-up assessment, although there were no differences among groups at treatment termination. Cognitive therapy was more effective than the behavior-rehearsal program on several measures. (40 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Evaluation of a behavioral program for the improvement of grades among high school students.

39 high school students designated by their teachers as at risk for academic problems received 10 50-min weekly behavioral treatment sessions that included self monitoring, study skill training, anxiety reducing procedures, and assertiveness training. The academic performance of these Ss was compared at 4 times during the year to that of 30 students at risk who agreed to participate in treatment but were placed on a waiting list (motivated controls), 43 at-risk students who refused to participate (unmotivated controls), and 43 students not at academic risk. Ss in the intervention group significantly improved their performance from the 1st to the 4th assessment, and both the intervention and not-at-risk groups performed significantly better than did the untreated, nonmotivated control group. Ss in the latter group failed to improve their grades, suggesting that without direct and systematic help, students with potential school problems do not find ways of solving their difficulties by themselves. (14 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Assertive training: A one year follow-up.

Reports results of a 1-yr follow-up of group assertive training with 20 of the 32 nonassertive college students in the original study. One yr after training, experimental and control Ss were significantly different on 2 self-report measures (the College Self-Expression Scale and the Subjective Unit of Disturbance Scale) and 2 of 4 behavioral measures (assertive content and scene length) of assertiveness. No differences were found on eye contact or response latency. Results indicate the long-term effects of assertive training. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of three psychological treatments and self-monitoring on the reduction of Type A behavior.

31 Type A (coronary prone) individuals received either cognitive–behavioral treatment, values-clarification treatment in combination with anxiety management training (AMT), or AMT alone. Ss were also blocked on the variable of self-monitoring, which is the extent to which one plans and enacts social behavior by using situational cues. Reduction in Type A behavior was achieved by all Ss, with none of the treatment groups producing clearly superior reductions. Reduction of anxiety was significantly effected by treatment condition, self-monitoring, and the interaction of these 2 variables. Implications for treatment of the Type A behavior pattern as well as the possible effects of self-monitoring on response to more general cognitive–behavioral techniques are discussed. (47 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Identification of therapist differences in a group treatment for depression.

Examined therapist variables presumed to be related to outcome in a structured, cognitive-behavioral group treatment for depression. Each of 8 leaders conducted 2 consecutive psychoeducational treatment groups consisting of 5–8 Ss. Of the 106 Ss (aged 17–67 yrs) who participated in the study, 79 were clinically depressed; measures of depression included the Beck Depression Inventory, Hamilton Rating Scale for Depression, and a measure of social adjustment. A broad multivariate assessment was conducted of pretreatment leader characteristics, leader behavior and style during treatment, group behavior and process, and depression outcome. Results indicate that leaders differed significantly on behavioral and group-process measures, but differences in depression outcome between leaders did not attain statistical significance. (5 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of covert modeling and model reinforcement on assertive behavior.

Investigated the effect of covert modeling in developing assertive behavior in 45 17-52 yr olds. Nonassertive Ss received covert modeling (imagined scenes in which a model performed assertively), covert modeling plus reinforcement (imagined scenes in which a model performed assertively and favorable consequences followed model performance), no modeling (imagined scenes with neither an assertive model nor favorable consequences), or delayed treatment (no-treatment controls who subsequently received either covert modeling or modeling plus reinforcement). In 4 treatment sessions, both model and model-reinforcement conditions improved significantly on self-report inventories (Conflict Resolution Inventory, Action Situation Inventory, Wolpe-Lazarus Assertive Training Scale, and Wolpe's Willoughby Scale) and a role-playing test of assertiveness. The modeling-reinforcement group tended to show greater assertiveness at posttreatment assessment and follow-up. The effects of covert modeling were maintained up to a 3-mo follow-up assessment. (35 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Covert and overt rehearsal and homework practice in developing assertiveness.

Evaluated the effects of overt rehearsal and homework practice on covert modeling treatment of social skills. 79 18–73 yr old nonassertive clients received 1 of 4 variations of covert modeling that resulted from a 2?×?2 combination of overt rehearsal and homework practice. Ss who received overt rehearsal engaged in overt enactments (role playing) within the treatment sessions; Ss who received homework practice engaged in extra treatment activities to develop their social skills. A delayed-treatment control group was also included to serve as a no-treatment condition before Ss were randomly assigned to 1 of the 4 treatments. Findings indicate that treatments led to significant improvements on self-report inventories, global ratings, and behavioral measures of assertiveness (the Conflict Resolution Inventory and the Wolpe-Lazarus Assertiveness Questionnaire). Ss who engaged in homework practice and/or overt rehearsal of assertive behavior within the treatment sessions made consistently greater improvements at posttreatment and at an 8-mo follow-up than Ss who did not receive the procedures. Treatment effects extended to novel assessment situations and brought Ss to the level of 45 16–41 yr olds who regarded themselves as adept in social situations. (28 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive-behavioral and pharmacologic interventions for hyperactive boys: Comparative and combined effects.

Assessed the effects of 2 interventions—reinforcement and reinforced self-evaluation—on the positive social behavior of 24 8–13 yr old hyperactive males to test the hypothesis that reinforced self-evaluation would produce greater positive social behavior in Ss. Comparisons between Ss receiving methylphenidate (5–40 mg/day) and Ss receiving placebo were also conducted to clarify the effects of stimulant medication on Ss' social behavior. The primary outcome measures were direct observations of appropriate and negative social interactions. Results indicate that both methylphenidate and reinforced self-evaluation were superior to the contrast treatments. When the effects of the 4 treatment combinations were rank ordered, medication plus cognitive-behavioral self-evaluation proved optimal; placebo plus reinforcement alone was significantly worse than all other conditions. Medication enhanced the accuracy of Ss' self-evaluation. Findings are discussed in the context of the need for intervention with the social and interpersonal difficulties of hyperactive children. (46 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relaxation training and attention placebo in the treatment of severe insomnia.

Compared the effectiveness of progressive relaxation training with and without a supplementary relaxation recording, which Ss played at home, and an attention placebo manipulation in the modification of severe insomnia. Ss were 40 29-72 yr old insomniacs recruited through newspaper ads. Assessment measures included sleep postcards mailed in by the Ss, the MMPI Pt , D , and K scales, ratings of the therapist by Ss, and physiological recordings (EKG, skin conductance, and respiration). The relaxation training procedures were significantly more effective than placebo and no-treatment controls in modifying several parameters of sleeping behavior, reducing consumption of sleep-inducing medication, and influencing self-reports of anxiety. The supplementary relaxation tape did not increase the effectiveness of relaxation training conducted in the clinic, and there was no difference in the efficacy of the placebo and no-treatment conditions. Physiological data gathered during the last treatment session indicated few significant correlations between reductions in arousal associated with relaxation training and treatment outcome. (21 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Increase in assertiveness and actualization as a function of didactic training.

Investigated whether didactic training could increase level of assertiveness and actualization. 65 low assertive undergraduates were randomly assigned to 1 of 5 groups. All groups except a no-treatment control group were exposed to 3 20-min videotapes during 1 wk. Group 1 was exposed to the didactic principles of Rogerian theory; Group 2 was given the didactic principles of assertiveness theory. All Ss were given a test battery administered before treatment, after treatment, and again at a 3-wk follow-up. Both Rogerian and assertiveness training increased the level of actualization and the level of time competence at posttesting and at follow-up; the effect of didactic training was significantly greater than the increase caused by inspiration or expectation. Didactic training, however, did not affect assertiveness. (18 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)