While we might debate the role of sport in our culture, its influence is certainly pervasive. Each day millions of Americans engage in some form of competition, training, or physical exercise. Such popularity and the value our culture places on competition have made sport a valid area of psychological inquiry. Within the cognitive behavioral model, sport psychology and, specifically, athletic performance enhancement have experienced vigorous growth over the past two decades. Behavior change strategies familiar to most cognitive behaviorists form the core of virtually all athletic performance enhancement interventions. Goal setting, imagery or mental rehearsal, relaxation training, stress management, self-monitoring, self-instruction, cognitive restructuring, and modeling interventions dominate this literature. Our examination of these performance enhancement programs, both through a qualitative review and the Whelan et al. (1989) meta-analysis, supports the efficacy of cognitive behavioral interventions for the enhancement of sport performance. First, the average effect size across the empirical literature indicates that these interventions are reliably effective. Furthermore, this positive result is observed across variations in treatment conditions, control conditions, and across different types of dependent measures. Evidence on goal setting, imagery, arousal management, cognitive self-regulation, and packaged programs specifically support the behavior change efficacy of these interventions. These findings are encouraging, but much work needs to be done. Few investigators cited in this review attend to crucial internal and external validity issues. Attention to treatment integrity, including training of behavior change agents, verification of intervention implementation, and verification of reception of the treatment, is sorely lacking. Psychological skill development and its relationship to performance improvements are rarely checked. Now that cognitive behavioral interventions appear to be reliably effective at posttreatment, we must have meaningful evaluation of maintenance of psychological skill and performance changes. Six-month, 12-month, and longer follow-up evaluations are necessary. We must also begin more detailed evaluations of these effective interventions.(ABSTRACT TRUNCATED AT 400 WORDS)
After a long history of both scientific and political debate, the notion that extreme psychological traumatic experiences, in and of themselves, could result in a severe, even malignant, psychiatric disorder is now established. In 1980 posttraumatic stress disorder finally became an officially classified anxiety disorder. Since then, the few controlled treatment outcome studies that have been carried out appear to indicate that the most effective treatment for PTSD is some form of exposure therapy. This is not surprising in light of the fact that several other types of anxiety disorders respond well to this form of behavioral treatment. However, PTSD may be more complex than the other types of anxiety disorders, especially with regard to the variety of symptoms involved. In its chronic form or in combat-related PTSD, no one type of treatment tested so far has been successful in reducing all the symptoms of the disorder. Psychophysiological overarousal to imaginal facsimiles of the traumatic event is especially difficult to influence with treatment. Identifying techniques that reduce or at least control this arousal will likely be grist for the research mill for many years. Theoretical and conceptual formulations regarding both the etiology and treatment of the disorder are in early stages of development. It is hoped that these efforts will eventually mature our understanding of the disorder as researchers explore important issues such as (1) predisposing factors; (2) how the nature and intensity of the stressor relates to the severity of the disorder; and (3) how biological, psychological, social, and cultural variables interact to result in PTSD and to either ameliorate or exacerbate its symptoms.
I. Theory, Research, and Clinical Methods 1. Overview of Cognitive-Behavioral Therapy of Personality Disorders, Daniel O. David & Arthur Freeman 2. Theory of Personality Disorders, Aaron T. Beck 3. Assessment of Personality Pathology, Jay C. Fournier 4. Neural Mechanisms of Maladaptive Schemas and Modes in Personality Disorders, Michael T. Treadway 5. General Principles and Specialized Techniques in Cognitive Therapy of Personality Disorders, Aaron T. Beck, Arthur Freeman, & Denise D. Davis 6. The Therapeutic Alliance with Patients with Personality Disorders, Denise D. Davis & Judith S. Beck 7. Diversity, Culture, and Personality Disorders, James L. Rebeta II. Clinical Applications 8. Dependent Personality Disorder, Lindsay Brauer & Mark A. Reinecke 9. Avoidant Personality Disorder, Christine A. Padesky & Judith S. Beck 10. Obsessive-Compulsive Personality Disorder, Karen M. Simon 11. Depressive Personality Disorder, David A. Clark & Catherine A. Hilchey 12. Paranoid, Schizotypal, and Schizoid Personality Disorders, Julia C. Renton & Pawel D. Mankiewicz 13. Passive-Aggressive Personality Disorder (Negativistic Personality Disorder), Gina M. Fusco 14. Narcissistic Personality Disorder, Wendy T. Behary & Denise D. Davis 15. Histrionic Personality Disorder, Mehmet Z. Sungur & Anil GA ndA z 16. Antisocial Personality Disorder, Damon Mitchell, Raymond Chip Tafrate, & Arthur Freeman 17. Borderline Personality Disorder, Arnoud Arntz III. Comorbidity and Clinical Management 18. Symptomatic Comorbidity, Robert A. DiTomasso & Bradley Rosenfield 19. Clinical Management: Working with Those Diagnosed with Personality Disorders, Gina M. Fusco 20. Synthesis and Prospects for the Future, Denise D. Davis & Arthur Freeman
The full participation of individuals with mental retardation in the community requires performance of newly acquired skills in novel circumstances and across the varying demands characteristic of life in the everyday world. For example, a person who has learned how to ride a bus may have to adapt to changes in scheduling, bus routes, or fares. Or an employee who has been taught by a coworker to make salads in a fast-food restaurant will need to continue to complete orders when the coworker no longer is present. Although skill generalization is an implicit educational goal, instructional strategies rarely are employed to influence the attainment of this goal (Haring & Laitinen, in press). Self-instruction is a strategy that has been effective in promoting the independent performance of people with mental retardation. Self-instruction provides individuals with the means for guiding their own behavior in novel situations not associated with training and after assistance has been withdrawn. For example, by using self-instruction, people with mental retardation have learned, among other skills, to sequence their tasks, increase their rate of production, and solve work-related problems. This chapter evaluated studies that investigated use of self-instruction among individuals with mental retardation in community settings. The focus of the review was on identification of factors relating to generalization across people, situations, tasks, and time. The combination of these factors suggests a model for promoting independent performance among individuals with mental retardation. This model combines self-instruction with teaching multiple exemplars and comprises the following six steps: (a) Select an array of examples (responses) an individual is likely to be required to perform in an environment (step 1); (b) classify responses into teaching sets based upon a functional analysis (step 2); (c) divide items of each set into responses that will serve as training examples and those that will serve as generalization probes (step 3); (d) teach trained examples using self-instruction (step 4); (e) evaluate effect of training on trained and untrained examples (i.e., generalization probes) as well as verbalized self-instructional statements (step 5); and (f) withdraw training based upon performance criteria while evaluating the effect of withdrawal (step 6). These steps represent the best practices for promoting independent performance of individuals with mental retardation in the community.
