Doing research on the effectiveness of psychotherapy and psychotherapy training: a person-centered/experiential perspective

In this article, we present a framework for selecting instruments for evaluating psychotherapy and psychotherapy training from a person-centered and experiential psychotherapy (PCEP) perspective. The protocol is divided into eight therapy measurement domains, consisting of four research themes (therapy outcome, therapy process, client predictors, training outcome) and two levels (general/pan-theoretical concepts vs. treatment specific/PCEP-oriented concepts). This research protocol provides recommendations about what to measure, encouraging collaboration across different training sites, while still allowing flexibility for individual centers. Minimum and systematic case study data collection designs are described: Minimum designs are appropriate for use in private practice settings with one's own clients; systematic case-study designs can be used for student case-presentation requirements or for publication. The framework and research protocols described are part of an emerging international research project involving private and public training centers in several countries

Unsupervised Context-Sensitive Spelling Correction of English and Dutch Clinical Free-Text with Word and Character N-Gram Embeddings

We present an unsupervised context-sensitive spelling correction method for clinical free-text that uses word and character n-gram embeddings. Our method generates misspelling replacement candidates and ranks them according to their semantic fit, by calculating a weighted cosine similarity between the vectorized representation of a candidate and the misspelling context. To tune the parameters of this model, we generate self-induced spelling error corpora. We perform our experiments for two languages. For English, we greatly outperform off-the-shelf spelling correction tools on a manually annotated MIMIC-III test set, and counter the frequency bias of a noisy channel model, showing that neural embeddings can be successfully exploited to improve upon the state-of-the-art. For Dutch, we also outperform an off-the-shelf spelling correction tool on manually annotated clinical records from the Antwerp University Hospital, but can offer no empirical evidence that our method counters the frequency bias of a noisy channel model in this case as well. However, both our context-sensitive model and our implementation of the noisy channel model obtain high scores on the test set, establishing a state-of-the-art for Dutch clinical spelling correction with the noisy channel model.Comment: Appears in volume 7 of the CLIN Journal, http://www.clinjournal.org/biblio/volum

Worrying and rumination are both associated with reduced cognitive control

Persistent negative thought is a hallmark feature of both major depressive disorder and generalized anxiety disorder. Despite its clinical significance, little is known about the underlying mechanisms of persistent negative thought. Recent studies suggest that reduced cognitive control might be an explanatory factor. We investigated the association between persistent negative thought and switching between internal representations in working memory, using the internal shift task (IST). The IST was administered to a group of undergraduates, classified as high-ruminators versus low-ruminators, or high-worriers versus low-worriers. Results showed that high-ruminators and high-worriers have more difficulties to switch between internal representations in working memory as opposed to low-ruminators and low-worriers. Importantly, results were only significant when the negative stimuli used in the IST reflected personally relevant worry themes for the participants. The results of this study indicate that rumination and worrying are both associated with reduced cognitive control for verbal information that is personally relevant

Attention, interpretation, and memory biases in subclinical depression: a path analysis approach to test the combined cognitive bias hypothesis

Emotional biases in attention, interpretation, and memory are viewed as important cognitive processes underlying symptoms of depression. To date, there is a limited understanding of the interplay among these processing biases. This study tested the dependence of memory on depression-related biases in attention and interpretation. Subclinically depressed and nondepressed participants completed a computerized version of the scrambled sentences test (measuring interpretation bias) while their eye movements were recorded (measuring attention bias). This task was followed by an incidental free recall test of previously constructed interpretations (measuring memory bias). Path analysis revealed a good fit for the model in which selective orienting of attention was associated with interpretation bias, which in turn was associated with a congruent bias in memory. Also, a good fit was observed for a path model in which biases in the maintenance of attention and interpretation were associated with memory bias. Both path models attained a superior fit compared with path models without the theorized functional relations among processing biases. These findings enhance understanding of how mechanisms of attention and interpretation regulate what is remembered. As such, they offer support for the combined cognitive biases hypothesis or the notion that emotionally biased cognitive processes are not isolated mechanisms but instead influence each other. Implications for theoretical models and emotion regulation across the spectrum of depressive symptoms are discussed

Bridging the gap between therapy research and practice in a person-centered/experiential therapy training program : the Leuven systematic case study research protocol

The goal of the Leuven Systematic Case Study Research Protocol project is to stimulate practice-oriented research in order to bridge the gap between research and practice. In this article we give a progress report of the project, in which a set of Dutch-language research instruments was created and tested with postgraduate trainees in person-centered/experiential therapy at the University Leuven (Belgium). We begin by presenting the general framework for the protocol, including the three major domains of therapy process, therapy outcome, and client/therapist characteristics. Then we give an overview of the quantitative and qualitative instruments used. We explain how the project has been implemented in the postgraduate program. To evaluate the success of the project, we analyzed the answers of our trainees on a questionnaire. We give an overview of the clinical cases involved and the variety of research questions that have been formulated in the individual case studies. Finally we discuss the value of this pilot project

An overview of decision table literature 1982-1995.

This report gives an overview of the literature on decision tables over the past 15 years. As much as possible, for each reference, an author supplied abstract, a number of keywords and a classification are provided. In some cases own comments are added. The purpose of these comments is to show where, how and why decision tables are used. The literature is classified according to application area, theoretical versus practical character, year of publication, country or origin (not necessarily country of publication) and the language of the document. After a description of the scope of the interview, classification results and the classification by topic are presented. The main body of the paper is the ordered list of publications with abstract, classification and comments.

Characterizing intonation deficit in motor speech disorders : an autosegmental-metrical analysis of spontaneous speech in hypokinetic dysarthria, ataxic dysarthria and foreign accent syndrome

The autosegmental-metrical (AM) framework represents an established methodology for intonational analysis in unimpaired speaker populations but has found little application in describing intonation in motor speech disorders (MSDs). This study compared the intonation patterns of unimpaired participants (CON) and those with Parkinson's disease (PD), ataxic dysarthria (AT), and foreign accent syndrome (FAS) to evaluate the approach's potential for distinguishing types of MSDs from each other and from unimpaired speech. Spontaneous speech from 8 PD, 8 AT, 4 FAS, and 10 CON speakers were analyzed in relation to inventory and prevalence of pitch patterns, accentuation, and phrasing. Acoustic-phonetic baseline measures (maximum-phonation-duration, speech rate, and F0-variability) were also performed. Results: The analyses yielded differences between MSD and CON groups and between the clinical groups in regard to prevalence, accentuation, and phrasing. AT and FAS speakers used more rising and high pitch accents than PD and CON speakers. The AT group used the highest number of pitch accents per phrase, and all 3 MSD groups produced significantly shorter phrases than the CON group. The study succeeded in differentiating MSDs on the basis of intonational performances by using the AM approach, thus, demonstrating its potential for charting intonational profiles in clinical populations

Training working memory to reduce rumination

Cognitive symptoms of depression, such as rumination, have shown to be associated with deficits in working memory functioning. More precisely, the capacity to expel irrelevant negative information from working memory seems to be affected. Even though these associations have repeatedly been demonstrated, the nature and causal direction of this association is still unclear. Therefore, within an experimental design, we tried to manipulate working memory functioning of participants with heightened rumination scores in two similar experiments (n = 72 and n = 45) using a six day working memory training compared to active and passive control groups. Subsequently the effects on the processing of non-emotional and emotional information in working memory were monitored. In both experiments, performance during the training task significantly increased, but this performance gain did not transfer to the outcome working memory tasks or rumination and depression measures. Possible explanations for the failure to find transfer effects are discussed