Psychoeducational Program for Breast Cancer Patients: A Pilot Study

Cancer treatments adversely affect cognition in general and memory in particular. The current study focused on developing and investigating the feasibility and effectiveness of a group program for breast cancer survivors suffering from cognitive problems post cancer treatment. This intervention was designed to provide participants with specific memory and stress-reducing strategies. Three breast cancer survivors participated in this program, which included five 2-hour weekly sessions and one 1-hour follow-up session 1 month later. Assessment included self-report and objective measures. No statistical analyses were performed: all presented results are descriptive. The data hint that the intervention is associated with enhanced quality of life, satisfaction with memory abilities, and some increases in both the quality and quantity of effective memory and stress-reducing strategies of participants. Although the intervention is feasible, there were challenges to recruitment. Further research regarding content and delivery methods for cognitive interventions for breast cancer survivors is warranted

Resistance and Outcome Expectations in Cognitive-Behavioural Therapy for Generalized Anxiety Disorder

Higher levels of resistance have been consistently found to be negatively associated with outcome in psychotherapy. However, the pathways through which resistance impacts therapy outcomes are underexplored. Given that outcome expectations have been identified as an important common factor influencing therapy outcomes, the goals of the present study were to: (1) examine impact of resistance on client and therapist outcome expectations (COE & TOE respectively) (2) explore whether the impact of resistance on these expectations mediates the relationship between resistance and therapy outcome. These relationships were tested among 44 clients with severe generalized anxiety disorder treated with Cognitive Behavioral Therapy for severe generalized anxiety in the context of a randomized controlled trial (Westra, Constantino, & Antony, 2016). Resistance was measured for a midtreatment session and COE and TOE were assessed at baseline and immediately after the session at which resistance was measured. Treatment outcome was measured via client-rated worry severity at posttreatment. As predicted, higher resistance was associated with lower subsequent COE and TOE (B = - 0.73, p < .001 and B = - 0.46, p < .001, respectively). COE post resistance in turn predicted higher posttreatment worry (B = - 0.5, p < .001) indicating mediation; TOE in contrast was not found to mediate the relationship between resistance and outcome (B = - 0.02, p = .876). These results suggest that resistance is potentially demoralizing to both clients and therapists. But it is the lower morale of clients associated with resistance that is detrimental to therapy outcome. This study makes a contribution to understanding the influences on outcome expectations. The discussion will consider the importance of managing resistance as one strategy for maintaining positive expectations for therapy

Parental Report of Self and Child Worry During Acute Pain: A Critical Factor in Determining Parental Pain Judgment

Objective: The objective of this study was to determine which variables predict parental postvaccination pain ratings. It was hypothesized that after child behavior, parental sensitivity, and parental reports of worry would be the strongest predictors. Methods: Data for 215 parent-child dyads were analyzed from a longitudinal cohort at the preschool (4 to 5 y of age) vaccination. Preschoolers' pain behaviors 15 seconds, 1 minute 15 seconds, and 2 minutes 15 seconds after the painful immunization were observed and rated. Parental sensitivity, as well as parental own worry and their assessment of their child's worry, were assessed before and after the needle. Three regression models were used to determine the impact of these variables on parental pain assessment. Results: Preschoolers' pain behaviors moderately accounted for variance in parental pain judgment (R=0.23 to 0.28). Parental sensitivity was not a significant unique predictor of parental pain rating at the preschool age. Parental assessment of their own worry and worry about their preschoolers after the needle were critical contributors to parental pain judgment. Post hoc analyses suggest that parents who report low child worry, are more congruent with their child during regulatory phases postvaccination. However, both parents with high and low self-worry had more congruent pain ratings with child pain behavior scores during the reactivity phase. Discussion: The study suggests that the majority of variance in parent pain ratings was not predominantly based on preschoolers' pain behaviors. Parental worry levels and their assessment of their child's worry were also significant predictors. Clinical implications are discussed