the Behavior Therapist - ABCT Association for Behavioral and

Summer II � 2003 301

the Behavior Therapist

ISSN 0278-8403

Volume 26, No. 5, Summer II, 2003

C O N T E N T SOPEN FORUM

Employee Assistance Programs: Opportunities for Behavior Therapists . . . . . . . . . . . . . . . . . . . 301

Derek R. Hopko and Sandra D. Hopko

Dependence on Alternative Medicine: Features, Mechanisms, and Treatment Strategies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 305

Shunsuke Kanahara

Behavior Therapy in Correctional Settings: Fertile Ground or Quicksand? . . . . . . . . . . . . . . . . . 308

Stephen E. Wong and Stephanie T. Wong

To Thine Own Self Be True . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 309Frank M. Dattilio

LIGHTER SIDEA Modest Proposal for a New Diagnostic Classification: Intrinsic Motivation Deficit Disorder (IMDD) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 310

David Reitman

19TH ANNUAL BOOKSELLING CATALOG . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .312

PROFESSIONAL AND LEGISLATIVE ISSUES . . . . . . . . . . . . . . . . . . . . . . . 322

Saul D. Raw

LETTERS TO THE EDITORWhat’s in a Name? Everything! . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .325

Kenneth D. Salzwedel

Yes, You Can Call Yourself a Real Doctor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .325

Barry A. Bass

Reno Re-Revisited . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .325

Barbara Parry

Response to Bobicz and Richard (2003) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .326

Barbara O. Rothbaum

In Response to Dr. Rothbaum’s Critique . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .326

David C. S. Richard

CLASSIFIEDS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 327

The Association for Advancement of BehaviorTherapy publishes the Behavior Therapist as a ser-vice to its membership. Eight issues are publishedannually. The purpose is to provide a vehicle forthe rapid dissemination of news, recent advances,and innovative applications in behavior therapy.

Feature articles that are approximately 16 double-spaced manuscript pages may be submitted. Brief

articles, approximately 6 to 12 double-spacedmanuscript pages, are preferred. Feature arti-

cles and brief articles should be accompanied by a75- to 100-word abstract. Letters to the Editor

may be used to respond to articles published in the

Behavior Therapist or to voice a professional opin-ion. Letters should be limited to approximately 3double-spaced manuscript pages. Please contact

the Editor or any of the Associate Editors for guid-ance prior to submitting series, special issues, orother unique formats. All submissions should be intriplicate and formatted according to thePublication Manual of the American Psychological

Association, 5th edition. Prior to publication, au-thors will be asked to provide a 3.5” diskette con-taining a file copy of the final version of theirmanuscript. Authors submitting materials to the

Behavior Therapist do so with the understandingthat the copyright of published materials shall beassigned exclusively to the Association forAdvancement of Behavior Therapy. Please submit

materials to the attention of the Editor: George F.Ronan, Ph.D., Department of Psychology, CentralMichigan University, Mount Pleasant, MI 48859.

INSTRUCTIONS FOR AUTHORS

Open Forum

Employee AssistancePrograms:Opportunities forBehavior Therapists

Derek R. Hopko, University of Tennessee,and Sandra D. Hopko, Covenant BehavioralHealth Employee Assistance Program

During the course of informal discussionswith colleagues and friends at the most re-cent AABT conference, we were intrigued

to discover that a significant majority of our ac-quaintances were unfamiliar with the term EAP(Employee Assistance Program). This unawarenesswas particularly concerning given the increasingprominence of EAPs as a primary context for mentalhealth services and the potential significance ofEAPs for behavioral therapy and research (Oher,1999; Van Den Bergh, 2000). A literature searchwas conducted using PsycINFO (1967 to the pre-sent) to better understand how information onEAPs has been disseminated to behaviorally ori-ented clinicians. Although over 400 citations madereference to EAPs, not a single record explicitly in-cluded the term “behavior therapy” and none of thereferenced articles were published in prominent be-havioral journals such as the Behavior Therapist,Behavior Therapy, Behavior Modification, or Cognitive

and Behavioral Practice. Given the many training,practice, and research opportunities availablewithin the context of EAPs, this article briefly high-lights the history and functions of EAPs and illus-trates how behavior therapists might benefit fromincreased awareness of these programs and collabo-ration with EAP personnel.

Employee Assistance Program Services

The development of EAPs began in the late1930s with the formation of occupational alcohol

19TH ANNUAL BOOKSELLING CATALOGINSIDE:

302 the Behavior Therapist

the Behavior TherapistPublished by the Association for

Advancement of Behavior Therapy

305 Seventh Avenue - 16th Floor

New York, NY 10001-6008

(212) 647-1890 /Fax: (212) 647-1865

www.aabt.org

EDITOR · · · · · · · · · · · George F. Ronan

Editorial Assistant · · · · · · · · Jennifer Slezak

Behavior Assessment · · · · · · John P. Forsyth

Book Reviews · · · · · · · · · · Kurt H. Dermen

Clinical Forum · · · · · · · · · James D. Herbert

Dialogues · · · · · · · · Christine Maguth Nezu

Dissemination· · · · · · · Michael A. Tompkins

Institutional Settings · · · · · · · · · · · Tamara Penix Sbraga

International Scene · · · · Fugen A. Neziroglu

Lighter Side· · · · · · · · · · · Donna M. Ronan

Professional Issues · · · · · · · · · Saul D. Raw

Research-Practice Link · · · · · · · · · · · · · · · · · David J. Hansen

Research-Training Link · · · · · · · · · · · · · · · · Gayle Y. Iwamasa

Science Forum· · · · · · · · · · · Jeffrey M. Lohr

Special Interest Groups · · · · · · · · · · Andrea Seidner Burling

Student Forum· · · · · · · · · · · Kelly McClure

AABT

President · · · · · · · · · · · Jacqueline B. Persons

Executive Director · · · · · · Mary Jane Eimer

Director of Publications· · · · · David Teisler

Managing Editor · · · · · · Stephanie Schwartz

Projects Manager · · · · · · · Patience Newman

Copyright © 2003 by the Association forAdvancement of Behavior Therapy. All rightsreserved. No part of this publication may bereproduced or transmitted in any form, or byany means, electronic or mechanical, includingphotocopy, recording, or any information stor-age and retrieval system, without permissionin writing from the copyright owner.

Subscription information: the Behavior

Therapist is published in 8 issues per year. It is provided free to AABT members.Nonmember subscriptions are available at$38.00 per year (+$17.00 surface postage or+$32.00 airmail postage outside USA).

Change of address: 6 to 8 weeks are requiredfor address changes. Send both old and newaddresses to the AABT office.

All items published in the Behavior Therapist,including advertisements, are for the informa-tion of our readers, and publication does notimply endorsement by the Association.

programs. This movement largely was in-fluenced by the founding of AlcoholicsAnonymous and involved the utilization ofrecovering alcoholics to provide assistanceand support to employees with similarproblems. In the course of a decade, a num-ber of organizations, most notably EastmanKodak and du Pont, recognized the poten-tial benefits of these programs in increasingwork productivity and improving employeequality of life. Informal assessment prac-tices and peer intervention slowly came tobe replaced by a more formalized systemthat included structured utilization of men-tal health professionals. The evolution ofEAPs continues, largely as a function of eco-nomic benefits achieved through decreasedabsenteeism and increased productivity. Infact, companies that utilize EAP serviceshave a 75% reduction in inpatient sub-stance abuse treatment costs, report 17%fewer accidents, 35% reduced turnover,21% lower absenteeism, and 14% higherproductivity (Rouse, 1995).

The organization of the Association ofLabor and Management Administratorsand Consultants on Alcoholism (AL-MACA) was formed in 1974 and was re-named the Employee AssistanceProfessionals Association (EAPA) in 1989.EAPA currently is the primary governingagency over EAP development and con-duct, the primary functions of which are todisseminate and enhance EAP knowledge,publish program standards to serve asguidelines for establishing EAPs (EAPA,1990), and credential employee assistanceprofessionals through the EmployeeAssistance Certification Commission(Bickerton, 1990). Numerous EAPs havebeen established within large businessesand federal organizations, including theUnited States Postal Service and the FederalBureau of Investigations (Kurutz, Johnson,& Sugden, 1996; McNally, 1999). Manysmaller businesses also frequently contractfor EAP services.

The function of EAPs has changed dra-matically over the years. Early EAPs gener-ally were sequestered within organizationalstructures and functioned on an assess-ment- and referral-based model (Van DenBergh, 2000). Over the past few decades,EAPs have expanded their focus to encom-pass case management and interventionservices that include ongoing assessment,crisis management (e.g., critical incidentstress debriefing), and brief psychotherapy(Oher, 1999; Summerall, Israel, Brewer, &Prew, 1999). In this capacity, master- anddoctoral-level EAP clinicians assist employ-ees with various mental health problems

that include depression, anxiety, substanceabuse and dependence, as well as family andrelationship problems. Among employeesseeking EAP services, as many as 55% to75% report significant problems with de-pression and anxiety (Fenrich, 2001;Poverny & Dodd, 2000) and approximately40% report significant impairment associ-ated with alcohol misuse (Thomas &Johnson, 1994). Perhaps more specific tothe EAP environment as compared withconventional practice, clinicians also fre-quently address issues of job stress, organi-zational layoffs, preretirement planning,and work addiction (Csiernik, Atkinson,Cooper, Devereux, & Young, 2001;Perkins, 2000; Robinson, 1997; Worster,2000). Importantly, employees who utilizeEAPs generally report moderate to highlevels of satisfaction with patient services(Leong & Every, 1997; Macdonald, Wells,Lothian, & Shain, 2000), and there arestrong indications that EAPs allocate toppriority to maintaining ethical and profes-sional standards (Chima, 1999; Emener &Hutchison, 1997). The increasing societalsignificance of EAP settings as a context formental health treatment, the diversity ofpatients and problems typically foundwithin these programs (Chima), and thepaucity of systematic treatment outcomeresearch conducted in this context makeEAPs an ideal environment in which behav-iorists may experience unique training op-portunities, engage in clinical practice, andconduct socially significant scientific re-search.

Opportunities for Behaviorists in EAPs

The importance of EAP programs to behavioral academicians and clinicians has,for the most part, been unrecognized.However, there are several reasons acade-mic training programs, practitioners, andresearchers might benefit from becomingmore aware of these programs and theirfunctions. First, establishing practicum op-portunities via communicative efforts withEAP staff and management may greatly en-hance clinical training programs. In addi-tion to increasing the availability ofpracticum sites, which is a significant con-cern in many training programs, studentscould be exposed to individuals with a greatbreadth of presenting problems, many ofwhich may be specific to the working envi-ronment. The specificity of these problemsto the EAP context would allow for richerclinical experiences and enhanced profes-sional development. Additional educational


terviewing in reducing drinking frequencyand improving job performance (Schneider,Casey, & Kohn, 2000), skill development infacilitating anger management (Bayer,1998), and modified rational emotive ther-apy for treating relational problems(Morris, 1992). Internal and external valid-ity of these studies is limited by method-ological shortcomings, however, and a moresystematic research program clearly is re-quired to assess the potential utility of be-havioral therapies within EAPs. Researchopportunities also may extend beyondtreatment outcome projects. For example,many EAPs accumulate extensive demo-graphic, self-report, and behavioral obser-vation data on employees. Establishingpsychometric properties of such measuresand the generalizability of commonly usedassessment instruments to the EAP settingwould be a worthwhile endeavor.Additionally, the EAP environment wouldprovide students with numerous opportuni-ties to formulate important research ques-tions and designs, perhaps extending tothesis and dissertation projects.

In closing, behavior therapists are in aunique position to contribute to the func-tioning of EAPs as well as benefit from prac-tice and research opportunities available inthis setting. This relationship is a symbioticone, however, as EAPs also could garnerbenefits from such partnerships. For exam-ple, behavioral practitioners, students, andresearchers could help to disseminate cur-rent knowledge into EAP programs to helpcounselors stay current with the latest de-velopments in assessment practices and em-pirically validated treatments, bridging thetypically wide gap between research andcommunity clinical practice. EAP personnelalso could look toward academicians forguidance in developing research designs toaddress questions related to program evalu-ation, epidemiology of psychiatric disor-ders, and other issues of interest to the EAP.EAPs are an increasingly prominent modeof mental health care. Recognizing theseprograms and establishing collaborative re-lationships could benefit both the programsthemselves and broaden opportunities forbehavioral scientists and practitioners.

References

Bayer, D. L. (1998). Brief anger-managementtherapy. Employee Assistance Quarterly, 14, 67-74.

Bickerton, R. L. (1990). Employee assistance: A history in progress. EAP Digest (No-vember/December), 34.

Cherbosque, J., & Italiane, F. L. (1999). The use ofbiofeedback as a tool in providing relaxationtraining in an employee assistance programsetting. Employee Assistance Quarterly, 15, 63-79.

Chima, F. O. (1999). Employee assistance rolesin managing workplace diversity. Employee

Assistance Quarterly, 15, 61-76.

CONSAD Research Program. (1999). Employee

assistance program handbook. Pittsburgh:CONSAD Research Corporation.

Csiernik, R., Atkinson, B., Cooper, R.,Devereux, J., & Young, M. (2001). An exam-ination of a combined internal-external em-ployee assistance program: The St. Joseph’sHealth Centre Employee CounsellingService. Employee Assistance Quarterly, 16, 37-48.

Emener, W. G., & Hutchison, W. S. (1997).Professional, ethical, and program develop-ments in employee assistance programs. InW. S. Hutchison & W. G., Emener (Eds.),Employee assistance programs: A basic text (2nded., pp. 330-351). Springfield, IL: Charles C.Thomas.

Employee Assistance Professional Association,Inc. (1990). EA program standards. Arlington,VA: Author.

Fenrich, E. W. (2001). Impact of anxiety and depres-

sion of work-related problems and advancing in-

tervention and prevention strategies for E.A.P.S.Unpublished doctoral dissertation,American University.

Kurutz, J. G., Johnson, D. L., & Sugden, B. W.(1996). The United States Postal ServiceEmployee Assistance Program: A multifac-eted approach to workplace violence preven-tion. In G. R. VandenBos & E. Q. Bulatao(Eds.), Violence on the job: Identifying risks and

developing solutions (pp. 343-352).Washington, DC: American PsychologicalAssociation.

Leong, D. M., & Every, D. K. (1997). Internaland external EAPs: Is one better than theother? Employee Assistance Quarterly, 12, 47-62.

Macdonald, S., Wells, S., Lothian, S., & Shain,M. (2000). Absenteeism and other work-place indicators of employee assistance pro-gram clients and matched controls. Employee


McNally, V. J. (1999). FBI’s EmployeeAssistance Program: An advanced law en-forcement model. International Journal of

Emergency Mental Health, 1, 109-114.

Morris, G. B. (1992). R.A.D.A.R.: A five-sessionapproach for referrals of employee assistanceprograms. Journal of Cognitive Psychotherapy, 6,259-276.

Oher, J. M. (1999). The Employee Assistance hand-

book. New York: John Wiley.

Perkins, K. (2000). EAP services to older adultsin the workplace: A strengths perspective.Employee Assistance Quarterly, 16, 53-75.

Poverny, L. M., & Dodd, S. J. (2000). Differentialpatterns of EAP service utilization: A nineyear follow-up study of faculty and staff.Employee Assistance Quarterly, 15, 29-42.

Robinson, B. E. (1997). Work addiction:Implications for EAP counseling and re-search. Employee Assistance Quarterly, 12, 1-13.

Rouse, B. A. (1995). Substance abuse and mental

health statistics sourcebook. DHHS Pub. No.95-3064. Washington, DC: U.S.Government Printing Office.

Schneider, R. J., Casey, J., & Kohn, R. (2000).Motivational versus confrontational inter-viewing: A comparison of substance abuseassessment practices at employee assistanceprograms. Journal of Behavioral Health Services

and Research, 27, 60-74.

Summerall, S. W., Israel, A. R., Brewer, R., &Prew, R. E. (1999). The role of employee as-sistance programs in the era of rapid changein the health care delivery system.International Journal of Emergency Mental

Health, 1, 251-252.

Thomas, J. C., & Johnson, N. P. (1994). Alcoholproblems of employee assistance programpopulations. Employee Assistance Quarterly, 10,13-23.

Van Den Bergh, N. (2000). Where have webeen?…Where are we going?: Employee as-sistance practice in the 21st century. Employee


Worster, D. (2000). An EAP approach to man-aging organizational downsizing. Employee

Assistance Quarterly, 16, 97-115. �

REPRESENTATIVE-AT-LARGE(2003-2006)

Anne Marie Albano

PRESIDENT-ELECT(2003-2004)

J. Gayle Beck

SECRETARY-TREASURER(2004-2007)

Frank Andrasik

AABT Election Results

B Y L A W S R E V I S I O N S A C C E P T E D


Many individuals prefer alternativemedicine to conventional, evi-dence-based medicine (Giddens,

2001). Such individuals hope to (a) providetheir own care (Cassileth, 1998/2000), (b) avoid experiencing side effects or mal-practice from evidence-based medicine(Bratman, 1997), or (c) enact some kind ofmiraculous improvement of their problems(Weil, 1995/1998). In the present article,the term “alternative medicine” indicatesany therapies, foods, activities, and medica-tions that are not deeply enmeshed intoday’s evidence-based medicine and inwhich personal expectations play a moreimportant role than empirical evidence re-garding effectiveness. Examples of alterna-tive medicine include acupuncture, herbs,magnetic field therapy, nutritional supple-ments, homeopathy, therapeutic touch, andso forth (The Burton Goldberg Group,1994). The variety of alternative medicinesthat exist around the world is countless.Types of alternative medicine differ fromculture to culture. Additionally, some thera-pies, activities, and medications have beenregarded either as alternative medicine or asevidence-based medicine, depending on theperiod in history in which they exist.

Such stressors as loss, disease, deterio-ration of appearance, and aging may be-come incentives for using alternativemedicine, and some individuals may be-come dependent on alternative medicines.Dependence on alternative medicine can bedefined as behavior in which individualsspend great amounts of time and money onuse and acquisition, and possess an inordi-nate belief in the medicine. AlthoughNakamura (2001) stated that 42% ofAmericans had experienced alternativemedicine in 1997 and Giddens (2001) esti-mated that as many as one in four Britonshad consulted an alternative practitioner,because of the scarcity of research data, thenumber or proportion of individuals depen-dent on alternative medicine is unknown.

Characteristics

According to Giddens (2001), the typi-cal profile of a user of alternative medicine isa young to middle-aged middle-class fe-male. The illustrative characteristics ofthose who are dependent on alternativemedicine are as follows. Some dependentindividuals hesitate to take evidence-basedmedications or even refuse to visit hospitals;other dependent individuals are comfort-able utilizing both alternative and evidence-based medicines (Giddens). Some cling to aparticular alternative medicine while otherskeep changing among a variety of alterna-tive medicines. Some dependent individualshave been criticized for their dependent be-havior by nondependent individuals. Onthe other hand, for other dependent indi-

viduals, even close family members andfriends may not know that their significantothers are dependent on alternative medi-cine. Those dependent individuals who aremore active may have tried to involve othersin using alternative medicine.

Profile of Ms. A

Ms. A is an unemployed 39-year-old sin-gle mother with one child. Though hermain income is a limited sum of govern-ment assistance for low-income individuals,she continues to purchase expensive nutri-tional supplements and herbal cosmetics.She likes to read magazine articles aboutnew alternative products. As there are agreat many of such products, she spends hertime looking for better and more interest-ing ones. She often does this almost all dayinstead of doing housework or trying to finda job.

Ms. A eats mostly expensive organicfoods. She takes citric acid three times a dayto enhance her appearance. At the sametime, she takes condoroitin made fromshark bones to prevent backache and sev-eral different vitamins, chlorella, and royaljelly to improve her physical condition.

Recently, she has been wearing a neck-lace made of tourmaline stones, which is

Open Forum

Dependence on Alternative Medicine:Features, Mechanisms, and TreatmentStrategies

Shunsuke Kanahara, Nagasaki Wesleyan University


supposed to improve her health. When shetakes a bath, she pours a liquid made frombamboo charcoal into the bath water. Thisis because she believes that the liquid cansmooth her skin. She applies Chinese oint-ments to her face before sleep. In bed, sheuses a magnetic pillow, but she cannot re-member the reason why she started using it.

Profile of Mr. B

Mr. B, a 72-year-old male, is retired andlives with his wife. His current concern istea. He buys and drinks teas that are as-sumed to contain plenty of vitamins, miner-als, and other nutrients that have not evenbeen proven to exist. His purpose in doingthis is to avoid senile dementia. He believesthat tea made from ginkgo leaves is espe-cially helpful in preventing the disorder. Hedrinks persimmon and rooibos teas, too.When he goes out, he takes with him a bigcanteen filled with his tea. Right before it isempty, he rushes back home.

Mr. B bought small globular stonesmeant to be played with by the fingers. Insome cultures, this activity is believed tomaintain memory. He does this when he hastime for it, and the sound of the stones hit-ting together are rather noisy. One day, hiswife could not help complaining about thenoise. He ignored her.

The kitchen utilities in his home are alliron or stainless steel. He has read of thepossibility that aluminum may contributeto Alzheimer’s disease. Consequently, he ex-changed all the aluminum goods for nona-luminum ones. His wife was unsuccessful instopping this. What he does not do to pro-tect his brain function is to visit a physicianspecializing in geriatrics in order to obtainadvice.

Explanations

Dependence on alternative medicine canbe explained through various viewpoints,such as mental health disorders noted in thefourth edition of the Diagnostic and

Statistical Manual of Mental Disorders (DSM-

IV; American Psychiatric Association,1994), and psychological and behavioralmechanisms. The viewpoints shown beloware not necessarily exclusive to each other.

DSM Views

Dependence on alternative medicine fitsone of the DSM viewpoints: obsessive-com-pulsive disorder with or without poor in-sight. Some individuals who are dependentmay find that their tendencies are annoyingto themselves or others and may attempt tosuppress such tendencies. They are usually

not successful and become uneasy when notbehaving according to their obsessive-com-pulsive desires.

Second, symptoms from hypochondria-sis with or without poor insight (APA,1994) may be related to the dependence.Hypochondriac individuals are preoccupiedwith fears of having, or the idea that theymight contract, a serious disease. Therefore,they may try to recover from or prevent the disease with the help of any means, in-cluding alternative medicine. For example,a hypochondriac may eat excessive amountsof certain mushrooms that are anecdotallysaid to be beneficial in curing cancer.

Third, it is possible that some individu-als dependent on alternative medicines sufferfrom delusional disorder. A delusion is a be-lief that is maintained despite argument,data, and sufficient refutation that wouldotherwise extinguish the belief (Reber,1995). Dependent individuals may persistin using alternative medicines regardless ofthe fact that many of such medicines havevery weak or no research evidence to sup-port their efficacy.

Finally, alternative-medicine depen-dence can result in noncompliance with tra-ditional treatment. Individuals who havecome to be dependent on alternative medi-cine tend to lose respect for and interest inevidence-based medicine (Giddens, 2001).Some may visit hospitals but subsequentlyfail to take the medications prescribed.Usually, doctors do not know about this.Other dependent individuals may decline tovisit conventional medical facilities alto-gether.

Psychological Views

Dependence as discussed in the contextof this article is not considered pathological.Rather, it should be seen as more ordinarybehavior which is grasped psychologically.

First of all, functional autonomy, an ideaintroduced by Allport (1937), can be usefulin understanding dependence on alterna-tive medicine. This idea indicates thathuman behaviors can become independentof the needs on which they were originallybased (Goranson, 1994): “Allport gave theexample of a man who first worked as asailor just to earn his living, and who thendeveloped a love for sailing that persistedyears later, even after he had becomewealthy and had no material need to con-tinue sailing” (p. 44). This raises the possi-bility that motives can function quiteindependently of any physiological need ordrive, as can dependence on alternativemedicine.

Second, some dependent individualstend not to scrutinize the results of theusage of alternative medicine because theydo not want to recognize the possibility thattheir behavior is meaningless. The theory ofcognitive dissonance (Festinger, 1957) canbe a tool to explain this tendency. The the-ory points out that humans are motivatedto maintain consistency among pairs of rele-vant cognitions, where a cognition refers toany knowledge or belief about self, behav-ior, or the environment. Because they hopeto continue believing in alternative medi-cine and in their behaviors regarding themedicine, dependent individuals may ig-nore the fact that the effect from alternativemedicine is less than they had expected.

Finally, although all alternative medi-cine is not always ineffective, most of themare questionable (Park, 2000/2001).Irrespective of that fact, even questionablealternative medicine can show a positivechange. When an inert substance is giveninstead of a potent drug, this substance iscalled a placebo. According to Chernow andVallasi (1993), “Placebo medications aresometimes prescribed when no drug is re-ally needed because they make patients feelwell taken care of ” (p. 2162). Placebo ef-fects occur when many individuals experi-ence some positive effect from a certainalternative medicine. Interestingly, whileCassileth (1998/2000) introduced outcomestudies that indicated that some alternativemedicines (e.g., acupuncture or biofeed-back) are effective, Sampson (1998) arguedthe possibility of the placebo effect usingacupuncture as an example.

Behavioral Views

In addition to the above psychologicalexplanations, there are more specific behav-ioral mechanisms working in alternative-medicine dependence. First, the dependenceis understood as the consequence of operantconditioning. Reinforcers may be apprecia-tion from others, such as “You look great!”and “You look different,” or the user’s real-ization that he or she feels somewhat betterthan before. Individuals show more inclina-tion to alternative medicine as a result ofsuch reinforcers.

Another reinforcer may be the user’s ex-pectation of future improvement. Thisprocess is explained through the Premackprinciple in which a higher-probability behavior serves as a reinforcer for a lower-probability behavior (Spiegler & Guev-remont, 1993). For instance, when a personeats rye bread in spite of the fact that theperson does not enjoy its taste, he or she


may maintain this behavior because of theexpectation that the rye bread will enrichthe person’s health in the future.

Self-reinforcement (Kratochwill, 1985/1987), which is as efficient as other forms ofreinforcement, can also be a possible keyfactor in understanding the dependence:

Improvement sometimes is simply aresult of heightened morale, whichenables a person to function better inspite of a medical handicap. Peoplewho are “cured” by faith healers andquacks tend to be those who aremore accepting than analytical.(Wedding, 1995, p. 439)

Some individuals have self-reinforced inrelation to alternative medicine and mayhave done it too strongly.

Observational learning (Bandura, 1969)may be a way to understand the reason whycertain individuals start relying on alterna-tive medicine. Such individuals may havefamily members, friends, or other modelswho have positively experienced alternativemedicine and have been enthusiastic aboutit. That is, if an individual is surrounded bythose who believe in and actually use horseoil for a burn, the person may show thesame behavior when he or she gets burned.

Behavioral Interventions

Modifying dependence on alternativemedicine can be difficult because individu-als with such dependence are not usuallymotivated to change their behaviors.Dependent individuals rarely visit thera-pists. Even if they are in a therapy session,their presenting problems can have nothingto do with the dependence on alternativemedicine. As therapy progresses, the de-pendence may eventually become obvious.Nevertheless, getting the individual toagree to modify his or her behavior can bedifficult.

When intervening, target behaviors willbe both overt and covert. Cognitive restruc-turing (Last, 1985/1987) regarding theclient’s way of thinking, especially his or herway of understanding health or appearance,can be the first step in treatment. For in-stance, a dependent client may need to real-ize that deterioration of physical strength asa result of age is a natural event. Anotherclient may need to be challenged regardinghis or her tendency to believe in somethingdespite a lack of rational reason to believe it.

Second, reducing the quantity of alter-native medicine and/or the amount of hoursspent thinking about, looking for, andusing alternative medicine can be targeted,

then decreased gradually. For example, atherapist can help the client decrease his orher use of alternative products from 10 to 9products per day. After the accomplishmentof this goal, it can be suggested that theclient use 8 products.

Differential reinforcement of other be-haviors (Deitz, 1985/1987) can be com-bined. This technique encourages andreinforces more of the dependent client’s ac-ceptable behavior, such as getting enoughsleep, avoiding fast food, doing appropriateexercise, or reducing the number of ciga-rettes. Because these behaviors are health-ful, the technique allows the client to feelless distressed when he or she is working onreducing the amount of alternative prod-ucts or activities.

Finally, exposure (Marshall, 1985/1987)to real stimuli and/or imagined stimuli canbe considered. Under this technique, a de-pendent client is advised to live with feweror no alternative medicines. For example, aclient will try to stay away from any activityrelated to Ayurveda, contrary to his or herdesire. In the beginning, it will be hard forthe client to endure this. Gradually, theclient will become accustomed to the situa-tion and will realize that his or her life withfewer or no alternative medicines is not nec-essarily hazardous.

Conclusion

Alternative medicine is generally consid-ered to be harmless, and using the medicineis not regarded as a mental disorder or aproblem. However, whether or not theusage of the medicine is considered patho-logical, research suggests that undesirableconsequences can take place in some usersunder some circumstances (O’Mathna,1998). For instance, one study found that48% of transcendental meditation practi-tioners reported adverse effects from themeditation, such as depression, confusion,and inexplicable outbursts of antisocial be-havior, even though meditation is believedto be safe and to have no side effects (Otis,Shapiro, & Walsh, 1984). More generally,use of alternative medicine may compro-mise one’s physical condition. In the case ofcontinued abuse of alternative medicine,the application of evidence-based medicinemay be delayed (Jilek, 1993). Furthermore,it is possible that the dependence may leadsome individuals to another mental prob-lem like an eating disorder. Dependence onalternative medicine can also be a sign ofother dependencies, such as on nicotine, al-cohol, or gambling, that are similarlythought serious or life-threatening. Thus,

understanding dependence on alternativemedicine and preparing effective treatmentregarding this dependence are necessary toassist the individuals concerned.

References

Allport, G. W. (1937). The functional autonomyof motives. American Journal of Psychology, 50,141-156.

American Psychiatric Association. (1994).Diagnostic and statistical manual of mental disor-

ders (4th ed.). Washington, DC: Author.

Bandura, A. (1969). Principles of behavior modifica-

tion. New York: Holt, Rinehart & Winston.

Bratman, S. (1997). Beat depression with St. John’s

wort. Roseville, CA: Prima Publishing.

Cassileth, B. R. (2000). Daitai iryo guidebook [Thealternative medicine handbook: The com-plete reference guide to alternative and com-plementary therapies]. Tokyo: Shunju-sha.(Original work published 1998).

Chernow, B. A., & Vallasi, G. A. (Eds.). (1993).The Columbia Encyclopedia (5th ed.). NewYork: Columbia University Press.

Deitz, S. M. (1985). Ta-koudou bunka kyouka[Differential reinforcement of other behav-iors]. In A. S. Bellack, & M. Hersen (Eds.),Kodo-ryoho jiten [Dictionary of behavior ther-apy techniques] (pp. 100-102). Tokyo:Iwasaki gakujutsu syuppansya.

Festinger, L. (1957). A theory of cognitive disso-

nance. Stanford, CA: Stanford UniversityPress.

Giddens, A. (2001). Sociology (4th ed.).Cambridge, England: Polity.

Goranson, R. E. (1994), Functional autonomy.In R. J. Corsini (Ed.), Encyclopedia of psychology

(2nd ed., pp. 44-45). New York: John Wiley& Sons.

Jilek, W. G. (1993). Traditional medicine rele-vant to psychiatry. In N. Sartorius, G. D.Girolamo, G. Andrews, G. A. German, & L.Eisenberg (Eds.), Treatment of mental disorders:

A review of effectiveness (pp. 341-383).Washington, DC: American PsychiatricPress.

Last, C. G. (1985). Ninchiteki saikouseihou[Cognitive restructuring]. In A. S. Bellack &M. Hersen (Eds.), Kodo-ryoho jiten

[Dictionary of behavior therapy techniques](pp. 53-54). Tokyo: Iwasaki gakujutsu syup-pansya.

Marshall, W. L. (1985). Exposure. In A. S.Bellack & M. Hersen (Eds.), Kodo-ryoho jiten

[Dictionary of behavior therapy techniques](pp. 111-114). Tokyo: Iwasaki gakujutsusyuppansya.

Nakamura, H. (2001). Daitai iryo [Alternativemedicine]. 2001 Encyclopedia of contemporary

words (pp. 1048-1049). Tokyo: Jiyukokumin-sha.

O’Mathna, D. P. (1998). Therapeutic touch:What could be the harm? The Scientific Review


of Alternative Medicine. Retrieved May 5, 2002, from http://www.hcrc.org/contrib/omathuna/harmtt.html

Otis, L. S., Shapiro, D. H., & Walsh, R. N.(1984). Meditation: Classic and contemporary

perspectives. New York: Aldone.

Park, R. L. (2001). Watashitachi wa naze kagaku

ni damasarerunoka [Voodoo science: The roadfrom foolishness to fraud]. Tokyo:Shufunotomo-sha. (Original work published2000).

Reber, A. S. (1995). The Penguin dictionary of psy-

chology. London, England: Penguin Books.

Sampson, W. (1998). On the National Instituteof Drug Abuse Consensus Conference on

Acupuncture. The Scientific Review of

Alternative Medicine. Retrieved May 5, 2002,from http://www.hcrc.org/contrib/sampson/acup.html

Spiegler, M. D., & Guevremont, D. C. (1993).Contemporary behavior therapy (2nd ed.).Pacific Grove, CA: Brooks/Cole.

The Burton Goldberg Group. (Eds.). (1994).Alternative medicine: The definitive guide. Fife,WA: Future Medicine Publishing.

Wedding, D. (1995). Behavior and medicine (2nded.). St. Louis: Mosby.

Weil, A. (1998). Iyasu kokoro, naoru chikara

[Spontaneous healing]. Tokyo: Kadokawabunko. (Original work published 1995) �

The January issue of the Behavior

Therapist contained a special series(DeGroot, 2003) on the application

of behavior therapy in correctional institu-tions that should concern us. As noted byRonan (2003), the number of people incar-cerated in this country has increased by400% since 1970, with the U.S. now im-prisoning more of its citizens than suppos-edly repressive countries such as China orRussia. Curiously, this increase in incarcera-tion has not been associated with changes incrime rates. Inmate populations havegrown rapidly since the mid-1980s, butduring that same period the U.S. nationalcrime rate has remained relatively flat. Theexplanation for the growing prison popula-tion is in higher arrest and conviction ratesfor minor crimes, especially nonviolent drugoffenses, and lengthier sentencing. Thesealterations in the criminal justice systemhave been spurred on by sensationalisticnews reports that have disproportionatelycovered violent crime, resulting in arousedpublic fear. “Tough on crime” political cam-paigns have harnessed this fear to advancelaw enforcement and criminal court policiesto produce an ever-expanding prison popu-lation (Beiser, 2001; Doyle, 2001; Dyer,2000).

As this nation’s bill for incarceration hasrisen to $46 billion annually, private corpo-rations have profited handsomely in con-structing and operating prisons and by

providing health care, telephone, and foodservices in these facilities. Should behaviortherapists develop their own niche withinthis booming industry? If behavior thera-pists pursue this employment opportunity,they may join ranks with other professionsthat have become increasingly responsive tomarket forces rather than moral civic-mind-edness or social responsibility (Brint, 1994).In the case of behavior therapists, however,expanding work with the present prisonsystem may actually involve ignoring theramifications of their own theoretical andscientific principles.

Behavior therapy is grounded in the as-sumption that human behavior is largely afunction of individual learning history andenvironmental contingencies. Persons whocommit crimes presumably could have beenprevented from performing these acts byprompting and reinforcing alternative ap-propriate responses. The finding that twoout of three prison inmates were earningless than $5,000 per year at the time of theirarrest (Dyer, 2000) suggests that insuffi-cient reinforcement for appropriate behav-ior may have been a contributing factor inthe performance of a large proportion ofcriminal acts. The earlier in life appropriateresponses were taught and the more consis-tently they were reinforced, the less likelycriminal behavior would have emerged.Such a preventive approach has been rec-ommended for preempting the develop-

ment of mental health problems (Albee,1998; Task Panel on Prevention, 1984), andit is reasonable to assume that this also ap-plies to criminal behavior. In stark contrast,our criminal justice system’s use of impris-onment is an old form of retribution. Itsmethods are neither based on a science ofbehavior nor a systematic technology of be-havior change, and this is reflected in itspoor outcomes (i.e., high rates of criminalrecidivism). As one of the series authorsnotes, prison is primarily for purposes ofpunishment, not rehabilitation (Spudic,2003). Hence, prison is for punishment—inbehavioral terms, woefully ineffective pun-ishment.

Behavior therapists working in prisonsrisk not only the loss of their guiding princi-ples but their replacement by the principlesand values of the surrounding prison cul-ture. Prisons are institutions whose highestpriorities are inmate security and control,and they are not reluctant to use coercivemethods to achieve those goals. One seriesauthor noted that prison personnel arelikely to find behavioral programmingmore acceptable if it is referred to as “behav-ioral control” rather than “behavior ther-apy” (Seegert, 2003). How long will it bebefore behavior therapists working in pris-ons become comfortable in this role and seethemselves primarily as behavior control ex-perts?

Another, more insidious aspect of prisonwork could be in bolstering the notion thatthe prisoners’ mental disorders are entirelydue to individual defects or pathologyrather than the aversive stimulation and deprivation of the prison environment.Prisons are terrifying places in which a per-son can expect to be intimidated, assaulted,raped, or murdered (Human Rights Watch,2001). While prisons are structured to pro-vide as little pleasant or rewarding stimula-tion as possible, even those few desirableevents may be withdrawn. Failure to com-

Open Forum

Behavior Therapy in Correctional Settings:Fertile Ground or Quicksand?

Stephen E. Wong and Stephanie T. Wong, Florida International University

Join the AABT

Listserve

CCC

Go to www.aabt.org.

Click on MEMBERSHIP

INFORMATION.

See LISTSERVE in the menu.

Click on it.

Follow the instructions.

To thine own self be true.” This sageadvice has been offered hundreds ofthousands of times throughout the

centuries since Shakespeare crafted it, and ithas always struck a chord with me both per-sonally and professionally. The phrase is alsoat the heart of CBT, and it has been my ex-perience that most of my colleagues standby it. However, a study by Gilroy, Carroll,and Murra (2002), which appeared inProfessional Psychology: Research and Practice,really threw me for a loop. The study in-volved a random sampling of 1,000 psy-chologists throughout the United States.The names were drawn from APA’sDivision 17 (Counseling Psychology).

The primary objective of the study wasto poll psychologists as to whether or notthey have ever experienced depression dur-ing their professional careers. More than60% of the psychologists who respondedreported experiencing depression, most ofwhich consisted of dysthymia. Fifty-threepercent of those admitting to depressioncontended that they primarily employ cog-nitive-behavioral interventions in theirwork as therapists. But what shocked me isthat 40% of those individuals who pro-fessed to be cognitive-behavioral therapistsalso stated that they chose psychodynamictherapy for their own treatment. The sec-ond most popular modality sought by thegroup was gestalt therapy, which consti-

tuted 19%, with a mere 12% selecting CBTfor the treatment of their own depression.The remaining percentage (29%) soughtother alternatives such as pharmacotherapy.

The results seem incongruous for agroup of individuals notorious for toutingempirically validated treatments, and ini-tially, I was hard-pressed to explain the phe-nomenon. The decision is particularly oddin light of the strong empirical evidence forthe use of CBT with depression, not to men-tion the other rationales that support it as atreatment of choice, including time frame,efficacy, cost factors, and so forth. I beganlooking for some palatable explanations.

First, with any empirical study, there is,of course, always the possibility that thedata may be flawed. I found myself rootingfor this alternative. Possible flaws with thesampling process in particular may have er-roneously designated certain subjects in thestudy as being pure cognitive-behavioraltherapists when, in fact, they were not. Itcould be that those who identified them-selves as using cognitive-behavioral tech-niques were “hybrid therapists,” whoactually use a mix of techniques. Perhaps if


ply with institutional rules can result in soli-tary confinement and restriction to onephone call and 4 hours of recreation permonth (Daniel, Jackson, & Watkins, 2003).In a growing number of maximum-securityprisons, inmates may be placed in solitaryconfinement for years at a time (Good,2003). Responses to such adverse condi-tions can include counteraggression, self-injury, bizarre behavior, and suicide at-tempts (Cox, 2003; Daniel et al., 2003;Seegert, 2003). But under such circum-stances, are these behaviors really maladap-tive or irrational? Should behaviortherapists adopt occupational goals of pro-moting inmate compliance with and adjust-ment to inhumane living conditions—inessence, pacifying disturbed inmates and fa-cilitating the smooth operation of these in-imical and counterproductive institutions?

Behavior therapists interested in socialissues should also consider the growth ofprisons within the context of recent politicalmovements and government funding pat-terns. During the past 2 decades of massiveprison growth we have seen simultaneousreductions in state and federal spending oneducation, mental health programs, and so-cial services. With shrinking state and fed-eral budgets, monies given to one publicsector come at the expense of another. Willbehavior therapists align themselves with“correctional” facilities instead of educa-

tional, therapeutic, or social support pro-grams that might have obviated the needfor those correctional institutions in the firstplace? Going one step further, will behaviortherapists endorse criminal justice and insti-tutions of punishment rather than promot-ing social justice and the widening ofeconomic opportunity to help preventcrime? These are crucial questions that willdefine the future values and practice of be-havior therapy.

References

Albee, G. W. (1998). Fifty years of clinical psy-chology: Selling our soul to the devil. Applied

and Preventive Psychology, 7, 189-194.

Beiser, V. (2001). How we got to two million:How did the Land of the Free become theworld’s leading jailer? In MotherJones.comSpecial Report: Debt to Society. RetrievedMarch 7, 2003, from http://www.mother-jones.com/prisons/overview.html

Brint, S. (1994). In an age of experts: The changing

role of professionals in politics and public life.Princeton, NJ: Princeton University Press.

Cox, G. (2003). Screening inmates for suicideusing static risk factors. the Behavior

Therapist, 26, 212-214.

Daniel, C., Jackson, J., & Watkins, J. (2003).Utility of an intensive behavior therapy unitin a maximum security female prison. the

Behavior Therapist, 26, 211-212.

DeGroot, J. F. (2003). Behavior therapy in cor-

rectional settings: Examples from the

Georgia department of corrections [Special

series]. the Behavior Therapist, 26(1), 208-

218.

Doyle, R. (2001). Why do prisons grow?

Scientific American, 285(6), 28.

Dyer, J. (2000). The perpetual prisoner machine:

How America profits from crime. Boulder, CO:

Westview Press.

Good, R. (2003). The supermax solution. The

Nation, March 3, p. 7.

Human Rights Watch. (2001). No escape: Male

rape in U.S. prisons. New York: Author.

Jackson, J. (2003). Outcome research with high-

risk inmates. the Behavior Therapist, 26, 215-

216.

Ronan, G. (2003). Behavior therapy and social

issues. the Behavior Therapist, 26, 205-206.

Seegert, C. R. (2003). Token economies and in-

centive programs: Behavioral improvement

in mental health inmates housed in state

prisons. the Behavior Therapist, 26, 208-211.

Spudic, T. J. (2003). Assessing inmate satisfac-

tion with mental health services. the Behavior

Therapist, 26, 217-218.

Task Panel on Prevention. (1984). Report of the

Task Panel on Prevention. In G. W. Albee, J.

M. Joffe, & L. A. Dusenbury (Eds.),

Prevention, powerlessness, and politics: Readings

on social change (pp. 25-52). Newbury Park,

CA: Sage Publications. �

Open Forum

To Thine Own Self Be True

Frank M. Dattilio, Harvard Medical School and University of Pennsylvania Schoolof Medicine


With the publication of DSM-IV-

TR (APA, 2000), it is apparentthat preparation of the much-

anticipated DSM-V can’t be far behind.Although behavior therapists once shunnedthe categorical taxonomic approach (seeFollette, Houts, & Hayes, 1992; Krasner,1992), only limited resistance remains(Scotti, Morris, McNeil, & Hawkins, 1996).So, whether conceived in the spirit of “if youcan’t beat ‘em, join ‘em” or simply to ensurethat behavior therapists have a larger role inrefining future DSMs than enhancing thereliability of existing DSM symptom pro-files, I offer a compelling new disorder foryour consideration. This disorder, IntrinsicMotivation Deficit Disorder (IMDD™), has

been known only to those few brave re-searchers and journalists who have dared toquestion the wisdom of contingent rein-forcement (see Deci, 1995; Kohn, 1993).Mental health professionals previously frus-trated in their attempts to identify enoughcases of ADHD or ODD to keep their prac-tices afloat will welcome this common andeasily diagnosed condition as a focus of clin-ical attention.

Although treatment studies are practi-cally nonexistent, the condition will mostcertainly respond to Reitman Therapy™,which has proven 87% effective in cases un-complicated by messy comorbidities anduncooperative family members. Indeed,certified Reitman Therapists™ are currently

training practitioners across the nation inthis revolutionary treatment for this previ-ously unknown and underdiagnosed condi-tion. We at Reitman Therapy™ are veryexcited about the prospects for continuedassociation with AABT. We feel that wehave something unique to offer today’smental health professional. While othersoffer only an untested therapy, we offer bothan untested therapy and an untested diag-nostic entity! For more information, pleasepoint your browser to http://www.thehellwithscience.showmethemoney.com.

Diagnostic Features. The essential fea-ture of IMDD™ is a persistent pattern ofcraving for tangible rewards that is morefrequent and severe than is observed in indi-viduals at a comparable level of develop-ment and socioeconomic status (CriterionA). Some symptoms of the craving for tan-gibles that cause impairment must havebeen present before 7 years of age (CriterionB). Some impairment must have been ob-served in at least two settings (e.g., homeand school) (Criterion C). There must beclear evidence of interference with social,academic, or occupational functioning(Criterion D). The disturbance does not

Lighter Side

A Modest Proposal for a New DiagnosticClassification: Intrinsic Motivation DeficitDisorder (IMDD)

David Reitman, Nova Southeastern University

the sample had been drawn from a more ho-mogeneous list, such as members fromAABT or IACP, the results would probablyhave been much different.

Barring this explanation, what elsemight account for so many cognitive-behavioral therapists turning to a treatmentmodality that has almost no empirical sup-port? Could the answer have something todo with immunity? In other words, perhapssome cognitive-behavioral therapists thinkthat because they espouse one modality intheir work with patients, they themselvesare immune to its benefits. This may not besuch an uncommon schema among thera-pists, particularly those who use a particularmodality over a long period of time. I mustsay, though, that I have always found thatmost psychodynamic psychotherapists sub-mit to psychodynamic therapy for their owntreatment. In fact, many are required to be inpsychodynamic therapy themselves duringtheir training. But back to cognitive-behav-ioral therapists: Why psychodynamic ther-apy over any others?

Another explanation might be thatmany cognitive-behavioral therapists workcollaboratively, and the world may seemsmall when it comes to reaching out for helpthemselves. Enlisting the aid of a colleaguemay not be comfortable. While this wouldcontradict one of the main tenets of CBT,

distorted thinking is a plausible explana-tion. Add to this that many therapists thinkthat they can fix their own problems.Armed with self-help manuals and the in-tensive training that cognitive-behavioraltherapists undergo, self-help may appear tobe a viable alternative.

The most unsettling explanation is, ofcourse, that some cognitive-behavioraltherapists may actually still believe that theonly type of treatment capable of gettingbeneath the surface and to the deeper rootsof an issue is long-term dynamic psy-chotherapy. Some have regarded CBT as the“therapy for the masses” as opposed to the“insightful.” This is particularly disturbingbecause such an underlying belief suggests abasic distrust in the effectiveness of what wedo. This and the previous explanation maybe said to fall in the category of cognitivedistortion—ironically, the types of distor-tions we try to rid clients of during thecourse of our work. So, why have some of usfallen victim to the same distortions that weattempt to change in others? Perhaps it’ssimply human nature. The fact that we engage in repetitious interventions as cog-nitive-behavioral therapists, conductingtreatment on a daily basis, may have a watering-down effect on our perception ofthe potency of CBT for ourselves. While Iwould like to think that the data were

flawed, it is more likely that something elseis at work. The results of Gilroy et al.’s(2002) study beg the question: Why dosome of us not practice what we preach?Obviously, the percentages don’t bode wellfor our profession or the field of CBT.Imagine how our clients would feel readingabout the study.

So, maybe we need to ask ourselves theGilroy question: If I were to require treat-ment for depression, which modality wouldI seek? Further, if the answer is somethingother than CBT, then we need to considerseriously what it means about our ownpractice and choice of modalities.

Obviously, this is only one small study,and more research is needed in this area inorder to get to the truth. But if we are dedi-cated to promoting our profession and theefficacy of what we do, we need to look seri-ously at why there seems to be some dis-crepancy between what is preached andwhat is practiced.

Reference

Gilroy, P. J., Carroll, L., & Murra, J. (2002). A

preliminary survey of counseling psycholo-

gists’ personal experiences with depression

and treatment. Professional Psychology: Research

and Practice, 33, 402-407. �


occur exclusively in the context of other an-noying behavioral patterns such as thosecharacteristic of children diagnosed withADHD or ODD or as a result of a severelyimpoverished upbringing (Criterion E).

The disorder primarily manifests itselfwhen the individual is asked or required toengage in nonrevenue-generating activitiessuch as exercise and social interaction withpersons other than business associates. Inthe most extreme cases the individual willscarcely raise a finger unless there is a clearincentive. Such individuals may be regardedby family, peers, and coworkers as narcissis-tic, materialistic, greedy, opportunistic, su-perficial, or spoiled brats. These individualsare often observed in adulthood drivingBMW or Mercedes-Benz convertibles withbumper stickers proclaiming HE WHO DIES

WITH THE MOST TOYS WINS or WINNING

ISN’T EVERYTHING, IT’S THE ONLY THING.Symptoms usually worsen in the absence oftangible reinforcement but will improverapidly with their delivery. Unfortunately,improvements are generally short-lived,and individuals with IMDD™ can developan insatiable appetite for material goods.

Associated Features. The associated fea-tures of the disorder include low frustrationtolerance, temper outbursts, bossiness, ex-cessive and frequent insistence that de-mands be met immediately, mood lability,demoralization, rejection by peers, and lowself-esteem. Academic achievement is de-valued, unless explicitly connected to an oc-cupation with an anticipated annualcompensation of over $100,000. The indi-vidual will strongly resent evaluation andfrequently present an air of “entitlement.”

Associated Laboratory Findings.

Although many laboratory analogues havebeen proposed (e.g., intrinsic motivationstudies), no study to date has clearly estab-lished that contingent reward can causeIMDD.

Associated Physical Examination

Findings and General Medical Conditions.No specific physical features are associatedwith IMDD™, although obesity may de-velop secondary to the consumption ofcandy, sodas, and Big Macs. In adulthood,the individual may develop acute hyperten-sion as a result of investing heavily in thestock market and real estate.

Specific Culture, Age, and Gender

Features. IMDD™ is a disorder known tooccur in various cultures, especially thosethat closely emulate the United States. It isdifficult to establish this diagnosis in prever-bal children, although children who are“bribed” for toileting may be particularly atrisk. In contrast, older children with

IMDD™ are easily identified by their char-acteristic aversion to situations in whichmaterial rewards or access to the family au-tomobile are unavailable. As children ma-ture, symptoms become less conspicuous asthe absence of intrinsic motivation becomesthe rule rather than the exception. No sig-nificant gender differences have been ob-served, but they are likely to emerge in oneof several studies planned as part of a large,multisite, collaborative investigation cost-ing several million dollars (with an authorlist rivaling the board of trustees of a largeurban bank).

Prevalence and Course. IMDD™ isnonexistent at birth. It is believed that theubiquity of tangible reward erodes intrinsicmotivation increasingly throughout child-hood and adolescence. As far as can be told,only two individuals, Edward Deci andAlfie Kohn, do not suffer from this disorder.

Familial Pattern. Since almost all par-ents suffer from IMDD™, they almost in-variably transmit the disorder to theirchildren through the adoption of tokeneconomies and consistent use of tangible re-ward. Though the specific mechanism oftransmission is unknown, recent geneticstudies show an abnormality on the long-arm of chromosome 1040, with suffererspersistently deemphasizing their materialwealth. Symptoms appear to worsen sea-sonally and are acute in mid-April of eachyear.

Differential Diagnosis. The craving formaterial goods is to be distinguished fromthe impulsive spending that may arise as partof a manic episode. Many associated features,such as the air of entitlement and attachmentto material things, may also be present insome forms of personality disorder, thoughmost individuals diagnosed with borderlinepersonality disorder display greater concernfor social reinforcers (especially praise).Differential diagnosis for antisocial personal-ity disorder will require an assessment of as-sociated features of aggression. Persons withIMDD™ are known to become aggressiveonly during stock market crashes, fenderbenders, and especially during divorce settle-ments. Major depression may occur afterlong periods of tangible deprivation. Inwomen, IMDD™ should be distinguishedfrom a rare condition involving shoe hoard-ing, known as Imelda’s Syndrome.

DIAGNOSTIC CRITERIA

A. Six or more of the following symp-toms of extrinsic motivation have persistedfor at least 6 months to a degree that is mal-adaptive and inconsistent with develop-

mental level: (1) Often makes statementssuch as, “What will you give me if I clean upmy room?” (2) often fails to follow throughon schoolwork or duties in the workplaceunless followed by the delivery of currency(preferably in unmarked bills); (3) oftenbargains or negotiates to exact highest pos-sible price for such routine acts as makingbeds or, for an adult with a partner, for per-forming such duties as intercourse, or tak-ing the children to Sunday school; (4)nonverbal behavior often gives the impres-sion of disinterest (e.g., eyes averted) unlessthere appears to be a clear indication of im-minent material reward; (5) reads Fortune,Money, or Forbes on more days than not; (6)spends more time counting assets thancounting blessings; (7) frequently asks (inschool setting), “Is this going to be on thetest?” or “Do we really have to know this?”

B. Some symptoms of extrinsic motiva-tion that caused impairment were presentbefore age 7 years.

C. Some impairment from the symp-toms is present in two or more settings (e.g.,at school [or work] and at home).

D. There must be clear evidence of sig-nificant impairment in social, academic, oroccupational functioning.

E. The disturbance does not occur exclu-sively in the context of other annoying behavioral patterns such as those character-istic of children diagnosed with ADHD orODD or as a result of a severely privilegedupbringing.

References

American Psychiatric Association. (2000).Diagnostic and statistical manual of mental disor-

ders (4th ed., text revision). Washington, DC:Author.

Deci, E. (1995). Why we do what we do: The dy-

namics of personal autonomy. New York:Grossett/Putnam.

Follette, W. C., Houts, A. C., & Hayes, S. C.(1992). Behavior therapy and the new med-ical model. Behavioral Assessment, 14, 323-343.

Krasner, L. (1992). The concepts of syndromeand functional analysis: Compatible or in-compatible? Behavioral Assessment, 14, 307-321

Kohn, A. (1993). Punished by rewards: The trouble

with gold stars, incentive plans, A’s, praise, and

other bribes. New York: Houghton-Mifflin.

Scotti, J. R., Morris, T. L., McNeil, C. B., &Hawkins, R. P. (1996). DSM-IV and disor-ders of childhood and adolescence: Canstructural criteria be functional? Journal of

Consulting and Clinical Psychology, 64, 1177-1191. �


The Bookselling Catalog is brought to you by AABT and publishers who

support your research and clinical endeavors, offering 20% discounts to

you, the members of AABT. Whether you are a student in need of

research materials, a clinician wanting to explore new techniques, or just a

good old-fashioned scholar hungry for knowledge, the Bookselling Catalog can

accommodate your needs. Which book will change your life? As Albert Ellis

once said, “We shall see!”

Simply use the coupons in the back of the catalog to place your order direct-

ly with the publisher. Or, visit the publisher’s Web site. This service is open

to AABT members only and should not be used for institutional orders.

Contact information is provided for each publisher if you require assistance.

We thank the publishers for offering these important, state-of-the-art

resources, and hope that you will take advantage of their generous offers,

explore their Web sites, and continue to learn, teach, and practice the work of

behavior therapy.

19TH ANNUAL

BOOKSELLING CATALOG

Now on our Web Site: www.aabt.org

CENTRE FOR ADDICTION ANDMENTAL HEALTH (CAMH)33 Russell StreetToronto, ON

Canada M5S2S1

Tel.: 800-661-1111

Fax: 416-593-4694

e-mail: [email protected]

www.camh.net

Can I Catch It Like a Cold? A Story to Help

Children Understand a Parent’s Depression

Gretchen Kelbaugh and Centre for Addiction and Mental Health;

Illustrated by Coral Nault

Written for children 5 to 9 years old, this engaging story bookanswers the key questions children have about depression.

PUB. DATE: 2002 LIST PRICE: $9.95 (CAN)SHIPPING: 15% outside Canada

When a Parent Is Depressed . . . What Kids Want to

Know

Centre for Addiction and Mental Health

Written to help adults talk to children, this brochure posesand asnwers common questions children have about a par-ent’s depression.

PUB. DATE: 2002 LIST PRICE: $10.00 (CAN) for a package of 50SHIPPING: 15% outside Canada

When a Parent Has Bipolar Disorder . . . What Kids

Want to Know


Written to help adults talk to children, this brochure posesand answers common questions children have about a par-ent’s bipolar disorder.

PUB. DATE: 2003 LIST PRICE: $10.00 (CAN) for a package of 50SHIPPING: 15% outside Canada

Is It Safe for My Baby? Risks and Recommendations

for the Use of MedicatIon, Alcohol, Tobacco, and

Other Drugs During Pregnancy and Breastfeeding


This booklet lists information about the use of over 200 drugswhile pregnant and breastfeeding, including prescription,over-the-counter, and illegal drugs.

PUB. DATE: 2003LIST PRICE: $15.00 (CAN) for a package of 50SHIPPING: 15% outside Canada

Antisocial and Violent Youth (Volume II)

Jalal Shamsie, Joanne Lawrence, and Carole Hood

Summaries of the latest research findings on bullying,advances in knowledge about risk and protective factors, andeffective methods of prevention and treatment.

PUB. DATE: 2003

LIST PRICE: $20.00 (CAN) SHIPPING: 15% outside Canada

Bridging Responses: A Front-Line Worker’s Guide to

Supporting Women Who Have Posttraumatic Stress

Dr. Lori Haskell

This booklet offers information and tools to help recognizeresponses to posttraumatic stress and encourage referrals toappropriate services or resources.

PUB. DATE: 2001 LIST PRICE: $5.95 (CAN) SHIPPING: 15% outside Canada

First Stage Trauma Treatment: A Guide for Mental

Health Professionals Working With Women

Dr. Lori Haskell

This book provides a conceptual framework and useful tech-niques for therapists working with women experiencing post-traumatic stress disorder.


Brief Couple Therapy: Group and Individual Couple

Treatment for Addiction and Related Mental Health

Concerns

Gloria Chaim, Sharon Armstrong, Joanne Shenfeld, Colleen Kelly,

and Selina Li

This manual is a tool for therapists and counsellors workingin substance use settings who would like to augment theirpractice by seeing couples.


EDEN PRESS1 Eden Way

Princeton, NJ 08540

Tel.: 609-987-0099

Fax: 609-987-0243


www.EdenServices.org

Eden Institute Curriculum Series

David L. Holmes, Ed.D., et al.

Five-volume series of teaching programs and strategies forindividuals with autism.

PUB. DATE: 1990LIST PRICE: $580MEMBER PRICE: $522SHIPPING: $12.00

Autism Through the Lifespan: The Eden Model

David L. Holmes, Ed.D.

Eden’s comprehensive model for helping children and adultswith autism over their entire lifetime.

PUB. DATE: 1998

AABT 2003 Bookselling Catalog 313

314 AABT 2003 Bookselling Catalog

LIST PRICE: $21.95MEMBER PRICE: $19.75SHIPPING: $4.00

ELSEVIER SCIENCECustomer Service Department11830 Westline Industrial DriveSt. Louis, MO 63146Tel: +1 800 545 2522 (Toll-free number) for US customersTel: +1 800 460 3110 (Toll-free number)

or +1 314 453 7010 for customers outside USFax: +1 800 535 9935 for US customersFax: +1 314 453 7095 for customers outside USe-mail: [email protected] • www.elsevier.com

Choice, Behavioural Economics and AddictionEdited by R. E. Vuchinich and N. Heather

ISBN: 0-08-044056-8

PUB. DATE: Sept 2003LIST PRICE: US$ 100.00 approxMEMBER PRICE: US $75.00� www.elsevier.com/locate/isbn/0080440568

Origins of Phobias and Anxiety Disorders: Why

More Women Than Men?Edited by Michelle G. Craske

ISBN: 0-08-044032-0

PUB. DATE: 2003LIST PRICE: US $80.00MEMBER PRICE: US $57.00� www.elsevier.com/locate/isbn/0080440320

Cognitive Approaches to Obsessions and

Compulsions: Theory, Assessment, and Treatment Edited by Randy O. Frost and Gail Steketee

This volume assembles nearly all of the major investigatorsresponsible for the development of cognitive therapy (and theo-ry) for OCD, as well as other major researchers in the field, towrite about cognitive phenomenology, assessment, treatment,and theory related to OCD. ISBN: 0-08-043410-X

PUB. DATE: May 2002 LIST PRICE: US $94.00MEMBER PRICE: US $70.50� www.elsevier.com/locate/isbn/008043410X

Handbook of Conceptualization and Treatment of

Child Psychopathology Edited by Helen Orvaschel, Jan Faust, and Michel Hersen

This handbook includes contributions from outstandingscholars active in both the science and practice of child andadolescent treatment. ISBN: 0-08-043362-6

PUB. DATE: 2001LIST PRICE: US $81.50 MEMBER PRICE: US $61.00� www.elsevier.com/locate/isbn/0080433626

Innovations in Adolescent Substance Abuse

Interventions Edited by Eric F. Wagner and Holly B. Waldron

This volume provides a single reference source for empirical-ly tested approaches to assessing, preventing, and treating

adolescent substance abuse problems. It includes 16 chaptersfrom leaders in the field. ISBN: 0-08-043577-7

PUB. DATE: 2001LIST PRICE: US $75.00MEMBER PRICE: US $56.25� www.elsevier.com/locate/isbn/0080435777

Integrated Behavioral HealthcareCummings

This book provides a roadmap of the emerging directionsintegrated behavioral healthcare is taking and lays out thesteps the mental health professional needs to take to adapt tothe new system of healthcare. ISBN: 0-12-198761-2

PUB. DATE: 2001LIST PRICE: $59.95MEMBER PRICE: $44.95� http://www.bh.com/apcatalog/

Clinician’s Guide to Adult ADHDEdited by Goldstein and Ellison

This book is devoted to the treatment of adult ADHD, pre-senting a comprehensive review of the existing literature, apractical set of clinical guidelines, and the observations andinsights of professionals on the research and the clinical treat-ment of this condition. ISBN: 0-12-287049-2


Therapist’s Guide to Substance Abuse InterventionJohnson

Presenting information in easy to read outline form, the guideidentifies how to assess, diagnose, and treat substance abuseor substance dependence. ISBN: 0-12-387581-1


Therapist’s Guide to Clinical Intervention

(2nd Edition)Johnson

This practical, hands-on handbook outlines treatment goalsand objectives for each type of psychopathology as defined bythe diagnostic and statistical manual by the AmericanPsychiatric Association, identifies skill-building resources,and provides samples of all major professional forms. ISBN: 0-12-386588-3

PUB. DATE: August 2003LIST PRICE: $49.95MEMBER PRICE: $37.95� http://www.bh.com/apcatalog/

Therapist’s Guide to Learning and Attention

DisordersEdited by Fine and Kotkin

Provides clinicians a blueprint for treatment of children andadolescents with learning and attention disorders. ISBN: 0-12-256430-8

PUB DATE: July 2003LIST PRICE: $65.00MEMBER PRICE: $48.95� http://www.bh.com/apcatalog/


A Guide to Starting Psychotherapy GroupsEdited by Price

This book assists psychologists, social workers, psychiatrists,nurse clinicians, pastoral counselors, school and college coun-selors and other trained therapists in the process of formingand maintaining groups. ISBN: 0-12-564745-X


How to Build a Thriving Fee-for-Service PracticeKolt

This book guides you from your ideal practice vision throughthe “how-to” steps to succeed. You will learn that a privatepractice is, in effect, a small business. ISBN: 0-12-417945-2


Effective Brief TherapiesEdited by Hersen and Biaggio

This book is devoted to facilitating the understanding ofstrategies for approaching cases, conducting viable assess-ments, and implementing contemporary therapies. ISBN: 0-12-343530-7


FANLIGHT PRODUCTIONS4196 Washington St.

Suite 2

Boston, MA 02131

Tel.: 800-937-4113

Fax: 617-469-3379

e-mail: [email protected]� www.fanlight.com

OCD: The War InsideMark Pancer and David Hoffert

Explores the causes and possible treatments for Obsessive-Compulsive Disorder, through the painful and occasionallyfunny stories of four children and adults with OCD.

PUB. DATE: 2002LIST PRICE: $229.00MEMBER PRICE: $206.10SHIPPING: $9.00

Bad Hair LifeJennifer Raikes

This vivid documentary is a personal exploration of trichotil-lomania, or compulsive hair-pulling, and of the social contextthat makes it such a secret epidemic.


Inside Out: Stories of BulimiaMichelle Blair

Bulimia can affect women and men from all walks of life, andit kills nearly 20 percent of its victims every year. This mov-ing documentary profiles individuals and families affected bythis eating disorder.


THE GRODEN CENTER86 Mount Hope Ave.

Providence, RI 02906

Tel.: 401-274-6310

Fax: 401-421-3280


www.grodencenter.org

Coping With Stress Through Picture Rehearsal: A

How-to Manual for Working With Individuals With

Autism and Developmental DisabilitiesJune Groden, Ph.D., Patricia LeVasseur, M.Ed., Amy Diller,

M.S., and Joseph Cautela, Ph.D.

This book was written as a guide to provide a model for usingpicture rehearsal to reduce stress in this population.

PUB. DATE: October 2002LIST PRICE: $40.00MEMBER PRICE: $32.00SHIPPING: $7.00

THE GUILFORD PRESS72 Spring Street

Dept. 6D

New York, NY 10012

Tel.: 800-365-7006

Fax: 212-966-6708


www.guilford.com

Schema Therapy: A Practitioner’s GuideJeffrey E. Young, Janet S. Klosko, and Marjorie E. Weishaar

This book—written by the model’s developer and two of itsleading practitioners—is the first major text for clinicianswishing to learn and use the popular schema therapyapproach. PUB. DATE: April 2003LIST PRICE: $45.00MEMBER PRICE: $36.00Cat. #: 6D0838� www.guilford.com/paci/young.htm

Biofeedback: A Practitioner’s Guide (3rd Edition)Edited by Mark S. Schwartz and Frank Andrasik

Now in a fully revised and updated third edition, this com-prehensive text offers state-of-the-science coverage of currentbiofeedback research, applications, clinical procedures, andbiomedical instrumentation.


PUB. DATE: June 2003LIST PRICE: $75.00MEMBER PRICE: $60.00Cat. #: 6D0845� www.guilford.com/hp/schwartz_new.htm

Cognitive-Behavioral Treatment of Obesity:

A Clinician’s GuideZafra Cooper, Christopher G. Fairburn, and Deborah M. Hawker

This book presents the first cognitive-behavioral treatmentmanual for obesity, delineating an innovative therapeuticmodel currently being evaluated in controlled research atOxford University. The approach is specifically designed toovercome a major weakness of existing therapies: post-treat-ment weight regain.

PUB. DATE: May 2003LIST PRICE: $35.00MEMBER PRICE: $28.00Cat. #: 6D0888� www.guilford.com/ed/cooper.htm

Cognitive Therapy With Children and Adolescents:

A Casebook for Clinical Practice (2nd Edition)Edited by Mark A. Reinecke and Frank M. Dattilio

This important casebook presents empirically supportedinterventions for a wide range of child and adolescent prob-lems. Leading cognitive-behavioral therapists demonstrateassessment and treatment approaches that have been careful-ly adapted—or specially designed—to meet the needs ofyoung clients.

PUB DATE: May 2003LIST PRICE: $48.00MEMBER PRICE: $38.40Cat. #: 6D0853� www.guilford.com/cpap/reinecke.htm

Integrated Treatment for Dual Disorders: A Guide

to Effective PracticeKim T. Mueser, Douglas L. Noordsy, Robert E. Drake,

and Lindy Fox

Grounded in decades of influential research, this comprehen-sive clinical handbook provides virtually everything needed toplan, deliver, and evaluate integrated treatment for dual dis-orders. Presented are clear guidelines for developing pro-grams, performing state-of-the-art assessments, and imple-menting a wide range of individual, group, and family inter-ventions. Designed in a convenient large-size format with lay-flat binding for ease of photocopying, the volume contains allneeded assessment forms, treatment planning materials, andclient handouts, most with permission to reproduce.

LIST PRICE: $42.00MEMBER PRICE: $33.60Cat. #: 6D0850� www.guilford.com/addictions/mueser.htm

Authoritative Guide to Self-Help Resources in

Mental Health, Revised EditionJohn C. Norcross, John W. Santrock, Linda F. Campbell, Thomas

P. Smith, Robert Sommer, and Edward L. Zuckerman

Keeping pace with the ever-changing world of self-help, therevised and expanded edition of this indispensable referencehelps consumers and professionals distinguish high-qualityself-help resources from those that are misleading, inaccurate,or even harmful. The volume is organized around 36 fre-

quently encountered clinical problems and life challenges,with entirely new chapters covering posttraumatic stress dis-order, obsessive-compulsive disorder, youth violence, border-line personality disorder, bipolar disorder, and suicide.

PUB DATE: June 2003LIST PRICE: $26.50MEMBER PRICE: $21.20Cat. #: 6D0839� www.guilford.com/ct/norcross.htm

The Paper Office: Forms, Guidelines, and Resources

to Make Your Practice Work Ethically, Legally, and

Profitably (3rd Edition)Edward L. Zuckerman

Now in a revised and expanded third edition, this popularmanual and CD-ROM provide the clinical, financial, andlegal record-keeping tools that every psychotherapy practiceneeds. Included are methods for documenting informed con-sent, treatment planning, and progress; advice on fee struc-tures, competitive pricing, and billing; tips on joining man-aged care panels and communicating with MCO reviewers;and much more.

PUB. DATE: March 2003LIST PRICE: $60.00MEMBER PRICE: $48.00Cat. #: 6D0769� www.guilford.comct/zuckerman2.htm

Science and Pseudoscience in Clinical PsychologyEdited by Scott O. Lilienfeld, Steven Jay Lynn,

and Jeffrey M. Lohr

This is the first major text designed to help professionals andstudents evaluate the merits of popular yet controversial prac-tices in clinical psychology, differentiating those that canstand up to the rigors of science from those that cannot.

PUB. DATE: February 2003LIST PRICE: $42.00MEMBER PRICE: $33.60Cat. #: 6D0828� www.guilford.com/paci/lilienfeld.htm

Addiction and Change: How Addictions Develop and

Addicted People RecoverCarlo C. DiClemente

From Carlo DiClemente, codeveloper of the transtheoreticalmodel, this book offers a panoramic view of the entire con-tinuum of addictive behavior change. Illuminated is the com-mon path that individuals travel as they establish and rein-force new patterns of behavior, whether they are developingan addiction or struggling to free themselves from one, andregardless of the specific addictive behavior.

PUB. DATE: April 2003LIST PRICE: $35.00MEMBER PRICE: $28.00Cat. #: 6D0057� www.guilford.com/addictions/diclemente.htm

Treatment Planning in Psychotherapy: Taking the

Guesswork Out of Clinical CareSheila R. Woody, Jerusha Detweiler-Bedell, Bethany A. Teachman,

and Todd O’Hearn

This book provides clinicians of any theoretical orientationwith a framework for evidence-based work. The innovativetreatment planning method presented is known as PACC


(Planning and Assessment in Clinical Care). Illustrated witha wealth of case examples, the book shows how to use PACCto conceptualize the distinct phases of therapy, identify spe-cific aims for each phase, develop a measurement plan forthose aims, specify the intervention strategies to be used,assess and document progress toward goals, and conduct reg-ular, collaborative progress reviews with clients.

LIST PRICE: $30.00MEMBER PRICE: $24.00CAT. #: 6D0805� www.guilford.com/paci/woody.htm

Evidence-Based Psychotherapies for Children and

AdolescentsEdited by Alan E. Kazdin and John R. Weisz

Provides a uniquely practical overview of evidence-basedtreatments for social, emotional, and behavioral problems inchildren and youth. Pioneering psychotherapy researchersoffer accessible, hands-on presentations of their respectiveapproaches: how each treatment was developed; its concep-tual and empirical bases; what it looks like in practice; andhow, why, and for whom the therapy works.

PUB. DATE: May 2003LIST PRICE: $50.00MEMBER PRICE: $40.00CAT. #: 6D0683� www.guilford.com/cpap/kazdin.htm

Intervening in Adolescent Problem Behavior: A

Family-Centered ApproachThomas J. Dishion and Kate Kavanagh

Grounded in over 15 years of clinical and developmentalresearch, this eagerly awaited book presents a multilevelintervention and prevention program for at-risk adolescentsand their families.

PUB. DATE: June 2003LIST PRICE: $35.00MEMBER PRICE: $28.00CAT. #: 6D0874� www.guilford.com/cpap/dishion.htm

Integrative Assessment of Adult Personality (2nd

Edition)Larry E. Beutler and Gary Groth-Marnat

This landmark text gives students and clinicians a solidgrounding in the most widely used approaches to adult per-sonality assessment. Thoroughly rewritten to reflect the lat-est findings, theories, and methods, the second editionincludes an extended case example bringing key concepts tolife.

PUB. DATE: July 2003LIST PRICE: $48.00MEMBER PRICE: $38.40CAT. #: 6D0670� www.guilford.com

HOGREFE & HUBER

44 Brattle Street

Cambridge, MA 02138

Tel.: 866-823-4726

Fax: 617-354-6875

www.hhpub.com

Clinical Handbook of Psychotropic Drugs

(13th Edition)Kalyna Z. Bezchlibnyk-Butler, J. Joel Jeffries (Editors)

A user-friendly and highly practical resource on the use ofpsychotropic drugs, based on published literature and clinicalexperience.

PUB. DATE: May 2003LIST PRICE: US $54.95MEMBER PRICE: US $43.95� www.hhpub.com/index.php?content=books/isbn/0-88937-273-X.html

Clinical Handbook of Psychotropic Drugs (Child

and Adolescent Version)Kalyna Z. Bezchlibnyk-Butler, Adil S. Virani (Editors)

The latest information is summarized in charts and bulletedlists for each class of psychotropic drug used in children andadolescents.PUB. DATE: September, 2003LIST PRICE: US $49.95MEMBER PRICE: US $39.95� www.hhpub.com/index.php?content=books/isbn/0-88937-271-3.html

Alcohol Consumption and Alcohol-Related Problems

in GermanyGerhard Bühringer et al.

The book provides up-to-date information on consumptionpatterns and the extent of negative effects associated withalcohol consumption

PUB. DATE: July 2002LIST PRICE: US $49.95MEMBER PRICE: US $39.95� www.hhpub.com/index.php?content=books/isbn/0-88937-262-4.html

Clinical Handbook of Health Psychology: A Practical

Guide to Effective InterventionsPaul Camic and Sara Knight (Editors)

This popular health psychology text is both a working refer-ence manual for professional health psychologists and a high-ly regarded teaching tool.

PUB. DATE: September 2003LIST PRICE: US $49.95MEMBER PRICE: US $39.95� www.hhpub.com/index.php?content=books/isbn/0-88937-260-8.html

Attempted Suicide: A Handbook of Treatment,

Theory, and Recent FindingsDiego De Leo, Unni Bille-Brahe, Ad JFM Kerkhof (Editors)

A practical handbook for those concerned with prevention ofsuicide, based on experience gained during the WHO/EUROMulticenter Study of Suicidal Behavior.

PUB. DATE: August, 2003LIST PRICE: US $39.95MEMBER PRICE: US $31.95� www.hhpub.com/index.php?content=books/isbn/0-88937-267-5.html


Suicide and Euthanasia in Older Adults:

A Transcultural JourneyDiego De Leo

This book brings together a unique range of perspectives onaging, suicide, and euthanasia from different cultures andcountries around the world.

PUB. DATE: August 2001LIST PRICE: US $24.95MEMBER PRICE: US $19.95� www.hhpub.com/index.php?content=books/isbn/0-88937-251-9.html

White Knuckles and Wishful Thinking: Learning

from the Moment of Relapse in Alcoholism and

Other AddictionsGeorge Manter DuWors

A practical guide for counselors and clients—how to dealwith the moment of relapse.

PUB. DATE: April 2000LIST PRICE: US $17.50MEMBER PRICE: US $14.00� www.hhpub.com/index.php?content=books/isbn/0-88937-224-1.html

Psychological TherapyKlaus Grawe

The book explores the basis and need for a generally validconcept of psychotherapy and develops a psychological theo-ry of psychotherapy.

PUB. DATE: October 2003LIST PRICE: US $49.95MEMBER PRICE: US $39.95� www.hhpub.com/index.php?content=books/isbn/0-88937-217-9.html

Dictionary of Psychology and PsychiatryRoland Haas

The 2-volume English-German/German-English Dictionary ofPsychology and Psychiatry is an exhaustive bilingual compilationof terminology.

PUB. DATE: September 2003LIST PRICE: US $94.95 for each volumeMEMBER PRICE: US $75.95 for each volume� www.hhpub.com/index.php?content=books/isbn/0-88937-300-0.html� www.hhpub.com/index.php?content=books/isbn/0-88937-301-9.htmlUS $169.00 both volumes in a setUS $135.00 both volumes in a set� www.hhpub.com/index.php?content=books/isbn/0-88937-302-7.html

Cognitive Therapy With Schizophrenic Patients:

The Evolution of a New Treatment Approach Marco C. G. Merlo, Carlo Perris, Hans D. Brenner (Editors)

The evolution of cognitive-based therapies for schizophreniais changing psychiatric treatment of schizophrenia. This bookdescribes the state of the art.

PUB. DATE: December 2001LIST PRICE: US $46.95MEMBER PRICE: US $37.55� www.hhpub.com/index.php?content=books/isbn/0-88937-253-5.html

The Behavioral Sciences and Health CareOlle Jane Sahler, John Carr (Editors)

This book is designed primarily for medical students andtrainees, but also for other health professionals needing anintroduction to the behavioral sciences.

PUB. DATE: May 2003LIST PRICE: US $39.95MEMBER PRICE: US $31.95� www.hhpub.com/index.php?content=books/isbn/0-88937-261-6.html

Suicidal Behavior in Europe: Results from the

WHO/EURO Multicenter Study of Suicidal BehaviorArmin Schidtke, Unni Bille-Brahe, Diego De Leo, Ad JFM

Kerkhof (Editors)

A vital source of up-to-the-minute information from one ofthe most important studies in the world on suicidal behavior.

PUB. DATE: September 2003LIST PRICE: US $39.95MEMBER PRICE: US $31.95� www.hhpub.com/index.php?content=books/isbn/0-88937-249-7.html

Involuntary Childlessness: Psychological Assessment,

Counseling, and TherapyBernhard Strauss (Editor)

This book describes a range of counseling and therapyapproaches, introducing most recent knowledge about psy-chosomatic treatment of fertility disorders.

PUB. DATE: December 2001LIST PRICE: US $32.95MEMBER PRICE: US $26.35� www.hhpub.com/index.php?content=books/isbn/0-88937-198-9.html

Behavior and MedicineDanny Wedding (Editor)

One of the most popular and highly regarded behavioral sci-ence and psychology textbooks, with a practical, clinicalemphasis.

PUB. DATE: May 2001LIST PRICE: US $34.95MEMBER PRICE: US $27.95� www.hhpub.com/index.php?content=books/isbn/0-88937-238-1.html

IMPACT PUBLISHERS, INC.P.O. Box 6016

Atascadero, CA 93423-6016

Tel.: 800-246-7228

Fax: 805-466-5919


www.impactpublishers.com

Sex, Drugs, Gambling and Chocolate: A Workbook

for Overcoming AddictionsA. Thomas Horvath, Ph.D.

Shows how to eliminate or reduce addictive behavior.Supported by research. Alternative to 12-step.

PUB. DATE: 1998


LIST PRICE: $15.95MEMBER PRICE: $12.76SHIPPING: $6.00 for first title, .50 for each additional� www.impactpublishers.com

Anger Management: The Complete Treatment

Guidebook for PractitionersHoward Kassinove, Ph.D., and R. Chip Tafrate, Ph.D.

Research-based and empirically validated “anger episodemodel,” presented in a desktop manual for practitioners.

PUB. DATE: 2002LIST PRICE: $27.95MEMBER PRICE: $22.36SHIPPING: $6.00 for first title, .50 for each additional� www.impactpublishers.com

You Can Beat Depression: A Guide to Prevention

and Recovery (3rd Edition)John Preston, Psy.D.

Resource recognized by National Mental Health Association.Information on prevention, brief therapy interventions andnonmedical approaches. For therapists and clients.


Master Your Panic and Take Back Your Life! Twelve

Treatment Sessions to Overcome High Anxiety (2nd

Edition)Denise F. Beckfield, Ph.D.

Parallels actual treatment program of 12 self-help treatmentsessions. Research-based methods, case examples. Identifiestriggers, challenges catastrophic thinking.


Ask Albert Ellis: Straight Answers and Sound Advice

from America’s Best-Known PsychologistAlbert Ellis, Ph.D.

Ellis responds to reader questions submitted to the “Ask Dr.Ellis” Web site. Distills 50 years of psychotherapy experienceand wisdom in this practical guide.


Your Perfect Right: Assertiveness and Equality in

Your Life and Relationships (8th Edition)Robert E. Alberti, Ph.D., and Michael L. Emmons, Ph.D.

Eighth edition of the most highly acclaimed and widely rec-ommended assertiveness training book. Includes new materi-al on living in a multicultural society, assertive expression,appropriate anger expression, treatment for social anxiety andphobia.

PUB. DATE: 2001`LIST PRICE: $15.95

MEMBER PRICE: $12.76SHIPPING: $6.00 for first title, .50 for each additional� www.impactpublishers.com

How to Make Yourself Happy and Remarkably Less

DisturbableAlbert Ellis, Ph.D.

Shows how to change disturbing thoughts into healthy ones,handle adversity, overcome anxiety, depression, rage, self-hate, or self-pity.

PUB. DATE: 1999`LIST PRICE: $15.95MEMBER PRICE: $12.76SHIPPING: $6.00 for first title, .50 for each additional� www.impactpublishers.com

How You Feel Is Up to You: The Power of Emotional

Choice (2nd Edition)Gary D. McKay, Ph.D., and Don Dinkmeyer, Sr., Ph.D.

Teaches how to take responsibility for emotions, enhanceawareness of feelings and manage anger, anxiety, depression,guilt and stress.


OXFORD UNIVERSITY PRESS198 Madison Avenue

New York, NY 10016-4314

Orders Department:

2001 Evans Road

Cary, NC 27513

Tel.: 800-451-7556


www.oup-usa.org

The Hair-Pulling Problem: A Complete Guide to

TrichotillomaniaFred Penzel

The most complete and scientifically accurate handbookavailable on compulsive hair pulling. ISBN: 0-19-514942-4

PUB. DATE: March 2003LIST PRICE: $30.00MEMBER PRICE: $22.50 (when ordering, please mention pro-motion code #23382)SHIPPING: $5 for the first book, $1.50 each additional

Obsessive-Compulsive Disorders: A Complete Guide

to Getting Well and Staying WellFred Penzel

The most comprehensive guide available to the full range ofobsessive-compulsive disorders. ISBN: 0-19-514092-3

PUB. DATE: October 2000LIST PRICE: $30.00MEMBER PRICE: $22.50 (when ordering, please mention pro-motion code #23382)SHIPPING: $5 for the first book, $1.50 each additional


Healthy Anger: How to Help Children and Teens

Manage Their AngerBernard Golden

A practical guide to helping children turn their anger into atool for self-knowledge and self-mastery. ISBN: 0-19-5156657-9

PUB. DATE: January 2003LIST PRICE: $28.00MEMBER PRICE: $21.00 (when ordering, please mention pro-motion code #23382)

SHIPPING: $5 for the first book, $1.50 each additional

Calm Energy: How People Regulate Mood with Food

and ExerciseRobert Thayer

“Practical…tells us why we eat too much and exercise too lit-tle.” -Frank Farley, Ph.D., Former President, AmericanPsychological Association. ISBN: 0-19-516339-7

PUB. DATE: May 2003LIST PRICE: $14.95MEMBER PRICE: $11.50 (when ordering, please mention pro-motion code #23382)SHIPPING: $5 for the first book, $1.50 each additional

A Guide to Treatments That Work (2nd Edition)Edited by Peter E. Nathan and Jack M. Gorman

This thoroughly updated desk reference assesses current drugtreatments and psychotherapeutic interventions for eachmajor DSM-IV disorder. ISBN: 0-19-514072-9

PUB. DATE: 2002LIST PRICE: $85.00MEMBER PRICE: $68.00 (When ordering, please mention pro-motion code #23495)SHIPPING: $5 for the first book, $1.50 each additional� Order online at www.oup-usa.org/psychweb and save 25%

Solution-Focused Treatment of Domestic Violence

Offenders: Accountability for ChangeMo Yee Lee, John Sebold, and Adriana Uken

This book describes a cutting-edge treatment approach thatcreates effective, positive changes in domestic violence offend-ers. ISBN: 0-19-514677-8

PUB. DATE: March 2003LIST PRICE: $35.00MEMBER PRICE: $28.00 (When ordering, please mention pro-motion code #23495)SHIPPING: $5 for the first book, $1.50 each additional� Order online at www.oup-usa.org/psychweb and save 25%

Clinical Applications of Evidence-Based Family

InterventionsJacqueline Corcoran

Reviews empirically validated treatments relevant to familypractice, including child physical and sexual abuse, substanceabuse, and depression. ISBN: 0-19-514952-1

PUB. DATE: March 2003LIST PRICE: $49.95MEMBER PRICE: $39.95 (When ordering, please mention pro-motion code #23495)SHIPPING: $5 for the first book, $1.50 each additional

� Order online at www.oup-usa.org/psychweb, save 25%

Psychotherapy Relationships That Work: Therapist

Contributions and Responsiveness to PatientsEdited by John C. Norcross

This volume’s 24 chapters identify the elements of effectivetherapy relationships and methods of customizing psy-chotherapy to each patient. ISBN: 0-19-514346-9

PUB. DATE: 2002LIST PRICE: $75.00MEMBER PRICE: $60.00 (When ordering, please mention pro-motion code #23495)SHIPPING: $5 for the first book, $1.50 each additional� Order online at www.oup-usa.org/psychweb, save 25%

Handbook of Positive PsychologyEdited by C. R. Snyder and Shane J. Lopez

Brings together leading scholars to give voice to the emerg-ing field of positive psychology, which refutes the traditionalpathology model. ISBN: 0-19-513533-4

PUB. DATE: 2002LIST PRICE: $95.00MEMBER PRICE: $76.00 (When ordering, please mention pro-motion code #23495)SHIPPING: $5 for the first book, $1.50 each additional� Order online at www.oup-usa.org/psychweb, save 25%

Phobic and Anxiety Disorders in Children and

Adolescents: A Clinician’s Guide to Effective

Psychosocial and Pharmacological InterventionsEdited by Thomas H. Ollendick and John S. March

Designed for the practitioner seeking to utilize effective inter-ventions with children and adolescents suffering from anxietyand phobic disorders. ISBN: 0-19-513594-6

PUB. DATE: September 2003

LIST PRICE: $65.00MEMBER PRICE: $52.00 (When ordering, please mention pro-motion code #23495)SHIPPING: $5 for the first book, $1.50 each additional� Order online at www.oup-usa.org/psychweb, save 25%

A Working Life for People With Severe

Mental Illness

Deborah R. Becker and Robert E. Drake

Describes the theory, empirical support, and practice of a rad-ically new conceptual approach to supported employment.ISBN: 0-19-513121-5

PUB. DATE: May 2003LIST PRICE: $50.00 MEMBER PRICE: $40.00 (When ordering, please mention pro-motion code #23495)SHIPPING: $5 for the first book, $1.50 each additional� Order online at www.oup-usa.org/psychweb, save 25%

The Developmental Psychopathology of AnxietyEdited by Michael W. Vasey and Mark R. Dadds

Takes a fresh look at the major factors that contribute to anx-iety disorders in childhood and across the life span. ISBN: 0-19-512363-8

PUB. DATE: 2001LIST PRICE: $24.95 MEMBER PRICE: $19.95 (When ordering, please mention pro-motion code #23495)SHIPPING: $5 for the first book, $1.50 each additional� Order online at www.oup-usa.org/psychweb, save 25%


PROFESSIONALRESOURCE PRESSPO Box 15560

Sarasota, FL 34277-1560

Tel.: 800-443-3364; Fax: 941-343-9201

www.prpress.com

A Guide to the 2002 Revision of the American

Psychological Association’s Ethics CodeSamuel Knapp and Leon VandeCreek

An insider’s guide to the new code. The first book thatexplains the rationale behind and implications of each changefrom the 1992 code. ISBN: 1-56887-079-5

PUB. DATE: 2003LIST PRICE: $29.95MEMBER PRICE: $23.96SHIPPING: $4.00 U.S.; $8.00 foreign� www.prpress.com

WISDOM PUBLICATIONS199 Elm St.

Somerville, MA 02144

Tel.: 617-776-7416� www.wisdompubs.org

Mindfulness in Plain English: Updated and

Expanded EditionBhante Henepola Gunaratana

The classic bestseller. The author’s distinctive voice invites usto see how meditation can help us to face our behaviors andlive more peacefully. 224 pages, ISBN: 0-86171-321-4

LIST PRICE: $14.95MEMBER PRICE: $11.96

Meditation for LifeMartine Batchelor ~ Photographs by Stephen Batchelor

Here the varied forms of Buddhist meditation are explainedin simple language complemented by photographs thatinspire us toward meditative awareness.168 oversized pages, ISBN 0-86171-302-8


MindScience: An East-West DialogueThe Dalai Lama, with Herbert Benson, Robert Thurman,

Howard E. Gardner, and Daniel Goleman

This famous collaboration offers important new insights intothe workings of perception, cognition and the mind/bodyconnection.142 pages, ISBN 0-86171-066-5


Sleeping, Dreaming, Dying: An Exploration of

ConsciousnessThe Dalai Lama

254 pages, ISBN 0-86171-123-8 A lover of philosophy and science, the Dalai Lama here exam-ines the complementary relationships of Buddhism, psychol-ogy, and neuroscience, and what they mean to everyday life.


KLUWER ACADEMIC101 Philip Dr.Norwell, MA 02061Tel.: 781-871-6600Fax: 781-681-9045e-mail: [email protected]� www.wkap.nl/

AABT Clinical Assessment Series

Practitioner’s Guide to Empirically Based Measures

of Depression (Edited by Nezu et al.)

ISBN: 0-306-46246-X


of Anxiety (Edited by Antony et al.) ISBN: 0-306-46582-5


of School Behavior (Edited by Kelley et al.) ISBN: 0-306-

47267-8

LIST PRICE: $69.95 eachMEMBER PRICE: $49.00 eachSHIPPING: $4.00 U.S.; $8.00 foreign

MAILING COUPON

Send this coupon and your payment directly to the publisher. Each

publisher’s address is listed in the catalog. Do not send your order

to AABT. Member prices are available through December 31, 2003.

I am a member in good standing with the Association for

Advancement of Behavior Therapy. I would like the following

item(s).

TITLE AND AUTHOR MEMBER PRICE

$

$

$

$

$

$

Shipping (see listing): $

State & Local Taxes (where applicable): $

Total Enclosed: $

Paying With: � Check � Credit Card

� Visa � MasterCard Exp. Date

CC#

Signature

Name:

Address:

Phone / e-mail:

BOOkSEliNG CATAoG


Doctors’ Suit Against Health CareCompanies Allowed to Proceed

The New York Times reports that a panelof federal appeals judges in Atlanta rejecteda request from several managed care com-panies to stop a proposed class-action suitfiled against them on behalf of 600,000physicians. The managed care companieshad argued that the doctors’ claims neededto be decided by arbitration and not by thecourts.

Lawyers for the doctors were reportedlyplanning to ask the United States Court ofAppeals for the 11th Circuit to lift the orderthat had up to now stalled the litigation. Ashad previously been reported in this col-umn, the plaintiffs in the case alleged thatthe insurance companies had “violated con-tracts and defrauded doctors in violation ofthe federal Racketeer Influenced andCorrupt Organizations Act, known asRICO; the Employee Retirement IncomeSecurity Act; and state laws.” A separatelawsuit was filed on behalf of “millions” ofsubscribers.

Archie Lamb, a lawyer for the plaintiffs,was planning to ask the court to requirethat the insurance companies make avail-able business records that he stated wouldsupport the plaintiffs’ position. Aspokesperson for the California MedicalAssociation, which joined in the suit, statedthat the doctors were “pleased that the cir-cuit court will allow us to continue with thelawsuit.”

The general counsel for the AmericanAssociation of Health Plans called the rul-ing a “victory for the health plans.” Shenoted that the lawsuits would end up in a“procedural morass” on account of doctorshaving different types of contracts with theinsurance companies.

The companies involved in the suit in-clude Aetna, Cigna, Humana, UnitedHealthcare, Wellpoint Health Networks,Health Net, Prudential, Pacificare, andCoventry Health Care of Georgia.

U.S. Judge Rules Bipolar Disorder Is a Physical Illness

The Wall Street Journal reports a story inwhich a person named Jane Pitt had to quither job 7 years ago as an employment attor-ney at the Federal National Mortgage

Association after she was diagnosed withbipolar disorder. Ms. Pitt received part ofher salary for 2 years under a long-term dis-ability policy. The payments then stopped.The agency’s disability policy provided ben-efits to people up to age 65 for physical dis-abilities but only provided 24 months ofcoverage for disabilities resulting frommental illness. This disparity in coveragewas said to be typical of those of many em-ployers.

In February 2002, however, a federalcourt ruled that Ms. Pitt’s illness could beconsidered physical and that she was enti-tled to full disability benefits. The presidingjudge in the case “cited statements byphysicians that [her] disorder was visible onbrain scans, was characterized by chemicalimbalances in the brain, and might have ge-netic causes.”

The ruling was said to have caused a stirin employment law circles, even though ef-forts by workers to challenge differentialbenefits for physical and mental illnessesunder the Americans With Disabilities Acthad not previously been successful. The ar-ticle notes that maintaining distinctions be-tween the two types of disorders wasbecoming increasingly difficult as researchblurred the lines between them.

The trial court ruling is not binding onother courts, but the ruling was expected toencourage other similar suits, according toan attorney specializing in employment law.Employers and insurers were said to bealarmed by the trend, according to StephenBokat, general counsel for the U.S.Chamber of Commerce. He warned that ifthe distinctions were not maintained, em-ployers would have increasing difficulty of-fering disability insurance.

Ronald Cooper, an attorney who repre-sents insurers, noted that the underlyingproblem is that the costs for mental health-related benefits are hard to control. “Theseare very difficult things to diagnose andtreat in a way that’s predictable.”

Ms. Pitt’s lawsuit alleged that mentalhealth disability caps violate the disabilitiesact. The judge in the case had to determineif bipolar disorder was clearly a mental ill-ness under the policy definitions of the dis-ability insurer, Unum. An Unum physiciannoted that the disorder was contained inDSM-IV and a psychologist employed byUnum asserted that bipolar disorder was a

mental illness because it was “characterizedby a cognitive, emotional, or behavioral ab-normality.”

The judge was not convinced by this ar-gument as he noted that even DSM-IV

“posits that the distinction between mentaldisorders and physical illnesses is a falseone.” He further noted that problems suchas Alzheimer’s disease and anorexia nervosaare brain based, but are commonly seen as“physical” illnesses.

Drug Companies ChallengeLongstanding European Ban on

Consumer Drug Advertising

The Wall Street Journal reports that theFrench-German company, Aventis SA,spent approximately $89 million in 2001 topublicize its allergy drug Allegra, but inEurope, decisions of the European Unionban prescription drug advertising and evenprevent Aventis from mentioning Allegraon its Web site or in its brochures.

These regulations, in effect for manyyears, help to control health-care costs,which are heavily subsidized in Europeancountries. Drug makers are arguing thatsuch restrictions unfairly limit patients’ ac-cess to information and hence limit their ac-cess to medications that may be clinicallyuseful. AstraZeneca PLC is the producer ofthe drug Prilosec, which is used for thetreatment of ulcers. Although the drug had$6 billion worth of sales worldwide, theUnited States contributed two-thirds ofthat total, with Europe contributing one-third, despite the United States having asmaller population.

The European Commission is now con-sidering allowing drug companies to mar-ket treatments for AIDS, diabetes, andrespiratory disorders on their corporateWeb sites and in brochures requested byconsumers. The overall rubric is that theconsumer must request the information.

Though falling far short of American di-rect-style marketing, the proposal reflectspressures on European governments, aswell as the fact that much of the informa-tion is already available to the Europeanconsumer on American and other Websites. The article notes that this can some-times create confusion because medicationsare given different names and sometimesavailable in different dosages depending onthe country.

Both consumer groups and European of-ficials assert that relaxing drug advertisingregulations will simply raise advertisingbudgets and drug prices without havingany significant effect on the health of

Professional and Legislative Issues

Saul D. Raw, Weill Medical College of Cornell University


Europeans. European governments typi-cally set some price controls on drugs, andprices are typically 40% to 60% lower thanin the U.S.

Charles Medwar, director of the groupSocial Audit, a consumer interest group inLondon, is skeptical about the benefits ofadvertising. He notes that the total healthcare cost per person, a significant part ofwhich is made up of drug prescriptions, was$3,724 in the U.S. as opposed to $1,660 inEurope (year 2000). He maintains that con-sumers can already learn about availablemedications through the media andthrough patient organizations. Finnish al-lergist Erkka Valorvirta states (referring todrug advertising), “It doesn’t help patientsseek out the best treatment . . . ; it usuallyjust happens to be the most expensive.”

John Patterson, a senior marketing exec-utive at AstraZeneca, notes that direct-to-consumer marketing is something of atwo-edged sword. “It’s expensive, and youend up in a spiral of costs because everyone isdoing it.” He maintains that such advertis-ing is often useful, as it may prompt con-sumers to make an appointment to see adoctor and seek treatment in situations inwhich they might not ordinarily do so.

Study Reveals Americans More Willingto Seek Out Treatment for Depression

in the United States

Psychiatric News, citing a study that ap-peared in the Journal of the American Medical

Association, reveals a threefold increase inoutpatient treatment for depression in thedecade 1987 to 1997. In 1987, 0.7%, or1.76 million people, sought treatmentwhile in 1997, 2.3%, or 6.33 million peo-ple, sought treatment. Of those treated fordepression, 44.6% were prescribed a psy-chotropic medication in 1987 as opposed to79.4% in 1997.

The study collected information fromsurveys done for the Federal Agency forHealthcare Research and Quality. In bothstudies, participants were asked to record“medical events” in a diary. Events could in-clude such things as visits to physicians.These diary entries were later discussedwith respondents in face-to-face interviews.Tens of thousands of households were re-portedly polled for these studies, whichwere designed to determine health-care uti-lization and sources of funding.

Other findings revealed that the overallpercentage of patients receiving psy-chotherapy for depression declined from71% to 60% during this period, while the

percentage of those being treated by aphysician increased from 69% to 87.3%.

The study concludes that “these changescoincided with the advent of better-toler-ated antidepressants, increased penetrationof managed care, and the development ofrapid and efficient procedures for diagnos-ing depression in clinical practice.”

More on the Evidence-Based Practice Debate

An article in NASW News discusses anumber of research reports that suggestthat treatment effects reported in outcomeliterature are less dependent on treatmenttechnique than on a number of other fac-tors. According to James Drisko, AssociateProfessor of Social Work at Smith College,the social work profession would be betteroff informing the public that those who par-ticipate in therapy do better than those whodo not. He also believes that the researchers’time would be better spent studying thera-peutic common factors, such as empathyand acceptance, as well as the agency andclient contexts within which service deliveryoccurs.

Drisko maintains that 25 years of in-creasingly sophisticated meta-analytic studiesreveal that “differences across therapies arenot particularly significant or meaningful.”He believes that, although studies compar-ing psychotherapies sometimes show differ-ences, meta-analyses, which factor outvarious biases and methodological prob-lems, reveal outcomes that are the same orsimilar. The article notes that there is con-troversy as to whether meta-analyses reallyreveal no significant differences betweentherapies.

Citing the work of Michael Lambert ofBrigham Young University, Drisko main-tains that 40% of outcome variance can beattributed to factors outside the therapy it-self, such as client context (neighborhoodand family, peer, social, workplace and spir-itual supports) and the client as commonfactor (intelligence, motivation, trust, re-silience, etc.). Thirty percent of the vari-ance, according to Lambert, comes from thetherapeutic relationship while only 15% ofoutcome variance comes from therapy tech-niques that are “unique to a specific treat-ment.” Lambert attributes the other 15% ofvariance to the placebo effect, includinghope and expectancy that clients bring tothe therapeutic encounter.

According to Drisko, the results of thesemeta-analytic studies have several strongimplications for the field of social work. It ismore important that the overall efficacy of

psychotherapy, rather than the type of ther-apy, be the basis for discussions of mentalhealth policy and funding. Meta-analysesshow an effect size of 0.8 for psychotherapy,a result said to be stronger than for manyservice programs and many medical treat-ments. “It isn’t the common notion outthere in the world that therapy works. Wehave become very critical of professionals,but empirical evidence shows that therapyworks. Since social workers do more of thiswork than other professions combined,that’s what we ought to be promoting.”

By contrast, William Reid, professor ofsocial work at the State University of NewYork at Albany, believes that when studiesare searched by problem and population,different interventions show different re-sults. In his study of 42 meta-analyses, 31reported different treatment effects be-tween interventions.

“Given the weight of the evidence, itmay make sense to consider differential ef-fects or the lack thereof in respect to specificproblems, population and interventionmatch-ups rather than to refer to a generaltie-score effect. . . .” According to Reid,“Determining whether or not comparisonsbetween intervention methods yield gen-uine differences in effectiveness will alwaysbe a daunting task, and one that will fre-quently yield null results.”

Kathleen Millstein, associate professorof social work at Simmons College, believesthat evidence-based practice may miss rela-tionship issues critical to client improve-ment. “Controlled studies take away theheart of social work—the relationshippiece. It doesn’t work unless you have agood relationship.”

Criticism of New Mexico Decision on Prescription Privileges for

Psychologists: More DispassionateViews From Another Psychiatrist

In response to pending legislation inNew Mexico that would give prescriptionprivileges to psychologists, two highly criti-cal letters, both from physicians, appearedin The Wall Street Journal. One was fromJoseph J. Zealberg, M.D., clinical professorof psychiatry at the Medical University ofSouth Carolina and former president of theAmerican Association for EmergencyPsychiatry. His letter, in its entirety, follows:

As a proponent of high-quality patientcare, I am writing regarding NewMexico’s pending legislation that wouldallow psychologists to prescribe psychi-atric medications.


Such an idea is myopic and pernicious.After receiving my medical degree, Ibegan psychiatric residency training in1981. In the past two decades, I’ve prac-ticed in all types of settings—ruralAppalachia, urban research centers, inhospitals, outpatient clinics, communitysettings and in emergency rooms. I’veevaluated thousands of patients.

Treatment of the nervous system re-quires the most sophisticated forms ofmedical expertise. Patients often take nu-merous medications for concomitantmedical or neurological syndromes.Alcohol and drug abuse often complicatetheir clinical histories. One medicationcan have profound effects on another.Worsening angina pectoris may mimicpanic disorder. Hyperthyroidism can bemistaken for mania. Confusional statescaused by medical illness or drug toxicitycan be misconstrued as severe depressionor dementia. In spite of their medicaltraining, even general physicians canmiss such differential causes of behavioralchange. Psychopharmacologic medica-tions can affect not only the brain, butalso the circulatory system, the liver’sbiochemical pathways, the body’s com-plex gastrointestinal system, and othercritical organ networks. Non-physicianshave no business ordering medicationsthat may affect the body’s most compli-cated organ—the brain.

Psychiatric syndromes are compli-cated by high levels of morbidity andmortality. Let’s not compound these ter-rible problems by devising inferior solu-tions. Incentives should be in place toattract outstanding psychiatrists to ruralareas. Government and state-sponsoredscholarship programs should be in placeto assist in this endeavor.

Another point of view is provided in aninterview with Ali Hashmi, M.D., in The

National Psychologist. Dr. Hashmi works in acommunity mental health center inJonesboro, Arkansas, a city of about55,000. Dr. Hashmi views the controversyas essentially economic. “It’s amusing thatthe whole argument is couched in philo-sophical, moralistic terms. Nobody seemsto be willing to acknowledge that this is pri-marily, or at least largely, an economicissue,” according to Hashmi. He adds,“There is a pervasive fear in psychiatric cir-cles that if nonphysicians are given prescrib-ing privileges the rates of reimbursement,salaries, and earnings of psychiatrists wouldbe driven down accordingly. Conversely, theother camp doesn’t want to admit that get-ting prescription privileges would boosttheir income since prescribing is much lesslabor and time intensive than therapy. It

guarantees a steadier income stream thantherapy,” he adds.

Hashmi believes that because of eco-nomic and political factors pushing pre-scription privileges forward, it is inevitablethat these privileges will one day be grantedin one state, and he predicts a domino effectin other states. He thinks that psychiatryshould be open to “physician extender”models, such as those already in effect inphysician assistant and nurse practitionerpractice.

Hashmi maintains that psychologistsand psychiatrists are fighting “over a largerpiece of an ever-shrinking pie.” He notesthat “almost all health insurance companieshave ‘carved out’ their mental health ser-vices to ‘for-profit’ behavioral health com-panies which slice off, 30, 40, 50% ofmember premiums for ‘overhead,’ meaningthat for every dollar paid into the plan, halfgoes into the company’s pocket, not forhealth care. At the same time, access to psy-chologists and psychiatrists alike is more re-stricted than ever. That is the fight weshould all be fighting.”

Psychological Needs of Hepatitis-C Patients

A paper in Issues in Interdisciplinary Care

describes support groups for patients receiv-ing combination therapy for Hepatitis C, adisease which is said to affect 4 million peo-ple in the United States. The combinationof physical, psychological, social, and cogni-tive side effects of the disease and its treat-ment poses major challenges to patients,friends, and family.

The treatment of choice for many ofthese patients is alpha interferon in combi-nation with ribavirin, an antiviral therapy.Interferon side effects include flulike symp-toms, hair loss, fatigue, and depressed whiteblood count. The author notes that al-though she has observed mild to severe psy-chological, social, and cognitive difficultiesin patients undergoing combination ther-apy, she has also attended physician confer-ences in which these side effects weredescribed as “minimal.” Significant areas ofdysfunction for combination therapy pa-tients include activities of daily living, work,social relationships, and marriage.

Support groups, led by professionals or“facilitators,” are essentially psychoeduca-tional in form and focus on decreasing isola-tion, encouraging sharing of feelings andcoping strategies, and disseminating thebest available information about the diseaseand its treatment in order to help patientsmake the most informed treatment choices.

Stress management techniques are said tobe another important component.

Report on Racial Disparities in Accessto Health Care Available On-Line

A study recently published by theInstitute of Medicine documents racial andethnic disparities in access to health care,even when patients have access to the sameinsurance. This study is available in its en-tirety in a fully searchable version on theWorld Wide Web (http://books.nap.edu/books/030908265X/html). The study re-ceived a great deal of media attention, in-cluding a front-page article in The New York

Times. The report, which examined both med-

ical and psychiatric care, is said to revealboth overt and covert factors that interferewith equal access to medical care.

References

Freudenheim, M. (2002). U.S. panel allows doc-tors’ suit against health care companies. The

New York Times. Retrieved March 18, 2002,from http://www.nytimes.com/2002/03/16/business/16CARE.html

Fuhrmans, V., & Naik, G. (2002, March 15). InEurope, prescription-drug ads are banned—and health costs lower. The Wall Street Journal,pp. B1, B4.

Institute of Medicine. (2002). Unequal treat-ment: Confronting racial and ethnic dispari-ties in health care. Retrieved May 9, 2003,from http://books.nap.edu/books/030908265X/html

Kupersanin, E. (2002, February 1). Americansmore willing to seek out treatment.Psychiatric News, pp. 1, 30.

Olfson, M., Marcus, S. C., Druss, B., Elinson, L.,Tanielian, T., & Pincus, H. A. (2002).National trends in the outpatient treatmentof depression. Journal of the American Medical

Association. Retrieved January 9, 2002, fromhttp://jama.ama-assn.org/issues/v287n2/toc.html

O’Neill, J. V. (2002, March). Therapy techniquemay not matter much. NASW News, p. 3.

Orey, M. (2002, March 12). Bipolar disorder is aphysical ill, U.S. judge rules. The Wall Street

Journal, pp. B1, B4.

Robinson, A. (2001). Meeting the psychologicalneeds of hepatitis C patients on combinationtherapy. Issues in Interdisciplinary Care,

3(July), 177-183.

Saeman, H. (2001, September/October). A psy-chiatrist dispassionately presents views onpsychology prescription rights. The National

Psychologist, pp. 1, 16-17.

Zealberg, J. J. (2002, March 20). An absurdmedical solution. The Wall Street Journal, p.A23. �

Yes, You Can CallYourself a RealDoctor

Barry A. Bass, Towson University

Frank M. Dattilio (2003) will be heart-ened to learn that all his worry aboutnot being a “real doctor” was for

naught. I’m pleased to inform him thatcontrary to popular opinion, it is the physi-cians who have “stolen” that title from thescholars and academics. From at least theearly Middle Ages, the honorific title ofdoctor had been reserved for men of greatlearning. It was not until the 18th centurythat medical schools began the now ac-cepted practice of referring to their gradu-ates as doctor. As noted in The Wall Street

Journal, it appears that it was “jealous[y] ofthe respect shown to scholars by the title

doctor” that was responsible for the changein how one was to address physicians(Sherman, 1995). So, Dr. Dattilio, it is nottoo late to disabuse your son of his mistakennotion and to point out to him that it is thePh.D.s of the world, and not the physicians,that are truly the “real doctors.”

References

Dattilio, F. M. (2003). So you call yourself a doc-tor? the Behavior Therapist, 26, 293-294.

Sherman, R. M. (1995, June 1). Are physiciansreally doctors? [Letter to the editor]. The

Wall Street Journal. �


What’s in a Name?Everything!

Kenneth D. Salzwedel, PrivatePractice, Whitewater, WI

Idon’t think the name of AABT shouldbe changed. To do so would give voiceto those who do not have a behavioral

orientation. There are other organizationsand SIGs they can join if they wish. I find itvery curious that these individuals want tobelong to a behavioral organization. Maybewe should ask them sometime. Already,many of the behavioral journals are devot-ing more and more space to “cognitive”work. This strikes me as being totally un-warranted.

I looked over the most recent issues ofBehavior Modification, Behavior Therapy, theJournal of Applied Behavior Analysis, and thepremier clinical journal, the Journal of

Consulting and Clinical Psychology, to deter-mine the extent of there being a “cognitive”emphasis in the articles that were printed.In Behavior Modification, there were 7 arti-cles in the issue. Of these, 4 were cognitive inorientation and none of them were behav-

ioral. The remaining 3 articles were of a re-search nature that would be a better fit inthe Journal of Consulting and Clinical

Psychology. In Behavior Therapy, there were 8articles: 4 cognitive, 1 behavioral. The re-maining 3 were of a research nature or wereimpossible to classify. Of course, the sec-ondary title of Behavior Therapy, “AnInternational Journal Devoted to theApplication of Behavioral and CognitiveSciences to Clinical Problems,” suggeststhat “cognitive” articles are okay.Fortunately, we still have the Journal of

Applied Behavior Analysis. A recent issue ofthis publication contains 12 articles, all ofwhich are behavioral. Finally, 5 articles ap-peared in an issue of the Journal of Consulting

and Clinical Psychology, all of which werecognitive in orientation.

The basic point of this discussion is to in-dicate that a behavioral article is difficult tofind, even when the term “behavior” is inthe journal’s name. We do not need tochange our name to ensure that others mayhave a place to hang their hats. The hatrackis already filled with their cognitive hats.

Let’s keep advancing behavior therapy,not cognitive therapy. Skinner would rollover in his grave if he noted how cognitionhas intruded into behaviorism. �

Letters to the Editor

Reno Re-Revisited

Barbara Parry, Private Practice, Las Vegas, NV

Iread with dismay the article inJanuary’s the Behavior Therapist

(Steffen, 2003) recapping the Renoconvention. I am a private practitioner andI pay for absolutely everything by myself.The Reno Convention was the only afford-able one AABT has ever put on. I lived inStockton, CA, prior to moving to LasVegas, and I could not afford to go to theone in San Francisco due to the cost of stay-ing there and the drive times.

I am appalled that people were appalledat the “casino atmosphere.” The Hilton ac-tually allows convention participants toenter their convention area without evergetting into the gambling area. I am sovery sorry that you will not use a casino-based hotel again. Can you give me the sta-tistics on the number of people who went tothe conference who complained of thecasino venue versus the number of peoplewho went who did not complain? I wouldlike to know what statistic you are basingthis decision on. Please count me as a non-complainer.

As the conventions tend to be expensiveand in far-away places for me, I am reallysaddened that I probably will never againattend an AABT conference. Price doesmatter. Los Angeles, Portland, Honolulu,San Diego, Palm Springs, Seattle, Victoria,BC, Banff, Canada, Anchorage, Chicago,Phoenix, Sedonia, Flagstaff, Albuquerque,Taos, Boulder, and Denver are all pretty ex-pensive places, both to get to and to stay in.I will be very interested in seeing if your at-tendance statistics go down again for WestCoast conventions when you have to selectan expensive venue.

Reference

Steffen, A. (2003). Reno revisited. the Behavior

Therapist, 26, 226. �

Sponsor a student’s membership today.

Help AABT Grow!


Response to Bobiczand Richard (2003)

Barbara O. Rothbaum, EmoryUniversity School of Medicine

Itake issue with some of the conclusionsreached by Bobicz and Richard (2003)in their recent tBT article “The Virtual

Therapist: Behavior Therapy in a DigitalAge.” Some of their conclusions fail to rec-ognize the extent of the research conductedon the therapeutic use of virtual reality.They criticize the field on a number of issuesthat have been addressed but were not in-cluded in their brief review. For example:

• “Most studies are either case studies or include small samples (. . . 5 to 20 partici-pants . . .)” (p. 267)

Response: In Rothbaum, Hodges, Smith,Lee, and Price (2000), there were 45 treat-ment completers. This study has now beenreplicated with 75 treatment completers.

• “. . . with inconclusive or absent follow-updata” (p. 267)

Response: In Rothbaum et al. (2000), datawere presented on participants 6 monthsafter completing treatment; in Rothbaum,Hodges, Anderson, Price, & Smith (2002),follow-up data were gathered 12 monthsafter treatment.

• “It is the rare study that compares VR ex-posure to its in vivo cousin” (p. 267)

Response: The Rothbaum et al. (2000)study compared virtual reality exposuretherapy to standard exposure therapy to await-list control group.• “Treatment outcome is often measuredusing questionnaires rather than by observ-ing more meaningful behavioral activities”(p. 267)

Response: In the studies listed below, par-ticipants were rated on a BAT of an actualairplane flight and rated for their ability oravoidance to fly on real airplanes. In ourwork on social phobia, we have pre- andposttreatment BATs of speeches deliveredin front of live audiences (Anderson,Rothbaum, & Hodges, in press).

• “Computer-based . . . could be enhancedby the use of digitized video” (p. 268).

Response: Not only do we currently dothis, we hold a patent on it!

I think it was slightly sloppy not to in-clude the very relevant studies below thatwere readily available. A list of publicationsis available at www.virtuallybetter.com.

References

Anderson, P. L., Rothbaum, B. O., & Hodges, L.(2001). Virtual reality: Using the virtualworld to improve quality of life in the realworld. Bulletin of the Menninger Clinic

Supplement, 65, 4-17.

Anderson, P., Rothbaum, B.O., & Hodges, L. F.(in press). Virtual reality exposure in thetreatment of social anxiety: Two case reports.Cognitive and Behavioral Practice.

Bobicz, K. P., & Richard, D. (2003). The virtualtherapist: Behavior therapy in a digital age.the Behavior Therapist, 26, 265-270.

Rothbaum, B. O., Hodges, L., Anderson, P. L.,Price, L. & Smith, S. (2002). 12-month fol-low-up of virtual reality exposure therapy forthe fear of flying. Journal of Consulting and

Clinical Psychology, 70, 428-432.

Rothbaum, B. O., Hodges, L., Smith, S., Lee, J.H., & Price, L. (2000). A controlled study ofvirtual reality exposure therapy for the fear offlying. Journal of Consulting and Clinical

Psychology, 68, 1020-1026. �

Letters to the Editor

In Response to Dr.Rothbaum’s Critique

David C. S. Richard, EasternMichigan University

Dr. Rothbaum (2003; see above)brings up a number of interestingpoints, and I am grateful for the

opportunity to address them. I am sure thatshe and her colleagues would agree thatwhen we say “most studies are either casestudies or include small samples,” we meanexactly that. We are not speaking exclu-sively of her research. VR studies reportedto date, as a whole, have been intriguingand well conceived. However, the majorityinclude small sample sizes with all the at-tendant power issues. The 2002 follow-uppaper she references was published after wesubmitted our manuscript to the Behavior

Therapist, and I concur that the follow-updata are of interest. However, we can not beheld responsible for papers that were notavailable at the time we wrote our manu-

script. Indeed, we note in the review thatour remarks would be outdated by the timethe article went to press. Despite the im-pression Dr. Rothbaum leaves in her letter,our remarks (like those you will find in allreview papers) were general summaries ofthe field and were not specifically directedat her research. Indeed, her comment re-garding the overreliance on questionnairedata seems odd given that the study wecited (i.e., Carlin et al., 1997) had nothingto do with her research. The fact that oneresearcher or one group of researchers em-ploys sound methods does not mean thefield as a whole does. Thus, we stand by ourreview and look forward to the fine workDr. Rothbaum and her colleagues will un-doubtedly contribute in the years to come. Iapplaud her pioneering work and look for-ward to reading of future developments.

Reference

Rothbaum, B. O. (2003). Response to Bobiczand Richard (2003). the Behavior Therapist,26, 326. �

On Our Web Site

w w w . a a b t . o r g

MEMBERSHIP

• sign up for the AABT listserve

CONVENTION

• list of accepted submissions

• poster guidelines

PUBLICATIONS

• article abstracts

• videotape/audiotape series

FOR STUDENTS

• careers in behavior therapy

PLUS

• Clinical Directory

• AABT Bylaws

and more . . .


Classifieds

Classified ads are charged at $4.00 per line. Classified ads

can be e-mailed directly to Stephanie Schwartz, Advertising

Manager, at [email protected]; otherwise, please fax or

mail hard copy to AABT, 305 Seventh Ave., New York,

NY 10001 (fax: 212-647-1865).

Positions Available

TWO POSTDOCTORAL FELLOWSHIPSIN CLINICAL PSYCHOLOGY. TheUniversity of New Mexico Clinical ResearchBranch in the Center on Alcoholism, SubstanceAbuse and Addictions (CASAA) has positionsavailable for two, two-year postdoctoral posi-tions in the areas of adolescent and family clinicalpsychology and substance abuse treatment.Fellows will receive training in conducting NIHfunded clinical research evaluating treatmentoutcome with runaway and homeless substanceabusing youth and their families. Applicantsshould be clinical psychologists who have com-pleted the Ph.D. requirements and an APA accredited internship. Fellows will receive com-prehensive training in obtaining extramuralfunding, offering clinical interventions to adoles-cents, and generating peer-reviewed publica-tions. Clinical supervision can be arranged, ifdesired. Review of candidates will begin imme-diately and continue until the positions are filled.Send a curriculum vita and a cover letter to:Natasha Slesnick, Ph.D., University of NewMexico, Center on Alcoholism, Substance Abuseand Addictions, 2650 Yale SE, Suite 200,Albuquerque, NM 87106. The University ofNew Mexico is an Equal Opportunity/Affirmative Action Employer.

NYU CHILD STUDY CENTER—DEPUTYDIRECTOR OF ADHD INSTITUTE. TheNYU Child Study Center is seeking to recruit anestablished investigator to serve as the DeputyDirector of the Institute for Attention DeficitHyperactivity and Related Disorders. TheInstitute’s mission is to advance our knowledgeregarding the nature of and interventions forADHD; provide state-of-the-art, empiricallybased clinical care to individuals with ADHD;and train psychologists and psychiatrists inADHD evaluation, diagnostic and treatmentprocedures. The Institute (Director: HowardAbikoff, Ph.D.) includes a large research portfolioof federal and industry funded grants, a clinicalservice, which includes a specialized summer daytreatment program, and a training program forpsychology interns, postdoctoral fellows andchild and adolescent psychiatry residents.Research collaborations are also available withother Institutes at the Child Study Center, in-cluding Pediatric Neuroscience (Director:Xavier Castellanos, M.D.), Anxiety and MoodDisorders (Director: Rachel Klein, Ph.D.),Tourette’s and Movement Disorders (Director:Barbara Coffey, M.D.), Children at Risk(Director: Laurie Miller, Ph.D.), and Trauma andStress (Director: Marylene Cloitre, Ph.D.). Thecandidate (Ph.D. or M.D.) should have a strongbackground in clinical research, a history ofgrant funding, and administrative experience.This individual will work closely with theInstitute Director and will be expected to carryout his/her own programmatic research.

Academic rank will be commensurate with acad-emic achievements. Please send a letter of interestand C.V. to Howard Abikoff, Ph.D., NYU ChildStudy Center, 215 Lexington Ave., 13th floor,New York, NY 10016 (email: [email protected]). NYU is an Equal-Opportunity, Affirmative-Action Employer.

COUNSELING/WELLNESS MANAGER,GRAND VALLEY HEALTH PLAN, GRANDRAPIDS, MI. Innovative staff model HMO lo-cated in Michigan’s life sciences corridor is seekingentrepreneurially-minded person to develop andimplement population-based counseling/well-ness programs fully integrated with primary careand other medical services. Responsibilities alsoinclude managing the operations of a multi-sitecounseling/wellness team. Minimum require-ments include Doctoral or Master’s degree in be-havioral medicine-related field; eligibility forprofessional licensure/registration in Michigan;and five to ten years of progressive responsibili-ties in clinical, program development and man-agement areas relevant to population-basedcounseling/wellness services and the integrationof behavioral health, wellness and other medicalservices. Requirements also include excellentteaching/coaching/consultation/assessment skillsand expertise in care coordination/disease man-agement models using group and team interven-tion approaches. Review of applications andpreliminary telephone interviews will begin im-mediately. Send (preferably via email) a CValong with a cover letter specifying how yourknowledge, skills, experience, philosophy andstyle fit with this role description to attention ofPamela L. Silva; Director, Market Services andOperations; Grand Valley Health Plan; [email protected] ( or to 829 Forest Hill Avenue,SE; Grand Rapids, MI 49546).

THE PSYCHOLOGY DEPARTMENT ATTHE UNIVERSITY AT BUFFALO, THESTATE UNIVERSITY OF NEW YORK, in-vites applications for the position of ClinicalDirector of its Psychological Services Center(PSC). The applicant should be a New York Statelicensed or license-eligible psychologist. This is aninitial 2-year appointment with the possibility ofrenewal. The PSC is an outpatient mental healthtraining clinic that operates under the auspices ofUniversity at Buffalo. Responsibilities include: su-pervision of graduate student therapy and assess-ment, consultation with community agencies,direct service, program development, routineclinic administration, and collaboration with re-search projects conducted by associated facultyand doctoral students. Primary requirements forthe position include: Ph.D. or Psy.D., prior clinicalexperience, preferably with some exposure to pro-tocol based treatments, and a commitment to theclinical-scientist model of professional training.Applicants should submit a current vita and a let-ter that describes their areas of specialty in clinicalwork and their approach to graduate clinicaltraining. All materials should be forwarded to:PSC Search Committee, Department ofPsychology, Park Hall, University at Buffalo, TheState University of New York, Box C, Buffalo,NY 14260-4110. To ensure consideration, ma-terials must be received by June 16, 2003. TheState University of New York at Buffalo is an Affirmative Action/Equal OpportunityEmployer.

BEHAVIORAL HEALTH CONSULTANT.The Mariposa Community Health Center, inNogales, Arizona, is seeking a full-timeBehavioral Health Consultant to assist providerswithin the primary care setting in treating pa-tients with behavioral health problems. The BHConsultant will function as an integral member ofthe primary care team and develop specific behav-ioral change plans for patients and behavioralhealth protocols for target populations. Qual-ifications: Master’s level education in Social Work,Counseling, Psychology, or related field, or anyequivalent combination of education, training,and/or experience will be considered. Excellentworking knowledge of behavioral medicine andevidence-based treatments for medical and men-tal health conditions. Current Arizona licensurerequired. Proficiency in Spanish preferred.Excellent compensation and benefits package of-fered. To apply please contact: Eladio Pereira,MD, Mariposa Community Health Center,Inc.,1852 N Mastick Way, Nogales, AZ 85621;phone: 520-375-5044; fax: 520-761-2151. AnEqual Opportunity, Affirmative Action Employer.

BEHAVIORAL PSYCHOLOGIST. Multi-disciplinary practice in suburban Philadelphiaseeks licensed psychologist for full or part time.Must have strong training in CBT and desire topractice free of managed care. Fax vita toMargaret Sayers, Ph.D. 215/396-1886

SUMMER EMOTIONS INSTITUTES withLes Greenberg, Ph.D. Skills training in a compre-hensive set of tools for working directly with emo-tion in psychotherapy. York University, Toronto.Level 1 = August 11-14, 2003; Level 2 = August18-21, 2003. Call (416) 410-6699 or visit us atwww.emotionfocusedtherapy.org.

At AABT’s Conventionin Boston you can spend 2 hours

learning from some of the most tal-

ented practitioners in the field.

Sign up early for the limited seating

at Master Clinician Seminars with

the extraordinary:

• Marylene Cloitre and Jill Levitt

• Sheila Eyberg and Cheryl McNeil

• Eva L. Feindler

• W. Kim Halford and Jennifer Scott

• Cory F. Newman

• Matthew R Sanders

• Zindel V. Segal

M E C H A N I S M S O F A C T I O N

BOSTON · November 20–23

AABT

PRSRT STD

U.S. POSTAGE

PAID

Hanover, PA

Permit No. 4

the workshops§ Anne Marie Albano & Mark Reinecke, Modularized Cognitive Behavioral Treatment

of Depression and Its Comorbidities in Adolescents

§ Aaron Beck, Neil Rector, & Corinne Cather, Cognitive Therapy of Schizophrenia:

A Paradigm Shift

§ Richard Bryant, Assessing and Treating Acute Stress Disorder

§ Linda W. Craighead, Kathy A. Elder, & Heather M. Niemeier,

How to Use Appetite Awareness Training in Cognitive Behavioral Treatment

for Eating and Weight Concerns

§ JoAnne Dahl, ACT and the Treatment of Chronic Pain and Stress

§ Martin E. Franklin & Lori A. Zoellner, Treatment Challenges in CBT for

Pediatric Obsessive-Compulsive Disorder

§ Kristina Coop Gordon, Donald H. Baucom, & Douglas K. Snyder,

Treating Affair Couples: An Integrative Approach

§ Stefan G. Hofmann & Raphael D. Rose,

Treating Social Anxiety Disorder: Group Behavioral Techniques

§ Lisa H. Jaycox & Bradley Stein, Early Intervention for Children Exposed to Trauma

§ Robert L. Leahy, Resolving Impasses in Cognitive Behavioral Therapy

§ Thomas R. Lynch & Steven R. Thorp, DBT for Older Adults With Personality Disorders

§ Barry W. McCarthy, Cognitive-Behavioral Strategies and Techniques

for Revitalizing a Nonsexual Marriage

§ Barbara S. McCrady & Elizabeth E. Epstein, Treating Alcohol and Drug Problems:

Individualized Treatment Planning and Intervention

§ Lisa M. Najavits & Tracey Rogers, Seeking Safety: Therapy for PTDS and Substance Abuse

§ Christine Maguth Nezu & Arthur M. Nezu, Spirituality-Guided Behavior Therapy

§ Susan M. Orsillo, Lizabeth Roemer, & Kristalyn Salters, Acceptance-Based

Behavioral Therapy for Generalized Anxiety Disorder

§ Michael W. Otto & Andrew A. Nierenberg, Writing NIH Grants:

Practical Strategies for Success

§ Michael R. Petronko, Russell J. Kormann, and Doreen DiDomenico,

Natural Setting Therapeutic Management (NSTM): A Multiple Model Approach

to Maintain Individuals with Developmental Disabilities and Severe Behaviors

in Community Settings

§ Maureen L. Whittal & Melanie L. O’Neill, The Paradox of Thought

Control: Cognitively Focused Treatment of OCD

§ Kelly G. Wilson, Rhonda Merwin, & Sushma Topiwala Roberts,

Values, Defusion, and Mindfulness in ACT

§ Eric A. Youngstrom & Norah C. Feeny, Assessment and Treatment

of Bipolar Disorder in Youths

37th

Annual

Convention

B O S TO N

Nov. 20–23, 2003

M E C H A N I S M S O F A C T I O N

AABT

the Behavior TherapistAssociation for Advancement of Behavior Therapy

305 Seventh Avenue, 16th floor

New York, NY 10001-6008

Tel.: 212-647-1890

Fax: 212-647-1865


www.aabt.org

ADDRESS SERV ICE REQUESTED

§

Documents

the Behavior Therapist - ABCT Association for Behavioral and