| 1. |
- Börjesson, Josefine, 1973-, et al.
(författare)
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Concurrent and predictive validity of the Adolescent Drug Abuse Diagnosis (ADAD)
- 2012
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Ingår i: Open Psychology Journal. - : Bentham Open. - 1874-3501. ; 5, s. 20-30
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- The concurrent and predictive validity of the Adolescent Drug Abuse Diagnosis (ADAD) in the Psychological status and problem area was examined for two adolescent groups: a non-clinical population of 121 Swedish adolescents (62 girls and 59 boys) aged 15 to17 years and a clinical population of 31 adolescents (14 girls and 17 boys) aged 12 to 19 years detained in special youth homes. Concurrent validity was demonstrated by significant correlations between the ADAD, Youth Self Report (YSR) and Beck Depression Inventory (BDI) scores. Findings regarding the predictive validity of ADAD show moderate associations with YSR, BDI and DICA problem ratings. The findings suggest that for clinical practice the ADAD Psychological status and problem area may be an appropriate assessment tool for measurement of current psychological problems. The utility obtained by making decisions using the test is substantial.
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| 2. |
- Börjesson, Josefine, 1973-
(författare)
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Psychometric studies of the Swedish version of the Adolescent Drug Abuse Diagnosis (ADAD) instrument
- 2011
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis describes studies into the psychometric properties of a Swedish language version of the Adolescent Drug Abuse Diagnosis (ADAD) instrument. The psychometric properties of this instrument have been examined in two previous studies: an American study was conducted by the developers of the interview, Friedman and Utada (1989), and a Swiss study was undertaken by Bolognini et al. (2001). The American and the French (as used in the Swiss study) versions of ADAD exhibit good validity and reliability, in the form of both interrater reliability and the internal consistency of the composite scores. Study I evaluated the psychometric properties of the Swedish version of the ADAD interview in normal adolescents and adolescents with antisocial problems. It was found that the instrument has good interrater reliability, that the composite scores exhibit moderate internal consistency, and that the concept validity was acceptable and similar to that of the American and Swiss versions. The results also showed that the problem areas of ADAD produced meaningful correlations. The interviewer ratings, the adolescent’s ratings and the composite scores were compared and discussed. Some problems concerning the composite scores were discovered and will need to be analyzed in future studies. Study II investigated the utility and problems associated with the composite scores in the ADAD within and between normal adolescents and adolescents with antisocial problems. When comparing interviewer severity ratings and composite scores within the two groups, the composite scores were found to behave differently to the interviewer ratings. For normal adolescents, the composite scores are generally higher than the interviewer ratings, but for the adolescents with antisocial problems the reverse is true. The interviewer severity ratings seem to be the most appropriate outcome when the objective is to separate antisocial and normal groups of adolescents from each other. The difference between the two groups is smaller as measured by composite scores. The composite scores appear to function as viable indicators of current problems in all areas except for Medical and Alcohol problem area. The critical items within the Medical and Alcohol composite scores are explored and discussed. Study III investigated the concurrent and predictive validity of the ADAD Psychological status and problem area. Concurrent validity was demonstrated by significant correlations between the ADAD, Youth Self Report (YSR) and Beck Depression Inventory (BDI) scores. The predictive validity of this problem area of the ADAD was tested by exploring its correlations with the YSR, BDI, and DICA problem ratings; moderate correlations were observed, suggesting that in clinical practice, the ADAD Psychological status and problem area may be a useful tool for the assessment and measurement of current psychological problems. The utility obtained by making decisions using the test is substantial. Overall, the results of these studies indicate that the Swedish version of ADAD appears to be a psychometrically good instrument for assessing the severity of adolescents’ problems and their need for treatment, but there are some problems with the Medical and Alcohol composite scores.
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| 3. |
- Börjesson, Josefine, 1973-, et al.
(författare)
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The psychometric propeerties of the Swedish version of the Adolescent Drug Abuse Diagnosis (ADAD)
- 2007
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Ingår i: Nordic Journal of Psychiatry. - : Informa UK Limited. - 0803-9488 .- 1502-4725. ; 61:3, s. 225-232
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Tidskriftsartikel (refereegranskat)abstract
- The psychometric properties of the Swedish version of the Adolescent Drug Abuse Diagnosis (ADAD) instrument were evaluated in two adolescent groups. The participants in the Normal group comprised 121 adolescents aged 15-17 years and the participants in the group of adolescents with antisocial problems comprised 1168 youths aged 10-21 years detained under the Swedish Care of Young Persons Act in special youth homes. The ADAD instrument produced good interrater reliability; the subscales showed moderate internal consistency and concept validity was satisfactory and comparable with American and Swiss versions. Finally, the ADAD subscales produced meaningful correlations. The interviewer rating, the adolescent’s rating and the composite scores are compared and discussed. The Swedish version of ADAD appears to be a psychometrically good instrument for assessing the severity of adolescent problems and their need for treatment. However, the composite scores need to be reconstructed to be useful in future research.
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| 4. |
- Dennhag, Inga, 1969-
(författare)
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Learning psychotherapy : An effectiveness study of clients and therapists
- 2012
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background Many psychotherapy studies with trainees have been conducted, but few have investigated how effective baseline trainee-led psychotherapies are. Baseline trainee-led psychotherapies are often provided by a professional education, and the therapists are often young, untrained and inexperienced. The present study was conducted at the Clinical Psychology Program at Umeå University, in Sweden. The psychology students were in their fourth or fifth year of, in total, five years, and few had practiced therapy before. Clients, students and education providers are interested in the outcome of trainee-led psychotherapies because clients want an effective treatment, and students and the educators want the best education. In research, there is an interest in knowing more about training, how training influences clients’ benefits of therapy, and how training works in regular activity. In the present thesis, we investigate questions related to outcome and how different training factors affect outcome. The overall purpose of the present thesis was to examine 1) the effectiveness of trainee-led therapies in a psychology education setting and 2) if clients’ self-image patterns would predict the outcome 3) if different training conditions covary with treatment outcome 4) how novices develop in their professional characteristics and work involvement styles.Methods and Result The current thesis utilized data from the Swedish naturalistic study Effects of Student Therapies (EUT) at Umeå University. The EUT is a naturalistic psychotherapist research project, which comprises client data from 2003 to 2012. The present study included 235 clients. The mean age of the clients was 31 years (SD = 9.66), and 69% of the clients were women. The clients had mixed psychological symptoms and were well functioning. Psychological symptoms were measured by Symptom Check List 90 (SCL-90; Derogatis, Lipman, & Covi, 1973). The patients’ self-image was measured using the Structural Analysis of Social Behavior (SASB), the introject questionnaire (Benjamin, 1974). All therapists were students at the psychology program. In Paper III, 76 therapists participated. The therapists’ mean age was 28 years (SD = 5.55), and 71% of the therapists were women. Therapists’ professional characteristics and work involvement styles were measured by Development of Psychotherapists’ Common Core Questionnaire (DPCCQ; Orlinsky et al., 1999).Four specific objectives have been addressed. The first objective was to investigate the overall effectiveness of treatment. In Papers I and II, the effect sizes implicated that the therapy outcome was moderate. Paper I showed that 67% of the clients were in the dysfunctional domain before therapy compared to 34% after completed therapy. Further in Paper I, it was found that 42% of the clients had recovered or improved at the end of the therapy, but most of the clients remained unchanged (55%) and a few percent had deteriorated (3%). This result is in line with a Norwegian training study (Ryum, Stiles & Vogel, 2007) but less effective than effectiveness studies have shown with professional therapists (e.g. Hunsley & Lee, 2007). Paper II, where we used a subsample of Paper I’s clients, showed a similar result.The second objective was to investigate if clients’ self-image pattern (attachment group, disrupted attachment group, self-control and self-autonomy) predicted change in psychological symptoms (GSI: global severity index) and personality symptoms (PSI: personality symptom index). The disrupted attachment group or the clients’ negative self-image had the strongest relationship to outcome and explained 8% vs. 10% in outcome (PSI vs. GSI). Self-control explained a further 3% (GSI) and 4% (PSI) of the result, and self-autonomy added 1% in both GSI and PSI. The result indicates that clients with an increased negative self-image, higher self-control, and lower level of self-autonomy before therapy improve more in both psychological symptoms and personality symptoms than clients with a less negative self-image, lower self-control, and higher level of self-autonomy.The third objective was to explore if treatment duration (one or two semesters) and training condition (cognitive therapy and psychodynamic therapy) could affect basic psychotherapy outcome. Paper II demonstrated that clients in all training conditions, cognitive therapy two semesters (CT2), psychodynamic therapy one semester (PDT1) and psychodynamic therapy two semesters (PDT2), had significant changes in self-image patterns and symptoms, except for cognitive therapy one semester (CT1). Analyses using clinically significant change demonstrated that fewer clients in CT1 had recovered and reliably improved compared to the other training conditions (in CT1: 20- 23%, in PDT1: 27- 43%, in CT2: 49- 54% and in PDT2: 35- 41%). Two hierarchical multiple regression analyses demonstrated that clients’ pre-tests characteristics self-image pattern (affiliation: AFF) and psychological symptoms (global severity index: GSI) explained 34% of the results. Treatment duration and training condition demonstrated an interaction effect between duration and theoretical approach, explaining about 2%. The regression lines for self-image pattern AFF and psychological symptoms GSI showed that clients in CT2 and PDT1 improved more than clients receiving CT1 and PDT2.The fourth objective was to examine how novice therapists in psychotherapy training develop in professional characteristics and work involvement styles (healing and stressful work involvement styles). The study was longitudinal and therapists were measured at session 2, 8, 16, 22 and endpoint. Mixed model analyses of the Development of Psychotherapists’ Common Core Questionnaire (DPCCQ) (when controlled for therapists’ age and gender) showed that the therapists’ professional characteristics and work involvement styles changed positively over time in training, except for in-session feelings of anxiety and boredom. The therapists increased most in technical expertise and less in basic relational skill. The result also indicated that the students changed linearly over time.Conclusion The present studies draw attention to the moderate outcome for clients in trainee-led psychotherapy. The novices appear to need time to increase in effectiveness possibly due to the high load of technical training in the beginning of the therapy. However, when exploring different training durations and training conditions, the contexts are shown to influence the outcome. In addition, clients with a more negative self-image pattern, with higher levels of self-control and lower levels of self-autonomy had better outcome, a finding with prognostic value. Finally, the training of students improves both a healing and a stressful involvement style, but in-session feelings of anxiety and boredom are more resistant to change.
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| 5. |
- Dennhag, Inga, 1969-, et al.
(författare)
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Novice psychotherapists’ development in professional characteristics and work involvement styles in training
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Information about how psychotherapists develop their professional characteristics and work involvement styles during training is scant; in addition, awareness of the need to find answers to how psychotherapy training can best be organized is increasing. This study investigated novice therapists’ development of healing and stressful work involvement in baseline psychotherapy education in Sweden. Undergraduate students (n = 76) provided information longitudinally by responding to the Development of Psychotherapists Common Core Questionnaire (DPCCQ). The results demonstrated that therapists’ healing and stressful work involvement, current therapeutic skills, perceived difficulties, and constructive coping strategies changed positively and linearly. Technical expertise changed the most, having a large effect, and relational skills developed moderately. Surprisingly, in-session feelings of anxiety and boredom did not change. The process of positive and linear development of in-session feelings is important in psychotherapy education. The question becomes how the training should address trainees’ personal issues or countertransference that might affect in-session feelings.
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| 6. |
- Dennhag, Inga, 1969-, et al.
(författare)
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Self-image pattern as predictors of change and outcome of trainee-led psychotherapy
- 2011
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Ingår i: Psychotherapy Research. - : Routledge, Taylor and Francis Group. - 1050-3307 .- 1468-4381. ; 21:2, s. 201-209
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Tidskriftsartikel (refereegranskat)abstract
- This study investigated the outcome of undergraduate trainee-led psychotherapy and how different self-image patterns explain symptom change. Pre- and post-treatment data from 235 Swedish outpatients were used. Clients were assessed with Symptom Checklist-90 (SCL-90) and the Structural Analysis of Social Behavior (SASB). Outcome effect size was moderate and in line with earlier studies on trainees. Clinical significant change showed that 42% of all clients were recovered or improved after 18 sessions in either training condition PDT or CBT. Regression analysis showed that a more negative self-image and higher levels of self-control before treatment predicted improvement in both psychiatric symptoms and personality factors. A negative self-image, when observed before treatment, can be understood as an increased motivation for change.
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| 7. |
- Dennhag, Inga, 1969-, et al.
(författare)
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The relationship between clients' personality traits, working alliance and therapy
- 2017
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Ingår i: Current Issues in Personality Psychology. - : Termedia Publishing House LTD. - 2353-4192 .- 2353-561X. ; 5
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: This study investigated the relationships between client personality traits, and changes in those traits after cognitive behavioral or psychodynamic short-term therapy, and clients' perceived working alliances with their therapists and their clinical outcomes at a university training clinic in Sweden.Design: This was a longitudinal study, with the measures collected at pre- and post-therapy.Methods: The sample consisted of 138 clients with moderate psychological symptoms. Personality traits were measured using the Health-Relevant Personality Inventory, a health-relevant instrument that measures five factors.Results: The results showed that Antagonism, Impulsivity, Hedonic Capacity, and Negative Affectivity improved significantly during therapy, while Alexithymia did not. Pre-therapy personality traits were not related to perceived working alliances (as measured by the Working Alliance Inventory) or therapeutic outcomes (as measured by the Clinical Outcomes in Routine Evaluation Outcome Measure). Post-therapy personality traits negative affectivity, hedonic capacity and alexithymia were related to working alliance, and changes in personality traits were predictive of therapy outcome. The change in Hedonic Capacity and Negative Affectivity explained about 20% of the variance in post-therapy symptoms after controlling for pre-therapy symptoms.Conclusions: The results suggest that therapeutic foci on hedonism (extraversion) and negative affectivity (neuroticism) could be important for working alliance formation and symptom reduction in therapy. Future research should examine whether changes in clients' negative affectivity or hedonic capacity mediates the relation between perceived working alliance quality and clinical outcome in training and other psychotherapeutic contexts.
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| 8. |
- Dennhag, Inga, et al.
(författare)
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Trainee Psychotherapists' Development in Self-Rated Professional Qualities in Training
- 2013
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Ingår i: Psychotherapy. - : American Psychological Association (APA). - 0033-3204 .- 1939-1536. ; 50:2, s. 158-166
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Tidskriftsartikel (refereegranskat)abstract
- This study investigated changes in trainees’ self-rated experience as a therapist over the course of one practicum treatment case in basic psychotherapy education in Sweden. Undergraduate students (n = 76) provided longitudinal information on their healing involvement and stressful work involvement. The results of the Development of Psychotherapists Common Core Questionnaire (DPCCQ) demonstrated that trainees’ basic relational skills, technical skills, perceived difficulties, and constructive coping strategies changed linearly, with an increasing slope. Technical expertise changed the most, and relational skills developed moderately. In-session feelings of anxiety and boredom did not change. The individualized reliable change scores show that the process during training is different for different students. Most students did not change at all, and some students even changed negatively. Investigation of how pedagogic variables affect therapists’ development is necessary to support the professional growth of trainees in their involvement with different types of psychotherapy.
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