Group psychotherapy training and effectiveness.

This study surveyed accredited programs in psychiatry, psychology, and social work, replicating and extending previous work in group training. Results detail the curriculum, group faculty/student participation, and predicted future therapy trends in four different formats of group treatment. The number of group courses in the curriculum, the number required, and the percent of students participating in these courses significantly varies among the three disciplines, indicating a discrepancy among those disciplines responsible for training in group therapy regarding the value and role of group training. Consensus does exist among the disciplines in forecasting that individual therapy will decrease and group treatment will increase, but what programs deliver in their training does not coincide with their predicted trends for group therapy use in the future. Ratings of the differential effectiveness of the four group modalities vs. individual are not consistent with empirical evidence. Results call for consensual clarity, accord of values and knowledge, and the integration of science, training, and practice across the three disciplines.

A survey of mental health care provider's and managed care organization attitudes toward, familiarity with, and use of group interventions.

Managed Care has had a significant impact on delivery systems for mental health services. Direct and indirect persuasion to provide more cost-effective treatments has been one consequence. The cost-saving qualities and the effectiveness of group interventions have produced clear expectations for an increased use of therapy groups. This study compared perceptions and uses of group treatments on a national sample of managed care organizations and mental health providers. Because group psychotherapy encompasses such a broad definition, five specific types of group interventions were defined: problem-focused homogenous, process-oriented heterogeneous, psycho-educational, self-help, and short-term groups. Implications of differences and similarities between directors of managed care organizations and treatment providers are examined and discussed across five response categories (familiarity/training, perceived effectiveness, likelihood of reimbursement/referral, daily use, and expectation for future use).

Hostility in depression.

Subjects (39 men and 30 women) from two university counseling centers and one university medical center were administered the Hamilton Rating Scale for Depression, the Buss-Durkee Hostility Inventory, the State-Trait Anger Scale, and the Hostility and Direction of Hostility Questionnaire. Results showed significant positive correlations between self-reported severity of depression and all subtypes of hostility including behavior, attitude, affect, intropunitiveness, and extrapunitiveness. Hierarchical regression analysis using demographic and hostility variables as predictors of depression scores showed increasing age, lower education, and female gender to account for 50% of the explained variance. The Intropunitive subscale from the Hostility and Direction of Hostility Questionnaire accounted for an additional 19% of the explained variance and was the single most powerful predictor of depression. Correlational analysis showed women tending to have higher scores on most hostility measures. Implications of these results with respect to theory and clinical practice are discussed.

Measurement of hostility, anger, and depression in depressed and nondepressed subjects.

This study examined the relationship between hostility and depression in depressed and nondepressed subjects as well as the reliability and validity of several measures of anger, hostility and depression. Sixty-nine subjects were evaluated for depression using the Hamilton Rating Scale for Depression (HRSD; Hamilton, 1960). These subjects were then administered the Beck Depression Inventory (BDI; Beck, Ward, Mendelson, Mock, & Ergaugh, 1961), Buss-Durkee Hostility Inventory (BDHI; Buss & Durkee, 1957), Hostility and Direction of Hostility Questionnaire (HDHQ; Foulds, Caine, & Creasy, 1960) and the State-Trait Anger Scale (STAS; Spielberger, Jacobs, Russell, & Crane, 1983). Results showed the BDI, STAS-TRAIT, HDHQ, and BDHI to have good temporal stability. Support was found for the convergent validity of all measures of depression, hostility, and anger. Limited discriminant validity was found between measures of anger and hostility and measures of depression. This latter finding was interpreted as lending support for the relationship between hostility and depression rather than as an indication of limited construct validity for the measures. Intercorrelations among hostility, anger, and depression scales offer some support for the hypothesis that depression is linked most strongly with attitudinal versus motoric forms of hostility. However, normative data suggests that both forms of hostility increase with severity of depression. Clinical implications and directions for further research are discussed.