AN APPLICATION OF COGNITIVE-BEHAVIORAL SELF-CONTROL PROCEDURES WITH HOSPITALIZED ADOLESCENTS.

Abstract

This study assessed the efficacy of the application of cognitive-behavioral self control therapy with a sample of psychiatrically impaired adolescents. Ten adolescent inpatients (5 male/5 female), residing within the Adolescent Unit of the State Hospital of a Southwestern state, were selected as subjects. Subjects ranged in age from 12 to 17 years and were paid volunteers. Subjects were assessed pretreatment for non self controlled behavior via the teacher rated Self Control Rating Scale (Kendall & Wilcox, 1979). This measure also served as the blocking variable utilized for random assignment to treatment or control group. Five adolescents were assigned to each group. Pretreatment measures of social perspective taking (Chandler Bystander Cartoons; Chandler, 1973) and social problem solving (Means-Ends Problem Solving test: Platt & Spivack, 1975) were taken additionally. All three measures were repeated at posttreatment and at 4 week follow-up. Treatment consisted of twelve 60-minute sessions held 3 times a week over the period of 4 weeks. The treatment consisted of a group application of Kendall's (1980) Cognitive-Behavioral Self Control therapy. The main treatment strategies included: (1) a problem solving approach, (2) self instructional training, (3) behavioral contingencies, (4) modeling, (5) affective education, and (6) role play exercises. The separate strategies were essentially interwoven. Except for the cognitive-behavioral self control training proper, subjects in both treatment and control groups were given similar tasks, task instructions, and performance feedback. Results found a range of behavioral self control skills distributed among the subjects but failed to support the hypothesis of associated poor social perspective taking and social problem solving skills. Treatment failed to improve teacher ratings of behavioral self control at posttreatment and at follow-up. Likewise, no significant improvement was found in social problem solving skills at posttreatment or follow-up, although a trend toward improvement was suggested. A significant improvement in social perspective taking skills was found in the treatment group at posttreatment. The improvement was maintained at 4 week follow-up. The results are interpreted as suggesting that cognitive-behavioral self control training can be useful in facilitating the further development and enhancement of previously inadequate cognitive capacities in psychiatrically impaired, non self controlled adolescents. Certain suggestions for enhancing the effectiveness and generalization of the treatment approach are discussed.