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Case studies in behavior modification
144
BOOK REVIEWS
found that this time the proportion of “cured and improved” had sunk to 25 per cent, a figure which would have been even lower, as the author admits, if those who refused to be interviewed had been included. The most interesting part of this follow-up study is to be found in the separate analysis of success rates for the different types of treatment; here psychoanalysis appears significantly superior and hypnosis significantly inferior to the remaining methods. ‘Can this be interpreted as showing the superiority, on the long term basis, of psychoanalytic methods ? The answer, unfortunately, must be no. As Cremerius points out on page 57 “the decisive prognostic characteristic is to be found in the premorbid personality of the patient . . this determines the choice of method of treatment, the duration of treatment and the depth at which problems can be worked through. All else is necessarily a consequence of this choice”. Thus method of therapy is not an independent variable in an experimental design but is a dependent variable consequent upon another variable (type of personality) which was not itself studied in any detail. This is unfortunate; it would be interesting to know something about the intelligence, extraversion, degree of neuroticism, etc., of subjects assigned to the various types of treatment. As this is impossible, all one can say of the results is that they cannot be used in any way to draw conclusions regarding the efficacy of the different types of treatment employed. Cremerius has a good deal to say about the reasons why the final outcome of treatment was so much poorer than that reported by other writers who have followed up groups of treated neurotics. He seems inclined to blame the low social level of his patients, but of course this is merely an opinion and there is no evidence to support this. Cremerius also discusses at some length the validity of issues which are relevant to his research design, such as the problem of spontaneous remission, the assessment of therapeutic success, and the problem of prognosis. One gains the impression that Cremerius’s scientific and objective attitude is fighting against certain “dynamic” preconceptions which make it difficult for him to understand and appreciate points of view other than his own, but even so he gives a thorough review of the literature much of which (particularly that part which appeared in German) may not be familiar to all readers. Altogether this is a very careful, thorough, empirical study that throws up many questions, although it does not answer any; to find proper answers, a much more experimental approach, coupled with a proper design would have been needed. H. J.
L. P. ULLMANNand L. KRASNER: Case Studies in Behavior New York. 396 pp., 64s. L.
KRA~NER
Modification.
and L. P. ULLMANN. Research in Behavior Modification. York. 392 pp. 72s.
Holt, Rinehart
Holt, Rinehart
EYSENCK
and Winston
and Winston, New
THESEtwo volumes will make a valuable contribution to the rapidly growing library of works on behaviour modification and therapy. The first book consists of no less than 50 papers describing the treatment of individual cases or groups of patients. Some of the articles will be familiar to readers of this joumalhaving first appeared in these pages. In addition many of the contributors have published other material in the journal. The book is divided into five sections: severely disturbed behaviour, neurotic behaviour, deviant adult behaviour, deviant child behaviour and mental deficiency. The overall emphasis is on disturbances of children and psychotic disorders and to a considerable extent complements Eysenck’s two collections of papers (Behaviour Therapy and the Neuroses and Experiments in Behaviour Therapy). The Eysenck collections, it will be remembered, dealt primarily with neuroses. The present two volumes also differ in devoting rather greater space to operant methods. Any review of such an extensive collection can only deal with a few papers and I will simply mention some of the best pieces. Among the reprinted articles those of Ayllon, Wolpe, Lang, Lazarus, Lindsley, Hart, Wolf and Harris deserve credit for having intluenced later developments so favourably. The paper on anorexia by Bachrach et al. is a welcome addition as is that of Huitgen et al. on shaping the behaviour of childhood schizophrenics. On the other hand, the significance and validity of the spectacular case., described by Brady and Lind, has recently been challenged. It appears that their “hysterical” patient was probably malingering.
BOOK REVIEWS
found that this time the proportion of “cured and improved” had sunk to 25 per cent, a figure which would have been even lower, as the author admits, if those who refused to be interviewed had been included. The most interesting part of this follow-up study is to be found in the separate analysis of success rates for the different types of treatment; here psychoanalysis appears significantly superior and hypnosis significantly inferior to the remaining methods. ‘Can this be interpreted as showing the superiority, on the long term basis, of psychoanalytic methods ? The answer, unfortunately, must be no. As Cremerius points out on page 57 “the decisive prognostic characteristic is to be found in the premorbid personality of the patient . . this determines the choice of method of treatment, the duration of treatment and the depth at which problems can be worked through. All else is necessarily a consequence of this choice”. Thus method of therapy is not an independent variable in an experimental design but is a dependent variable consequent upon another variable (type of personality) which was not itself studied in any detail. This is unfortunate; it would be interesting to know something about the intelligence, extraversion, degree of neuroticism, etc., of subjects assigned to the various types of treatment. As this is impossible, all one can say of the results is that they cannot be used in any way to draw conclusions regarding the efficacy of the different types of treatment employed. Cremerius has a good deal to say about the reasons why the final outcome of treatment was so much poorer than that reported by other writers who have followed up groups of treated neurotics. He seems inclined to blame the low social level of his patients, but of course this is merely an opinion and there is no evidence to support this. Cremerius also discusses at some length the validity of issues which are relevant to his research design, such as the problem of spontaneous remission, the assessment of therapeutic success, and the problem of prognosis. One gains the impression that Cremerius’s scientific and objective attitude is fighting against certain “dynamic” preconceptions which make it difficult for him to understand and appreciate points of view other than his own, but even so he gives a thorough review of the literature much of which (particularly that part which appeared in German) may not be familiar to all readers. Altogether this is a very careful, thorough, empirical study that throws up many questions, although it does not answer any; to find proper answers, a much more experimental approach, coupled with a proper design would have been needed. H. J.
L. P. ULLMANNand L. KRASNER: Case Studies in Behavior New York. 396 pp., 64s. L.
KRA~NER
Modification.
and L. P. ULLMANN. Research in Behavior Modification. York. 392 pp. 72s.
Holt, Rinehart
Holt, Rinehart
EYSENCK
and Winston
and Winston, New
THESEtwo volumes will make a valuable contribution to the rapidly growing library of works on behaviour modification and therapy. The first book consists of no less than 50 papers describing the treatment of individual cases or groups of patients. Some of the articles will be familiar to readers of this joumalhaving first appeared in these pages. In addition many of the contributors have published other material in the journal. The book is divided into five sections: severely disturbed behaviour, neurotic behaviour, deviant adult behaviour, deviant child behaviour and mental deficiency. The overall emphasis is on disturbances of children and psychotic disorders and to a considerable extent complements Eysenck’s two collections of papers (Behaviour Therapy and the Neuroses and Experiments in Behaviour Therapy). The Eysenck collections, it will be remembered, dealt primarily with neuroses. The present two volumes also differ in devoting rather greater space to operant methods. Any review of such an extensive collection can only deal with a few papers and I will simply mention some of the best pieces. Among the reprinted articles those of Ayllon, Wolpe, Lang, Lazarus, Lindsley, Hart, Wolf and Harris deserve credit for having intluenced later developments so favourably. The paper on anorexia by Bachrach et al. is a welcome addition as is that of Huitgen et al. on shaping the behaviour of childhood schizophrenics. On the other hand, the significance and validity of the spectacular case., described by Brady and Lind, has recently been challenged. It appears that their “hysterical” patient was probably malingering.