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Chronic pain is common among adults and frequently interferes with regular functioning while reducing quality of life. Though pharmacological approaches are used most frequently to treat pain-related issues, the side effects often lead to other problems. Group therapy has been used and studied for decades in treating pain although its general efficacy in this is not clear. We conducted a meta-analysis to determine group therapy's effectiveness in reducing pain intensity and improving adjacent issues. Potential randomized clinical trials were selected from various databases and included if published between 1990 and 2020, investigated group treatment's efficacy for pain-related concerns, measured pain intensity, included a comparison condition, and reported sufficient data in each trial arm at the first postassessment. We included 29 studies representing 4,571 participants in group therapy being treated for pain. The analysis yielded a significant, small effect when group was contrasted against passive control groups ( g = 0.26, 95% CI [0.11, 0.41], p = .001) on the reduction of pain intensity. Two variables were found to moderate group therapy's efficacy: gender composition of groups and theoretical orientation. Although effects on reducing pain intensity are small, group psychotherapy should be considered a viable treatment option for chronic pain patients given the lower risks of side effects compared to pharmaceutical analgesics and comparable effects compared to other chronic conditions. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Study Objectives: Insomnia is a risk factor for suicidal behavior including attempts and death by suicide. We investigated whether insomnia symptom severity was associated with suicidality and death by suicide in patients with psychiatric disorders., Methods: The sample included 180 deceased patients with psychiatric disorders seen at Weber Human Services between 2008 and 2018 who completed the Outpatient Questionnaire-45.2 (OQ) prior to death. Insomnia symptom severity was assessed using item 41 from the OQ. Manner of death was determined by death records and autopsy reports. History of suicidality was determined through electronic medical records. Cases were grouped into four lifetime categories: non-suicidal (n = 30), suicidal ideation (n = 36), suicide attempt (n = 95), and death by suicide (n = 19). Demographic, medical, and psychiatric features of each group were compared using linear regression. Logistic regression was used to determine whether insomnia symptom severity was associated with lifetime suicidality severity grouping, adjusting for psychiatric disorders commonly linked to suicidality., Results: Lifetime suicidality was associated with sleep problems, fatigue, headaches, and psychiatric disorders (i.e. depressive, personality, and trauma-related disorders). Referenced to the non-suicidal group, greater insomnia symptom severity was significantly associated with suicide attempts and death by suicide, with odds ratios (OR) of OR = 2.67, p = 0.011, and OR = 5.53, p = 0.002, respectively, even after adjusting important psychiatric diagnoses., Conclusions: Results suggest that insomnia symptom severity endorsed during a clinical visit is associated with heightened suicidality, especially suicidal behavior. The presence of insomnia symptoms in patients with psychiatric disorders may indicate risk for suicide and is a target for suicide prevention., (© Sleep Research Society 2021. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

The Group Questionnaire (GQ) is a measure recently developed by Krogel et al. (2013) for the evaluation of the therapeutic relationship in group. The GQ identifies a three-factor model of the relationship that allows to measure quality (Positive Bonding, Positive Working and Negative Relationship) and structure (member-member, member-leader and member-group), dimensions in group. This work shows the results of a first study on the Italian validation of the GQ. In this study the GQ was administered to 536 subjects from 32 non-clinical groups of undergraduate students. The cross-cultural validity of the GQ in the Italian population has been examined by comparing the psychometric properties and equivalence in factor structure and scores of the Italian GQ with the original American version. Multilevel confirmatory factor analysis was used to examine both the between- and within-group structures. Data concerning reliability and validity of GQ and the results for different SEM in Multilevel CFA confirm the three factors structure of the GQ. Data from the Italian population have a good fit with the original proposed model. Finally, we discuss the importance of an instrument like GQ, short but consistent, for the evaluation of the therapeutic relationship in clinical and training group., Competing Interests: Conflict of interest: the authors declare no potential conflict of interests., (©Copyright: the Author(s).)

There is a constant tension between having measures short enough for daily practice and long enough to provide useful information. Although shorter measures are more convenient for clients, fewer items necessarily mean less information, a loss of psychometrics, and possible floor and ceiling effects. This study examined the effects of shortening the Group Questionnaire (GQ) on its clinical utility and psychometric integrity. Creation of a 12-item GQ (GQ-12) was done using archival data with 1,087 participants gathered from counseling centers, nonclinical process groups, outpatient psychiatric hospitals, and an inpatient state hospital. Testing of the loss of clinical utility was conducted using archival data from 432 group counseling center patients. Analysis for creation of the GQ-12 was done using multilevel structural equation modeling. Items were selected using clinical judgment and statistical judgment considering interitem correlation and factor loading. Model fit was analyzed in comparison with the standards in the literature and with the full-length GQ. Loss of clinical utility was analyzed by comparing alerts generated by the GQ-30 with alerts generated by the GQ-12. The GQ-12 has good model fit and acceptable reliability. A significant number of alerts were lost by reducing the items (status alerts: sensitivity 82-93%, specificity 97-99%; change alerts: sensitivity 52-67%, specificity 99-100%). This study suggests that although it is possible to create a psychometrically sound, shortened version of a feedback measure, clinicians should be aware that helpful information is lost. (PsycINFO Database Record, ((c) 2018 APA, all rights reserved).)

The Group Questionnaire (GQ) is a recently developed self-report measure of the therapeutic relationship based on Johnson and colleagues (2005) three-factor model; Positive Bonding, Positive Working, and Negative Relationship. This study validated Johnson's model with a new and extended sample and created a shorter 40-item trial version. SEM analysis of the GQ tested whether it produced the same three-factor structure found in three earlier studies with 486 participants from three populations-outpatient university counseling center, non-patient AGPA process groups, and inpatient state hospital. Results of further SEM refinements demonstrated that a final 30-item version had good fit to the three-factor model although distinct differences in response pattern were found between the three populations. Implications for future utility and clinical relevance of the GQ are discussed.

The Group Selection Questionnaire (GSQ) has been shown to predict which individuals will improve during group psychotherapy. The present study sought to quantitatively and qualitatively describe those who are predicted to benefit (low scorers) and not benefit (high scorers) from group, based on their GSQ scores. High and low scorers were selected from two samples-a "non-clinical" group of undergraduates in an introductory psychology course and a "clinical" group of clients from a university counseling center. Analyses of differences in GSQ scores and interview transcripts indicated that low scorers anticipated benefits from groups, found it easy to share feelings and opinions, felt they were a part of groups, and described themselves as open. High scorers reported being passive, private, reserved, and unlikely to share feelings.

There are three main questions that need to be answered to address nuisance odors at the fenceline of a wastewater treatment plant: What odors are occurring at the fenceline of the plant? What processes within the plant give rise to these odors? What priority should we assign to mitigation of the nuisance odors? The prioritization is based on three factors that make odors a nuisance: strength or intensity of the odor when it is detected; quality or description of the odor; persistence or occurrence of the odor at the fenceline. Since fenceline odors vary according to: wind direction; wind speed; atmospheric stability and obstructions (buildings, trees, roadways), this study conducted odor surveys at the fenceline of a wastewater plant between April and November for 20 surveys. The data were used to develop a practical framework in three steps: summarize fenceline (residential vs non-residential) odor survey data; use odor type category and average odor strength to determine the annoyance factor; use annoyance factor and fenceline occurrence to determine the priority rating for nuisance odors to be mitigated.

Customers are sensitive to the flavour of water. Customers evaluate drinking water based on their expectations, on experiences with their usual drinking water and on experiences with alternative waters. The Philadelphia Water Department provides one example of success in developing a better understanding of customer perceptions and attitudes about tap water taste and odour. Philadelphia found that customers do communicate in ways that water utilities can understand. Water utilities can enhance that communication and collect useful data. In addition, water utilities can characterise their tap water flavour, track it for changes and correlate changes to customer complaints.

Odours caused by volatile organic sulphides (VOS) have a history spanning over 20 years for Philadelphia's Northeast Water Pollution Control Plant (NEWPCP). A "canned corn" type of odour has caused residential complaints. Traditional odour control approaches based on hydrogen sulphide failed. This study confirmed that dimethyl sulphoxide (DMSO) from a chemical facility was the dominant cause of the "canned corn" nuisance odour in the form of dimethyl sulphide (DMS). During a discharge, DMSO concentrations up to 12 mg/L were found in the influent of the NEWPCP. Each DMSO concentration peak induced a DMS peak. DMS concentrations increased from less than 50 microg/L to 6 mg/L with a corresponding decrease in DMSO. Approximately 79% of DMSO from the primary sedimentation influent was passed to the effluent, and to downstream processes, such as the aeration tanks where the DMS was volatilised by the aeration. The DMS partial pressure in ambient air of NEWPCP can be between 0.03 and 0.18 x 10(-3) atm during a DMSO discharge. From the above information, the potential of VOS production is estimated and a practical plan for remediation can be designed.

More than 100 years of research has focused on removing acute and chronic health threats to produce safe drinking water, but limited research has focused the consequences of removing minerals that affect drinking water taste and health. This paper covers the human sense of taste, typical variations in drinking water taste, comparisons of global taste standards, the role of water chemistry and future research needs for understanding consumer preference. Results of several consumer tap and bottled water acceptability investigations conducted by the authors are presented.

Traditional research has focused on the visible effects of corrosion--failures, leaks, and financial debits--and often overlooked the more hidden health and aesthetic aspects. Clearly, corrosion of copper pipe can lead to levels of copper in the drinking water that exceed health guidelines and cause bitter or metallic tasting water. Because water will continue to be conveyed to consumers worldwide through metal pipes, the water industry has to consider both the effects of water quality on corrosion and the effects of corrosion on water quality. Integrating four key factors--chemical/biological causes, economics, health and aesthetics--is critical for managing the distribution system to produce safe water that consumers will use with confidence. As technological developments improve copper pipes to minimize scaling and corrosion, it is essential to consider the health and aesthetic effects on an equal plane with chemical/biological causes and economics to produce water that is acceptable for public consumption.

A new sensory method was developed and tested at a full-scale water treatment plant. The method evaluates changes in aesthetic water quality during transit in the distribution system. A paired comparison format is used to determine if the odor of a distribution-system sample is different from that of a control sample. The control sample represents the "ideal" water, such as treated water leaving the plant. The method can rapidly determine whether or not a problem exists in the distribution system, and, if one does exist, it allows for characterization of the problem. Over a three-month period a 4-member odor panel evaluated 118 distribution samples by this new procedure. Among the 118 samples tested, 39 samples yielded a consensus among the analysts as to the odor characteristics of the sample; 35 were rated "not different from the control" (about 90%), and only 4 were rated "different from control" (about 10%). The 79 samples for which no consensus was generated had only slight rating differences between analysts and for odor intensity. No taste-and-odor problems were reported by consumers during the time period for this study and the method indicated that no major odor problems existed in the distribution system.

Overall, in the air pollution control field, odor concentration and intensity as well as hedonic rating have been well studied to the point where some level of standardization is being developed or is already in place. However, there has been no standardization with respect to odor quality characterization. There is now sufficient understanding of the types of odorous compounds that can arise from wastewater treatment processes to develop an odor classification scheme. This article presents the first wastewater odor wheel or classification scheme that should form the foundation for the evolution of odor quality data reporting with links to chemical causes.

Each odorant possesses a unique odor signature (i.e. odor character or quality, odor threshold and chemical concentration). This paper develops an initial understanding of how the volatile odorous chemicals and their relative concentrations produced are related to the total odor quality from the process by their odor threshold concentrations and odor signatures.

This article is based on the authors' experience in designing and implementing outcomes management systems for large managed care organizations. Topics addressed include design of instruments, use of cost-effective technology, development of computerized decision-support tools, and methods for case-mix adjustment. The case-mix-adjustment models are based on a data repository of several thousand treatment cases with multiple measurement points across the course of treatment. Data from controlled and field studies are described. These data suggest that the outcomes management methods outlined in this article can result in significantly improved clinical outcomes and a more rational allocation of behavioral health care resources.

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.

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).

Although high levels of reliability are emphasized in the construction of many measures of psychological traits, tests that are intended to measure patient change following psychotherapy need to emphasize sensitivity to change as a central and primary property. This study proposes 2 criteria for evaluating the degree to which an item on a test is sensitive to change: (a) that an item changes in the theoretically proposed direction following an intervention and (b) that the change measured on an item is significantly greater in treated than in untreated individuals. Outcome Questionnaire (Lambert et al., 1996) items were subjected to item analysis by examining change rates in 284 untreated control participants and in 1,176 individuals undergoing psychotherapy. Results analyzed through multilevel or hierarchical linear modeling suggest the majority of items on this frequently used measure of psychotherapy outcome meet both criteria. Implications for test development and future research are discussed.

Self-help groups (SHGs) may rival all other forms of treatment sometime within the next century (see Goodman & Jacobs article in "The Handbook of Group Psychotherapy," Wiley, 1994), though the "purist" model of SHGs seems inaccurate because many professionals are actually involved. Although traditional forms of group treatment have kept pace with empirical research (Fuhriman & Burlingame, "The Handbook of Group Psychotherapy," 1994), SHGs have not. In particular, medical SHGs, often promoted by hospitals as viable treatment alternatives, have no systemized database from which to draw conclusions about overall effectiveness compared to traditional group therapies. A preliminary assessment of this area is presented using a meta-analysis of articles culled from a comprehensive review of the literature from 1970 to 1997. Results indicate that although the posttreatment analysis produced no significant differences between active and control conditions, pre to posttreatment scores indicated that SHGs produced higher patient improvement when compared to the control condition. Future implications for research and use of medical SHGs are explored.

For Study 1, 24 readers with dysphonetic dyslexia and 21 with dyseidetic dyslexia, classified by Boder criteria, were compared to 90 control group participants (45 matched for age and 45 for reading level) on the Composite Memory Index (CMI) score from the Test of Memory and Learning (TOMAL). CMI scores were significantly lower for children with dyslexia (p <.0001). Plotting average subtest score profiles for all reader groups revealed auditory sequential memory impairments for both types of readers with dyslexia, and multiple strengths for good readers. Dysphonetic and dyseidetic dyslexia profiles were nearly identical. For Study 2, average linkage cluster analysis was performed using principal components derived from subtests of the TOMAL. Homogeneous clusters of normal readers and children with reading disabilities emerged. Results indicated that qualitatively distinct subtypes of readers with dyslexia exist.

Utilizing 56 outcome studies published between 1974 and 1997, this meta-analysis specifically examines the effect of group treatment with children and adolescents (ages 4-18). Various types of group treatment were assessed, including preventative programs, psychotherapy, counseling, guidance, and training groups. Results indicate that group treatment was significantly more effective for children than wait-list and placebo control groups (effect size = .61). That is, the average child or adolescent treated by group treatment is better off than 73% of those in control groups. This meta-analysis strengthens and supports conclusions in the current literature and challenges others regarding the treatment of children and adolescents by group treatment. For instance, allegiance of the experimenter, setting of the therapy, socioeconomic status of the patient, and publication year of the study were variables that were significantly related to improvement, whereas diagnosis, content and source of the outcome measure were unrelated to improvement.

The outcome of clients who saw one of four "expert" professional group therapists selected by peer nomination or four "natural helper" nonprofessional nominated by students is contrasted in a 15-session psychotherapy group. Process measures tapping specific group and "common factors" were drawn from sessions 3, 8, and 14; outcome was assessed at pre, mid, posttreatment, and a 6-month follow-up. Results were examined by leader condition (professional vs. nonprofessional therapists) and time (group development). Virtually no reliable differences were found on measures of outcome primarily because of a floor effect on several measures. Therapist differences on the process measures tapping the "common factors" of therapeutic alliance, client expectancy, and perception of therapists were either nonsignificant or disappeared by the end of treatment. A complex picture of differences on one therapeutic factor (insight), common factor measures and subtle variation in the outcome data suggests a distinct pattern of change, however. Methodological limitations are also addressed including problems inherent in large-scale clinical-trial studies, ethical concerns raised by using nonprofessional leaders, and problems with generalizability, given the absence of significant psychopathology in group members.

Jacobson, Follette, and Revenstorf's (1984) proposal for assessing clinical significance provides a needed convention for psychotherapy outcome research. Several limitations that exists in this method (Jacobson & Revenstorf, 1988) are addressed in this paper and extensions are proposed. Specifically, limitations regarding the operationalization of the underlying social validation methodology in the derivation of normative samples and the resultant standards they set are discussed. Extensions and guidelines are proposed for specifying normative samples, determining the distinctness of these samples, and expanding procedures to accommodate multiple samples. This paper initially assumes a psychometric perspective and presents extensions, based on the Symptom Checklist 90-R. Then it shifts to a clinician perspective and applies reliable change estimates and cutoff scores to actual outcome data by analyzing the progress of four patients during and after therapy. The overall merit and utility of extensions to clinical significance are then discussed.

Developing procedures to evaluate the clinical significance of psychotherapy outcome is imperative. We see social validation as the most promising, viable methodology in this endeavor. Several concerns have been raised, however, about our proposed extensions. In this article, we illuminate and reassert the importance of generating and using multiple normative samples, and the utility of our statistical extensions. We address the limitations of procedural error and skewed sample distributions. Finally we see our commentary as a call for extensive study of the relationship between scores on standard outcome instruments and client's life functioning. We trust our commentary will continue to stimulate healthy dialogue on this crucial topic.

Accountability, cost effectiveness, and continuous quality improvement are essential features of all managed health care systems. However, application of these principles to mental health treatments has lagged behind other health care services. In this article, administrative, practice, and technical issues are addressed through a joint effort between academically based researchers and administrators from two large managed health care organizations. Principles related to the measurement of outcome, instrument selection, and obstacles to the implementation of an ongoing program to assess mental health treatment outcomes are identified. Finally, principles for successfully changing mental health provider behavior toward outcome assessment and the implications of such for mental health delivery systems are discussed.

Surprisingly few quantitative studies have addressed the question of whether visually impaired individuals evidence, perhaps in compensation for their loss of vision, increased acuteness in their other senses. In this experiment we sought to determine whether blind subjects outperform sighted subjects on a number of basic tests of chemosensory function. Over 50 blind and 75 sighted subjects were administered the following olfactory and gustatory tests: the University of Pennsylvania Smell Identification Test (UPSIT); a 16-item odor discrimination test; and a suprathreshold taste test in which measures of taste-quality identification and ratings of the perceived intensity and pleasantness of sucrose, citric acid, sodium chloride, and caffeine were obtained. In addition, 39 blind subjects and 77 sighted subjects were administered a single staircase phenyl ethyl alcohol (PEA) odor detection threshold test. Twenty-three of the sighted subjects were employed by the Philadelphia Water Department and trained to serve on its water quality evaluation panel. The primary findings of the study were that (a) the blind subjects did not outperform sighted subjects on any test of chemosensory function and (b) the trained subjects significantly outperformed the other two groups on the odor detection, odor discrimination, and taste identification tests, and nearly outperformed the blind subjects on the UPSIT. The citric acid concentrations received larger pleasantness ratings from the trained panel members than from the blind subjects, whose ratings did not differ significantly from those of the untrained sighted subjects. Overall, the data imply that blindness, per se, has little influence on chemosensory function and add further support to the notion that specialized training enhances performance on a number of chemosensory tasks.

The membrane filter (MF) method for detection and enumeration of coliform bacteria in drinking water requires that the coliforms both grow and produce a green metallic sheen when the filter is incubated on modified Endo medium at 35 degrees C for 22 h. Large numbers of noncoliform bacteria, which are enumerated by the standard plate count (SPC) technique, can interfere with the detection of coliforms on MF. This paper presents quantitative evidence from laboratory experiments on the interference of specific SPC bacteria on coliform colony sheen production on MF. Pseudomonas aeruginosa and Aeromonas hydrophila caused significant reductions in Escherichia coli sheen colony counts when present at 3,000 and 220 per filter, respectively. The Flavobacterium sp. and Bacillus sp. selected for this study from SPC did not interfere with coliform colony sheen production. Excessive crowding of E. coli and Enterobacter cloacae colonies on MF also caused a reduction in the number of colonies that produced sheen. Even when there was no crowding (14 colonies per filter), only a fraction of the E. cloacae colonies produced sheen colonies on modified Endo medium.

Granular activated carbon (GAC) beds may be used for removal of dissolved organic matter during the treatment of drinking water. However, they might also change the microbiological quality of the water entering the distribution system either by changing the predominant bacteria or the bacterial density of the treated water. A 3-year pilot plant study of water treatment using GAC beds was conducted at the Baxter Water Treatment Plant in Philadelphia. During the study, bacteria were isolated from the raw water and from the effluents of the GAC treatment units. At the end of the study, bacteria were also isolated from the GAC units and from sand beds operated in parallel with the GAC units. Bacterial genera in the GAC effluents and in the GAC units themselves were similar to those found in the raw water and in the sand beds. Prechlorination and (or) preozonation of the water before GAC treatment had no noticeable effect on the bacterial genera found as compared with GAC unit having no predisinfection. The bacterial genera found in this study were similar to those found in seven other studies of GAC water treatment that used a variety of treatment schemes and a variety of heterotrophic plate count techniques to evaluate bacterial populations. From these several studies it appears that GAC treatment does not change the nature of the bacterial populations associated with drinking water.