CLINICIAN'S DIGEST: In the Bronx, a Little Bit of Therapy Can Go a Long Way

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Every Clinician's Digest consists of several brief (400-500 word) articles of specific clinical relevance to therapists. For technical reasons, it is impossible to provide a Preview of the individual articles within a Digest.

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Heartening News for Group Therapy

It has been nearly 10 years since psychiatrist David Spiegel of Stanford University discovered that group psychotherapy for women with breast cancer resulted in less anxiety and depression, half the pain and, most surprisingly, longer life. Now a metanalysis of 23 separate studies, comprising more than 3,000 patients, proves that group psychotherapy improves the health of heart patients as well. Patients with heart disease who undergo psychotherapy along with medical treatment have less surgery, fewer heart attacks and lower death rates, according to the study in April's Archives of Internal Medicine . The August Harvard Mental Health Letter , summarizes this and other studies that prove the efficacy of group therapy for heart-disease patients. A group that received therapy along with standard medical care and discussions about medication, exercise and diet suffered 44 percent fewer heart attacks than groups receiving either standard medical care alone or medical care plus health education.

The American Psychological Association (APA) recently signed an agreement with the Mayo Clinic to hire Coopers & Lybrand, an international accounting firm, to demonstrate the cost savings of psychosocial treatment of heart patients. The study will use the data from a 1995 Mayo Clinic study of 381 heart disease patients in which, over six months, the mean medical costs for emotionally distressed patients was $9,504 compared to $2,146 for the nondistressed. If the figures in the Coopers & Lybrand model work out the way the APA hopes and research suggests, the APA plans to set up a demonstration project with a third-party payer, and the APA's public relations firepower will certainly disseminate the results.

This will take time. In the meantime, it looks like therapists, those low-tech metaphorical heart specialists, will have an important role in the continuing struggle with this and other diseases.

Mind Over Megabytes

No one knows better than the people at Princeton University's Princeton Engineering Anomalies Research Laboratory (PEAR)--physicists, engineers, computer scientists and psychologist Brenda Dunne--how suspicious their research findings sound. But they have 18 years of accumulated data showing that human beings can affect computers just by thinking about them, even from thousands of miles away. Consistently, over millions of repetitions, random-event generators--computer random programs that simulate recognizable visual patterns such as coin tossing--exhibit definite alterations in those patterns when human subjects concentrate on them. The results are modest but significant. Last January, PEAR organized a global meditation event with people around the world concentrating at a specific time, and once again, U.S. and European random-event generators showed a discernible variation.

The only thing PEAR spends more time on than its tedious, repetitive, scrupulously controlled experiments is downplaying its findings. "We have to be very careful of Princeton's image," says Communication Director Arnold Lettieri. "We're entitled to do research only if we meet Princeton's ethical and scholarly guidelines."

There are several reasons why this startling news hasn't gotten more media play. First, PEAR doesn't want attention. Also, the findings, although intriguing, don't meet media criteria for earthshaking pronouncements. As a PEAR paper explains, "The observed effects are usually quite small, of the order of a few parts in ten thousand, but they are statistically respectable. …