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But some recent writers point to a far more specific factor when asking what makes a traumatic event traumatic The factor is that of the person s extremely important and characterologically anchored schemas, or worldviews From this perspective, a traumatic event is one that violates or destroys a very important and deeply held belief about yourself or your world (Everly, 1993b, 1994; Frank & Frank, 1991) In doing so, the traumatic event can be seen to threaten the structural integrity of the core foundations of personality This notion has been recognized by the World Health Organization (WHO; 1992), which, in its International Classification of Disease-10, noted that traumatic experiences may lead to a fundamental alteration in personality Under the category of Enduring Personality Change after Catastrophic Experience (F620), WHO recognizes the notion that personality can be lastingly altered by trauma.

of treatment packages, the goal of experimental therapy investigations is to hold constant all variables except the manipulated variable, allowing investigators to rule out all rival explanations of differential outcome between conditions and leaving the one manipulated feature as the unambiguous explanation for the cause of that outcome difference Such causal conclusions can signi cantly enhance our knowledge about the pathology and about the investigated intervention Unfortunately, in the case of a comparative design, the two (or more) contrasted treatments are so fundamentally different in terms of their theoretical foundations, historical traditions, and most importantly, their (often myriad) speci c techniques, that the scienti c ideal of holding all variables constant except one is not even nearly approximated For example, consider for a moment how many techniques are used in psychodynamic therapy and in cognitive behavioral therapy.

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If the two conditions are compared and found to differ in outcome, one cannot determine what among those many differences caused the difference in outcome Although a drug condition may appear to be more simple and straightforward when involved in a comparative trial in its contrast to a psychotherapy condition, there still remain several ways in which the two conditions differ (eg, who administers the drug, with what types of interpersonal interaction, for how many minutes per session and how many sessions, in what treatment or medical context) Thus, implementation of such a design yields almost no scienti c knowledge (ie.

In the final analysis, it may be argued that PTSD represents a phenomenological insult or injury to the structure and function of the essence of an individual s being, that is, the.

, speci c cause-and-effect information) because so many rival hypotheses exist; any difference in outcome may be due to any one or a combination of the ways in which the compared conditions differ, including ways that have nothing to do with the speci c elements of the interventions Even more fundamental problems having to do with the internal validity of comparative designs make their results wholly uninterpretable One major threat to internal validity is potentially differential quality of treatment across conditions If one therapy is administered poorly and the other therapy expertly, obviously this is an unfair comparison Even if researchers employ separate expert therapists from each type of therapy, as is often done in comparative trials in an effort to maximize quality, there is no way to know whether the expertise of each set of therapists is equivalent.

This is because valid measurements of expertise and quality of treatment are not yet available for any single therapy, much less for two different therapies that might be entered into a comparative trial Furthermore, even if researchers could ensure by valid measurement equivalence of expertise and quality of the treatments offered by expert therapists, the grave threat of a therapist-by condition confound would.

Ernest Henderson and Robert Moore started the Sheraton chain in 1937, when they acquired their rst hotel the Stonehaven in Spring eld, Massachusetts. Within two years, they purchased three hotels in Boston and, before long, expanded their holdings to include properties from Maine to Florida. At the end of its rst decade, Sheraton was the rst hotel chain to be listed on the New York Stock Exchange. In 1968, Sheraton was acquired by ITT Corporation as a wholly owned subsidiary, and ambitious development plans were put into place to create a truly global network of properties. In the 1980s, under the leadership of John Kapioltas, Sheraton s chairman, president, and chief executive of cer, the company received international recognition as an industry innovator.10 The Sheraton chain is currently owned by Starwood Hotels & Resorts Worldwide.

Again, the stick figure needs to land. Fortunately, the squatting figure can be reused, by just moving the squatting character over to the right in your image editor. The standing figure (Figure 38-1) can also be moved to the right in your image editor to make the stick figure stand where it should have landed. The two figures created are shown in Figures 38-6 and 38-7.

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