Themes in Therapist Development During the First Three Months of Clinical Experience

The results of a qualitative research study designed to better understand the developmental processes active in beginning therapists during the first three months of clinical contact is reported. Thirteen beginning therapists were asked to complete a monthly log describing experiences impacting their clinical work and themselves as therapists during their first three months of client contact. Data analysis revealed that the primary developmental theme active during this period of time is the development of therapist confidence. Two additional themes, the development of an internal gauge on which to evaluate current experiences and the development of boundaries around the self as a professional, were also found to be active during this time. These additional themes support the development of therapist confidence. Implications for training and research are identified.     

Children With Conduct Problems and Co-occurring ADHD: Behavioral Improvements Following Parent Management Training

To scale up evidence-based treatment of conduct problems, parent management training, Oregon model (PMTO) has been disseminated throughout Norway. This study examined whether Attention Deficit Hyperactivity Disorder (ADHD) predicted the outcomes of PMTO. Of 253 children and families, 97 were reported to have an ADHD diagnosis. Although different at intake, the groups with and without ADHD had close to an equal change in behavioral status following treatment. Maternal depression and family income predicted the combined group's behavior following PMTO. The study indicates that reductions in conduct problems following PMTO are of the same magnitude in children with or without ADHD. However, some characteristics may differentially predict outcomes for children with combined problems.     

A Comparison of Interactions Among Children,Parents, and Therapists in Cognitive Behavior Therapy for Anxiety Disorders in Australia and Japan

Despite growing attention to the efficacy of culturally adapted cognitive-behavioral treatment (CBT) programs for children and adolescents, there is still little empirical and practical information available to therapists who adapt original treatment protocols to suit clients of a specific culture. The current study aimed to compare therapeutic interactions across CBT treatment delivered with two different cultural groups. We developed an observational coding system to examine behaviors exhibited by child, parent, and therapist during CBT sessions conducted in Australia and Japan for children with anxiety disorders. Our results demonstrated significant differences between the two countries with respect to the treatment readiness of children, the proportion of talking during the sessions by parents and children, therapists’ laughter, length of silence during the first session, and parent indices of accommodation. In terms of transitions over time (i.e., first to last CBT session), parents in both countries tended to talk more during the last CBT session, whereas only Australian therapists talked less over time. The proportion of silence decreased over time during the Japanese sessions, and the amount of interruptions by parents increased over time for Australian sessions. Finally, our exploratory analyses demonstrated that a number of behavioral observations were correlated with anxiety treatment outcome at posttreatment. This study suggests that interactions between a child, parent, and therapist during CBT sessions may be affected by the culture in which the CBT session occurs, which could have implications for culturally adapted CBT programs.     

Parenting Interventions for Children with Autism Spectrum and Disruptive Behavior Disorders: Opportunities for Cross-Fertilization

Empirical support exists for parent training/education (PT/PE) interventions for children with disruptive behavior disorders (DBD) and autism spectrum disorders (ASD). While the models share common roots, current approaches have largely developed independently and the research findings have been disseminated in two different literature traditions: mental health and developmental disabilities. Given that these populations often have overlapping clinical needs and are likely to receive services in similar settings, efforts to integrate the knowledge gained in the disparate literature may be beneficial. This article provides a systematic overview of the current (1995–2005) empirical research on PT/PE for children with DBD and ASD; attending to factors for cross-fertilization. Twenty-two ASD and 38 DBD studies were coded for review. Literature was compared in three main areas: (1) research methodology, (2) focus of PT/PE intervention, and (3) PT/PE procedures. There was no overlap in publication outlets between the studies for the two populations. Results indicate that there are opportunities for cross-fertilization in the areas of (1) research methodology, (2) intervention targets, and (3) format of parenting interventions. The practical implications of integrating these two highly related areas of research are identified and discussed.     

The Contribution of the Dyadic Parent-Child Interaction Coding System (DPICS) Warm-Up Segments in Assessing Parent-Child Interactions

This study evaluated the inclusion of uncoded segments in the Dyadic Parent-Child Interaction Coding System, an analogue observation of parent-child interactions. The relationships between warm-up and coded segments were assessed, as well as the segments’ associations with parent ratings of parent and child behaviors. Sixty-nine non-referred parent-child dyads engaged in the observation. Parents completed measures about their parenting and children's behaviors. Significant differences were observed between the first situation's warm-up and coded segments, whereas minimal differences were found for the second situation. Findings suggest that the second warm-up segment may not be necessary for optimal assessment of parent-child interactions.     

Assessing Preferences Among Behavioral Interventions With Japanese Parents of Children With Developmental Disabilities

As the cultural dynamic continues to become increasingly complex, it is critical to assess cultural factors that influence practice. The present study considers the treatment preferences of Japanese mothers of children with developmental disabilities. After answering demographic questions, each participant was given four scenarios and asked how they would respond by choosing one of four interventions (differential reinforcement, ignoring, reprimanding, and time-out). Overall, we found that parents preferred differential reinforcement strategies the most. Moreover, parents who reported that their children had a history of involvement with applied behavior analysis were especially likely to choose differential reinforcement. Implications for future research and practice are provided.     

Preventative Behavioral Parent Training: A Preliminary Investigation of Strategies for Preventing At-Risk Children From Developing Later Conduct Problems

Children exhibiting conduct problems comprise the largest source of referrals to children's mental health services. The treatment for conduct problems that possesses the greatest amount of empirical support is behavioral parent training. Unfortunately, a cogent approach to the identification of risk factors and prevention of chronic conduct problem display has not been developed. This project was an initial longitudinal assessment examining the merits of preventative behavioral parent training as a primary prevention strategy for at-risk children. Results demonstrated that prevention participants were engaging in normative rates of disruptive behaviors at 6-month follow-up, whereas comparison children showed a behavioral decline over time.     

Assessing Stress in Families of Children with ADHD: Preliminary Development of the Disruptive Behavior Stress Inventory (DBSI)

This paper describes the initial development of the Disruptive Behavior Stress Inventory (DBSI). This 40-item measure, which provides indices of the number of stressors experienced during the past 6 months and the rated stressfulness of these events, is designed to assess behavior-related family stress experienced by families of children with attention-deficit/hyperactivity disorder (ADHD). Findings provide strong support for the internal consistency of the DBSI and suggest adequate test-retest reliability. Support for the validity of the measure is suggested by findings that DBSI stress indices differentiate between parents of children with ADHD and those with no history of this disorder. Additional support is provided by findings that scores on the DBSI also differentiate between parents of children with ADHD, combined type and parents of children with ADHD, inattentive type. It is suggested that this measure may provide useful clinical information regarding stress levels in families of children with ADHD and that it may be of potential value as an ADHD treatment outcome measure.     

Attachment and Mother-Child Communication in Adjustment to the Death of a Father Among Cambodian Adolescents

This study examined quality of attachment to the mother and child-mother communication in adolescents' adjustment to the death of a father. Forty-eight Cambodian adolescents whose father had died within the previous 3 years completed a set of measures that included attachment, communication, grief, and self-esteem. Results showed that quality of attachment to the mother and whether the adolescent communicated with the mother about the father and found this to be helpful were positively related to adaptive grief and self-esteem. Moreover, support was shown for an indirect effect of quality of attachment to the mother on adaptive grief as mediated by communication. Implications of the findings for quality of attachment in adjustment to bereavement in a non-Western cultural context are discussed.     

Combined Individual Cognitive Behavior Therapy and Parent Training for Childhood Depression: 2- to 3-Year Follow-Up

Fourteen children with significant depressive symptoms from an open clinical trial of Primary and Secondary Control Enhancement Training augmented with Caregiver–Child Relationship Enhancement Training, participated in a 2- to 3-year follow-up assessment. The results suggested that the significant decreases in depressive symptoms observed at posttreatment were maintained at 2- to 3-year follow-up. Mothers' reports of significant improvement of child psychosocial functioning were also maintained, providing social validation of the effects. Pretreatment child-rated mother-child relations predicted depressive symptoms at 2- to 3-year follow-up. These long-term data support the use of the combined intervention and suggest the need for further research on caregiver involvement in treatment.     

The Bursts and Lulls of Multimodal Interaction: Temporal Distributions of Behavior Reveal Differences Between Verbal and Non‐Verbal Communication

Recent studies of naturalistic face‐to‐face communication have demonstrated coordination patterns such as the temporal matching of verbal and non‐verbal behavior, which provides evidence for the proposal that verbal and non‐verbal communicative control derives from one system. In this study, we argue that the observed relationship between verbal and non‐verbal behaviors depends on the level of analysis. In a reanalysis of a corpus of naturalistic multimodal communication (Louwerse, Dale, Bard, & Jeuniaux, 2012 ), we focus on measuring the temporal patterns of specific communicative behaviors in terms of their burstiness. We examined burstiness estimates across different roles of the speaker and different communicative modalities. We observed more burstiness for verbal versus non‐verbal channels, and for more versus less informative language subchannels. Using this new method for analyzing temporal patterns in communicative behaviors, we show that there is a complex relationship between verbal and non‐verbal channels. We propose a “temporal heterogeneity” hypothesis to explain how the language system adapts to the demands of dialog.     

Honoring and Privileging Personal Experience and Knowledge: Ideas for a Narrative Therapy Approach to the Training and Supervision of New Therapists

This article discusses an approach for the training and supervision of new therapists built around social constructionist and poststructuralist ideas from a narrative therapy perspective. We briefly discuss some of the pitfalls of current training/supervision in marriage and family therapy (MFT) that are deficit based and/or that disproportionately grant privilege to expert knowledge. We articulate this emerging training approach which utilizes the rite of passage metaphor, centers relationalism, and incorporates the honoring and privileging of new therapists' lived experience, knowledges, skills, talents, ideas, morals, personal ethics, values, beliefs. Concrete practices of experience privileging, re-membering, and creating communities of concern are detailed, and illustrative examples from our supervision work are given.     

Acceptability of Time Out from Reinforcement Procedures for Disruptive Child Behavior:

Forty-eight teachers and forty-eight parents evaluated the effectiveness and acceptability of five behavioral procedures for reducing disruptive behavior in children. The results showed that teachers evaluated the procedures as being more effective and acceptable than did the parents. The treatment procedures rated as most effective and acceptable were reinforcement and isolation and contractual agreement. In additon, the procedures were rated as being more effective and acceptable for 5-year-olds than for 10-year-olds. The results of this study are compared to similiar studies reported by Kazdin.     

The 1-2-3 Magic Program: Implementation Outcomes of an Australian Pilot Evaluation With School-Aged Children

No abstract available for this article.     

Enhancements to the Behavioral Parent Training Paradigm for Families of Children with ADHD: Review and Future Directions

Behavioral parent training (BPT) is one of the empirically supported psychosocial treatments for ADHD. Over many years and in many studies, BPT has been documented to improve both child ADHD behavior and maladaptive parenting behavior. In some studies, BPT has also been found to result in benefits in additional domains, such as parenting stress and child classroom behavior. However, the BPT literature on children selected as having ADHD lags behind research conducted on BPT for children selected as having oppositional defiant and conduct disorders (ODD and CD, respectively) with regard to examination of factors that may limit treatment attainment, compliance, and outcomes, such as single parenthood, parental psychopathology, and child comorbidity. Because of the high degree of comorbidity between ADHD and ODD/CD, it is difficult to separate the two BPT literatures. The parameters of BPT (e.g.. format and setting), parent factors, and child factors that may contribute to treatment outcomes for families of children with ADHD are reviewed here and recommendations for future BPT research in the area of ADHD are made.     

Interviewing a Therapist in the Presence of a Couple: A Description of the Therapeutic Process

A therapy research team interviewed a therapist in the presence of a couple. Following each of six consecutive sessions with a couple, an interviewer posed questions to the therapist and couple. While one question was standard to each interview, other questions were generated by team members who tracked the entire process via live observation. These questions were directed first at the therapist, then at the couple, and then focused on therapeutic process and outcome. Findings of this process for the therapy system included decreasing the hierarchy within the client/therapist relationship; increasing the client ownership and energy in the therapy process; discovering the presence of parallel processes between the systems; and informing the direction of future therapy sessions. Practical, clinical implications are discussed for a variety of therapy settings.