Delivery of Psychological Interventions by Clinical Neuropsychologists: Current Practice in Australia and Implications for Training

Clinical neuropsychologists are increasingly involved in delivering psychological interventions to people with neurological conditions. This is a key competency for accredited Australian postgraduate neuropsychology courses; however it is not clear how effective courses are in preparing neuropsychologists to deliver interventions. The study aims were to (a) determine the frequency and confidence with which particular types of interventions are delivered by Australian neuropsychologists, (b) examine the availability of opportunities to deliver interventions on clinical placements, (c) identify barriers to delivering interventions in current workplaces; and (d) determine which factors influence the frequency and confidence with which neuropsychologists deliver interventions. An online survey was completed by 114 participants who had graduated from a postgraduate neuropsychology program. Results indicated that respondents delivered different intervention types with varying frequency. They reported limited opportunities to practice these interventions on placements. The majority wanted to be doing more interventions, with lack of time, resources, and adequate training being the major barriers. There were several significant relationships between the frequency and confidence with which respondents delivered interventions and the perceived quality of their postgraduate training. These results highlight the need to consider appropriate postgraduate training options in delivery of interventions, including increasing opportunities to practice interventions on placements.     

Therapists' Use of Religious and Spiritual Interventions in Christian Counseling: A Preliminary Report

This study explored the use of religious and spiritual interventions in counseling by Christian therapists (N = 100). Use of religious and spiritual interventions correlated with personal religiousness and clinical training involving religious clients and religious and spiritual interventions. Course work involving either psychology or theology did not correlate with use of or self‐reported competency in using religious and spiritual interventions. Self‐reported competency was associated with personal religiousness; professional beliefs, attitudes, and values; personal experiences with counseling; and clinical training involving religious clients and religious and spiritual interventions. It is suggested that training programs incorporate clinical rotations, workshops, and supervision involving religious clients and religious and spiritual interventions to teach therapists to use religious and spiritual interventions in counseling.     

Using a new taxonomy to combine the uncombinable: integrating results across diverse interventions

Researchers have examined numerous psychosocial and behavioral interventions intended to alleviate distress among family caregivers of persons with dementia. Many of these interventions are complex, combining numerous treatment components. Although some multicomponent interventions have been successful in reducing caregiver distress, the impact of specific elements of these interventions on outcomes is not known. The article presents results of an analytic approach that allows researchers to describe the individual elements of multicomponent interventions and to examine the relationships between those components and outcomes. This approach is successfully applied to interventions being evaluated in the Resources for Enhancing Alzheimer's Caregiver Health (REACH) program. The results indicate that actively targeting caregiver behavior is effective in achieving positive outcomes with respect to caregiver depression.     

Comparison of Explicit Forgiveness Interventions With an Alternative Treatment: A Randomized Clinical Trial

Forgiveness interventions can help people forgive past offenses. However, few studies have compared forgiveness interventions with genuine alternative treatments. The authors compared forgiveness interventions with a therapeutic alternative treatment. Participants reduced unforgiveness and increased forgiveness regardless of treatment condition. Trait forgivingness was not related to change in forgiveness, whereas greater offender contrition was related to greater reductions in unforgiveness. The type of treatment may not be as important as factors common to the interventions.     

Occupational Therapy Interventions for Children with Attention Deficit Hyperactivity Disorder: A Systematic Review

This systematic review examined evidence published 2005–2015 for occupational therapy interventions for children with Attention Deficit Hyperactivity Disorder (ADHD). We identified 590 abstracts with 17 full-text articles eligible for review. Fourteen articles were included in the final analysis with two level I studies, two level II studies, eight level III studies, and two level IV studies. Occupational therapy interventions focused on play, sensory, motor, and cognitive skills. While the interventions yielded good results, there were limitations in study design, interventions, and outcome measures. Future research should include larger sample size, randomization, control groups, and interventions that can be replicated.     

Contextual Intervention for Caregiver Non-Adherence With Behavioral Intervention Plans

The extent to which parents and other caregivers implement behavioral interventions with integrity has an important impact on treatment effectiveness. This article considers popular interventions that train caregivers and improve treatment integrity in applied behavior analysis. After considering these interventions a contextual approach is described, whereby the function of caregiver non-adherence is considered. In particular, interventions aimed at manipulating setting factors are reviewed. The examples of respite and social support groups are provided as function-based interventions to improve caregiver adherence to behavioral recommendations. Implications for more contextual, coordinated, and comprehensive function-based behavioral services are provided.     

Intervention for Children Exposed to Interparental Violence (IPV): Assessment of Needs and Research Priorities

In this paper we review the development of interventions for children who have been exposed to interparental violence (IPV), assess current needs in the evaluation of interventions, and provide suggestions for research priorities in this area. Interventions for negative outcomes associated with exposure to IPV only recently have been carefully designed and evaluated, thus knowledge regarding program effectiveness is minimal. Three of the most comprehensive interventions that have been evaluated are presented. Each has demonstrated effectiveness, and focuses on children with different levels of symptoms and distress. However, many questions remain regarding which interventions are beneficial for diverse children with different kinds and intensities of problems. A number of research priorities and suggestions for further improvements in the evaluation of effectiveness of interventions are identified.     

Say something nice: A meta-analytic review of peer reporting interventions

Peer reporting interventions (i.e., Positive Peer Reporting and tootling) are commonly used peer-mediated interventions in schools. These interventions involve training students to make reports about peers' prosocial behaviors, whether in oral or written form. Although peer reporting interventions have been included in meta-analyses of group contingencies, this study is the first meta-analytic review of single-case research focusing exclusively on peer reporting interventions. The literature search and application of inclusion criteria yielded 21 studies examining the impact of a peer reporting intervention on student behavior compared to baseline conditions. All studies used single-case experimental designs including at least three demonstrations of an effect and at least three data points per phase. Several aspects of studies, participants, and interventions were coded. Log response ratios and Tau were calculated as effect size estimates. Effect size estimates were synthesized in a multi-level meta-analysis with random effects for (a) studies and (b) cases within studies. Overall results indicated peer reporting interventions had a non-zero and positive impact on student outcomes. This was also true when data were subset by outcome (i.e., disruptive behavior, academically engaged behavior, and social behavior). Results were suggestive of more between- than within-study variability. Moderator analyses were conducted to identify aspects of studies, participants, or peer reporting interventions associated with differential effectiveness. Moderator analyses suggested published studies were associated with higher effect sizes than unpublished studies (i.e., theses/dissertations). This meta-analysis suggests peer reporting interventions are effective in improving student behavior compared to baseline conditions. Implications and directions for future investigation are discussed.     

A Review of Occupation-Based Life Skills Interventions for Adults with Neurodevelopmental Disorders

Adults with neurodevelopmental disorders are at a higher risk for poverty, unemployment, and difficulties in relationships. Instrumental activities of daily living deficits often go unaddressed and minimal research has explored interventions to address them. The purpose of this study was to synthesize findings about occupation-based life skills interventions for adults with neurodevelopmental disorders. Ten articles met inclusion criteria and the American Occupational Therapy Association level of evidence and quality ratings were identified. Results indicate that occupation-based life skills interventions effectively address limitations experienced by adults with neurodevelopmental disorders but the overall quantity and quality of evidence-based interventions are lacking.     

Tobacco, Drug, and HIV Preventive Media Interventions

Media-based health promotion interventions can reach large segments of the population and lower barriers to participation in programs. By collaborating with media specialists, we can develop interventions that might be broader, more publicized, and ultimately more likely to change behaviors and attitudes within the community. The present paper describes a series of media interventions involving smoking cessation, drug abuse prevention, stress reduction, weight control, and HIV/AIDS prevention. The process by which I became involved in these interventions is discussed, and the implications of developing these types of large-scale behavioral interventions are discussed.     

The importance of decision making in causal learning from interventions

Recent research has focused on how interventions benefit causal learning. This research suggests that the main benefit of interventions is in the temporal and conditional probability information that interventions provide a learner. But when one generates interventions, one must also decide what interventions to generate. In three experiments, we investigated the importance of these decision demands to causal learning. Experiment 1 demonstrated that learners were better at learning causal models when they observed intervention data that they had generated, as opposed to observing data generated by another learner. Experiment 2 demonstrated the same effect between self-generated interventions and interventions learners were forced to make. Experiment 3 demonstrated that when learners observed a sequence of interventions such that the decision-making process that generated those interventions was more readily available, learning was less impaired. These data suggest that decision making may be an important part of causal learning from interventions.     

Stress Management Counseling: From crisis to prevention

The importance of developing preventive stress management interventions in major societal institutions is emphasised, with particular attention given to the schools and employment settings. The unique role that counseling psychology can assume in promoting preventive stress management interventions is discussed. Review of major stress theories and examples of interventions are presented.     

The efficacy of postdivorce intervention programs for children: A meta-analytical review

Preventive postdivorce interventions aim to help children cope with divorce and promote their adjustment. Nevertheless, questions remain regarding the concrete outcomes of these interventions and the intervention characteristics that influence them. This meta-analysis of 30 studies analyzes the efficacy of postdivorce interventions on children's symptomatology, personal resources, and adaptation to divorce. Likewise, it explores whether the intervention impacts the putative mediators from the family context and whether the characteristics of the studies themselves also influence the results. Using a data set of N = 4344 individuals, 258 effect sizes were calculated. Random effects analyses evidenced the impact of the interventions on specific variables instead of on children's global adjustment. There were no significant effects on children's mental health outcomes, and none of these effects were qualified by the moderators that were examined. Preventive postdivorce interventions had significant effects, specifically on children's divorce adjustment and self-esteem. The study of the moderators found that the interventions were generally homogeneous, and only one of the 20 moderators examined had a significant effect. Based on children's age, the interventions had an impact on family functioning only when they involved younger children, but this result should be interpreted with caution due to the small sample of studies. This meta-analysis provides evidence of the relevance of postdivorce interventions to critical variables as well as information about the role of the intervention characteristics in the effects and makes suggestions for future research on divorce interventions that encompass both practical and empirical developments.     

Intervention Studies on Forgiveness: A Meta‐Analysis

In this meta‐analysis, 9 published studies (N = 330) that investigated the efficacy of forgiveness interventions within counseling were examined. After a review of theories of forgiveness, it was discovered that the studies could logically be grouped into 3 categories: decision‐based, process‐based group, and process‐based individual interventions. When compared with control groups, for measures of forgiveness and other emotional health measures, the decision‐based interventions showed no effect, the process‐based group interventions showed significant effects, and the process‐based individual interventions showed large effects. Consequently, effectiveness has been shown for use of forgiveness in clinical and other settings.     

Young children infer causal strength from probabilities and interventions

We examine the interaction of two cues that children use to make judgments about cause-effect relations: probabilities and interventions. Children were shown a "detector" that lit up and played music when a block was placed on its surface. We varied the probabilistic effectiveness of the block, as well as whether the experimenter or the child was performing the interventions. In Experiment 1, we found that children can use probabilistic evidence to make inferences about causal strength. However, when the results of their own interventions are in conflict with the overall frequencies, preschoolers favor the results of their own interventions. In Experiment 2, children used probabilistic evidence to infer a hidden causal mechanism. Though they again gave preference to their own interventions, they did not do so when their interventions were explicitly confounded by an alternative cause.     

A systematic review and narrative synthesis of occupational therapy-led interventions for individuals with anxiety and stress-related disorders

Anxiety and stress-related disorders are highly prevalent and impede participation in life activities. Occupational therapists work extensively with people diagnosed with these disorders but the effectiveness of their interventions is unclear. A systematic search strategy identified 19 papers describing 13 studies. Studies varied in methodology, intervention type, and theory base. The results show the potential for lifestyle approaches, occupational science-based programs, and skill-building to improve mental health. The variety of interventions and methodologies of many studies means that the effectiveness of occupational therapy interventions for this population is not yet determined. High-quality research is required to replicate interventions with emerging potential for effectiveness.     

Should medicare reimburse providers for weight loss interventions?

This issue of the American Psychologist (April 2007) includes two reviews of the literature on the effects of behavioral programs to reduce body weight. One review (T. Mann et al., 2007) concentrates on dietary interventions and finds little evidence that diets are of benefit. The second review (L. H. Powell, J. E. Calvin III, & J. E. Calvin Jr., 2007) concentrates on multicomponent interventions and reports some significant achievements of behavioral interventions. Although the reviews come to different conclusions about the value of supporting weight loss interventions, there appears to be agreement that diet alone results in little or no long-term benefit. Evidence-based multicomponent behavioral interventions or interventions that combine behavioral with medical or surgical treatments may offer better chances of long-term weight control. Evidence-based studies are needed to inform policy on provider reimbursement for weight loss programs.     

Crafting usable knowledge

Current emphasis on evaluating interventions does not address the problems of dissemination and utilization of these interventions, particularly in complex settings such as schools. Research on interventions is of value, but its generalizability to specific contexts is limited. Further, little is known about actual use of empirically supported interventions in practice settings. These concerns suggest the following: (a) There is a need to examine the dissemination process, including practitioner education and the development of a consumer information mindset by researchers; (b) guidance about selecting interventions would benefit from a systematic problem-solving orientation; and (c) research training and methodology need to be augmented with strategies and techniques suitable for developing an empirical approach to practice. These issues are addressed with specific examples drawn from school-based practice.     

No Easy Answers: Avoiding Potential Pitfalls of De‐implementation

In 2012, the Centers for Disease Control and Prevention (CDC) began to de‐emphasize and de‐implement multiple evidence‐based HIV prevention practices that had been around for 20 years, thus changing the scope of implementation across the globe. The authors provide evidence how existing interventions (e.g., CDC HIV interventions) may influence implementation of interventions that came after the program was discontinued. De‐implementation is an ecological event that influences, and is influenced by, many parts of a system, for instance, implementation of one type of intervention may influence the implementation of other interventions (biomedical and/or behavioral) after a long‐running program is discontinued. Researchers and policy makers ought to consider how de‐implementation of behavioral interventions is influenced by biomedical interventions mass‐produced by companies with lobbying power. The scientific study of de‐implementation will be inadequate without consideration of the political climate that surrounds de‐implementation of certain types of interventions and the promotion of more‐profitable ones.     

The perceived effectiveness of road safety interventions: Regulation of drivers’ behavioral intentions and self-consciousness

We consider road safety interventions to be potential sources of social influence, altering the intentions and behaviors of drivers when they are perceived by the latter as effective. We also consider that perceiving their effectiveness depends on drivers’ self-consciousness. 852 drivers replied to a questionnaire measuring dispositional self-consciousness, the perception of the effectiveness of 10 road safety interventions, and reported intentions and behaviors related to speeding and drinking and driving. The results revealed several phenomena: (1) interventions were perceived as related to penalty/surveillance or social communication (factor analysis); (2) the former were perceived as more effective than the latter; (3) the perceived effectiveness of road safety interventions was moderately correlated with intentions and behaviors; (4) this link was stronger for interventions of the penalty/surveillance type; (5) age, level of education, frequency of use of a vehicle and gender were moderately associated with the perception of these interventions; (6) self-consciousness (in particular its public dimension) had an additional positive association with this perceived effectiveness. These results are discussed from a practical and methodological point of view.