Family reconciliation as a response to adolescent crises

Concern for adolescents who act in dangerous, life-threatening ways has heightened dramatically in recent years. Many of these adolescents appear to come from nuclear families isolated from their kinship systems. Without the mediating effects of kin, the adolescent transition can become a major crisis. Kinship systems remain cohesive when members can reconcile their beliefs about essential aspects of family functioning with the demands for adaptation during major life transitions. Reconciliation is lost when members believe that kin can no longer be trusted to insure their well-being. Kinship fragmentation ensues as family members leave the field or are excluded. Isolated nuclear families then rapidly lose the resilience to respond to life transitions without resorting to extreme, maladaptive solutions. The Systemic Crisis Intervention Program (SCIP) uses the opportunity of the crisis precipitated by the adolescent's life-threatening behavior to alter family myths that have led to network fragmentation. Crisis teams mobilize and meet with kin in four-hour gatherings to foster reconciliation and kinship system reintegration.     

Suicide survivors seeking mental health services: a preliminary examination of the role of an active postvention model

Archival data from suicide survivors presenting for treatment from 1999-2005 at the Baton Rouge Crisis Intervention Center (BRCIC) were used to examine differences in those who received an active model of postvention (APM; n=150) compared to those who received a traditional passive postvention (PP, n=206). APM presented sooner for treatment (48 days) than PP (97 days). APM survivors were more likely to have been the survivor of a violent suicide. APM were more likely than PP to attend survivor support group meetings and APM attended more groups. To better understand the efficacy of APM in helping survivors, a prospective evaluation is needed.     

新形势下的危机干预:2001年"9.11"事件后的新泽西

提供了一个研究参与式心理教育研习班发展的事例.作为对世贸遭袭一事的回应,这种研习班迅速发展并传播开来,成为一种有影响力的团体.它为个人及团体提供了以概念和经验为基础的训练,以应对灾难,精神创伤,恢复力,忍耐力以及同情心的疲乏等问题.     

BOOK REVIEWS

Book reviewed in this article: Guidance: Techniques for Individual Appraisal and Development by Bruce Shertzer and Herman J. Peters. Crisis Intervention: Selected Readings edited by Howard J. Parad. Action Programs for Juvenile Delinquency Prevention by William E. Amos, Raymond L. Monella, and Marilyn A. Southwell. The Prediction of Academic Performance: A Theoretical Analysis and Review of Research by David E. Lavin. Personal and Organizational Change Through Group Methods: The Laboratory Approach by Edgar H. Schien and Warren G. Bennis. Occupational Information by Max F. Baer and Edward C. Roeber.     

The Development and Validation of the Memory Support Treatment Provider Checklist

Patient memory for the contents of treatment is staggeringly poor, and poor memory for treatment is associated with worse treatment outcome. Accordingly, the Memory Support Intervention was developed to improve patient memory for treatment as an adjunct to treatment as usual. As plans to disseminate the Memory Support Intervention are developed, it is important to have efficient, accurate methods of measuring fidelity to the intervention. However, the existing method of assessing fidelity to the Memory Support Intervention, the Memory Support Rating Scale (MSRS), is burdensome and requires trained independent-raters to spend multiple hours reviewing session recordings, which is not feasible in many routine mental health care settings. Hence, a provider-rated measure of fidelity to the MSI has been developed. The goal of this study is to examine the reliability and validity of scores on this measure—the Memory Support Treatment Provider Checklist. A sample of Memory Support Treatment Provider Checklists (N = 319) were completed by providers (N = 8) treating adults with depression (N = 84). Three metrics of the Memory Support Treatment Provider Checklist were evaluated: (a) the internal consistency and structural validity using confirmatory factor analysis based on prior research on the MSRS and the Memory Support Intervention, (b) construct validity, and (c) predictive validity. Results indicate that the Memory Support Treatment Provider Checklist yields reliable and valid scores of fidelity to the Memory Support Intervention. Overall, this checklist offers a viable, brief method of evaluating fidelity to the Memory Support Intervention.     

Brief Behavioral Intervention for Young Children with Disruptive Behaviors

Parent reported behavioral difficulties in young children are relatively common. Without adequate intervention, some children will later present with more severe problem behaviors. Parent management training is one of the best methods of treatment for behavior problems; however, existing treatments can be lengthy and difficult to conduct outside of a research setting. The Brief Behavioral Intervention was designed as a briefer version of a manualized parent management training treatment package. Thirty-one parents of children aged 2–6.5 presenting with behavior problems were included in this initial study of treatment effectiveness. Based on parent and teacher report, treatment was effective in a mean of 7.2 sessions.     

The Decline of Youth Suicidal Behavior in an Urban,Multicultural Public School System Following the Introduction of a Suicide Prevention and Intervention Program

A 5-year longitudinal study of suicidal behavior of students attending Dade County Public Schools (DCPS) in Miami, Florida, between the 1989–1990 and 1993–1994 school years, is described. As the fourth largest public school system in the United States, DCPS is representative of an urban, multicultural community. The prevalence of suicidal behavior among DCPS students necessitated the development of a districtwide Suicide Prevention and School Crisis Management Program (SPSCMP), including the creation of the “Youth in Crisis Hotline.” A review of eight national school districts' suicide prevention and intervention programs indicates similarities with the DCPS model. Statistical data compiled by the DCPS program are organized into annual, monthly, grade level, and school level classifications, and are analyzed to determine the degree and direction of self-destructive behavior among youth in a culturally and linguistically diverse school population following the introduction of a suicide prevention and intervention program. Evaluative data regarding the effectiveness of the program as well as implications for suicide prevention and intervention are discussed.     

Training to be a volunteer Rape Crisis counsellor: a qualitative study of women's experiences

This is an account of a qualitative study designed to elicit and analyse the narratives of women who had trained to be volunteer counsellors at a Rape Crisis centre. Little prior research has focused on the experiences of workers in Rape Crisis centres and this project was designed to explore women's experiences in ways that were meaningful to them. The research methods used were face-to-face, unstructured, in-depth individual interviews and group sessions. Participants in the individual interviews had all undertaken Rape Crisis training within the preceding two years. The group sessions involved all workers who were actively involved with the Rape Crisis centre at the time of the research. Five themes emerged from an inductive analysis of the data: motivation to train, complexity and change, changes in personal relationships, personal change and feminism. Overall the study highlights the complex, transformative processes that volunteer Rape Crisis counsellors may experience. The article concludes by identifying implications for practice that may serve to enhance training for volunteer counsellors in the future.     

Critical elements of the crisis intervention team model of jail diversion: An expert survey

The Crisis Intervention Team (CIT) model of jail diversion is a promising approach to addressing the over-involvement of people with mental illness with the criminal justice system. Despite its popularity and promising empirical support, the literature has yet to clarify CIT's critical elements. The aim of this study was to assess the degree to which experts agreement on the importance and perceived implementation of the critical elements of CIT. Study 1 used a literature review to cull potential elements. Three experts familiar with the CIT model reviewed these elements. Study 2 utilized an online survey of 55 CIT co-ordinators/officers and published experts to assess agreement regarding importance and degree the element is implemented. A preliminary list of 36 elements was identified with a high level of expert agreement on their importance regarding importance and implementation. This study developed a preliminary list of elements of the CIT's program. Further research should develop consensus, explore elements' association with outcomes, and differentiate elements from those common to all jail diversion programs. Copyright © 2010 John Wiley & Sons, Ltd.     

Short-Term Suicide Awareness Curriculum

ABSTRACT: The present study attempted to determine the effectiveness of a suicide awareness curriculum and to assess two methods of presenting the information. It was hypothesized that students receiving instruction via lectures and handouts would score significantly higher than students who only received handouts. Dependent variables included the Suicide Intervention Response Inventory (SIRI), the Knowledge of Suicide Test (KOST), the Suicide Prevention Questionnaire (SPQ), and specific suicide-related vignettes. There was a significant main effect for treatment. Univariate analyses demonstrated significant treatment effects for all dependent measures. Two orthogonal contrasts demonstrated significant differences on the KOST and the vignettes, suggesting that the lectures were instrumental in the increased performance on those tasks.     

Sexual Assault: The Female Victim,Her Male Partner,and Their Relationship

Using the Crisis model of Fox and Scherl, treatment issues for the female sexual assault victim and her male partner are proposed.     

The Effectiveness of Functional Family Therapy in Reducing Adolescent Mental Health Risk and Family Adjustment Difficulties in an Irish Context

To evaluate the effectiveness of Functional Family Therapy (FFT) 42 cases were randomized to FFT and 55 to a waiting‐list control group. Minimization procedures controlled the effects of potentially confounding baseline variables. Cases were treated by a team of five therapists who implemented FFT with a moderate degree of fidelity. Rates of clinical recovery were significantly higher in the FFT group than in the control group. Compared to the comparison group, parents in the FFT group reported significantly greater improvement in adolescent problems on the Strengths and Difficulties Questionnaire (SDQ) and both parents and adolescents reported improvements in family adjustment on the Systemic Clinical Outcomes and Routine Evaluation (SCORE). In addition, 93% of youth and families in the treatment condition completed FFT. Improvements shown immediately after treatment were sustained at 3‐month follow‐up. Results provide a current demonstration of FFT's effectiveness for youth with behavior problems in community‐based settings, expand our understanding of the range of positive outcomes of FFT to include mental health risk and family‐defined problem severity and impact, and suggests that it is an effective intervention when implemented in an Irish context.     

A randomized pilot trial comparing videoconference versus face-to-face delivery of behavior therapy for childhood tic disorders

Comprehensive Behavioral Intervention for Tics (CBIT) has been shown to be effective for reducing tics in children with chronic tic disorder. Unfortunately, there remain significant barriers to dissemination. The aim of the current study was to examine the effectiveness of CBIT delivered over videoconference. Twenty children were randomly assigned to receive CBIT over videoconference or via traditional face-to-face delivery. Results show that both treatment delivery modalities resulted in significant tic reduction with no between group differences. Furthermore, acceptability and therapist-client alliance ratings were strong for both groups. Together, these results suggest that videoconference is a viable option for disseminating CBIT.     

Development of a Brief Adjunctive Intervention for Family Members of Veterans in Individual PTSD Treatment

Family involvement in the treatment of posttraumatic stress disorder (PTSD) among veterans has the potential to improve treatment retention and outcomes. Current protocols that incorporate family members into treatment tend to involve at least 15 sessions, and none are designed to complement Cognitive Processing Therapy (CPT) or Prolonged Exposure (PE), the two most widely used and heavily promoted evidence-based PTSD therapies in the Veterans Affairs (VA) healthcare system. The current paper describes the development and initial feasibility and acceptability of a Brief Family Intervention (the BFI) designed to be delivered as an adjunct to veterans’ individual CPT/PE. The BFI focuses on providing psychoeducation about PTSD and treatment, building family member support for treatment, and reducing family symptom accommodation. A detailed review of the treatment structure and activities is provided, and qualitative data from four dyads (veterans and their spouses/significant others) at baseline and post-intervention are presented. Veterans and partners reported positive responses to the program and were enthusiastic about its utility. Larger randomized controlled studies will be needed to determine the protocol’s efficacy and effectiveness.     

Consultation-based Academic Interventions for Children with ADHD: Effects on Reading and Mathematics Achievement

The purpose of this investigation was to evaluate the relative efficacy of two consultation-based models for designing academic interventions to enhance the educational functioning of children with attention-deficit/hyperactivity disorder (ADHD). Children (N=167) meeting DSM-IV criteria for ADHD were randomly assigned to one of two consultation groups: Individualized Academic Intervention (IAI; interventions designed using a data-based decision-making model that involved ongoing feedback to teachers) and Generic Academic Intervention (GAI; interventions designed based on consultant-teacher collaboration, representing "consultation as usual"). Teachers implemented academic interventions over 15 months. Academic outcomes (e.g., standardized achievement test, and teacher ratings of academic skills) were assessed on four occasions (baseline, 3 months, 12 months, 15 months). Hierarchical linear modeling analyses indicated significant positive growth for 8 of the 14 dependent variables; however, trajectories did not differ significantly across consultation groups. Interventions in the IAI group were delivered with significantly greater integrity; however, groups did not differ with respect to teacher ratings of treatment acceptability. The results of this study provide partial support for the effectiveness of consultation-based academic interventions in enhancing educational functioning in children with ADHD; however, the relative advantages of an individualized model over "consultation as usual" have yet to be established.     

Differential Effects of Self-graphing on Self-monitoring of Early Literacy Outcomes in Kindergarten Students

The purpose of this study was to examine how an early literacy intervention, Kindergarten Peer-Assisted Learning Strategies (K-PALS; Mathes et al. Kindergarten peer-assisted literacy strategies (K-PALS): Sopris West, 2001), can be intensified to extend the positive outcomes to students who do not initially demonstrate an adequate response to intervention. K-PALS was intensified by incorporating a self-monitoring package that included self-graphing. An alternating treatment design was used to compare the effectiveness of K-PALS with self-graphing alone and K-PALS with a self-monitoring package to baseline/K-PALS for the purpose of increasing student performance on the early literacy measure of phonemic awareness. The results of the study indicate that while the self-monitoring package was the more effective intervention for two of the three student participants, the self-graphing alone intervention also resulted in positive outcomes for both of these participants. There was no change in the phonemic awareness performance for the third participant throughout the alternating treatment phase. Implications for intensifying academic interventions within the context of a Response to Intervention framework are discussed.

     

Systemische Therapien bei Menschen mit psychotischen Verhaltens- und Erlebnisweisen

Systemic therapy for persons who have been diagnosed as having schizophrenic or schizoaffective psychosis has been practiced since the 1950s, not everywhere and routinely but in many psychiatric hospitals and outpatient clinics with a strong psychosocial orientation. Evidence of the effectiveness is well documented in randomized controlled studies. This article describes three systemic approaches in which the authors are actively involved: (1) systemic constructivist family therapy developed in Heidelberg for outpatient contexts, (2) need-adapted treatment and open dialogue developed in northern Europe that has gained access to psychiatric clinics through regional training within integrated care projects and (3) the concept of systemic therapeutic methods of acute psychiatric treatment (SYMPA) a systemic family-oriented inpatient treatment.     

CIT in small municipalities: Officer‐level outcomes

Research on the Crisis Intervention Team (CIT) as a method to deal with mental illness in policing encounters has primarily focused on officers from large urban areas. The current study examined officer‐level outcomes in a non‐urban geographical setting using a pre/post‐CIT training design. The sample included 46 police officers from seven departments that would be considered rural and 13 that would be classified as suburban. Officers completed scales to gauge change in mental illness attitudes at the beginning and end of their one‐week CIT training. CIT training resulted in reductions in stigmatic attitudes with seven large effect sizes (ranging from η² = .24 to .59) across the two measures. The findings from this research are a direct response to the call for greater diversity in the size of police settings in the CIT literature and serve to expand the empirical base for CIT in relation to officer‐level outcomes.