Helping Children Access and Use Services: A Review

High rates of dropping out from mental health services are documented for children and their families. These high rates exist at different treatment stages, in different service settings, and for different populations of children and families. Some researchers have developed and tested engagement interventions to address barriers to service access and use and increase participation in services by children and their families. Studies of engagement interventions for children and their families are critically reviewed in this paper. Overall, the engagement interventions were effective in increasing attendance at first appointments. Only those with an ecological and total service delivery approach reduced the drop-out rate. However, even then, the drop-out rate was 26% to 29%. Suggestions for future research are made, including ascertaining from children and families their reasons for quitting or staying in treatment, comparing the outcomes of drop-outs with the outcomes of those who remain in treatment, developing and testing conceptual models of engagement for subgroups of at-risk children and their families, and examining the cost-effectiveness of engagement interventions.     

An overview of issues in research on consumer satisfaction with child and adolescent mental health services

Research that focusses on consumer satisfaction with child and adolescent mental health services is reviewed. Satisfaction is broadly conceived to include any study where the perspectives of children, adolescents or their parents about mental health services were gathered and presented. Important conceptual issues in research on consumer satisfaction with children's mental health services are discussed. Some of the general methodological issues that have faced satisfaction researchers are also considered. The wide range of methodological variations that have been used to investigate this topic area are outlined. The most significant findings of previous research are presented and critiqued. In conclusion, suggestions are made about the most fruitful directions for future research.     

Psychosocial Treatment Strategies in the MTA Study: Rationale, Methods, and Critical Issues in Design and Implementation

The Collaborative Multimodal Treatment Study of Children with Attention Deficit Hyperactivity Disorder (ADHD), the MTA, is the first multisite, cooperative agreement treatment study of children, and the largest psychiatric/psychological treatment trial ever conducted by the National Institute of Mental Health. It examines the effectiveness of Medication vs. Psychosocial treatment vs. their combination for treatment of ADHD and compares these experimental arms to each other and to routine community care. In a parallel group design, 579 (male and female) ADHD children, aged 7–9 years, 11 months, were randomly assigned to one of the four experimental arms, and then received 14 months of prescribed treatment (or community care) with periodic reassessments. After delineating the theoretical and empirical rationales for Psychosocial treatment of ADHD, we describe the MTA's Psychosocial Treatment strategy applied to all children in two of the four experimental arms (Psychosocial treatment alone; Combined treatment). Psychosocial treatment consisted of three major components: a Parent Training component, a two-part School Intervention component, and a child treatment component anchored in an intensive Summer Treatment Program. Components were selected based on evidence of treatment efficacy and because they address comprehensive symptom targets, settings, comorbidities, and functional domains. We delineate key conceptual and logistical issues faced by clinical researchers in design and implementation of Psychosocial research with examples of how these issues were addressed in the MTA study.Deceased     

New Directions in the Cognitive-Behavioral Treatment of OCD: Theory,Research, and Practice

The beneficial effects of cognitive-behavioral interventions (particularly exposure and response prevention) for OCD are among the most consistent research findings in the mental health literature. Nevertheless, even after an adequate trial, many individuals experience residual symptoms, and others never receive adequate treatment due to limited access. These and other issues have prompted clinicians and researchers to search for ways to improve the conceptual and practical aspects of existing treatment approaches, as well as look for augmentation strategies. In the present article, we review a number of recent developments and new directions in the psychological treatment of OCD, including (a) the application of inhibitory learning approaches to exposure therapy, (b) the development of acceptance-based approaches, (c) involvement of caregivers (partners and parents) in treatment, (d) pharmacological cognitive enhancement of exposure therapy, and (e) the use of technology to disseminate effective treatment. We focus on both the conceptual/scientific and practical aspects of these topics so that clinicians and researchers alike can assess their relative merits and disadvantages.     

Toward a culturally anchored ecological framework of research in ethnic-cultural communities

Proposed a research framework (the “cube” model) in which community psychologists working in ethnic-cultural communities can make appropriate decisions on conceptual and methodological issues from a culturally anchored, ecological-contextualist perspective. The intent of the model is to articulate ethnic-cultural heterogeneity in community research by elucidating three metamethodological issues: (a) definition of an ethnic-cultural community, (b) applicability of cross-cultural theories and methods to ethnic-cultural community research, and (c) geographical or ecological stability of an ethnic-cultural community. The model posits that ethnic-cultural community research can be conceptualized as a three-dimensional structure that represents an interaction among research questions, methods, and cultural complexity (referring to the extent to which an ethnic-cultural group is defined in a larger ecological context or community both at the individual and collective levels). Future directions for research were discussed in terms of the utility and the limitations of the proposed research model.     

School-Based Mental Health Programs and Services: Overview and Introduction to the Special Issue

School-based mental health (SBMH) programs and services have grown progressively in the United States in the past two decades, related in part to increased recognition of their advantages and heightened federal support. However, SBMH is an emerging field, with many issues needing attention. This introductory article provides a context for the special issue by highlighting the importance of increased conceptual clarity about SBMH, enhanced mental health—education systems integration, and advancement of the SBMH research base. Key elements for success of SBMH programs and services are discussed, as underscored recently by the report of the New Freedom Commission on Mental Health (2003) and other important initiatives. These elements include (a) school–family–community agency partnerships, (b) commitment to a full continuum of mental health education, mental health promotion, assessment, problem prevention, early intervention, and treatment, and (c) services for all youth, including those in general and special education. A synopsis of the articles in the special issue is provided, emphasizing their conceptual and empirical contributions to delivery and sustainability of effective mental health practices in schools.     

A School-Based Multilevel Preventive Intervention: Issues in Program Development and Evaluation

This article describes conceptual, methodological, and practical issues of prevention research generally and specifically relevant to a school-based primary and secondary prevention effort to reduce the prevalence of learning and emotional disorders in primary grade children.     

Treatment of parental children and their families: Conceptual and technical issues

Abstract

This article focuses on conceptual and technical issues in family systems treatment of children who are assigned burdensome parental responsibilities. Specifically, after considering the role behaviors and family context of these children, we present therapeutic problems that predictably emerge at different stages in the treatment process. Some implications of these observations for theorizing about the interrelation of individual and family systems processes are discussed.     

The "prodromal" patient: both symptomatic and at-risk

This article discusses conceptual issues relevant to the prospective diagnosis of the schizophrenic prodrome. Recent efforts to diagnose these patients with operational criteria based on current symptoms are reviewed. Symptomatic patients so identified appear to be treatment-seeking and to have mild cognitive impairments. In addition to being currently symptomatic, these patients are imminently at risk for progression of illness and development of schizophrenia. Data from three international centers suggest that this risk is approximately 40% over the next year of follow-up if untreated. The implications of the reviewed data for the appropriateness of the term "prodromal" and for treatment/prevention research for these patients are discussed.     

The stitching and the unstitching: What can behavior analysis have to say about creativity?

Traditional critics of behaviorism and behavior analysis have emphasized that these approaches cannot deal with creative achievements in the arts or sciences, or even in ordinary speech. This essay explores several lines of research and conceptual issues from different sources in an effort to refute this claim. The emphasis is on scientific and mathematical creativity. Some of the topics considered include the role of special practice and manipulation, conditions for development of automaticity, the interplay of contingency-controlled and rule-governed behavior, modeling, abstraction, intuition, the blending of response units, and emergent behavior. Some limitations of a behavioral account are also considered.     

Person-environment congruence in work,school, and health care settings

After providing a conceptual framework that focuses on the interplay of persons and environments, I describe three broad domains of social climate dimensions that characterize work, school, and health care settings. Next, I draw some general conclusions about the influence of these social climate factors on morale and performance and about how their impact may vary depending on personal factors. Some research on cross-situational linkages also is covered, especially the interplay between educators' work climates and students' learning environments and that between students' school and family contexts. Finally, some important conceptual issues are reviewed, such as the need to examine the influence of personal resources and coping strategies, the varying impact of powerful environments, and the harmful as well as growth-producing outcomes of person-environment congruence.     

儿童青少年创伤后应激障碍(PTSD)治疗的研究热点——基于美国文献的知识图谱分析

为了解近10年(2006~2016)来美国18岁及以下的儿童青少年创伤后应激障碍(PTSD)治疗研究的热点和重点,利用Bicomb 2.0软件和IBM SPSS Statistics 20.0软件,对ISI Web of Science数据库中查询到的363篇论文进行了知识图谱的可视化分析。结果表明,近10年来美国儿童青少年PTSD治疗研究可分为两个大的研究领域。领域一为儿童青少年PTSD的精神科和神经生物学相关的治疗,包括了两个小的研究热点:(1)儿童青少年PTSD精神科药物治疗相关的研究;(2)儿童青少年PTSD眼动脱敏再加工治疗等神经生物学机制的疗法。领域二为儿童青少年PTSD的心理学治疗,包括了两个小的研究热点:(1)家庭暴力导致的儿童青少年PTSD心理学治疗研究;(2)儿童青少年PTSD的认知行为治疗研究。其中关于儿童青少年PTSD的认知行为治疗研究是研究的热点和重点领域,但关于儿童青少年PTSD治疗效果的长期纵向研究还较为缺乏,未来研究者应加强对儿童青少年PTSD治疗效果的追踪研究,并开展心理治疗与药物治疗相结合的疗效研究。     

Community Violence and Youth: Affect, Behavior, Substance Use, and Academics

Community violence is recognized as a major public health problem (WHO, World Report on Violence and Health, 2002) that Americans increasingly understand has adverse implications beyond inner-cities. However, the majority of research on chronic community violence exposure focuses on ethnic minority, impoverished, and/or crime-ridden communities while treatment and prevention focuses on the perpetrators of the violence, not on the youth who are its direct or indirect victims. School-based treatment and preventive interventions are needed for children at elevated risk for exposure to community violence. In preparation, a longitudinal, community epidemiological study, The Multiple Opportunities to Reach Excellence (MORE) Project, is being fielded to address some of the methodological weaknesses presented in previous studies. This study was designed to better understand the impact of children’s chronic exposure to community violence on their emotional, behavioral, substance use, and academic functioning with an overarching goal to identify malleable risk and protective factors which can be targeted in preventive and intervention programs. This paper describes the MORE Project, its conceptual underpinnings, goals, and methodology, as well as implications for treatment and preventive interventions and future research.     

肺癌防治三层一体整合医疗体系的建立

探索建立肺癌防治整合医疗模式的具体实施方案并对其效果进行评估.在大港医院建立肺癌防治整合医疗模式：由通科人才管理治疗患者、专科人才会诊治疗患者、健康管理师追踪管理患者的管理方式.把肺癌患者的诊断治疗分为三个层次,即对肺癌患者的癌症诊断治疗、宿主管理、危险因素调控三个层面的关注、管理和治疗,三个层面成为统一整体同时或序贯实施,即建立＂肺癌防治三层一体整合医疗体系＂.新的肺癌防治整合医疗模式作为整合医疗模式的具体体现,设计完整,已经形成体系.＂肺癌防治三层一体整合医疗体系＂设计合理,容易实施,可以推广.     

Military Service and the Life-Course Perspective: A Turning Point for Military Personnel Research

The political and scientific climate is ready for a change in perspective in the field of military personnel psychology. Although more than 200,000 of America's most fit young men and women pass through the military establishment each year, we know very little about the effects of their early military experiences on their life choices or on their subsequent military or civilian careers. Recent interest in these issues shown by Congress, the press, and the Department of Defense (DoD) strongly suggests that psychologists need to address research questions that can evaluate the real lifetime costs and benefits of military service. Current military personnel research approaches are inadequate for this task. Life-course theory is presented as a viable and vigorous conceptual and analytic framework for accomplishing this mission.     

Clinical Experiences in Conducting Empirically Supported Treatments for Generalized Anxiety Disorder

Knowledge of the efficacy of cognitive-behavioral therapy (CBT) for generalized anxiety disorder (GAD) predominantly derives from randomized controlled trials (RCTs). However, there may be unique or complex issues encountered in practice, but not necessarily in the context of a controlled clinical trial. Therefore, launching a systematic dialogue between researcher and practicing clinician can be instrumental in augmenting evidence-based therapies through identification of variables that promote and interfere with clinical effectiveness. Through an initiative sponsored by the American Psychological Association’s Divisions 12 (Society for Clinical Psychology) and 29 (Psychotherapy), this study aimed to examine clinical experiences conducting CBT for GAD. The participants were 260 psychotherapists who completed an online survey on assessment and therapeutic intervention utilization and their experience of factors that limit successful GAD treatment and symptom reduction. The majority of respondents reported 20 years or less experience using ESTs for GAD, typically treating clients in outpatient clinics, treatment centers, and private practice. Some of the most commonly used interventions address clients’ maladaptive cognitions and elevated anxiety and muscle tension typical of GAD. Approximately one half of respondents reported incorporating integrative techniques into treatment. Factors perceived as limiting effective GAD treatment included severity and chronicity of GAD, presence of comorbid conditions, stressful home and work environments, client motivation and resistance to treatment, and issues encountered when executing therapy techniques. This study provides researchers with clinically derived directions for future empirical investigation into enhancing efficacy of GAD treatment.     

Methodological and theoretical issues on psychological traditionality and modernity research in an Asian society: In response to Kwang-Kuo Hwang and beyond

Three objectives are addressed in the present study. First, the methodological and conceptual aspects of my long-term research program on psychological (individual) traditionality and modernity in Taiwan are briefly reviewed to provide a background for systematically responding to Kwang-Kuo Hwang's critique of the research program. Second, my reply to Hwang is made in terms of five major issues, viz. the methodological approach adopted, the theoretical or conceptual basis, the explanation of the discontinuity between individual traditionality and modernity, the semantic opposites and psychological opposites, and the conceptual evaluation of the traditionality and modernity items. Third, a plea is made for conducting more and better studies on individual traditionality and modernity in developing Asian countries. Methodological and theoretical issues are further discussed and clarified for the sake of conducting methodologically and theoretically sounder research in this area.     

Cognitive Behaviour Therapy: How is it Different with Older People?

This paper discusses the treatment of depression in older adults (over age 65) using cognitive therapy techniques first developed by Beck and colleagues. The focus of this paper concerns whether modifications of CBT are required in order to ensure maximal efficacy and discusses what modifications may be suitable by advocating conceptual and theoretical reasons for their adoption. Some important contextual factors may need to be taken account of when working with older people such as dealing with expectancies about lifespan, the likelihood of chronic physical illness and longevity and chronicity of the personal history of problems. It is our contention that much more has been written about outcome in CBT with older people than has been written about psychotherapy process issues. This paper aims to address this perceived gap in the literature.     

Context and coping: Toward a unifying conceptual framework

After offering a conceptual framework to unify the domains of context and coping, some conclusions are drawn about the underlying patterns of social climate and the characteristics of growth-promoting environments. New directions of research on the dynamics of the environmental system are described. The conceptual framework is used to exemplify ways to explore the stress and coping process in regard to such issues as stress and resource predictors of adaptation, stress prevention and resistance, and cross-situational influences. The foregoing material then highlights implications of a social ecological perspective for conducting conceptually informed evaluation research and changing and improving community settings. Finally, such conceptual problems as person-environment matching and the need to formulate unified perspectives of stressors and resources are discussed to identify promising ways to spark the maturation of community psychology.     

Suicide as an interpersonal phenomenon: Dyadic methodological and statistical considerations in suicide research

Interpersonal risk and resilience factors are prominent in current conceptual models of suicide. A growing body of empirical evidence links suicidal thoughts and behaviors to a range of interpersonal phenomenon adding further support to the value of this line of inquiry. At present, research on interpersonal phenomenon focuses on assessing individuals' perceptions of interpersonal phenomenon, such as appraisals of burdensomeness, experienced loneliness, and thwarted belongingness. As this line of research continues to develop, we argue that it would be valuable to consider incorporating conceptual models of interpersonal phenomenon and corresponding methodological approaches from closely allied fields. After providing a brief overview of interpersonal models of suicide, we present an introduction to conceptual models of interpersonal phenomenon developed in relationship science, describe how these models can be applied to the study of interpersonal phenomenon in suicide research, and close with a guided tutorial on data collection and statistical analysis methods for testing hypotheses derived from these conceptual approaches. References for additional reading are provided, and the Appendix S1 provides simulated data sets and statistical code for the analyses in the tutorial section.