Quality at the Point of Service: Profiles of Practice in After-School Settings

A unique observational data set was used to explore quality at the point of service in after-school programs. Staff practices in after-school settings were represented on a series of unidimensional scales closely indexed to staff behavior. In order to account for heterogeneity of staff performances, pattern-centered methods were used to construct profiles of common staff practices. Results revealed six pedagogy profiles that were classified in terms of three broad types of performances delivered by after-school staff: (1) positive youth development, (2) staff-centered, and (3) low-quality. Staff membership in these profiles was not related to youth-staff ratio. However, results revealed significant differences between the profiles on the content of the offering and the age of youth in the setting.     

Building Opportunity: Developing City Systems to Expand and Improve After School Programs

A growing body of research is examining the strengths and weaknesses of specific after school programs and their effect on youth outcomes. Few reviews, however, have sought to examine the components of citywide system-building—to understand intentional efforts to develop, support and sustain high quality after school programming across a community. Beginning in the mid-1990s and continuing through the present, private funders, public officials and program practitioners in cities across America have joined together to build systems to support the expansion and improvement of after school programs at the city-level. This paper presents the community context and underlying principles that drove the development of Baltimore’s After-School Strategy; articulates a set of system components derived from this experience and the available literature; and lays out future work to expand high quality after-school opportunities for youth in Baltimore and in other distressed urban environments.     

Workforce Support for Urban After‐School Programs: Turning Obstacles into Opportunities

Organized after‐school programs can mitigate risk and build resilience for youth in urban communities. Benefits rely on high‐quality developmental experiences characterized by a supportive environment, structured youth–adult interactions, and opportunities for reflective engagement. Programs in historically disenfranchised communities are underfunded; staff are transient, underpaid, and undertrained; and youth exhibit significant mental health problems which staff are variably equipped to address. Historically, after‐school research has focused on behavior management and social‐emotional learning, relying on traditional evidence‐based interventions designed for and tested in schools. However, after‐school workforce and resource limitations interfere with adoption of empirically supported strategies and youth health promotion. We have engaged in practice‐based research with urban after‐school programs in economically vulnerable communities for nearly two decades, toward building a resource‐efficient, empirically informed multitiered model of workforce support. In this paper, we offer first‐person accounts of four academic–community partnerships to illustrate common challenges, variability across programs, and recommendations that prioritize core skills underlying risk and resilience, align with individual program goals, and leverage without overextending natural routines and resources. Reframing obstacles as opportunities has revealed the application of mental health kernels to the after‐school program workforce support and inspired lessons regarding sustainability of partnerships and practice.     

Improving Fairness in Coverage Decisions: Performance Expectations for Quality Improvement

Patients and physicians often perceive the current health care system to be unfair, in part because of the ways in which coverage decisions appear to be made. To address this problem the Ethical Force Program, a collaborative effort to create quality improvement tools for ethics in health care, has developed five content areas specifying ethical criteria for fair health care benefits design and administration. Each content area includes concrete recommendations and measurable expectations for performance improvement, which can be used by those organizations involved in the design and administration of health benefits packages, such as purchasers, health plans, benefits consultants, and practitioner groups.     

Partnerships with Psychiatry and Other Clinical Disciplines: A Key to Psychology's Success in U.S. Medical Schools

This paper describes the growth of psychology in medical schools and the distribution of psychologists across medical school departments. The Association of American Medical Colleges (AAMC) and American Psychological Association (APA) use different data collection approaches that reflect their different missions. AAMC focuses solely on medical school faculty, whereas APA tries to reach all psychologists working in academic health centers (AHCs). The number of psychologists in medical school settings has increased, largely due to their research expertise; but psychologists also contribute through teaching and clinical service. Psychologists hold appointments in wide variety of medical school departments, which has been a key factor in their success. Through partnership and interdisciplinary collaboration with a wide range of academic physicians, psychologists have gained increased support, become valued members of the AHC and medical school communities, and can rise to leadership positions in medical schools.     

Enhancing Program Quality in a National Sample of After‐school Settings: The Role of Youth–Staff Interactions and Staff/Organizational Functioning

Using multilevel data from the national evaluation of Boys and Girls Clubs of America (BGCA), this study examined associations among programmatic structures, workplace and workforce characteristics, and relational practices of program staff as they relate to young people's ratings of their experience attending local clubs. The sample included 57,710 members and 5,231 staff members at 740 BGCA sites throughout the United States. Staff relational practices—including establishing caring relationships, setting high expectations, positive behavior management, encouraging youth input and agency, and cultural sensitivity—explained associations between staffing and organizational functioning and youths’ perceptions of the quality of their clubs. Findings suggest a central role of staff relational practices in establishing conditions that youth experience positively, and that staffing and organizational processes, including community engagement and teamwork and efficiency can be viewed as foundations for establishing a culture of positive adult‐youth interaction, which in turn can contribute to the promotion of positive youth development. Further, identification with the experiences of youth had a direct association with youths’ perceptions of club quality. These results underscore the importance of staff workforce development initiatives as key to improving youth experiences in after‐school programs.     

走向双赢:动机倾向和信息分享质量在整合性谈判过程中的作用

研究的主要目的是考察谈判组的动机倾向、信息分享数量和质量、对优先考虑事项和利益一致事项的判断准确性和联合收益之间的关系,以及信息分享质量在谈判过程中的重要性。采用一对一的买卖式谈判任务,由226名被试组成113个谈判组进行面对面的谈判。结果表明,动机倾向、信息分享数量和质量以及谈判双方对优先考虑事项的判断准确性都对联合收益有显著影响,而且信息分享质量比信息分享数量更有预测力。中介作用分析结果显示,信息分享质量在动机倾向和联合收益之间起完全中介作用,对优先考虑事项的判断准确性在信息分享质量和联合收益之间起部分中介作用。研究揭示了整合性谈判的整个过程,验证了信息分享质量在谈判过程中的重要作用。     

Skills for Social and Academic Success: A School-Based Intervention for Social Anxiety Disorder in Adolescents

This paper describes Skills for Academic and Social Success (SASS), a cognitive–behavioral, school-based intervention for adolescents with social anxiety disorder. Clinic-based treatment studies for socially anxious youth are reviewed, and a strong rationale for transporting empirically-based interventions into schools, such as SASS, is provided. The SASS program consists of 12, 40-min group sessions that emphasize social skills and in-vivo exposure. In addition to group sessions, students are seen individually at least twice and participate in 4 weekend social events with prosocial peers from their high schools. Meetings with teachers provide information about social anxiety and facilitate classroom exposures for socially anxious participants. Parents attend 2 psychoeducational meetings about social anxiety, its treatment, and approaches for managing their childs anxiety. Initial findings regarding the programs effectiveness are presented. We conclude by discussing the challenges involved in implementing treatment protocols in schools and provide suggestions to address these issues.     

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     

Toward an Evidence-Based System for Innovation Support for Implementing Innovations with Quality: Tools,Training, Technical Assistance,and Quality Assurance/Quality Improvement

An individual or organization that sets out to implement an innovation (e.g., a new technology, program, or policy) generally requires support. In the Interactive Systems Framework for Dissemination and Implementation, a Support System should work with Delivery Systems (national, state and/or local entities such as health and human service organizations, community-based organizations, schools) to enhance their capacity for quality implementation of innovations. The literature on the Support ystem has been under-researched and under-developed. This article begins to conceptualize theory, research, and action for an evidence-based system for innovation support (EBSIS). EBSIS describes key priorities for strengthening the science and practice of support. The major goal of EBSIS is to enhance the research and practice of support in order to build capacity in the Delivery System for implementing innovations with quality, and thereby, help the Delivery System achieve outcomes. EBSIS is guided by a logic model that includes four key support components: tools, training, technical assistance, and quality assurance/quality improvement. EBSIS uses the Getting To Outcomes approach to accountability to aid the identification and synthesis of concepts, tools, and evidence for support. We conclude with some discussion of the current status of EBSIS and possible next steps, including the development of collaborative researcher-practitioner-funder-consumer partnerships to accelerate accumulation of knowledge on the Support System.     

Collaboration in Business Schools: A Foundation for Community Success

Business schools are often thought of as being accountable for the individual student’s personal development and preparation to enter the business community. While true that business schools guide knowledge development, they must also fulfill a social contract with the business community to provide ethical entry-level business professionals. Three stakeholders, students, faculty, and the business community, are involved in developing and strengthening an understanding of ethical behavior and the serious impacts associated with an ethical lapse. This paper discusses the ways the business schools may enhance the student’s ethical knowledge and understanding, and proposes a roadmap that business schools may use to develop or strengthen a strong ethical culture. The authors, Leland Horn and Michael Kennedy, are third year doctorate of management students at Colorado Technical University, 4435 North Chestnut Street, Colorado Springs CO 80907.     

Challenges in Supporting Community Implementation of Science-based Programs: A Critical Review of Local Partnerships for Success Plans

This paper provides the opportunity to consider local challenges to implementing science-based programs. Wandersman et al. (American Journal of Community Psychology 2008) define three systems necessary to effectively implement science-based programming. These systems include the Prevention Support System, which is responsible for assisting communities in implementing effective practices; the Prevention Research System, which is responsible for developing and packaging prevention programming; and the Prevention Delivery System, which is responsible for delivering services. The authors conduct a content analysis related to six county level efforts to implement science-based programs in Ohio. These counties are part of a larger Ohio initiative referred to as Partnerships for Success. The authors suggest that local officials are quite skilled at accessing the Prevention Research System and providers at the local level represent an effective service delivery system. The authors contend that the Prevention Support System in these counties is capable of enhancing several functions related to local infrastructure but is deficient in other important elements.     

Application of a Quality Improvement Process to Evaluate Self-Directed Therapy for Patients on a Waitlist in an Outpatient Anxiety Disorders Specialty Clinic

The demand for psychological services in the United States is higher than the available supply of qualified mental health professionals. As a result, there is a substantial need for low-cost interventions that are more accessible and amenable to scale-up independent of the availability of clinicians. Previous studies have found that self-directed bibliotherapy can be an effective intervention with minimal therapist contact. Using the Plan-Do-Study-Act (PDSA) improvement process framework, we implemented self-directed therapy in our outpatient anxiety disorders specialty clinic. We identified four self-directed therapy resources (two books and two smartphone apps) based on cognitive behavioral or acceptance and mindfulness principles. We conducted initial 30-minute billable bibliotherapy consultations with six patients on our waitlist, where we provided the rationale for self-guided treatment, introduced the four resources, helped the patient identify one resource to use, and answered any questions. Eight weeks later, we met with five of these patients for a second billable 30-minute consultation (one had already started individual therapy) and gathered information regarding feasibility and acceptability of these resources as well as helped the patient make continued or better use of the resource until beginning therapy. This case series suggests that self-directed interventions can be effectively implemented in this manner, though with mixed outcomes and effects on patients and their course of care. We describe improvements we intend to implement in future iterations of self-directed therapy.     

The Council for Accreditation of Counseling and Related Educational Programs: Promoting Quality in Counselor Education

Much has changed for the counseling profession in the 30 years since the founding of the Council for Accreditation of Counseling and Related Educational Programs (CACREP). CACREP, the primary specialized accreditor for the counseling profession, has been an influential participant in the growing recognition and professionalization of counseling. This article offers an overview of CACREP and accreditation and addresses some primary issues confronting CACREP, counselor preparation programs, and, in some instances, overall U.S. higher education.     

小学生同伴接纳对其人格发展的影响：友谊质量的多层级中介效应

以班级为单位选取1-6年级23个班级的小学生,通过最好朋友提名法,得到有互选朋友有效被试700人,采用同伴提名法、小学生友谊质量问卷、小学生人格发展教师评定问卷,运用多层线性模型（HLM）考察个体和班级两个水平上的同伴接纳、友谊质量对人格的影响,并在两个水平上检验友谊质量在同伴接纳对人格的影响上的多层中介效应。结果表明：（1）班级水平：班级平均友谊质量对外倾性、亲社会性、认真自控、情绪稳定性有预测作用;班级平均同伴接纳对情绪稳定性有预测作用。（2）个体水平：同伴接纳对人格5个维度均有直接影响;除情绪稳定性,友谊质量分别在同伴接纳对智能特征、外倾性、亲社会性、认真自控影响上有部分中介效应。     

汉字刺激质量和频率在N400上的交互

采用事件相关电位,运用无启动的同一字判断（靶字延迟反应）范式,以大学生为被试探讨汉字刺激质量和频率是否具有交互作用。行为结果显示,刺激质量和频率在反应时上存在交互作用。脑电结果显示,重度模糊诱发了更大的N250和N400,且刺激质量和频率在N400上存在交互作用。结论是,汉字刺激质量和频率在反应时和N400上存在交互作用,表明在汉字识别中存在串级加工,支持IA模型。     

Exploring the Use of the Interactive Systems Framework to Guide School Mental Health Services in Post‐disaster Contexts: Building Community Capacity for Trauma‐Focused Interventions

Over the past two decades schools have been identified as the de facto mental health system for youth. Therefore, improving and expanding school mental health (SMH) has become a pressing agenda item for researchers, practitioners, policy makers, and funders. Advancing this agenda includes not only translating intervention research into practice within schools, but building capacities for these interventions to occur. The interactive systems framework (ISF) of Wandersman and colleagues, and the focus of this special issue, provides guidance in bridging the gap between research and practice through multisystem capacity building. There is some evidence that application of the ISF has helped to build capacity for SMH in states, but this evidence is preliminary. In addition, application of the ISF has not occurred in SMH at the community level or in relation to the specific stresses a community undergoes in relation to a disaster. The purpose of this article was to conduct a preliminary attempt to connect these three areas—the ISF, SMH and strengthening SMH through the ISF to better address impacts of a community level disaster; in this case, we explore the impacts of Hurricane Katrina on New Orleans schools, their students and families, and SMH programming within them. Special Issue: Advances in Bridging Research and Practice Using the Interactive System Framework for Dissemination and Implementation; Guest Editors: Abraham Wandersman, Paul Flaspohler, Catherine A. Lesesne, Richard Puddy; Action Editor: Emilie Phillips Smith