Integrative problem-centered metaframeworks therapy II: planning, conversing, and reading feedback

This is the second of 2 articles presenting Integrative Problem Centered Metaframeworks (IPCM) Therapy, a multisystemic, integrative, empirically informed, and common factor perspective for family, couple, and individual psychotherapy. The first article presented IPCM's foundation concepts and Blueprint for therapy, focusing on the first Blueprint component—Hypothesizing or assessment. This article, focusing on intervention, presents the other 3 Blueprint components—Planning, Conversing, and Feedback. Articulated through the Blueprint, intervention is a clinical experimental process in which therapists formulate hypotheses about the set of constraints (the Web) within a client system that prevents problem resolution, develop a therapeutic Plan based on those hypotheses, implement the Plan through a coconstructed dialogue with the clients, and then evaluate the results. If the intervention is not successful, the results become feedback to modify the Web, revise the Plan, and intervene again. Guided by the therapeutic alliance, this process repeats until the presenting problems resolve. IPCM Planning sequentially integrates the major empirically and yet‐to‐be empirically validated therapies and organizes their key strategies and techniques as common factors. Conversing and Feedback employ empirical STIC^® (Systemic Therapy Inventory of Change) data collaboratively with clients to formulate hypotheses and evaluate interventions. This article emphasizes the art and science of IPCM practice.     

Pro-criminal attitudes,intervention, and recidivism

We review the recent research literature on pro-criminal attitudes (PCAs) as a causal factor of recidivism with a focus on studies on the effectiveness of offender treatment programs targeting PCAs to prevent recidivism. The main conclusions that can be derived from the literature are: (1) the evidence supports the hypothesis that PCAs are related to reoffending; (2) most investigated offender treatment programs tend to reduce PCAs, although the general lack of adequate control group designs does not rule out alternative explanations for this reduction; and (3) there is no conclusive empirical evidence that intervention programs designed to reduce PCAs are effective in reducing recidivism. Empirical research in this area lacks the theoretical and methodological rigor to test causal models of the influence of treatment on reducing PCAs, and effects of PCAs on recidivism. Limitations of the empirical evidence are related to inadequate research designs and/or suboptimal data analysis strategies. Recommendations concerning optimized research designs and data analysis strategies that are likely to provide more conclusive evidence on the relation of PCAs, PCA treatment, and recidivism are given.     

Systematic,Evidence-Based Review of Exercise,Physical Activity,and Physical Fitness Effects on Cognition in Persons with Multiple Sclerosis

Cognitive dysfunction is highly prevalent, disabling, and poorly-managed in persons with multiple sclerosis (MS). Recent evidence suggests that exercise might have beneficial effects on cognition in this population. The current systematic, evidence-based review examined the existing literature on exercise, physical activity, and physical fitness effects on cognition in MS to accurately describe the current status of the field, offer recommendations for clinicians, and identify study-specific and participant-specific characteristics for providing future direction for ongoing MS research. We performed an open-dated search of Medline, PsychInfo, and CINAHL in December 2015. The search strategy involved using the terms ‘exercise’ OR ‘physical activity’ OR ‘physical fitness’ OR ‘aerobic’ OR ‘resistance’ OR ‘balance’ OR ‘walking’ OR ‘yoga’ OR ‘training’ OR ‘rehabilitation’ AND ‘multiple sclerosis’. Articles were eliminated from the systematic review if it was a review article, theoretical paper, or textbook chapter; did not involve persons with MS; involved only persons with pediatric-onset MS; did not involve neuropsychological outcomes; did not include empirical data to evaluate outcomes; involved pharmacological interventions; or was not available in English. The selected articles were first classified as examining exercise, physical activity, or physical fitness, and were then randomly assigned to 2 independent reviewers who rated each article for level of evidence based on American Academy of Neurology criteria. Reviewers further completed a table to characterize important elements of each study (i.e., intervention characteristics), the cognitive domain(s) that were targeted, participant-specific characteristics, outcome measures, and study results. The present review resulted in 26 studies on the effects of exercise, physical activity, and physical fitness on cognition in persons with MS. This included 1 Class I study, 3 Class II studies, 8 Class III studies, and 14 Class IV studies. Of the 26 total studies, 6 were randomized controlled trials. Overall, there is conflicting evidence for the effects of exercise on cognition in MS, and overall positive, but not definitive evidence for the effects of physical activity and physical fitness, respectively, on cognition in this population. Collectively, there is insufficient well-designed research to definitively conclude that exercise, physical activity, and physical fitness are effective for improving cognition in MS. This is based, in part, on methodological issues of Class I and II studies, such as inclusion of cognition as a secondary outcome (35 % of reviewed studies), poorly-developed exercise interventions, and paucity of research that included cognitively-impaired MS samples. However, promising evidence from Class III and Class IV studies may be useful for informing the development of better intervention research.     

QT & RR variability spots the earliest autonomic deregulation in diabetes

Step 1

Preliminary MANOVA/ANOVA showed significant effects on the ensemble of spectral variables of every single factor (status: normal or patient group; intervention; gender) with no significant factor interactions. Significant effects of intervention or status on main RR spectral variables and on a few QT spectral variables were also documented.

Step 2

Non-parametric tests showed that diabetics had (mildly to moderately) shorter mean RR, while their RR-LF was always singificantly lower than those found in normals—a difference propagated to QT-LF but not to idioventricular QT-LF. In the intra-group there were similar responses to interventions except stress with respect to mean RR. Consistent reduction in RR-LF under moderate or no change in mean RR suggests vagal down-regulation that, judging by idioventricular QT-LF showing, goes perhaps before a similar process with sympathetic control of ventricles. This phase delay may introduce an early arrhythmic risk worth dealing with in secondary prevention.     

Is There Life After DEBI? Examining Health Behavior Maintenance in the Diffusion of Effective Behavioral Interventions Initiative

The evidence-based interventions that are identified, packaged, and disseminated by the Division of HIV/AIDS Prevention at the Centers for Disease Control and Prevention as part of the Diffusion of Effective Behavioral Interventions (DEBI) initiative—commonly referred to the "DEBIs"—currently represent a primary source of HIV prevention interventions for community-based providers. To date, little attention has focused on whether the intended outcomes of the DEBIs, i.e., reductions in HIV-related risk behaviors, are maintained over time. This review summarized evidence for the sustainability of the effects of the DEBIs on HIV sexual risk behavior and intravenous drug use from studies of original and adapted DEBIs. Evidence of intervention decay or a lack of any intervention effect was identified in several original and adapted versions of the DEBIs included in this review. Recommendations include modifications to current criteria for inclusion in the DEBI portfolio, in addition to the development of remediation strategies to address intervention decay. Further, theoretical models that specify the processes that underlie the maintenance of health behaviors over time should be used in developing HIV prevention interventions.     

A Low-Intensity,High-Frequency Intervention to Reduce Procrastination

Studies assessing the efficacy of interventions aimed at reducing procrastination have generally lacked robust longitudinal measurement tools. Recent developments in communication technology and applications of the Experience Sampling Method (ESM) have made observations of such dynamic phenomena possible. We leveraged recent advancements in smartphone technology and ESM to measure delay associated with procrastination, while testing a low-intensity, high-frequency intervention to reducing that delay. First-year university students (N = 107) reported their progress on an assignment twice daily over 14 days prior to the required submission date. Half (n = 51) were randomly allocated to an intervention condition in which they were also asked open-ended questions designed to prompt reflection on four domains proposed to reduce procrastination, namely: expectancy, value, delay sensitivity, and metacognition. Multilevel mixed effect models revealed lower behavioral delay in the intervention condition compared to the control condition. This effect was strongest in those who at baseline scored below the median on trait procrastination. Behavioral delay over the 14-day period was not associated with later assignment submission or lower assignment marks. These findings support a novel method for reducing delay and suggest procrastination can be alleviated in a wide range of contexts using relatively inexpensive and non-intrusive strategies.     

Parenting Interventions for Refugees and Forcibly Displaced Families: A Systematic Review

Globally, an estimated 79.5 million individuals have been displaced, nearly 40% of whom are children. Parenting interventions may have the potential to improve outcomes for displaced families. To investigate this, we conducted a systematic review to identify the types of caregiver or parenting interventions that have been evaluated among displaced families, to assess their efficacy across a range of contexts, and to describe their cultural and contextual adaptations. The review followed PRISMA guidelines. At stage one, all articles describing caregiver/parenting interventions for forcibly displaced families were included to provide a scoping review of the state of the literature. At stage two, only randomized controlled trials (RCTs) and quasi-experimental designs were included, allowing for quantitative analysis of program effects. A total of 30 articles (24 studies) were identified in stage one. 95.8% of these articles were published in the past 10 years. Of these, 14 articles (10 studies) used an RCT or quasi-experimental design to assess program efficacy or effectiveness. Relative to control groups, those assigned to caregiving programs showed significant, beneficial effects across the domains of parenting behaviors and attitudes, child psychosocial and developmental outcomes, and parent mental health. Cultural adaptations and recruitment and engagement strategies are described. The evidence base for caregiving programs for displaced families has expanded in recent years but remains limited. Caregiving/parenting programs show promise for reducing the negative effects of forced displacement on families, but future studies are needed to understand which programs show the greatest potential for scalability.

     

Systematic review of the effectiveness of interpersonal coach education interventions on athlete outcomes

ObjectivesTo systematically review and evaluate the literature on the effectiveness of coach education interventions. Specifically, we aimed to: (a) describe the non-formal coach education interventions aimed at coaches' interpersonal knowledge base, (b) highlight underpinning theoretical models, (c) assess the methodological quality of articles evaluating these interventions, (d) identify participant characteristics, and (e) establish the effect of these interventions on athletes' cognitive, affective, and behavioural outcomes.DesignSystematic review of published empirical research.MethodPublished English language articles were identified using electronic databases and manual searches of reference lists. The quality of the identified articles was assessed using the Effective Public Health Practice Project (EPHPP) tool.ResultsFour interventions fulfilled the inclusion criteria and were thus systematically reviewed. Overall, education interventions based on coach effectiveness training and achievement goal theory produced mixed effects on a variety of athlete outcomes, such as anxiety, self-esteem, fear of failure, and motivational orientation.ConclusionsDue to the diversity in athlete outcomes and intervention design, it is difficult to draw firm conclusions around the effectiveness of coach education interventions. The small number of identified interventions highlights the current paucity of empirical data on coach education intervention effectiveness. More research is needed to further our understanding of intervention effectiveness to allow for growth and improvement in coach education. Furthermore, theory-based, rather than “theory inspired” coach education interventions are required.     

Strategy-Based Cognitive Training for Improving Executive Functions in Older Adults: a Systematic Review

Given projected increases in dementia prevalence, emphasising earlier stages of cognitive impairment in older adults enables targeted early intervention strategies. Strategy-based cognitive training (SCT) is a remedial approach involving guidance and practice in compensatory techniques to improve cognition, including memory and attention. It may also be effective for improving executive functions (EF) integral to everyday tasks. This review systematically evaluates SCT effects on EF in older adults without dementia. Following PRISMA guidelines, we reviewed eligible trials according to pre-defined criteria, differentiating SCT from other cognitive interventions and stipulating total EF-focused intervention time, study design and target population (healthy older adults or mild cognitive decline). We then evaluated trials according to design, methodological quality and outcomes. Unfortunately, with too few studies in mild cognitive impairment, we refocused our review only on healthy older adults. Thirteen studies with 4120 participants in total were included, primarily targeting inductive reasoning. Despite heterogeneous study designs and SCT programs, 11/13 trials reported significant EF improvements, generally of moderate effect size (Hedges’ g > 0.3). Four studies reported sustained benefits from one month to 10 years. There was some evidence of far transfer. We conclude that there is promising evidence for SCT as a targeted intervention for EF in healthy older adults and preliminary evidence for maintaining effects over time. Fewer trials have investigated far transfer (e.g. improved everyday functioning) or capacity to delay/prevent dementia, which are most relevant to clinical utility. Limitations include the inability to calculate effect sizes for four studies and absence of statistical meta-analysis.     

A systematic review of internet-delivered cognitive behavior therapy for alcohol misuse: study characteristics,program content and outcomes

ABSTRACT

Alcohol misuse is a common, disabling and costly issue worldwide. Internet-delivered cognitive behavior therapy (ICBT) has the potential to reduce the harms of alcohol misuse, particularly for individuals who are unable or unwilling to access face-to-face therapy. A systematic review was conducted using Medline, CINAHL, EMBASE and PsycINFO databases for all relevant articles published from 1980 to January 2019. Randomized controlled trials (RCTs) were included if (i) an ICBT intervention targeting alcohol misuse was delivered; (ii) participants were aged 18 years or older; and (iii) primary outcomes were quantity of drinking. A qualitative analysis was conducted on the content of the ICBT programs. Fourteen studies met inclusion criteria. Most studies included participants from the general population, while studies conducted within clinic settings with diagnosed individuals were rare. The programs were similar in terms of included modules. Small effects were seen in studies on self-guided ICBT, while therapist-guided ICBT rendered small to large effects. The current review indicates that ICBT has a significant effect in reducing alcohol consumption. Larger studies evaluating ICBT compared to active control groups especially within clinic settings are warranted.     

Truthiness,the illusory truth effect,and the role of need for cognition

Ease of processing—cognitive fluency—is a central input in assessments of truth, but little is known about individual differences in susceptibility to fluency-based biases in truth assessment. Focusing on two paradigms—truthiness and the illusory truth effect—we consider the role of Need for Cognition (NFC), an individual difference variable capturing one’s preference for elaborative thought. Across five experiments, we replicated basic truthiness and illusory truth effects. We found very little evidence that NFC moderates truthiness. However, we found some evidence that (without an experimental warning), people high on NFC may be more susceptible to the illusory truth effect. This may reflect that elaborative thought increases the fluency with which encoded statements are processed after a delay (thus increasing the illusory truth effect). Future research may fruitfully test whether the influence of NFC and other individual difference measures depends on whether people are making immediate or delayed truth judgments.     

Behavioral Activation Disseminated by Non–Mental Health Professionals,Paraprofessionals, and Peers: A Systematic Review

There is a striking disparity between the number of individuals with significant mental health concerns and those who are able to access care globally. One promising solution to expanding the mental health taskforce is task-sharing, or employing nonspecialists in the delivery of evidence-based interventions. Behavioral activation (BA), a brief intervention that focuses on scheduling rewarding activities into one’s daily life, may have promise for delivery using task-sharing approaches due to its straightforward, flexible nature. The aim of this systematic review was to examine the current state of the literature on non-specialist-delivered BA and evaluate the evidence base of this approach. Three databases (Pubmed, PsycInfo, and Cochrane) were searched, and all articles were screened for inclusion criteria by two research assistants, included the review of titles, abstracts, and full-text. The final dataset consisted of 13 research studies, represented through 15 articles. A meta-analysis was conducted to examine the overall pooled effects of peer-delivered BA on depressive symptoms (the most widely examined clinical outcome). Studies reported on effectiveness and implementation outcomes of non-specialist-delivered BA for depression, substance use, loneliness, trauma survivors, and individuals with comorbid physical health conditions. Results provide initial support for the effectiveness of BA utilizing a task-sharing approach, and highlight the feasibility and acceptability of using nonspecialists to deliver BA in a variety of contexts, including low-resource settings.     

Is there evidence for the use of art therapy in treatment of psychosomatic disorders,eating disorders and crisis? A comparative study of two different systems for evaluation

A comparative study of two different systems for evaluation. Scandinavian Journal of Psychology 53, 47-53. As with any type of treatment the requirement for evidence based practice (EBP) has also affected art therapy (AT) when used as an intervention. This review evaluates the available evidence for using AT for psychosomatic disorders, eating disorders and crisis. The search in Cochrane, Best Practice, AMED, CINAHL, PION, PsycINFO and PubMed from 1987 until now resulted in a huge number of articles but only 32 articles met our criteria for evaluations. The articles were assessed with two evaluation systems, the GRADE system used by the Swedish Council on Health Technology Assessment (SBU) and the US Preventive Services Task Force (USPSTF/Task Force). When comparing the results we found that the GRADE evaluation system rejected the quality in 84% of the 32 studies and the USPSTF/Task Force 41% of these studies. An evidence base for AT was found only according to the criteria of USPSTF/Task Force. Hence, the evidence concept is not explicit, which means that effective treatments run a risk of not being implemented in health care. We suggest a broader view of what constitutes evidence in order to make it possible to include different types of research designs and methods.     

产前母亲心理压力对儿童心理行为发展影响的研究述评

产前母亲心理压力对儿童心理行为发展有着重要的影响。大量的研究证据表明,产前母亲的心理应激,对后代的情感或认知发展会产生消极的影响,如容易出现注意力缺陷/活动过度、焦虑、语言迟缓等问题。这种影响的潜在机制之一是下丘脑-垂体-肾上腺（HPA）轴的变化,另一个机制可能是,母亲压力或焦虑引起交感-肾上腺系统高度激活。关于产前母亲心理压力对儿童心理行为发展影响的研究,在方法学上存在一定的缺陷,也还有一些未明确的问题,如产前压力的敏感期、性别特异性效应等。未来这一领域应该开发更多的研究途径。已有的证据足以表明,应该积极开展关于预防、干预和支持性方案方面的研究,以减轻妊娠期的压力或焦虑及其对儿童发展的不利影响。     

Negative and positive pretrial publicity affect juror memory and decision making

The experiment examined the effects of exposure to pretrial publicity (PTP) and delay on juror memory and decision-making. Mock jurors read news articles containing negative PTP, positive PTP, or unrelated articles. Five days later, they viewed a videotaped murder trial, after which they made decisions about guilt. Finally, all participants independently attributed specific information as having been presented during the trial or in the news articles. Half of the jurors rendered their verdicts and completed the source-memory test immediately after the trial, while the other half did so after a 2-day delay. Exposure to PTP significantly affected guilty verdicts, perceptions of defendant credibility, juror ratings of the prosecuting and defense attorneys, and misattributions of PTP as having been presented as trial evidence. Similar effects were obtained for negative and positive PTP. Delay significantly increased source-memory errors but did not influence guilt ratings. Defendant's credibility and juror ratings of prosecuting and defense attorneys significantly mediated the effect of PTP on guilt ratings. (PsycINFO Database Record (c) 2008 APA, all rights reserved).     

Occupational Therapy Interventions in Mental Health: A Literature Review in Search of Evidence

A growing body of literature sheds light on occupational therapy (OT) interventions and outcomes in adult mental health. Although this research has not developed to the point where a systematic review is warranted, a synthesis of these findings is needed. This article provides an overview of OT interventions in adult mental health and their documented outcomes. Fifty peer-reviewed intervention studies targeting adults with mental illness were reviewed. Seven categories of interventions emerged: employment/education; psychoeducation; creative occupations/activity; time use/occupational balance; skills/habit development; group/family approaches; and animal-assisted therapy. Further research involving rigorous designs is needed to establish a solid evidence base for OT interventions in adult mental health.     

School-Based Supports and Interventions to Improve Social and Behavioral Outcomes with Racially and Ethnically Minoritized Youth: A Review of Recent Quantitative Research

School discipline disproportionality has long been documented in educational research, primarily impacting Black/African American and non-White Hispanic/Latinx students. In response, federal policymakers have encouraged educators to change their disciplinary practice, emphasizing that more proactive support is critical to promoting students’ social and behavioral outcomes in school. Results from a literature review conducted nearly a decade ago indicated that there was, at that point, a paucity of empirical research related to considering students’ culture (e.g., race, ethnicity) and supporting school behavior. The purpose of this study is to replicate and expand the previous review to summarize the characteristics of the most recent school-based quantitative research addressing interventions to promote social and behavioral outcomes for racially and ethnically minoritized youth. We screened 1687 articles for inclusion in the review. Upon coding 32 eligible research studies, we found that intervention and implementer characteristics within these studies varied, but noted strong intervention effects in studies that included established evidence-based practices, adapted interventions, as well as new practices piloted with student participants. Results inform recommendations to continue to study interventions that promote positive social and behavioral outcomes for racially and ethnically minoritized students to disrupt a long history of subjection to exclusionary discipline disproportionately.

     

Is Suicide Ideation a Surrogate Endpoint for Geriatric Suicide?

The present study explored the validity of treating suicide ideation as a surrogate endpoint that can serve as a proxy for suicide in clinical intervention research with suicidal seniors. Two criteria; that suicide ideation is modulated by the proposed intervention and that modulation of suicide ideation leads to a quantitative reduction in suicide rates, were the focus of this review. A series of literature searches of the PsychINFO and Medline databases were conducted on the terms geriatric, elderly, seniors, suicide, self-destruction, clinical, randomized, trial, treatment, intervention , and ideation . Articles were analyzed if they provided sufficient information to examine whether an intervention effectively led to a reduction in suicide ideation among seniors. Two hundred and eight articles were considered for potential inclusion in this study, with 19 articles meeting final inclusion criteria. The articles reviewed were divided into three broad categories: articles supporting suicide ideation as a surrogate endpoint for geriatric suicide ( n = 6); those not supporting this hypothesis ( n = 1); and those providing insufficient information to test the hypothesis ( n = 12). The present analysis provided modest evidence for suicide ideation as a surrogate endpoint for geriatric suicide, due, in part, to a paucity of randomized controlled trials of treatment interventions for suicidal seniors, thus demonstrating a clear need for research in this area. Implications of utilizing surrogate endpoints in suicide research are discussed.     

Use of Technology to Provide Mental Health Care for Racial and Ethnic Minorities: Evidence,Promise, and Challenges

Mental health disparities among racial and ethnic minorities (R&EM) are well documented. Some of the variables driving these disparities are limited care availability, difficulty accessing services, and attitudinal barriers. Although no single approach will eliminate all these obstacles, the use of technology to provide mental health services represents a paradigmatic shift in care delivery that could reduce unmet mental health need. Despite increasing evidence supporting the feasibility and efficacy of behavioral intervention technologies (BITs), such evidence is more limited among R&EM. For BITs to truly reduce disparities in care, these interventions need to overcome common barriers to treatment that disproportionally affect R&EM. This article reviews the empirical support of different BIT modalities with R&EM. We then provide informed clinical recommendations for the use of BITs with these groups, as well as a case example illustrating these guidelines. We conclude this article by discussing future directions that can inform the development and refinement of BIT approaches for R&EM.     

The Better Beginnings,Better Futures Project: Long‐term Parent,Family, and Community Outcomes of a Universal,Comprehensive, Community‐Based Prevention Approach for Primary School Children and their Families

Better Beginnings, Better Futures is a large‐scale, multi‐year, longitudinal research‐demonstration project designed to reduce children's problems, promote healthy child development, and enhance family and community environments in three economically disadvantaged communities in the province of Ontario, Canada. The initial intervention was implemented from 1993 to 1997 and focused on families with children from 4 to 8 years of age in their first 4 years of schooling (from Junior Kindergarten to Grade 2). This study examined the long‐term parent, family and community programme outcomes, 15 years after the start of the intervention, when the young people who had participated in the intervention as young children were 18 to 19 years of age. Comparison of intervention communities with matched non‐intervention communities showed a mix of outcomes. Although few significant differences between intervention and comparison communities were found with regard to parents' health and family outcomes, there was evidence that parents in the intervention communities were engaging in fewer risk behaviours, had lower levels of depression and had more community involvement than parents in the comparison communities. These results suggest that the intervention did have some positive long‐term effects on youths' parents and on their community environments. Results are discussed with respect to the importance of considering family and neighbourhood contexts in the development and evaluation of prevention programmes. Copyright © 2012 John Wiley & Sons, Ltd.