Ethnicity and adolescent substance use

This study focuses on diverse ethnic differences among adolescent substance use, utilizing selected items from the Substance Abuse Subtle Screening Inventory-Adolescent version (SASSI-A). Data were gathered from a large-scale, cross-sequential study of adolescents during the 1993-1996 school years. Exploratory analyses were conducted for 3,711 students on the basis of their responses to a self-administered survey. Results indicated significant ethnic and gender differences for specific SASSI-A items and factor scores, with Hawaiian, "Other," and Caucasian students reporting higher scores than Japanese students and greater scores for female than male students. These findings suggest the need to develop culturally sensitive substance use prevention and treatment strategies that should also take gender differences into consideration for adolescents in Hawai'i.     

Using the WDEP System of Reality Therapy to Support Person‐Centered Treatment Planning

Formulating a written treatment plan is now required by most 3rd‐party payers and is standard practice in mental health agencies throughout the United Sates. Treatment plans include the formulation of goals, objectives, and treatment interventions. Congruent with diagnostic categories, the WDEP (wants, doing, evaluation, and planning; Wubbolding, 2000 , 2011 ) system of reality therapy provides a useful structure for fulfilling these requirements. This structure can be readily integrated into other modalities used by counselors for a person‐centered approach to treatment planning.     

Tell Us What Your Drawings Say

A projective evaluation tool is used in occupational therapy to evaluate short-term inpatient psychiatric clientele to gather information for treatment planning is described. Areas of assessment covered in the evaluation include: (1) cognitive performance, (2) affect and mood, (3) insight, (4) motivation, and (5) situational components. A case illustration showing results of the use of the tool is presented, and the value of information gathered for occupational therapy treatment planning is discussed.     

Planning of reach-and-grasp movements: effects of validity and type of object information

Individuals are assumed to plan reach-and-grasp movements by using two separate processes. In 1 of the processes, extrinsic (direction, distance) object information is used in planning the movement of the arm that transports the hand to the target location (transport planning); whereas in the other, intrinsic (shape) object information is used in planning the preshaping of the hand and the grasping of the target object (manipulation planning). In 2 experiments, the authors used primes to provide information to participants (N = 5, Experiment 1; N = 6, Experiment 2) about extrinsic and intrinsic object properties. The validity of the prime information was systematically varied. The primes were succeeded by a cue, which always correctly identified the location and shape of the target object. Reaction times were recorded. Four models of transport and manipulation planning were tested. The only model that was consistent with the data was 1 in which arm transport and object manipulation planning were postulated to be independent processes that operate partially in parallel. The authors suggest that the processes involved in motor planning before execution are primarily concerned with the geometric aspects of the upcoming movement but not with the temporal details of its execution.     

The Treatment Planning of Experienced Counselors: A Qualitative Examination

Using consensual qualitative research, the authors examined the treatment planning process of experienced counselors (N = 9). The data analysis resulted in 4 domains: assessment steps, clinical impressions, treatment factors, and treatment strategies. These domains describe the process used by experienced counselors in making clinical decisions and offer insight into the nature of clinical expertise and the need for further research on treatment planning.     

Planning of Reach-and-Grasp Movements: Effects of Validity and Type of Object Information

Individuals are assumed to plan reach-and-grasp movements by using two separate processes. In 1 of the processes, extrinsic (direction, distance) object information is used in planning the movement of the arm that transports the hand to the target location (transport planning); whereas in the other, intrinsic (shape) object information is used in planning the preshaping of the hand and the grasping of the target object (manipulation planning) In 2 experiments, the authors used primes to provide information to participants (N = 5, Experiment 1; N = 6, Experiment 2) about extrinsic and intrinsic object properties. The validity of the prime information was systematically varied. The primes were succeeded by a cue, which always correctly identified the location and shape of the target object. Reaction times were recorded. Four models of transport and manipulation planning were tested. The only model that was consistent with the data was 1 in which arm transport and object manipulation planning were postulated to be independent processes that operate partially in parallel. The authors suggest that the processes involved in motor planning before execution are primarily concerned with the geometric aspects of the upcoming movement but not with the temporal details of its execution.     

Assessment and Treatment of Selective Mutism

Abstract

We present the results of a stimulus fading procedure used to treat a six-year-old girl who met DSM-DJ-R criteria for elective mutism (now Selective Mutism in DSM-IV). An assessment protocol is presented that features procedures that can be used to render a diagnosis and assist in treatment planning. A treatment program was implemented through a consultation process that required close monitoring and revision over several months. Results of the case study suggested that the stimulus fading of new persons into the school setting was effective in producing speech. Future re-search directions in assessment and treatment of selective mutism are discussed.     

Assessing clients in their natural environments with electronic diaries: rationale, benefits, limitations, and barriers

Increasingly, mobile technologies are used to gather diary data in basic research and clinical studies. This article considers issues relevant to the integration of electronic diary (ED) methods in clinical assessment. EDs can be used to gather rich information regarding clients' day-to-day experiences, aiding diagnosis, treatment planning, treatment implementation, and treatment evaluation. The authors review the benefits of using diary methods in addition to retrospective assessments, and they review studies assessing whether EDs yield higher quality data than conventional, less expensive paper-pencil diaries. Practical considerations--including what platforms can be used to implement EDs, what features they should have, and considerations in designing diary protocols for sampling different types of clinical phenomena--are described. The authors briefly illustrate with examples some ways in which ED data could be summarized for clinical use. Finally, the authors consider barriers to clinical adoption of EDs. EDs are likely to become increasingly popular tools in routine clinical assessment as clinicians become more familiar with the logic of diary designs; as software packages evolve to meet the needs of clinicians; and as mobile technologies become ubiquitous, robust, and inexpensive.     

Purchase task sensitivity to drug and nondrug reinforcers in opioid-agonist treatment patients

The behavioral economics of substance abuse has been increasingly recognized as a method of determining the value of abused substances for individuals who use those substances. It has been hypothesized that such analyses could serve as a clinical tool and that demand functions can be targeted predictors for the level of intervention necessary. This study evaluated the sensitivity of a demand task in 2 patient groups in a medication assisted treatment program (methadone maintenance), those who had used opioids in the last 2 months and those who had not used opioids in at least 18 months. Demand for 7 drugs and a control was assessed using hypothetical purchase tasks. Participants maintaining long-term abstinence had significantly higher α (sensitivity to price) and lower Q₀ (intensity of demand) for heroin than participants who had recently used opioids. Further research is necessary to illustrate if treatment is responsible for this reduction in demand. If so, demand analyses may provide clinical utility as an aid for treatment planning or as a target for treatment.     

A Preliminary Study Using the Substance Abuse Subtle Screening Inventory—Adolescent Form as an Outcome Measure With Adolescent Offenders

The authors describe a preliminary study using the Substance Abuse Subtle Screening Inventory‐Adolescent Form (SASS‐A; E Miller, 1994) as an outcome measure with adolescent offenders. Results indicate that the SASSI‐A can be successfully used as a treatment planning tool as well as a measure to evaluate programs.     

Angstbewältigung

In the psychiatric outpatient clinic of the University Hospital Tulln, the Canadian Occupational Performance Measure (COPM) – an occupational therapy, evidence-based, and diagnosis-independent assessment – is used to collect and assess performance problems in everyday life. Subjectively perceived everyday problems are assessed with regard to performance and satisfaction on a scale from 1–10 at the start and upon completion of treatment. The particular focus is on the impact and relevance of anxiety symptoms. Using the example of a 35-year-old woman with obsessive-compulsive disorder and anxiety, the possibilities of diagnosis, treatment planning, and quality assurance are shown and the relevance for the treatment process is illustrated.     

Defense mechanisms in alcoholics attending outpatient treatment. Results from the MCT-test (Meta-Contrast Technique)

Defensive strategies were studied in 72 alcoholics participating in outpatient treatment by using, before the treatment started, the Meta-Contrast Technique, MCT, a percept-genetic method. Alcoholics had less often adaptive strategies than controls. A lack of adaptive defense strategies was related to a more impaired psychic status, more psychological benefits from drinking, and more psychiatric symptoms but not to severity of alcoholism or results of psychometric tests (intellectual level, field-dependence, spatial performance). It does not seem inconceivable that the MCT could be used as a diagnostic tool in treatment planning.     

Low scores on California Psychological Inventory as predictors of psychopathology in alcoholic patients

This study concerned the use of generally low California Psychological Inventory (CPI) profiles to predict elevated MMPI scores. In a sample of 110 subjects, a CPI profile with T-scores of 25 or less reflects major psychopathology and there is a 79% chance of correct prediction of MMPI T-scores over 80. As a further validation, a Goldberg Individual Index was established with a cut-off score of 70 to classify profiles as psychotic or nonpsychotic. It appears that the California Psychological Inventory can be expanded in making dual diagnoses for alcoholic patients. Scores can be used in treatment planning for alcoholic patients and to identify those individuals who should complete an MMPI for additional treatment planning and diagnoses.     

Intensive family therapy: a way to change family functioning in multi-problem families

TA single group treatment outcome study of intensive family therapy (IFT) is presented. One hundred and nine families from five Swedish units participated and results on family measures for eighty-six of these families are reported. This multi-centre study is the largest so far of this treatment model. The units offered a full-day multi-impact treatment programme for families during an intensive period of approximately one month preceded by a period of extensive planning. Measures used were the self-rating 'Family Climate' and Family Relation Scale and observer-rated CRS-Turbo and the Beavers' System Scales. Significant changes in the direction towards a better family climate and a higher family functioning occurred. Given the very difficult circumstances of these multi-problem families the results are considered promising.     

Proactive career behaviours and career success during the early career

The current article tests a longitudinal model of the process of proactive career behaviours and career success with two samples of graduates making the transition from college to work. Using structural equation modelling, we tested a theoretical model that specified the relationships between career progress goals, career planning, networking behaviours, and career success. A longitudinal panel study was conducted within two samples using a 3‐year (sample 1) and 1‐year (sample 2) time lag between the first and second data collection. The results support the process model and suggest that at graduation, career planning is affected by the goal of making career progress. In turn, career planning is positively associated with networking behaviours. Both career planning and networking at graduation are positively related to career planning and networking 1 year later (sample 1) but in sample 2, in which a 3‐year time lag was used, these relationships were no longer significant. Support is found for the relationship between networking during the early career and objective and subjective career success. The findings are discussed in terms of their general implications for understanding the proactive career behaviour process through which graduates affect their career success during the first years of their professional career.     

Integrated treatment: a conceptual framework for an evidence-based approach to the treatment of personality disorder

Evidence that various therapies are effective in treating personality disorder and that outcome does not differ substantially across treatments suggests that it is time replace concerns about the efficacy of specific therapies and which form of therapy to use with an evidence-based approach that combines methods that work from all therapies. A framework is proposed for selecting and combining eclectic treatment methods and delivering them in a coordinated way. The framework has two components: (1). a system for conceptualizing personality disorder based on empirical knowledge about the structure, etiology, development, and stability of personality pathology to use as a guide to selecting interventions and planning the sequence in which they will be used; and (2), a model of therapeutic change based on the general literature on psychotherapy outcome and specific studies of PD treatments. The framework proposes that integrated treatment be organized around general principles of therapeutic change common to all effective therapies supplemented with more specific treatment methods taken from the different therapies as needed to tailor treatment to individual patients and treat specific problems and psychopathology. The coordinated delivery of such a diverse array of interventions is achieved by using a phases of treatment scheme that proposes that treatment focus on specific symptoms and problems is a systematic and orderly way according to their stability and potential for change.     

Comparing Alliance in Two Cognitive-Behavioural Therapies for Adolescents With ADHD Using a Randomized Controlled Trial

Alliance is defined as the client-therapist bond and their ability to collaborate on therapeutic activities. Treatment for adolescents with ADHD is rarely studied in terms of alliance. In this study, two cognitive-behavioral treatments (CBT; one structured treatment aimed at planning skills and one less-structured solution-focused treatment, both delivered in the style of Motivational Interviewing) were compared with regard to alliance and alliance-outcome association. The influence of therapist competence on this alliance-outcome association was also evaluated. The alliance between 69 adolescents diagnosed with ADHD and their therapists was measured early in treatment, using the Therapy Process Observational Coding System for Child Psychotherapy–Alliance scale. Observer-rated therapist competence was measured using the Motivational Interviewing Treatment Integrity scale (version 3.1.1.). Outcome variables were the adolescents’ reduction in planning problems and ADHD symptoms. The alliance, and, more specifically, collaboration on therapeutic activities, was significantly higher for the more structured CBT (p = .04; moderate effect size). Alliance was not related to outcome in the more structured CBT, while the alliance was positively related to the reduction in planning problems in the less structured CBT. Finally, alliance was a significant mediator between therapist competence and treatment outcome for the less-structured CBT. The clarity and structure of CBT may help facilitate alliance formation for adolescents with ADHD who often have difficulty implementing structure themselves. Therapists may need to invest more in alliance formation in less structured CBT as the alliance affects outcome. Moreover, enhancing therapist competence in less structured CBT may help improve outcomes in less structured CBT, as therapist competence may impact outcome through alliance.     

Adaptive Planning

Adaptive Planning is an approach to planning in the commonsense domain. An adaptive planner takes advantage of the habitual nature of many of the planning situations for which it plans by bosing its activities on a memory of pre-stored plans. A critical issue, and the subject of this paper, is the question of flexibility: How does an adaptive planner refit an old plan in order to meet the demands of some new planning situation? An adaptive planner refits prestored plans by constructing an interpretation of the situation in which it is engaged. Key elements in the theory of adaptive planning are its treatment of specific plans and a notion of situation matching. The theory of adaptive planning has been modeled by a computer program called PLEXUS.     

Assessing and Facilitating Children's Cognitive Development: Developmental Counseling and Therapy in a Case of Child Abuse

This article presents practical implications for assessing a child's cognitive development and then facilitating developmental growth. The concepts of developmental counseling and therapy (Ivey, 1986, 1990) are presented as a systematic framework to integrate neo-Piagetian developmental theory into the interview. Specific techniques may be used for assessing cognitive development, expanding horizontal and vertical development, designing systematic questioning sequences, and planning overall treatment. An example of treatment of a case of child abuse illustrates the concepts in action.     

Effects of Concept Mapping on Creativity in Photo Stories

This research tested the use of concept map planning to support the development of creativity in photo stories, hypothesizing that skills taught to support organization would improve creativity. Concept maps are a type of graphic organizer, used to represent an ordering of ideas with nodes and linking words that form propositional statements. They were applied to story development under the assumption that the creative development of narrative elements requires organization. Undergraduate education students were randomly assigned to either concept map or text-based planning groups for the production of digital photo stories. Creativity was operationalized using dimensions of novelty, interest, clarity, and ability to be understood. A multivariate effect of planning method was found for these dimensions favoring the concept map group, due largely to greater clarity in the photo stories. Clarity in photo stories adds to their utility as creative products. This study represents first steps toward empirically assessing concept maps for a creative purpose, and further investigation, with a larger sample in an authentic context, over a longer period of planning time is recommended.