Mandated Interventions with Drug-Dependent, Pregnant Women

Increased concern about the influence of pregnant women's substance use on fetal health has prompted a variety of actions, including calls for legal interventions against some pregnant women with chronic substance abuse problems. In this paper I examine the legal and social science arguments used to support and oppose these interventions. Several assumptions about the behaviors of pregnant women that are used to support the arguments are described. The types of social science research that could inform the ongoing debate about interventions with pregnant women are explored.     

A pilot evaluation of the efficacy of a couple-tailored print intervention on colorectal cancer screening practices among non-adherent couples

The objective of this study was to evaluate the efficacy of a couple-tailored print (CTP) intervention on colorectal cancer screening (CRCS), CRCS intentions, and on knowledge and attitudes among couples in which neither partner is on schedule with regard to CRCS. A total of 168 married couples with both members non-adherent with CRCS were randomly assigned to receive either a CTP pamphlet accompanied by a generic print (GP) pamphlet or a GP pamphlet only. Couples completed measures of CRCS, intentions, relational perspective on CRCS, discussions about CRCS, spouse support for CRCS, spouse influence strategies, CRC knowledge, perceived CRC risk, and CRCS benefits and barriers. Results indicated there was no significant benefit of CTP vs. GP on CRCS, but there was a significant increase in CRCS intentions in CTP compared with GP. There was also a significant increase in relationship perspective on CRCS, a significant increase in husbands’ support of their wives’ CRCS, and a significant increase in CRCS benefits in CTP. In summary, CTP did not increase CRCS practices but increased intentions and perceived benefits of CRCS as well as improving couples’ ability to view CRCS as having benefit for the marital relationship.     

Unique Ethical Concerns in Clinical Trials Comparing Psychosocial and Psychopharmalogical Interventions

In recent years, there has been a particular emphasis placed on conducting randomized controlled trials (RCTs) that compare the relative efficacy of psychosocial and pharmacological interventions. This article addresses relevant ethical considerations in the conduct of these treatment trials, with a focus on RCTs with children. Ethical concerns, including therapeutic misconception, treatment preference, therapeutic equipoise, structure of treatments, and balancing risks versus benefits, are introduced through a clinical scenario and discussed as they relate to psychotherapy versus medication RCTs. In each case, suggestions are made for researchers seeking to minimize the impact of these ethical concerns on research participants.     

Behavioral interventions to improve performance in collegiate football

Using a multitreatment withdrawal design, this study evaluated the differential effects of publicly posted plus verbal feedback, goal setting plus verbal feedback, and publicly posted feedback, verbal feedback, and goal setting together on the performance of 3 collegiate football players in practice scrimmages. Also assessed was whether the changes in practice behavior generalized to games. The dependent variables were performances on three wide receiver skills. The results show that public posting with verbal feedback, goal setting, and public posting with verbal feedback and goal setting were effective in improving player performance to a 90% criterion level during practice, and these changes generalized to game performance.     

Interventions for inappropriate sexual behavior in individuals with intellectual and developmental disabilities: A brief review

Although prevalence rates vary, 6% to 28% of individuals with intellectual or developmental disabilities (IDDs) engage in inappropriate sexual behavior (ISB), ranging from public masturbation to sexually aggressive behavior. Along with increased risk for contacting the criminal justice system, people with IDDs who display ISB may encounter negative social consequences, restricted community access and barriers to independence, and a variety of counter-therapeutic outcomes. The purpose of the present review is to highlight recent, efficacious behavior-analytic treatments for ISB in individuals with IDDs. Ethical considerations and areas for future research will be discussed.     

In vivo functional assessment and multi-element interventions for problem behaviors of students with disabilities in classroom settings

Persons with developmental disabilities often do not follow instructions or complete tasks in educational settings, thus further disadvantaging themselves as they try to lead more normalized lives. The purpose of this paper was to address the problems of three persons referred for not following instructions and for engaging in associated behavior problems (e.g., crying, hitting, throwing materials) when given instructions. A functional assessment was conducted in the natural school setting without any prescribed conditions as in analogue functional assessments. Results of the assessments showed that problem behaviors for two subjects occurred much more in demand conditions requiring active responses than in demand conditions requiring passive responses. The results for a third subject showed problem behaviors were associated with toileting demands, less so with other demand conditions, but not with conditions in which there were an absence of demands. Individualized multi-element interventions were based on the negative reinforcement hypothesis and were intended to make tasks less aversive and to make instructions easier to understand. Results of the interventions showed increases in task engagement and decreases in problem behaviors during the active tasks and toileting tasks for which interventions were programmed, as well as for the passive tasks and other demand conditions for which no interventions were programmed. Results were discussed in terms of the value of functional assessments in directing therapists to base interventions on hypotheses of the function of the presenting problem.     

A diagnostic approach to increase reusable dinnerware selection in a cafeteria

The current project tested a diagnostic approach to selecting interventions to increase patron selection of reusable dinnerware in a cafeteria. An assessment survey, completed by a sample of 43 patrons, suggested that the primary causes of wasteful behavior were (a) environmental arrangement of dinnerware options and (b) competing motivational variables. A functional relation between environmental arrangement and reusable product selection was demonstrated in a reversal design. However, the largest effect occurred as function of a multicomponent intervention involving environmental arrangement, employee involvement, and personal spoken prompts with motivational signs. The results support the use of informant assessments when designing community interventions.     

Training in Evidence-Based Interventions (EBIs): What are school psychology programs teaching?

This study examined the degree to which school psychology programs provided training in Evidence-Based Interventions (EBIs). Survey data were collected from 97 school psychology training directors to assess their familiarity, level of student exposure, and perceived importance of EBIs. This study also examined the contextual factors that interfere with EBI training, and whether students are taught to apply the criteria developed by Divisions 12, 16, and 53 of the APA when evaluating outcome research. Results indicated that relatively low percentages of respondents were familiar with the EBIs included on the survey, exposure to EBIs occurred more frequently in coursework than practical experiences, and EBIs were rated as either somewhat important or important. Lack of time was rated as the most serious challenge to EBI training and a high percentage of directors reported students were taught to apply the criteria developed by professional organizations in psychology and education when evaluating outcome research.     

Two short-term,cognitive interventions for the reduction of test anxiety

Abstract

Relative efficacy of Attentional Skills Training and Systematic Rational Restructuring as short-term (50 minutes each), cognitive interventions was determined on a sample of ninth-grade girls from India. Only Attentional Skills Training and not Systematic Rational Restructuring has been found to be effective for high test-anxious girls (regardless of intelligence), not only in the reduction of state test anxiety and its worry state component, but also in the reduction of anxiety interference and in the improvement of the estimated percent time spent on task. However, neither of the interventions improved the performance on the two difficult experimental tasks when compared to controls.     

Behavioral Outcomes of Parent-Child Interaction Therapy and Triple P—Positive Parenting Program: A Review and Meta-Analysis

We conducted a review and meta-analyses of 24 studies to evaluate and compare the outcomes of two widely disseminated parenting interventions—Parent-Child Interaction Therapy and Triple P-Positive Parenting Program. Participants in all studies were caregivers and 3- to 12-year-old children. In general, our analyses revealed positive effects of both interventions, but effects varied depending on intervention length, components, and source of outcome data. Both interventions reduced parent-reported child behavior and parenting problems. The effect sizes for PCIT were large when outcomes of child and parent behaviors were assessed with parent-report, with the exclusion of Abbreviated PCIT, which had moderate effect sizes. All forms of Triple P had moderate to large effects when outcomes were parent-reported child behaviors and parenting, with the exception of Media Triple P, which had small effects. PCIT and an enhanced version of Triple P were associated with improvements in observed child behaviors. These findings provide information about the relative efficacy of two programs that have received substantial funding in the USA and Australia, and findings should assist in making decisions about allocations of funding and dissemination of these parenting interventions in the future.

灾后心理援助的组织与实施

本文根据汶川震后心理援助的工作实践和经验积累,提出灾后心理援助应当从警戒期、抵抗期和衰竭期（时间维度）和灾难中心、周边地区、非灾区（空间维度）构建工作框架,针对重灾区的应激阶段、灾难周边地区的应激阶段、非灾区的应激阶段、重灾区的冲击阶段、灾难周边地区的冲击阶段、灾区的重建期的不同特点,有针对性地实施心理援助。总目标是通过在灾区建立心理援助工作的长期机制,降低受灾群众的心理创伤程度,激发内在潜能,增进面对灾难和挫折的能力,培养积极、乐观、向上的心理品质,帮助其认识生命的意义和价值,从而促进个体顺利完成心理重建。此外,对心理援助工作的原则、组织结构和规章制度等进行了阐述,并提出心理援助的组织和实施工作亟待解决的问题     

Efficacy of In-Home Parent-Child Interaction Therapy

ABSTRACT

In recent years, there has been much discussion of the efficacy of mental health interventions for children as well as the transportation of empirically-supported treatments (ESTs) to field settings. A logical initial step in this line of research is to examine whether the efficacy of ESTs can be demonstrated in community settings such as in the home environment. The purpose of the study was to examine the efficacy of an in-home Parent-Child Interaction Therapy (PCIT) program using a single-subject, A/B design across five subjects with staggered baselines. Decreases in caregiver use of negative behavior and caregiver-reported child behavior problems were observed for the three families that completed treatment. In addition, completers demonstrated increases in child compliance, caregiver use of positive behavior, and contingent praise. Data regarding caregivers' reported parenting stress and caregiver proportion of direct commands were less convincing. All three dyads completing treatment reported satisfaction with the intervention. Clinical implications regarding the possible benefits of PCIT for improving the effectiveness of home visiting programs are discussed as well as directions for future research.     

Effectiveness of a Cognitive Behavioral Intervention for Young Adults with Cystic Fibrosis

This study examined the effectiveness of a cognitive behavioral intervention for young adults with cystic fibrosis (CF). Four young adults were referred for the therapy by medical staff because of perceived problems with anxiety, anger, or coping. Treatment impact was assessed on measures of anxiety, anger, perceptions of functional disability, and coping. A multiple baseline design across subjects was used. Overall, the impact of the cognitive behavioral intervention for young adults with CF was mixed. If participants had elevated baseline scores on anxiety, anger, or perceived functional disability, then some improvement was shown. However, only one participant had elevated baseline anxiety and anger scores, while two had higher functional disability scores. For coping, only one participant clearly displayed a greater use of approach relative to avoidance coping by the end of treatment. Results are discussed in terms of treatment implications, assessment, and coping issues.     

The perceived effectiveness of road safety interventions: Regulation of drivers’ behavioral intentions and self-consciousness

We consider road safety interventions to be potential sources of social influence, altering the intentions and behaviors of drivers when they are perceived by the latter as effective. We also consider that perceiving their effectiveness depends on drivers’ self-consciousness. 852 drivers replied to a questionnaire measuring dispositional self-consciousness, the perception of the effectiveness of 10 road safety interventions, and reported intentions and behaviors related to speeding and drinking and driving. The results revealed several phenomena: (1) interventions were perceived as related to penalty/surveillance or social communication (factor analysis); (2) the former were perceived as more effective than the latter; (3) the perceived effectiveness of road safety interventions was moderately correlated with intentions and behaviors; (4) this link was stronger for interventions of the penalty/surveillance type; (5) age, level of education, frequency of use of a vehicle and gender were moderately associated with the perception of these interventions; (6) self-consciousness (in particular its public dimension) had an additional positive association with this perceived effectiveness. These results are discussed from a practical and methodological point of view.     

Community-Based Interventions to Reduce Low Income, African American Women's Risk of Sexually Transmitted Diseases: A Randomized Controlled Trial of Three Theoretical Models

A community-based sample of disadvantaged African American women (n = 445) was recruited to participate in 1 of 3 theoretically driven experimental interventions based on either the theory of gender and power, social learning theory, or cognitive behavioral theory. Intervention outcomes were compared with a waiting list control condition. From baseline to postintervention, women in the experimental interventions showed differential change on cognitive indices (knowledge and attitudes) and skill acquisition (partner negotiation skills, correct condom application, lubricant selection, and information-provision to social networks) whereas control participants were unchanged. Women in the 3 experimental interventions also completed follow-up assessments for 1 year following the interventions. In all 3 experimental conditions, condom use increased relative to the control group and there were no differences between the experimental interventions. Women who participated in one of the theoretically grounded interventions continued to increase condom use over the following year. Women entering new relationships reported significantly more condom use than did women who remained in ongoing relationships. The findings suggest that intervention models that have proven effective for women who engage in high-risk behavior may be less effective for women in established relationships for whom risk is primarily derived from the extrarelationship behavior of their partners.     

Trauma Among Unaccompanied Homeless Youth: The Integration of Street Culture into a Model of Intervention

Homeless adolescents comprise a population particularly vulnerable to developing symptoms of post-traumatic stress. Research has shown that prevalence of trauma-related symptoms among homeless youth living in shelters and on the streets without families is approximately 18%. The detrimental effects of traumatic experiences often inhibit homeless youths' ability to employ the psychosocial skills necessary to a transition out of homelessness. Consequently, interventions targeting the mitigation of post-traumatic stress symptoms among this population are crucial. This article aims to address the symptoms and needs of unaccompanied homeless youth who experience post-traumatic stress disorder symptomatology and offers a strength-based intervention framework for understanding, identifying, and beginning to address trauma-related mental health needs within the cultural context and experience of youth homelessness.     

Rationale for Individualizing Interventions to Promote Adjustment to the Nursing Home

This study was designed to determine whether certain variables were predictors of nursing home residents' membership in groups representing qualitative categories of nursing home adjustment. Responses of 186 residents to an open-ended question about how they handled the change to nursing home life were coded as very good, fair, or poor; an adjustment variable was created on the basis of this classification. Analysis of variance of random samples from each adjustment group showed that affect and social support varied significantly with adjustment. However, when discriminant analysis was applied, the three groups could not be differentiated using measure of affect, life satisfaction, social support, participation in the decisions leading to admission, nursing home satisfaction, or health. Based on the conclusion that adjustment to the nursing home is a unique experience for each individual, strategies were proposed for individualizing interventions to enable adjustment.     

Combining Employment and Breastfeeding: Utilizing a Work-Family Conflict Framework to Understand Obstacles and Solutions

Although authorities advocate breastfeeding as the ideal form of infant nutrition, breastfeeding rates remain low among employed mothers in the United States. Utilizing a work-family conflict framework, specific time-based, strain-based, and behavior-based conflicts that can occur for women combining breastfeeding and employment are explored. Research indicates that these conflicts often lead to decreased breastfeeding durations, which result in costs for employers, mothers, and infants. The review links workplace interventions (e.g. prenatal education, lactation programs, support systems, job flexibility, and child care) to the types of conflict (e.g. time, behavior, and strain-based) that each intervention can reduce. A previous version of this paper was presented in March of 2003 at the American Psychological Association’s Work, Stress, and Health Conference in Toronto, Canada.